Sample records for fact sheet septic
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Superfund fact sheet: The remedial program. Fact sheet
International Nuclear Information System (INIS)
1992-09-01
The fact sheet describes what various actions the EPA can take to clean up hazardous wastes sites. Explanations of how the criteria for environmental and public health risk assessment are determined and the role of state and local governments in site remediation are given. The fact sheet is one in a series providing reference information about Superfund issues and is intended for readers with no formal scientific training
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... Archive STDs Home Page Bacterial Vaginosis (BV) Chlamydia Gonorrhea Genital Herpes Hepatitis HIV/AIDS & STDs Human Papillomavirus ( ... sheet Pelvic Inflammatory Disease (PID) – CDC fact sheet Gonorrhea – CDC fact sheet STDs Home Page Bacterial Vaginosis ( ...
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Vitamin and Mineral Supplement Fact Sheets
... website Submit Search NIH Office of Dietary Supplements Vitamin and Mineral Supplement Fact Sheets Search the list ... Supplements: Background Information Botanical Dietary Supplements: Background Information Vitamin and Mineral Fact Sheets Botanical Supplement Fact Sheets ...
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Rubella - Fact Sheet for Parents
... and 4 through 6 years Fact Sheet for Parents Color [2 pages] Español: Rubéola The best way ... according to the recommended schedule. Fact Sheets for Parents Diseases and the Vaccines that Prevent Them Chickenpox ...
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... Education About NIGMS NIGMS Home > Science Education > Anesthesia Anesthesia Tagline (Optional) Middle/Main Content Area En español ... Version (464 KB) Other Fact Sheets What is anesthesia? Anesthesia is a medical treatment that prevents patients ...
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National Information Center for Children and Youth with Disabilities, Washington, DC.
This fact sheet offers definitions of the three types of spina bifida, outlines their incidence, describes characteristics of individuals with spina bifida, and reviews educational implications. The fact sheet emphasizes that school programs should be flexible to accommodate these students' special needs and frequent absences, that children with…
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Whooping Cough (Pertussis) - Fact Sheet for Parents
... months 4 through 6 years Fact Sheet for Parents Color [2 pages] Español: Tosferina (pertussis) The best ... according to the recommended schedule. Fact Sheets for Parents Diseases and the Vaccines that Prevent Them Chickenpox ...
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Interstate Research Associates, McLean, VA.
This fact sheet on cerebral palsy is offered in both English and Spanish. First, it provides a definition and considers various causes (e.g., an insufficient amount of oxygen reaching the fetal or newborn brain). The fact sheet then offers incidence figures and explains characteristics of the three main types of cerebral palsy: spastic, athetoid,…
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Public Health Agency
2012-01-01
Fact sheet on Pseudomonas, including:What is Pseudomonas?What infections does it cause?Who is susceptible to pseudomonas infection?How will I know if I have pseudomonas infection?How can Pseudomonas be prevented from spreading?How can I protect myself from Pseudomonas?How is Pseudomonas infection treated?
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... news-room/fact-sheets/detail/cholera","@context":"http://schema.org","@type":"Article"}; العربية 中文 français русский español ... that includes feedback at the local level and information-sharing at the global level. Cholera cases are ...
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International Nuclear Information System (INIS)
Anon.
1994-01-01
This fact sheet gives details of the Hibernia oil field including its location, discovery date, oil company's interests in the project, the recoverable reserves of the two reservoirs, the production system used, capital costs of the project, and overall targets for Canadian benefit. Significant dates for the Hibernia project are listed. (UK)
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... NIGMS NIGMS Home > Science Education > Structural Biology Structural Biology Tagline (Optional) Middle/Main Content Area PDF Version (688 KB) Other Fact Sheets What is structural biology? Structural biology is the study of how biological ...
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Best Management Practice Fact Sheet. 12, Filtering Practices
Sample, David; Barlow, Stefani
2013-01-01
This fact sheet is one of a 15-part series on urban stormwater management practices. This fact sheet discusses filtering practices, what they are, where they are used, how they work, maintenance, limitations, performance, expected costs and includes a glossary of terms.
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Best Management Practice Fact Sheet. 10, Dry Swale
Sample, David; Doumar, Lia
2013-01-01
This fact sheet is one of a 15-part series on urban stormwater management practices. This fact sheet discusses dry swales, what they are, where they are used, how they work, maintenance, limitations, performance, expected costs and includes a glossary of terms.
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Best Management Practice Fact Sheet. 11, Wet Swale
Sample, David; Doumar, Lia
2013-01-01
This fact sheet is one of a 15-part series on urban stormwater management practices. This fact sheet discusses wet swales, what they are, where they are used, how they work, maintenance, limitations, performance, expected costs and includes a glossary of terms.
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75 FR 55340 - Recovery Fact Sheet 9580.100, Mold Remediation
2010-09-10
...] Recovery Fact Sheet 9580.100, Mold Remediation AGENCY: Federal Emergency Management Agency, DHS. ACTION... accepting comments on Recovery Fact Sheet RP9580.100, Mold Remediation. DATES: Comments must be received by... 20472-3100. II. Background The Recovery Fact Sheet RP9580.100, Mold Remediation, identifies the expenses...
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Fact Sheets on Pesticides in Schools.
National Coalition against the Misuse of Pesticides, Washington, DC.
This document consists of a collection of fact sheets about the use of pesticides in schools and how to reduce it. The sheets are: (1) "Alternatives to Using Pesticides in Schools: What Is Integrated Pest Management?"; (2) "Health Effects of 48 Commonly Used Pesticides in Schools"; (3) "The Schooling of State Pesticide…
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... Submit Search The CDC Chronic Obstructive Pulmonary Disease (COPD) Note: Javascript is disabled or is not supported ... message, please visit this page: About CDC.gov . COPD Homepage Data and Statistics Fact Sheets Publications Publications ...
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Energy Technology Data Exchange (ETDEWEB)
2015-01-01
Ethanol is a widely-used, domestically-produced renewable fuel made from corn and other plant materials. More than 96% of gasoline sold in the United States contains ethanol. Learn more about this alternative fuel in the Ethanol Basics Fact Sheet, produced by the U.S. Department of Energy's Clean Cities program.
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16 CFR 460.15 - How installers must handle fact sheets.
2010-01-01
... ADVERTISING OF HOME INSULATION § 460.15 How installers must handle fact sheets. If you are an installer, you... from you, you must show them the fact sheet(s) for the type(s) of insulation they want. You can decide...
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Best Management Practice, Fact Sheet 2. Sheet Flow to Open Space
Sample, David; Doumar, Lia
2013-01-01
This publication explains what sheet flow to open space is, where and how it is used, their limitations, routine and nonroutine maintenance, expected costs, and a glossary of terms. This fact sheet is one of a 15-part series on urban stormwater management practices.
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2012 Swimming Season Fact Sheets
To help beachgoers make informed decisions about swimming at U.S. beaches, EPA annually publishes state-by-state data about beach closings and advisories for the previous year's swimming season. These fact sheets summarize that information by state.
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2010-01-01
... INSULATION § 460.13 Fact sheets. If you are a manufacturer, you must give retailers and installers fact... uses. (b) A heading: “This is ____ insulation.” Fill in the blank with the type and form of your... compressed during installation.” (e) After the chart and any statement dealing with the specific type of...
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Creutzfeldt-Jakob Disease Fact Sheet for Healthcare Workers and Morticians
... here Home » Disorders » Patient & Caregiver Education » Fact Sheets Creutzfeldt-Jakob Disease Fact Sheet for Healthcare Workers and Morticians Creutzfeldt-Jakob disease (CJD) is a rare, fatal brain disorder that ...
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Energy Technology Data Exchange (ETDEWEB)
2004-01-01
This fact sheet explains the Clean Cities Program and provides contact information for all coalitions and regional offices. It answers key questions such as: What is the Clean Cities Program? What are alternative fuels? How does the Clean Cities Program work? What sort of assistance does Clean Cities offer? What has Clean Cities accomplished? What is Clean Cities International? and Where can I find more information?
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Interstate Research Associates, McLean, VA.
This fact sheet on autism is offered in both English and Spanish, and is the same in both languages although numbered differently. It provides a definition, information on incidence, typical characteristics, and educational implications. It notes that autism is listed as a separate category under the Individuals with Disabilities Education Act.…
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75 FR 24740 - Recovery Fact Sheet RP9580.102, Permanent Relocation
2010-05-05
... DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency [Docket ID FEMA-2010-0028] Recovery Fact Sheet RP9580.102, Permanent Relocation AGENCY: Federal Emergency Management Agency, DHS... Management Agency (FEMA). DATES: This fact sheet is effective April 14, 2010. ADDRESSES: This final fact...
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Nanotechnology for Site Remediation: Fact Sheet
This fact sheet presents a snapshot of nanotechnology and its current uses in remediation. It presents information to help site project managers understand the potential applications of this group of technologies at their sites.
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HIV/AIDS Clinical Trials Fact Sheet
... AIDS Drugs Clinical Trials Apps skip to content HIV Overview Home Understanding HIV/AIDS Fact Sheets HIV/ ... 4 p.m. ET) Send us an email HIV/AIDS Clinical Trials Last Reviewed: August 25, 2017 ...
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Catalog of CERCLA applicable or relevant and appropriate requirements (ARARs) - fact sheets
Energy Technology Data Exchange (ETDEWEB)
1990-07-01
Section 121(d) of the Comprehensive Environmental Response Compensation and Liability Act (CERCLA) as amended by the Superfund Amendments and Reauthorization Act of 1986 (SARA), requires attainment of federal and state applicable or relevant and appropriate requirements (ARARs). Subpart E, Section 300.400(g) {open_quotes}Identification of applicable or relevant and appropriate requirements{close_quotes} of the National Oil and Hazardous Substances Pollution Contingency Plan (NCP)(55 FR 8666, March 8, 1990) describes the process for attaining ARARs. The purpose of this catalog is to provide DOE Program Offices and Field Organizations with all of the {open_quotes}Quick Reference Fact Sheets{close_quotes} on attaining ARARS. These fact sheets provide overviews of ARARs for CERCLA cleanup actions pertinent to DOE environmental restoration activities. All of the fact sheets in this catalog were prepared by the Environmental Protection Agency`s Office of Solid Waste and Emergency Response. Fact sheets 1-7 discuss land disposal restrictions (LDRs) and their applicability. LDRs may pertain to a number of CERCLA response actions at DOE facilities. Fact Sheets 8-13 are based on the CERCLA Compliance with Other Laws Manual: Parts I and II and provide an overview of many other CERCLA ARARs. Overview of ARARs-Focus on ARAR Waivers (fact sheet 11), provides a good introduction to ARARS. The last two fact sheets, 14 and 15, are periodic reports that describe additional fact sheets and clarify issues.
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Interstate Research Associates, McLean, VA.
This fact sheet on epilepsy is offered in both English and Spanish. It provides a definition, information on incidence, typical characteristics, and educational implications. It notes that epilepsy is classified as "other health impaired" under the Individuals with Disabilities Education Act and that students with epilepsy are eligible for special…
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Biomolecular Science (Fact Sheet)
Energy Technology Data Exchange (ETDEWEB)
2012-04-01
A brief fact sheet about NREL Photobiology and Biomolecular Science. The research goal of NREL's Biomolecular Science is to enable cost-competitive advanced lignocellulosic biofuels production by understanding the science critical for overcoming biomass recalcitrance and developing new product and product intermediate pathways. NREL's Photobiology focuses on understanding the capture of solar energy in photosynthetic systems and its use in converting carbon dioxide and water directly into hydrogen and advanced biofuels.
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Spina Bifida. Fact Sheet = Espina Bifida. Hojas Informativas Sobre Discapacidades.
National Information Center for Children and Youth with Disabilities, Washington, DC.
This fact sheet offers definitions of the three types of spina bifida (spina bifida occulta, meningocele, and myelomeningocele), outlines their incidence, describes characteristics of individuals with spina bifida, and reviews educational implications. The fact sheet discusses the need for many children with myelomeningocele to learn to manage…
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Supporting Documentation for the 2008 Update to the Insulation Fact Sheet
Energy Technology Data Exchange (ETDEWEB)
Stovall, Therese K [ORNL
2008-02-01
The Insulation Fact Sheet provides consumers for general guidance and recommended insulation levels for their home. This fact sheet has been on-line since 1995 and this update addresses new insulation materials, as well as updated costs for energy and materials.
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75 FR 13777 - Disaster Assistance Fact Sheet DAP9580.107, Child Care Services
2010-03-23
...] Disaster Assistance Fact Sheet DAP9580.107, Child Care Services AGENCY: Federal Emergency Management Agency... (FEMA) is providing notice of the availability of the final Disaster Assistance Fact Sheet DAP9580.107...'s Web site at http://www.fema.gov . You may also view a hard copy of the fact sheet at the Office of...
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Energy Technology Data Exchange (ETDEWEB)
None
2016-02-01
This fact sheet is an overview of the Photovoltaics (PV) subprogram at the U.S. Department of Energy SunShot Initiative. The U.S. Department of Energy (DOE)’s Solar Energy Technologies Office works with industry, academia, national laboratories, and other government agencies to advance solar PV, which is the direct conversion of sunlight into electricity by a semiconductor, in support of the goals of the SunShot Initiative. SunShot supports research and development to aggressively advance PV technology by improving efficiency and reliability and lowering manufacturing costs. SunShot’s PV portfolio spans work from early-stage solar cell research through technology commercialization, including work on materials, processes, and device structure and characterization techniques.
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Advancing Concentrating Solar Power Research (Fact Sheet)
Energy Technology Data Exchange (ETDEWEB)
None, None
2014-02-01
Researchers at the National Renewable Energy Laboratory (NREL) provide scientific, engineering, and analytical expertise to help advance innovation in concentrating solar power (CSP). This fact sheet summarizes how NREL is advancing CSP research.
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Fact Sheets: Air Toxics Rules for the Manufacture of Amino/Phenolic Resins
This page contains a December 1999 fact sheet for the proposed National Emission Standards for Hazardous Air Pollutants (NESHAP): Manufacture of Amino/Phenolic Resins and a September 2014 fact sheet with information regarding the final NESHAP
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Interstate Research Associates, McLean, VA.
This fact sheet on spina bifida is offered in both English and Spanish. It provides definitions of the three types of spina bifida (spina bifida occulta, meningocele, and myelomeningocele). Incidence figures are given as are typical characteristics of children with spina bifida. Educational implications are briefly noted, including the need to…
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Hispanics/Latinos & Cardiovascular Disease: Statistical Fact Sheet
Statistical Fact Sheet 2013 Update Hispanics/Latinos & Cardiovascular Diseases Cardiovascular Disease (CVD) (ICD/10 codes I00-I99, Q20-Q28) (ICD/9 codes 390-459, 745-747) Among Mexican-American adults age 20 ...
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College Experience and Volunteering. Fact Sheet
Marcelo, Karlo Barrios
2007-01-01
College experience and volunteering are positively correlated. Measurable differences in civic activity exist between young people who attend college and young people who do not. This fact sheet explores volunteering as civic engagement among youth with college experience, ages 19-25, which was down for the second year in a row in 2006. The…
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Large Fleets Lead in Petroleum Reduction (Fact Sheet)
Energy Technology Data Exchange (ETDEWEB)
Proc, H.
2011-03-01
Fact sheet describes Clean Cities' National Petroleum Reduction Partnership, an initiative through which large private fleets can receive support from Clean Cities to reduce petroleum consumption.
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Chemical Data Reporting Fact Sheet: Chemicals Snapshot
This fact sheet provides a brief overview of the chemical manufacturing, processing, and use information collected for the 2012 Chemical Data Reporting (CDR) rule. Users do not have access to the complete CDR data set and should draw conclusions with care.
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Cerebral Palsy. Fact Sheet = La Paralisis Cerebral. Hojas Informativas Sobre Discapacidades.
National Information Center for Children and Youth with Disabilities, Washington, DC.
This fact sheet on cerebral palsy is written in both English and Spanish. First, it provides a definition of cerebral palsy and considers various causes (e.g., an insufficient amount of oxygen reaching the fetal or newborn brain). The fact sheet then offers incidence figures and explains characteristics of the three main types of cerebral palsy:…
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World War II Informational Fact Sheets.
Department of Defense, Washington, DC.
This commemorative book provides numerous fact sheets on various aspects of World War II, both on the fighting front and the homefront. Replicas of posters of the war era, descriptions of battles with maps, contributions of women and minorities to the war effort, even music of the wartime era, add to this collection of resource materials useful to…
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Vietnamese Hurricane Response Fact Sheets
Các tờ dữ kiện được cung cấp nơi đây mô tả vai trò của EPA trong việc đáp ứng với bão và cách các chương trình cụ thể cung cấp sự hỗ trợ. The Vietnamese fact sheets provided here describe EPA's role in a hurricane response.
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Are we reaching the target audience? Evaluation of a fish fact sheet.
Burger, J; Waishwell, L
2001-09-28
According to the US Environmental Protection Agency, over 16% of freshwater lakes and 7% of the rivers are under some sort of fish consumption advisory because of the presence of toxic chemicals. There is considerable interest in the issuing of information, advisories, and fact sheets concerning the consumption of wild-caught fish from contaminated waters, and in the actual consumption patterns of subsistence and recreational anglers. Despite the large number of consumption advisories issued by state agencies, there is little information on how these advisories, or other forms of risk communication, are perceived by target audiences, notably fishermen and women of child-bearing age. The states of South Carolina and Georgia issue consumption advisories for fish from the Savannah River, among other sites. To gain a greater insight into the perception of anglers about a supplemental fish fact sheet jointly developed by South Carolina, Georgia, federal agencies, and the Consortium for Risk Evaluation with Stakeholder Participation, we interviewed fisherman along the Savannah River. The objectives were to determine: (1) whether they had previously read the Fish Fact Sheet or had heard about the consumption advisories; (2) what major message they obtained from the sheet; (3) who they felt the fact sheet was aimed at, and who should get the Fish Fact Sheet; (4) who should be concerned about health risks from consuming the fish; and (5) the best method of disseminating such information. We interviewed 92 fishermen (37% black, 62% white) during the fishing season of 1999. Half had heard some information about consumption advisories, mainly from the media (64%). The study concluded that there were no ethnic differences in whether they had heard about the advisories, understood the major message of the fact sheet, felt they could reduce their risk from consuming the fish, or felt that it made a difference which agency issued the fact sheet. There were significant ethnic
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Renewable Energy Project Development Assistance (Fact Sheet)
Energy Technology Data Exchange (ETDEWEB)
2013-07-01
This fact sheet provides information on the Tribes selected to receive assistance from the U.S. Department of Energy Office of Indian Energy 2013 Strategic Technical Assistance Response Team (START) Program, which provides technical expertise to support the development of next-generation energy projects on tribal lands.
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Interstate Research Associates, McLean, VA.
This fact sheet on Down Syndrome is offered in both English and Spanish. First it provides a definition and description of this syndrome, noting its etiology in a chromosomal abnormality. Incidence figures are then given. Typical characteristics of people with Down Syndrome are listed. Commonly associated health-related problems are noted,…
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Canada and the Kyoto Protocol: Fact Sheet No. 5 - Developing countries
International Nuclear Information System (INIS)
2000-11-01
This fact sheet acknowledges that global change affects developed and developing countries alike, and the fact that most developing countries do not have the human, financial and technical capacity to effectively address climate change issues without help from the industrialized nations. The fact sheet also puts Canada on record as being in agreement with the spirit of the Kyoto Protocol to encourage the participation of developing countries in global efforts to combat climate change and promote sustainable development and reaffirms Canada's willingness to provide financial and technical assistance to developing countries to enable them to play a meaningful part in this global effort. In this context, the fact sheet briefly describes the new Canada Climate Change Development Fund which has been set up to reduce the growth of GHG emissions and support carbon sink activities in developing countries, to strengthen the capacity of developing conuntries to reduce their vulnerability to adverse effects of climate change, and to participate in global efforts to combat them
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TSCA Chemical Data Reporting Fact Sheet: Imported Articles
This fact sheet provides guidance and sample reporting scenarios on the reporting exemption for the import of a chemical substance as part of an article, for purposes of the Chemical Data Reporting (CDR) rule.
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Toxicity of Pesticides. Agrichemical Fact Sheet 2.
Hock, Winand K.
This fact sheet gives the acute oral and dermal toxicity (LD 50) of over 250 pesticides in lab animals. The chemicals are categorized as fungicides, herbicides, insecticides, or miscellaneous compounds. One or more trade names are given for each pesticide. In addition, a brief explanation of toxicity determination is given. (BB)
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Energy Technology Data Exchange (ETDEWEB)
None
2016-05-01
This fact sheet is an overview of the systems integration subprogram at the U.S. Department of Energy SunShot Initiative. Soft costs can vary significantly as a result of a fragmented energy marketplace. In the U.S., there are 18,000 jurisdictions and 3,000 utilities with different rules and regulations for how to go solar. The same solar equipment may vary widely in its final installation price due to process and market variations across jurisdictions, creating barriers to rapid industry growth. SunShot supports the development of innovative solutions that enable communities to build their local economies and establish clean energy initiatives that meet their needs, while at the same time creating sustainable solar market conditions.
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77 FR 40626 - RP9580.210, Personal Assistance Services in Shelters Fact Sheet
2012-07-10
... DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency [Docket ID FEMA-2012-0014] RP9580.210, Personal Assistance Services in Shelters Fact Sheet AGENCY: Federal Emergency Management... Management Agency (FEMA) is accepting comments on Recovery Fact Sheet RP9580.210, Personal Assistance...
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Energy Technology Data Exchange (ETDEWEB)
DOE Solar Energy Technologies Office
2015-04-01
The U.S. Department of Energy (DOE) SunShot Initiative is a collaborative national effort launched in 2011 that aggressively drives innovation to make solar energy fully cost competitive with traditional energy sources before the end of the decade. The SunShot fact sheet outlines goals and successes of the program as it works with private companies, universities, non-profit organizations, state and local governments, and national laboratories to drive down the cost of solar electricity to $0.06 per kilowatt-hour, without incentives, by the year 2020.
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TSCA Chemical Data Reporting Fact Sheet: Articles
This fact sheet provides guidance on classifying articles under the Toxic Substances Control Act (TSCA) and determining the applicability of EPA’s articles exclusion policy for purposes of the Chemical Data Reporting (CDR) rule. The primary goal of this document is to help the regulated community comply with the requirements of the CDR rule.
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SunShot Catalyst Prize Competition Fact Sheet
Energy Technology Data Exchange (ETDEWEB)
Solar Energy Technologies Office
2015-04-01
This fact sheet is an overview of the Catalyst Energy Innovation Prize, an open innovation program launched in 2014 by the U.S. Department of Energy SunShot Initiative. This program aims to catalyze the rapid creation and development of products and solutions that address near-term challenges in the U.S. solar energy marketplace.
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Careers "Fact Sheets" for clinical engineering & biomedical technology.
Pacela, A F
1991-01-01
Three Careers "Fact Sheets" include information on CE and BMET job titles, job descriptions, and certification. These materials are intended to aid in furthering professional recognition for Clinical Engineers and BMETs, and may be useful in communicating with Administration or Human Resources departments.
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Systems Integration Fact Sheet
Energy Technology Data Exchange (ETDEWEB)
None
2016-06-01
This fact sheet is an overview of the Systems Integration subprogram at the U.S. Department of Energy SunShot Initiative. The Systems Integration subprogram enables the widespread deployment of safe, reliable, and cost-effective solar energy technologies by addressing the associated technical and non-technical challenges. These include timely and cost-effective interconnection procedures, optimal system planning, accurate prediction of solar resources, monitoring and control of solar power, maintaining grid reliability and stability, and many more. To address the challenges associated with interconnecting and integrating hundreds of gigawatts of solar power onto the electricity grid, the Systems Integration program funds research, development, and demonstration projects in four broad, interrelated focus areas: grid performance and reliability, dispatchability, power electronics, and communications.
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Interstate Research Associates, Inc., Washington, DC.
This fact sheet providing general information about learning disabilities is presented in both English and Spanish versions. It begins with the federal definition of learning disabilities and a discussion of its implications followed by estimates of incidence. Typical characteristics of students with learning disabilities are then summarized as…
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Final Rule for Industrial Process Cooling Towers: Fact Sheet
Fact sheet concerning a final rule to reduce air toxics emissions from industrial process cooling towers. Air toxics are those pollutants known or suspected of causing cancer or other serious health effects.
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Energy Technology Data Exchange (ETDEWEB)
NONE
1991-12-01
The safety and benefits of foods processed by ionizing radiation are well documented. In an effort to provide governments, especially those of developing countries, with scientifically accurate information on issues of general interest to the public, the International Consultative Group on Food Irradiation (ICGFI), which was established under the aegis of the Food and Agriculture Organization of the United Nations (FAO), the World Health Organization (WHO), and the IAEA, decided at its 7th Annual Meeting in Rome, Italy, on October 1990, to issue a series of ''Fact Sheets'' on the subject. ICGFI, an inter-governmental body with a membership of 37 governments, has as one of its mandates the function to provide information to Member States of the FAO, WHO, and IAEA and to the three organizations themselves on the safe and proper use of food irradiation technology. The Fact Sheets included here cover issues relating to: status and trends; scientific and technical terms; food irradiation and radioactivity; chemical changes in irradiated food; nutritional quality of irradiated foods; genetic studies; microbiological safety of irradiated food; irradiation and food safety; irradiation and food additives and residues; packaging of irradiated foods; safety of irradiation facilities; controlling the process; food irradiation costs; and irradiated foods and the consumer. The Fact Sheets have been separately indexed and included in the INIS Database under Reference Numbers 23011206-23011217, 23011319 and 23012743. The Fact Sheets were first issued by the ICGFI Secretariat (Joint FAO/IAEA Division of Nuclear Techniques in Food and Agriculture, Vienna, Austria) in May 1991.
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International Nuclear Information System (INIS)
1991-12-01
The safety and benefits of foods processed by ionizing radiation are well documented. In an effort to provide governments, especially those of developing countries, with scientifically accurate information on issues of general interest to the public, the International Consultative Group on Food Irradiation (ICGFI), which was established under the aegis of the Food and Agriculture Organization of the United Nations (FAO), the World Health Organization (WHO), and the IAEA, decided at its 7th Annual Meeting in Rome, Italy, on October 1990, to issue a series of ''Fact Sheets'' on the subject. ICGFI, an inter-governmental body with a membership of 37 governments, has as one of its mandates the function to provide information to Member States of the FAO, WHO, and IAEA and to the three organizations themselves on the safe and proper use of food irradiation technology. The Fact Sheets included here cover issues relating to: status and trends; scientific and technical terms; food irradiation and radioactivity; chemical changes in irradiated food; nutritional quality of irradiated foods; genetic studies; microbiological safety of irradiated food; irradiation and food safety; irradiation and food additives and residues; packaging of irradiated foods; safety of irradiation facilities; controlling the process; food irradiation costs; and irradiated foods and the consumer. The Fact Sheets have been separately indexed and included in the INIS Database under Reference Numbers 23011206-23011217, 23011319 and 23012743. The Fact Sheets were first issued by the ICGFI Secretariat (Joint FAO/IAEA Division of Nuclear Techniques in Food and Agriculture, Vienna, Austria) in May 1991
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Epilepsy. Fact Sheet = Epilepsia. Hojas Informativas Sobre Discapacidades.
National Information Center for Children and Youth with Disabilities, Washington, DC.
This fact sheet, written in both English and Spanish, provides a definition, information on incidence, typical characteristics, and educational implications of epilepsy. It notes that epilepsy is classified as "other health impaired" under the Individuals with Disabilities Education Act (IDEA) and that children with epilepsy or seizure disorders…
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OPA Q's and A's: Overview of the Oil Pollution Act of 1990. Fact sheet
International Nuclear Information System (INIS)
1991-12-01
The OPA Q's and A's are part of a series of fact sheets that provide up-to-date information on EPA's implementation of the OPA. The first fact sheet provides an overview of the various provisions of the OPA and the Agency's responsibilities under the new law
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Teenage Pregnancy. Highlights: An ERIC/CAPS Fact Sheet.
Lachance, Laurie L.
This fact sheet addresses the issue of teenage pregnancy. Six factors contributing to the current attention focused on teenage pregnancy and parenthood are listed and teenage pregnancy and birth rates are discussed. Other areas covered include teenage nonuse of contraception, sex education by schools and parents, family planning services, and the…
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Energy-Saving Opportunities for Manufacturing Companies, International Fact Sheet (Spanish)
Energy Technology Data Exchange (ETDEWEB)
2010-08-01
This English/Spanish fact sheet describes the Industrial Technologies Program Save Energy Now model and provides information on tools and resources to help manufacturing facilities reduce industrial energy intensity.
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Participation in Sports and Civic Engagement. Fact Sheet
Lopez, Mark Hugo; Moore, Kimberlee
2006-01-01
One reason to offer sports in school is to teach youth the values, skills, and habits that will make them more active, engaged, and responsible citizens. Past evidence on the civic effects of sports is mixed, but points to some potential positive civic effects. This fact sheet uses recent data from the 2002 National Youth Survey of Civic…
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Supporting documentation for the 1997 revision to the DOE Insulation Fact Sheet
Energy Technology Data Exchange (ETDEWEB)
Stovall, T.K.
1997-08-22
The Department of Energy (DOE) Insulation Fact Sheet has been revised to reflect developments in energy conservation technology and the insulation market. A nationwide insulation cost survey was made by polling insulation contractors and builders, and the results are reported here. These costs, along with regional weather data, regional fuel costs, and fuel-specific system efficiencies were used to produce recommended insulation levels for new and existing houses. This report contains all of the methodology, algorithms, assumptions, references, and data resources that were used to produce the 1997 DOE Insulation Fact Sheet.
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CMS, Outreach
2010-01-01
2-sided color print A4 size sheet containing the facts on the CMS Detector, its name, what it is designed to do, questions scientists hope to answer, collaboration members, detector parts and their functions, and other miscellaneous facts on the CMS detector
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Child Care in Sweden. Fact Sheets on Sweden.
Swedish Inst., Stockholm.
This fact sheet outlines Sweden's policies of government-supported child care and parental insurance provisions. Swedish families receive: (1) free maternity and child health care; (2) child allowances for each child of 9,000 krona per year through age 16; (3) up to 450 days of paid parental leave for the birth of a child, with 360 days paid at 90…
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State Arts Agency Fact Sheet: Support for Arts Education
Online Submission, 2015
2015-01-01
This national overview of state arts agency grants and services for arts education includes summary statistics and geographic distribution. The fact sheet uses data from Final Descriptive Reports of state arts agency grant-making activities submitted annually to the National Assembly of State Arts Agencies (NASAA) and the National Endowment for…
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Fact Sheet: What Parents Need to Know About Zika Virus
... Management Post-Disaster Child Care Resources ACF Capabilities Policies Resources You are here ACF Home › Office of Human Services Emergency Preparedness and Response › Resource Library › Fact Sheet: What Parents Need to Know About ...
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75 FR 45144 - Recovery Fact Sheet 9580.203, Debris Monitoring
2010-08-02
... DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency [Docket ID FEMA-2010-0045] Recovery Fact Sheet 9580.203, Debris Monitoring AGENCY: Federal Emergency Management Agency, DHS. ACTION: Notice of availability; request for comments. SUMMARY: The Federal Emergency Management Agency (FEMA) is...
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75 FR 33821 - Recovery Fact Sheet RP9580.205, Public Assistance Funding to Public Housing Facilities
2010-06-15
... Emergency Management Agency (FEMA) is providing notice of the availability of the final Recovery Fact Sheet... the fact sheet at the Office of Chief Counsel, Federal Emergency Management Agency, Room 835, 500 C... DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency [Docket ID FEMA-2010-0034...
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Clean Energy Solutions Center Services (Vietnamese Translation) (Fact Sheet)
Energy Technology Data Exchange (ETDEWEB)
2014-11-01
This is the Vietnamese language translation of the Clean Energy Solutions Center (Solutions Center) fact sheet. The Solutions Center helps governments, advisors and analysts create policies and programs that advance the deployment of clean energy technologies. The Solutions Center partners with international organizations to provide online training, expert assistance, and technical resources on clean energy policy.
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Clean Energy Solutions Center Services (Arabic Translation) (Fact Sheet)
Energy Technology Data Exchange (ETDEWEB)
2014-06-01
This is the Arabic translation of the Clean Energy Solutions Center Services fact sheet. The Clean Energy Solutions Center (Solutions Center) helps governments, advisors and analysts create policies and programs that advance the deployment of clean energy technologies. The Solutions Center partners with international organizations to provide online training, expert assistance, and technical resources on clean energy policy.
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African American Students and U.S. High Schools. Fact Sheet
Alliance for Excellent Education, 2008
2008-01-01
This fact sheet highlights the statistics of the status of the African American students living in the continental United States in terms of: population; graduation, dropouts, and preparedness; schools, segregation, and teacher quality; and special, gifted, and college preparatory education. According to the National Center for Education…
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Fact sheet on thyroid test in Fukushima prefecture
International Nuclear Information System (INIS)
Hiranuma, Yuri
2017-01-01
Fukushima Prefecture chose about 360,000 people who were 18 years old or younger at the time of the accident at Fukushima Daiichi NPS on March 11, 2011, and started thyroid test as part of the prefectural health survey on October 9, 2011. The survey is entrusted to Fukushima Medical University of Medicine from Fukushima Prefecture. This fact sheet summarizes the current state of thyroid test in Fukushima Prefecture. A considerable amount of data and related information have been accumulated in the seventh year from the beginning. However, especially the information disclosed in English by people concerned combined the results of the second round, which was not analyzed properly, with those of the first round. This fact gives a suspicion of intention to deny the possibility of radiation influence in such a way as to make it invisible even if there was the influence. This study firstly prepared an English fact sheet to convey the actual situation in English. However, since some official information/views were contained in papers only available in English, this study also prepared the Japanese version for enabling to grasp the current situation. The Japanese version is supplemented with explanation rather than the Japanese translation of the English version, in order to make it easier to understand. The future of thyroid test is a topic that is causing controversy. Now that the transparency, scientific fairness, and the data integrity of Fukushima Medical University are suspected, it is extremely important that an independent analysis in the true sense is to be performed by qualified experts based on the latest evidence. (A.O.)
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Fact Sheet: Alternative Low-Sulfur Diesel Fuel Transition Program for Alaska
This fact sheet summarizes EPA's final rule modifying the diesel fuel regulations to apply an effective date of 6-1-2010 for 15 ppm sulfur requirements for highway, nonroad, locomotive and marine diesel fuel produced/imported for, distributed
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Drinking water regulations under the Safe Drinking Water Act. Fact sheet
International Nuclear Information System (INIS)
1990-12-01
The fact sheet describes the requirements covered under the 1986 amendments to the Safe Drinking Water Act. Levels of various contaminants (including radio nuclides) are explained. Also discussed are the Surface Water Treatment Rule and the Total Coliforms Rule
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Delinquency Cases in Juvenile Court, 2002. OJJDP Fact Sheet #02
Stahl, Anne L.
2006-01-01
This fact sheet presents statistics on delinquency cases processed by juvenile courts in 2002. The number of delinquency cases handled by juvenile courts decreased 11 percent between 1997 and 2002. During this time, the number of person offense cases decreased 2 percent, property offense cases decreased 27 percent, drug law violation cases…
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Juvenile Delinquency Probation Caseload, 1985-2002. OJJDP Fact Sheet #04
Livsey, Sarah
2006-01-01
This fact sheet presents statistics on delinquency cases resulting in probation, 2002. Probation was the disposition in 38 percent of all delinquency cases processed by the juvenile courts in 2002. The number of cases placed on probation increased 44 percent between 1985 and 2002. Property offense cases made up the greatest proportion of the…
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EERE-Supported International Activities in Latin America (Fact Sheet)
Energy Technology Data Exchange (ETDEWEB)
2010-05-01
The Office of Energy Efficiency and Renewable Energy (EERE) is involved in a variety of international initiatives, partnerships, and events that promote greater understanding and use of renewable energy (RE) and energy efficiency (EE) worldwide. In support of the Energy and Climate Partnership of the Americas (ECPA), EERE is working with several Latin American countries to advance EE and RE deployment for economic growth, energy security, poverty relief, and disaster recovery goals. This fact sheet highlights those activities.
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This page contains the July 1995 final rule fact sheet and the January 2015 proposed rule fact sheet that contains information on the National Emission Standards for Aerospace Manufacturing and Rework Facilities, as well as a 2001 Q&A document on the rule
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Fact sheet: National primary drinking water regulations for lead and copper
International Nuclear Information System (INIS)
1991-05-01
The Fact Sheet contains a summary of what the regulations will do, establish, and provide; regulatory impact in regards to benefits and costs; treatment technique requirements; tap water monitoring for lead and copper; water quality monitoring (other than lead and copper); monitoring schedules, regulatory schedules for large, medium-sized, and small systems
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Fact Sheet - Final Air Toxics Rule for Gold Mine Ore Processing and Production
Fact sheet summarizing main points of National Emissions Standards for Hazardous Air Pollutants for gold ore processing and production facilities, the seventh largest source of mercury air emission in the United States.
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Human Trafficking of Children in the United States: A Fact Sheet
US Department of Education, 2007
2007-01-01
This fact sheet presents questions and answers related to the human trafficking of children in the United States. It describes human trafficking and its extent in the United States, how human traffickers target children for coerced labor and sex exploitation, how to identify victims of human trafficking, how to report a suspected incidence of…
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Framework for DOE mixed low-level waste disposal: Site fact sheets
Energy Technology Data Exchange (ETDEWEB)
Gruebel, M.M.; Waters, R.D.; Hospelhorn, M.B.; Chu, M.S.Y. [eds.
1994-11-01
The Department of Energy (DOE) is required to prepare and submit Site Treatment Plans (STPS) pursuant to the Federal Facility Compliance Act (FFCAct). Although the FFCAct does not require that disposal be addressed in the STPS, the DOE and the States recognize that treatment of mixed low-level waste will result in residues that will require disposal in either low-level waste or mixed low-level waste disposal facilities. As a result, the DOE is working with the States to define and develop a process for evaluating disposal-site suitability in concert with the FFCAct and development of the STPS. Forty-nine potential disposal sites were screened; preliminary screening criteria reduced the number of sites for consideration to twenty-six. The DOE then prepared fact sheets for the remaining sites. These fact sheets provided additional site-specific information for understanding the strengths and weaknesses of the twenty-six sites as potential disposal sites. The information also provided the basis for discussion among affected States and the DOE in recommending sites for more detailed evaluation.
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Young People and Political Campaigning on the Internet. CIRCLE Fact Sheet.
Levine, Peter; Lopez, Mark Hugo
2004-01-01
This fact sheet discusses young people and political campaigning on the Internet. It explains how the Internet has become a powerful force in political campaigns. A survey released by the Pew Research Center for the People & the Press on January 11, 2004 found that the Internet is gaining importance as a source of political news, especially for…
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Servicios del Centro de Soluciones Para la Energia Limpia (Fact Sheet)
Energy Technology Data Exchange (ETDEWEB)
2014-05-01
This is the Spanish translation of the Clean Energy Solutions Center Services fact sheet. The Clean Energy Solutions Center (Solutions Center) helps governments, advisors and analysts create policies and programs that advance the deployment of clean energy technologies. The Solutions Center partners with international organizations to provide online training, expert assistance, and technical resources on clean energy policy.
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Fact Sheet- Ancient DNA: What is it? Why is it Important?
Alexa Walker; George Nicholas; Daryl Pullman; Alan Goodman; Bioarchaeology and Genetics Working Group
2016-01-01
As genetic research is increasingly applied to new areas of study, including in archaeological and heritage contexts, a range of questions arise concerning the social, ethical, legal, and political implications of ancient DNA. This fact sheet explains the nature and challenges of aDNA research, and why information from it is important and relevant to people today.
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Fact Sheet: Notice of Ambient Water Quality Criteria Document for Tributyltin (TBT) - Final
Information pertaining to 2004 Final Acute and Chronic Ambient Aquatic Life Water Quality Criteria for Tributyltin (TBT) for freshwater and saltwater. This fact sheet includes the safe levels of TBT that should protect the majority of species.
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History Documents US Underground Nuclear Test History Reports NTPR Radiation Exposure Reports Enewetak Atoll Cleanup Documents TRAC About Who We Are Our Values History Locations Our Leadership Director Support Center Contact Us FAQ Sheet Links Success Stories Contracts Business Opportunities Current
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Sloan Work and Family Research Network, 2009
2009-01-01
The Sloan Work and Family Research Network has prepared Fact Sheets that provide statistical answers to some important questions about work-family and work-life issues. This Fact Sheet includes statistics about Children in Self-Care, and answers the following questions about school-age children in self-care: (1) How many school-age children are in…
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Systems Performance Analyses of Alaska Wind-Diesel Projects; Kotzebue, Alaska (Fact Sheet)
Energy Technology Data Exchange (ETDEWEB)
Baring-Gould, I.
2009-04-01
This fact sheet summarizes a systems performance analysis of the wind-diesel project in Kotzebue, Alaska. Data provided for this project include wind turbine output, average wind speed, average net capacity factor, and optimal net capacity factor based on Alaska Energy Authority wind data, estimated fuel savings, and wind system availability.
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Rocky Mountain Research Station USDA Forest Service
2004-01-01
Other fact sheets identified considerations for communicating about hazards, talked about the importance of working locally, and discussed the seven laws of effective hazard communication. This fact sheet introduces the "Golden Rule" of hazard communication and shares some final lessons from hazard educators.
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Christine Esposito
2006-01-01
Wildland fire professionals at the Federal, State, and local levels have a long tradition of collaborating across agencies and jurisdictions to achieve goals that they could not achieve independently. This fact sheet discusses the reasons and resources for collaboration.Other...
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Christine Esposito
2006-01-01
Collaboration is a powerful tool for improving both the management of wildland fire and the overall health of forests and other elements of fire-dependent ecosystems. This fact sheet discusses seven stages that are typical of most collaborations.Other publications in this...
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This page contains an August 2003 fact sheet with information regarding the National Emissions Standards for Hazardous Air Pollutants (NESHAP) for Stationary Combustion Turbines. This document provides a summary of the information for this NESHAP.
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Ancient DNA (aDNA): What is it? Why is it important?- Fact Sheet
Alexa Walker; George Nicholas; Daryl Pullman; Alan Goodman; Bioarchaeology and Genetics Working Group
2014-01-01
As genetic research is increasingly applied to new areas of study, including in archaeological and heritage contexts, a range of questions arise concerning the social, ethical, legal, and political implications of ancient DNA. This fact sheet explains the nature and challenges of aDNA research, and why information from it is important and relevant to people today.
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This fact sheet provides guidance on the Chemical Data Reporting (CDR) rule requirements related to the reporting of mined metals, intermediates, and byproducts manufactured during metal mining and related activities.
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Canada and the Kyoto Protocol: Fact Sheet No. 1 - Overview
International Nuclear Information System (INIS)
2000-11-01
This fact sheet outlines the principles underlying Canada's position at the sixth Conference of Parties (COP6) regarding climate change. Capsule descriptions of the Canadian view on carbon sinks (advocating a broader inclusion of sink activities), application of the flexibility mechanisms (the Clean Development Mechanism, Joint Implementation and International Emissions Trading), the issue of compliance (Canada favoring strong incentives to ensure compliance), and strengthening the capacity of developing countries to enhance their contribution to fighting climate change (Canada acknowledging that capacity building and technology transfer needs to be a central part of the global approach to combating climate change)
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ATLAS Fact Sheet : To raise awareness of the ATLAS detector and collaboration on the LHC
ATLAS Outreach
2010-01-01
Facts on the Detector, Calorimeters, Muon System, Inner Detector, Pixel Detector, Semiconductor Tracker, Transition Radiation Tracker,, Surface hall, Cavern, Detector, Magnet system, Solenoid, Toroid, Event rates, Physics processes, Supersymmetric particles, Comparing LHC with Cosmic rays, Heavy ion collisions, Trigger and Data Acquisition TDAQ, Computing, the LHC and the ATLAS collaboration. This fact sheet also contains images of ATLAS and the collaboration as well as a short list of videos on ATLAS available for viewing.
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Energy Technology Data Exchange (ETDEWEB)
2011-08-01
This fact sheet provides essential information about the 2011 publication of the Workforce Guidelines for Multifamily Home Energy Upgrades, including their origin, their development with the help of industry leaders to create the standard work specifications for retrofit work.
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Christine Esposito
2006-01-01
Bringing the right people into a collaborative process can be difficult. Potential collaborators must all feel they have something to gain to justify investing resources, sharing knowledge, and perhaps compromising on goals and actions. This fact sheet discusses some of the common challenges that individuals, communities, and institutions face in collaboration.
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Technical fact sheets on the impacts of new energy efficiency technologies and measures in ice rinks
Energy Technology Data Exchange (ETDEWEB)
NONE
2003-07-01
This paper presents energy efficiency facts on ice rinks and arenas to advise and inform refrigeration and building professionals. The aim of the paper was to facilitate estimation and compare impacts of various energy efficiency measures and new technologies on the consumption of energy and the reduction of greenhouse gas (GHG) emissions. A computer-based tool modelling ice rink energy consumption was constructed based on DOE-2.1E software. The simulation tool was developed to study the sensitivity of various eco-energetic technologies applied to arenas. Results of the simulations have made it possible to construct 8 facts sheets, including information on simulated heat exchange; calculation of energy consumption for heating and refrigeration; the incorporation of several types of Heating Ventilation and Air Conditioning (HVAC) systems; and to show various strategies of operation. To account for the effects of ice within a building, calculation routines in the form of functional values were added. The model addressed the following parameters: climate; characteristics of the envelope; lighting power and intensity; temperature of the resurfacing water; ice sheet temperature; humidity level of the ice rink; fresh air intake; emissivity index of the ceiling above the ice sheet; refrigeration systems according to type, capacity, output and operation mode; capacity output and operation mode of the air heating system, including heat recovery from the refrigeration system; and capacity, output and operation mode of the domestic and resurfacing hot water heating system, including heat recovery from the refrigeration system. Fact sheets were presented for the type of technology; description; direct or indirect benefits; energy-savings potential; environmental impacts; specific comments from specialists; and a set of charts to facilitate comprehension. tabs., figs.
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Rocky Mountain Research Station USDA Forest Service
2004-01-01
Mastication, or mulching, is a mechanical fuel treatment that changes the structure and size of fuels in the stand. This fact sheet describes the kinds of equipment available, where mastication should be used, and treatment factors affecting cost.Other publications in this...
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This page contains a February 2003 fact sheet with information regarding the National Emissions Standards for Hazardous Air Pollutants (NESHAP) for Asphalt Processing and Asphalt Roofing Manufacturing.
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Rocky Mountain Research Station USDA Forest Service
2004-01-01
Confidence in decisionmaking can often come from knowing if others in similar circumstances would choose the same management strategy. Researchers at the USDA FS Pacific Northwest Research Station and the University of Saskatchewan have developed a Selection Criteria Analysis for answering this very question. This fact sheet discusses factors affecting the choice of...
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Catalogue of Energy Efficiency Measures for France: descriptive fact sheets
International Nuclear Information System (INIS)
2012-06-01
ADEME wished to learn about existing effective energy efficiency measures implemented outside of France, whether cross-sectoral or targeted at a specific sector (industry, transport, buildings or agriculture). The objective of this survey was to determine whether any of these measures could be applied in France, with the goal of holding down the growth of energy consumption. This survey has led to the writing of a catalog of 53 two-page fact sheets describing the measures identified as interesting for France. These measures were analysed via classic criteria of evaluation such as cost-efficiency or impact, allowing to highlight the most successful measures for the French territory
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Christine Esposito
2006-01-01
Collaborating on fire and fuels management with a host of public and private partners may seem like an impossible undertaking, and presents many challenges. This fact sheet reviews tips for what to focus on as you embark on a collaborative fuels management project.Other...
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Women, Work and Health Hazards: A Fact Sheet and Cosmetologists: Health Risks at Work.
National Commission on Working Women, Washington, DC.
The first part of this document is a fact sheet that provides information on health hazards faced by employed women. It covers the Occupational Safety and Health Act (OSHA), job-related diseases suffered by workers in female-dominated occupations, employer responsibilities under OSHA, and the lack of statistical reporting on job-related disease.…
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Fuels planning: science synthesis and integration; economic uses fact sheet 02: log hauling cost
Rocky Mountain Research Station USDA Forest Service
2004-01-01
Knowing the cost of fuel reduction treatments and associated activities, such as hauling cut trees, is essential for fire and fuels planning. This fact sheet explores the main factors that determine the cost of hauling cut trees and points the user to an interactive tool that can help plan for those and other expenses.
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Long-Term Consequences for Teens with Older Sexual Partners. Fact Sheet. Publication #2008-16
Schelar, Erin; Ryan, Suzanne; Manlove, Jennifer
2008-01-01
Existing research on the risks of having sex at a young age with an older partner has focused on poorer reproductive health outcomes in the adolescent years, but scant attention has been paid to the longer-term implications of these relationships. Using survey data from high school students, this "Fact Sheet" presents findings from recent Child…
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Fuels planning: science synthesis and integration; economic uses fact sheet 05: NEPA and economics
Rocky Mountain Research Station USDA Forest Service
2004-01-01
The National Environmental Policy Act (NEPA) is the law that requires Federal agencies to consider the environmental impacts of their actions, involve the public in the decisionmaking process, and disclose information, starting at the initial stages of planning. This fact sheet discusses when you should consider economics in the NEPA process, when to do an analysis,...
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This fact sheet provides guidance for people who may be subject to the Chemical Data Reporting (CDR) rule on how their requirements for reporting for 2016 may be affected when chemical substances are the subject of certain TSCA actions.
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Rocky Mountain Research Station USDA Forest Service
2004-01-01
Markets and prices for logs vary widely across the West, fluctuating from place to place in response to regional variables and hauling costs. This fact sheet discusses those variables, locality of log markets, markets for low-value logs, and caveats to consider when using My Fuel Treatment Planner.
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Rocky Mountain Research Station USDA Forest Service
2004-01-01
Fire hazard reflects the potential fire behavior and magnitude of effects as a function of fuel conditions. This fact sheet discusses crown fuels, surface fuels, and ground fuels and their contribution and involvement in wildland fire.Other publications in this series...
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Waste generation and pollution prevention progress fact sheet: Nevada Test Site
International Nuclear Information System (INIS)
1994-01-01
The Nevada Test Site is responsible for maintaining nuclear testing capability, supporting science-based Stockpile Stewardship experiments, maintaining nuclear agency response capability, applying environmental restoration techniques to areas affected by nuclear testing, managing low-level and mixed radioactive waste, investigating demilitarization technologies, investigating counter- proliferation technologies, supporting work-for-others programs and special Department of Defense activities, operating a hazardous materials spill test center, and providing for the commercial development of the site. This fact sheet provides information on routine waste generation and projected reduction by waste type. Also, materials recycled by the Nevada Test Site in 1994 are listed
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Christine Esposito
2006-01-01
Research shows that, while prescribed burning and other fuels treatments can lower visual quality in some situations, they can also improve it in others. This fact sheet reviews the visual aspects of different levels of prescribed burning.Other publications in this series...
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Energy Technology Data Exchange (ETDEWEB)
NONE
1999-05-31
This fact sheet is intended to provide an overview of the advantages of ethanol from corn, emphasizing ethanol`s contribution to environmental protection and sustainable agriculture. Ethanol, an alternative fuel used as an octane enhancer is produced through the conversion of starch to sugars by enzymes, and fermentation of these sugars to ethanol by yeast. The production process may involve wet milling or dry milling. Both these processes produce valuable by-products, in addition to ethanol and carbon dioxide. Ethanol contains about 32,000 BTU per litre. It is commonly believed that using state-of-the-art corn farming and corn processing processes, the amount of energy contained in ethanol and its by-products would be more than twice the energy required to grow and process corn into ethanol. Ethanol represents the third largest market for Ontario corn, after direct use as animal feed and wet milling for starch, corn sweetener and corn oil. The environmental consequences of using ethanol are very significant. It is estimated that a 10 per cent ethanol blend in gasoline would result in a 25 to 30 per cent decrease in carbon monoxide emissions, a 6 to 10 per cent decrease in net carbon dioxide, a slight increase in nitrous oxide emissions which, however, would still result in an overall decrease in ozone formation, since the significant reduction in carbon monoxide emissions would compensate for any slight increase in nitrous oxide. Volatile organic compounds emission would also decrease by about 7 per cent with a 10 per cent ethanol blend. High level blends could reduce VOCs production by as much as 30 per cent. 7 refs.
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Erisman, Wendy; Looney, Shannon
2008-01-01
This fact sheet presents a snapshot of important facts that are specific to the state of New York from the "Opening the Door to the American Dream: Increasing Higher Education Access and Success for Immigrants" report, which exposes systemic barriers that prevent immigrants from entering college and/or completing bachelor's degrees…
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This page contains an August 2004 fact sheet with information regarding the final NESHAP for Surface Coating of Plastic Parts and Products. This document provides a summary of the information for the information for this regulation.
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2012-01-19
...] Recovery Directorate Fact Sheet 9580.213, Residential Electrical Meter Repair--``Power Up'' AGENCY: Federal..., Residential Electrical Meter Repair--``Power Up.'' DATES: Comments must be received by February 21, 2012... authority, FEMA may fund the repair of residential electrical meters damaged in a major disaster or...
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Energy Technology Data Exchange (ETDEWEB)
2011-08-01
Fact sheet on the FlashQE system, a 2011 R&D 100 Award winner. A solid-state optical system by NREL and Tau Science measures solar cell quantum efficiency in less than a second, enabling a suite of new capabilities for solar cell manufacturers.
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Energy Technology Data Exchange (ETDEWEB)
Hotchkiss, E.
2014-08-01
This fact sheet provides information on how private industry; federal, state, and local governments; non-profit organizations; and communities can utilize NREL's expertise, tools, and innovations to incorporate energy efficiency and renewable energy into the planning, recovery, and rebuilding stages of disaster.
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Steve Sutherland; Melanie Miller
2005-01-01
The Understory Response Model is a species-specific computer model that qualitatively predicts change in total species biomass for grasses, forbs, and shrubs after thinning, prescribed fire, or wildfire. The model examines the effect of fuels management on plant survivorship and reproduction. This fact sheet identifies the intended users and uses, required inputs, what...
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Melanie Miller
2004-01-01
Fuels planning: science synthesis and integration; environmental consequences fact sheet 5: prescriptions and fire effects. Miller, Melanie. 2004. Res. Note RMRS-RN-23-5-WWW. Fort Collins, CO: U.S. Department of Agriculture, Forest Service, Rocky Mountain Research Station. 2 p. While our understanding of the causes for variation in postfire effects is increasing, burn...
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Energy Technology Data Exchange (ETDEWEB)
2012-09-01
This fact sheet describes the U.S. Department of Energy's Community Renewable Energy Deployment (CommRE) program, which is a more than $20 million effort funded through the American Recovery and Reinvestment Act of 2009, to promote investment in clean energy solutions and provide real-life examples for other local governments, campuses, and small utilities to replicate. Five community-based renewable energy projects received funding from DOE through the CommRE and their progress is detailed.
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RAND Corporation, 2007
2007-01-01
This fact sheet summarizes a study that examined how schools in the U.S. Gulf Coast region perceived the mental health needs of students after Hurricanes Katrina and Rita and how schools responded. According to the report, despite strong initial efforts to support the mental health needs of students displaced by Hurricanes Katrina and Rita, many…
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Rocky Mountain Research Station USDA Forest Service
2004-01-01
In the face of rapidly changing public and political attitudes toward fire and fuel planning, one thing remains constant: the fuel planner is ultimately responsible for making decisions on the land. This fact sheet discusses the options for fuel treatments, and the need, development, and use of the MS Excel-based tool, My Fuel Treatment Planner.
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Rocky Mountain Research Station USDA Forest Service
2004-01-01
Effective public education and communication campaigns about wildland fire and fuels management should have clear objectives, and use the right techniques to achieve these objectives. This fact sheet lists seven important considerations for planning or implementing a hazard communication effort.
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Rocky Mountain Research Station USDA Forest Service
2004-01-01
With increased interest in reducing hazardous fuels in dry inland forests of the American West, agencies and the public will want to know the economic impacts of fuel reduction treatments. This fact sheet discusses the economic impact tool, a component of My Fuel Treatment Planner, for evaluating economic impacts.
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Rocky Mountain Research Station USDA Forest Service
2004-01-01
Other fact sheets discuss the different types of information that are useful in explaining to property owners the importance of taking personal responsibility for fuels management on their land. However, for some property owners, new information is not enough-they may need more information in order to understand that change is necessary. This fact sheet discusses ways...
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Christine Esposito
2006-01-01
Fuels management produces changes in the landscape that can impact scenic beauty. If people do not consider a forest to be scenic, they may think that the low scenic quality is a result of poor management or ecological health. This fact sheet looks at the relevency of the effects of natural and human-caused landscape changes, when planning fuels management.
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Trent Wickman; Ann Acheson
2005-01-01
The Smoke Impact Spreadsheet (SIS) is a simple-to-use planning model for calculating particulate matter (PM) emissions and concentrations downwind of wildland fires. This fact sheet identifies the intended users and uses, required inputs, what the model does and does not do, and tells the user how to obtain the model.
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Septic-embolic and septic-metabolic brain abscess
International Nuclear Information System (INIS)
Weber, W.; Henkes, H.; Kuehne, D.; Felber, S.; Jaenisch, W.; Woitalla, D.
2000-01-01
The hematogeneous spread of bacteria, fungi and protozoa may also reach the brain vessels, which happens mostly through septic emboli. From such an embolus a metastatic focal encephalitis and later a septic-embolic brain abscess may arise. The most frequently underlying infections that may cause septic emboli are bacterial endocarditis as well as bacterial infections of artificial heart valve prostheses. Congenital heart malformations with a right-to-left shunt also play here a certain role. Basically, however, all septic conditions and bacteriemias may cause septic-embolic brain abscesses. They occur frequently as multiple lesions. MRI is superior to CT in depicting the different stages of evolution from focal encephalitis, through the hardly encapsulated early abscess, to the formation of a membrane and later a dense fibrous capsule. The medical treatment of a brain abscess requires properly performed CT or MRI follow-up examinations in order to realize early enough a possible growing of such a lesion. (orig.) [de
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This page contains a December 2007 fact sheet with information regarding the National Emissions Standards for Hazardous Air Pollutants (NESHAP) for Clay Ceramics Manufacturing, Glass Manufacturing, and Secondary Nonferrous Metals Processing Area Sources
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Steve Sutherland
2004-01-01
The Fire Effects Information System (FEIS) provides accessible, up-to-date fire effects summaries, taken from current English-language literature, for almost 900 plant species, about 100 animal species, and 16 Kuchler plant communities found on the North American continent. This fact sheet discusses the development of FEIS and what is contained in the species summary....
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Christine Esposito
2006-01-01
It is important to understand what types of landscape settings most people prefer to be able to plan fuels treatment and other forest management activities that will be acceptable to the general public. This fact sheet considers the four common elements of visually preferred forest settings: large trees; herbacious, smooth groundcover; open midstory canopy; and vistas...
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Pulmonary Septic Emboli due to Azygos Vein Septic Thrombosis
Directory of Open Access Journals (Sweden)
Ginius Pradhan
2013-01-01
Full Text Available The triad of extrapulmonary infection, contiguous septic vein thrombosis, and septic pulmonary embolism is a rare complex but associated with significant morbidity and mortality. Septic azygos vein thrombosis is extremely rare and potentially serious since it may also cause pulmonary emboli and sudden death. We report a case of a 32-year-old woman with history of IV drug abuse who presented with epidural abscess and methicillin-resistant S. aureus (MRSA bacteremia. Later she developed signs of septic pulmonary embolism secondary to septic azygos vein thrombosis. With early diagnosis, appropriate antimicrobial therapy, and control of the infectious source, resolution of the illness can be expected for most patients with avoidance of potential complications.
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Energy Technology Data Exchange (ETDEWEB)
2011-04-01
This fact sheet proposes a framework for how states and localities can build policy portfolios by first setting the stage for clean energy in the market with low cost policies, and then growing the market with successive policies until the need for financial incentives can be reduced and eventually eliminated.
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Septic encephalopathy and septic encephalitis.
Tauber, Simone C; Eiffert, Helmut; Brück, Wolfgang; Nau, Roland
2017-02-01
During the last two decades, septic encephalopathy (SE) was recognized as a clinically relevant problem with a high prevalence in patients at admission and during their hospital stay. SE is a condition associated with increased mortality and morbidity such as long-term cognitive impairment. Areas covered: This review illustrates the pathophysiology of sepsis-associated encephalopathy and encephalitis involving blood-brain-barrier dysfunction and neuroinflammation caused by endothelial and microglial activation by endogenous or pathogen-derived compounds, hypoxia by impaired microvascular regulation and septic shock as well as imbalance of neurotransmitters. The continuum between septic-embolic and septic-metastatic encephalitis and SE is underlined by histological findings. The options of technical examinations and biomarkers to diagnose SE are discussed together with established therapeutic options as well as current experimental approaches. Expert commentary: An outlook for clinicians is provided including promising diagnostic approaches by means of new imaging techniques. Clinical trials with drugs already established for other indications such as statins, erythropoietin and minocycline are warranted in the future.
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International Nuclear Information System (INIS)
Ericksen, E.
1999-01-01
Interested in learning about innovative ways to improve the efficiency of your plant's steam, electric motor, and compressed air systems? This US Department of Energy Office of Industrial Technologies fact sheet offers information regarding training sessions, teleconferences, and various training materials to teach you and your company ways to reduce energy use, save money, and reduce waste and pollution through system optimization
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Rocky Mountain Research Station USDA Forest Service
2004-01-01
People who evaluate their actions in terms of what others think are often said to be guided by community norms. With respect to fuels management, this means that when you are "selling" a property owner on taking steps to reduce fuels, you are not just "selling" to one person, but to a network of people. This fact sheet discusses three tools to help...
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Retrospective evaluation of recurrent secondary septic peritonitis in dogs (2000-2011): 41 cases.
Barfield, Dominic M; Tivers, Michael S; Holahan, Matthew; Welch, Kristin; House, Arthur; Adamantos, Sophie E
2016-01-01
To describe the clinical characteristics of recurrent septic peritonitis in dogs. Multicenter retrospective observational study. Client-owned dogs with recurrent septic peritonitis. Three university emergency and referral hospitals. None. Medical records from 3 veterinary university teaching hospitals were reviewed and data were collected using a standardized data collection sheet for all cases of septic peritonitis during the study period (2000-2011). Forty one dogs met the inclusion criteria for recurrent peritonitis. All dogs underwent relaparotomy. The original cause of septic peritonitis in these cases included previous surgery for gastrointestinal foreign body removal (n = 26), gastrointestinal neoplasia (n = 3), gastric or duodenal ulceration (n = 3), biliary tract leakage (n = 2), and single instance for each of the following: penetrating foreign body, hernia strangulation, intussusception, mesenteric volvulus, infection of the laparotomy incision, prostatic abscess, and trauma. Eighteen animals survived to discharge. There was no difference detected between survivors and nonsurvivors with recurrent peritonitis in terms of inciting cause, serum albumin concentration, surgical management, or provision of appropriate initial antimicrobials. The survival rate for dogs having recurrent peritonitis was 43.9% (18/41 dogs). This retrospective study did not identify any significant prognostic indicators for dogs with recurrent peritonitis and that the mortality rate for dogs having more than one surgery for septic peritonitis is similar to that reported for a single surgery for septic peritonitis. ©Veterinary Emergency and Critical Care Society 2015.
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Oil Notifications: Emergency Response Notification System (ERNS) fact sheet
International Nuclear Information System (INIS)
1992-04-01
The Emergency Response Notification System (ERNS) is a national computer database which provides the only centralized mechanism for documenting and verifying incident notification information as initially reported to the National Response Center (NRC), the U.S. Environmental Protection Agency (EPA), and to a limited extent, the U.S. Coast Guard (USCG). The initial notification data may be followed up with updated information from various Federal, State and local response authorities, as appropriate. ERNS contains data that can be used to analyze release notifications, support emergency planning efforts, and assist decision makers in developing spill prevention programs. The fact sheet provides summary information on notifications of releases of oil reported in accordance with the Clean Water Act (CWA). Under Section 311 of the CWA, discharges of oil which: (1) cause a sheen to appear on the surface of the water; (2) violate applicable water quality standards; or (3) cause sludge or emulsion to be deposited beneath the surface of the water or adjoining shoreline, must be reported to the NRC
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William Elliot; Pete Robichaud
2005-01-01
This fact sheet describes the sources of sediment in upland forest watersheds in the context of fuel management activities. It presents the dominant forest soil erosion processes, and the principles behind the new sediment delivery interface developed to aid in erosion analysis of fuel management projects.
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9/11 and the War on Terror in Curricula and in State Standards Documents. CIRCLE Fact Sheet
Stoddard, Jeremy; Hess, Diana
2011-01-01
This Fact Sheet reports findings from an ongoing study of the representation of 9/11 and terrorism in curricula, textbooks, and state standards documents. The study was conducted in three stages. The first two stages focused on how supplemental curricula and best-selling social studies textbooks published between 2002-2010 present the events of…
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Christine Esposito
2006-01-01
Researchers have tried to understand how information about forest management can influence a person's landscape preferences and aesthetic appreciation. These findings are relevant for fuels management projects, since these projects are often characterized by conflicts between aesthetic and ecological objectives. This fact sheet discusses different aspects and ways...
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Christine Esposito
2006-01-01
When making decisions about fuels treatments, forest managers need to assess not only the biological impacts of a treatment, but the social impacts as well. Social acceptability is based on value judgments by people-their notions of what is "good" and what is "better." This fact sheet discusses six questions that may be useful for framing initial...
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Campbell, Norm R C; Lackland, Daniel T; Lisheng, Liu; Niebylski, Mark L; Nilsson, Peter M; Zhang, Xin-Hua
2015-03-01
Increased blood pressure and high dietary salt are leading risks for death and disability globally. Reducing the burden of both health risks are United Nations' targets for reducing noncommunicable disease. Nongovernmental organizations and individuals can assist by ensuring widespread dissemination of the best available facts and recommended interventions for both health risks. Simple but impactful fact sheets can be useful for informing the public, healthcare professionals, and policy makers. The World Hypertension League has developed fact sheets on dietary salt and hypertension but in many circumstances the greatest impact would be obtained from national-level fact sheets. This manuscript provides instructions and a template for developing fact sheets based on the Global Burden of Disease study and national survey data. ©2015 Wiley Periodicals, Inc.
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Energy Technology Data Exchange (ETDEWEB)
Aceto, Donato Gonzalo [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Astuto-Gribble, Lisa M. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Gaudioso, Jennifer M. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)
2007-11-01
Numerous terrorist organizations have openly expressed interest in producing and deploying biological weapons. However, a limiting factor for many terrorists has been the acquisition of dangerous biological agents, as evidenced by the very few successful instances of biological weapons use compared to the number of documented hoaxes. Biological agents vary greatly in their ability to cause loss of life and economic damage. Some agents, if released properly, can kill many people and cause an extensive number of secondary infections; other agents will sicken only a small number of people for a short period of time. Consequently, several biological agents can potentially be used to perpetrate a bioterrorism attack but few are likely capable of causing a high consequence event. It is crucial, from a US national security perspective, to more deeply understand the likelihood that terrorist organizations can acquire the range of these agents. Few studies have attempted to comprehensively compile the technical information directly relevant to the acquisition of dangerous bacteria, viruses and toxins. In this report, technical fact sheets were assembled for 46 potentially dangerous biological agents. Much of the information was taken from various research sources which could ultimately and significantly expedite and improve bioterrorism threat assessments. By systematically examining a number of specific agent characteristics included in these fact sheets, it may be possible to detect, target, and implement measures to thwart future terrorist acquisition attempts. In addition, the information in these fact sheets may be used as a tool to help laboratories gain a rudimentary understanding of how attractive a method laboratory theft is relative to other potential acquisition modes.
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Christine Esposito
2006-01-01
The public's acceptance of forest management practices, including fuels reduction, is heavily based on how forests look. Fuels managers can improve their chances of success by considering aesthetics when making management decisions. This fact sheet reviews a three-part general strategy for managing fuels and visual quality: planning, implementation, and monitoring...
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2010-01-01
... (CONTINUED) PROPERTY MANAGEMENT Management of Property Exhibit D to Subpart B of Part 1955—Fact Sheet—The... 7 Agriculture 14 2010-01-01 2009-01-01 true Fact Sheet-The Federal Interagency Task Force on Food and Shelter for the Homeless D Exhibit D to Subpart B of Part 1955 Agriculture Regulations of the...
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Geral I. McDonald; Philip D. Tanimoto; Thomas M. Rice; David E. Hall; Jane E. Stewart; Paul J. Zambino; Jonalea R. Tonn; Ned B. Klopfenstein; Mee-Sook Kim
2005-01-01
The Root Disease Analyzer-Armillaria Response Tool (ART) is a Web-based tool that estimates Armillaria root disease risk in dry forests of the Western United States. This fact sheet identifies the intended users and uses, required inputs, what the model does and does not do, and tells the user how to obtain the model.
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Rocky Mountain Research Station USDA Forest Service
2004-01-01
The amount of science applicable to the management of wildfire hazards is increasing daily. In addition, the attitudes of landowners and policymakers about fire and fuels management are changing. This fact sheet discusses three critical keys to communicating about wildfire hazards.
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Steve Sutherland
2004-01-01
National Fire Protection Association (NFPA) data indicate that wildfires destroyed approximately 9,000 homes between 1985 and 1994 in the United States. The loss of homes to wildfire has had a significant impact on Federal fire policy. This fact sheet discusses the causes of home ignitions in the wildland-urban interface, home ignition zones, how to reduce home...
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Rocky Mountain Research Station USDA Forest Service
2004-01-01
Within the past 10 years, breakthrough research has identified factors that are most important for effectively communicating about wildland fire hazards. This fact sheet discusses seven "Laws" of effective public communication that should be considered in any state-of-the-art education campaign.
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This page contains a February 2011 fact sheet with information regarding the final NSPS and Emission Guidelines for Existing Sources for Sewage Sludge Incinerators (SSI). This document provides a summary of the information for these regulations.
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Rocky Mountain Research Station USDA Forest Service
2004-01-01
The software described in this fact sheet provides managers with tools for visualizing forest and fuels information. Computer-based landscape simulations can help visualize stand and landscape conditions and the effects of different management treatments and fuel changes over time. These visualizations can assist forest planning by considering a range of management...
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This page contains a November 2005, and and November 2006 fact sheet with information regarding the final and proposed NSPS and Emission Guidelines for Existing Sources for OSWI. This document provides a summary of the information for this regulation
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Rocky Mountain Research Station USDA Forest Service
2004-01-01
The principal goals of fuel treatments are to reduce fireline intensities, reduce the potential for crown fires, improve opportunities for successful fire suppression, and improve forest resilience to forest fires. This fact sheet discusses thinning, and surface fuel treatments, as well as challenges associated with those treatments.
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New technology for sulfide reductions and increased oil recovery: Petroleum project fact sheet
Energy Technology Data Exchange (ETDEWEB)
NONE
1999-12-14
This Fact Sheet is written for the Inventions and Innovations Program about a new technology for sulfide reduction and increased oil recovery. The new technology, called Bio-Competitive Exclusion (BCX), results in greater oil production and prevents the production of corrosive hydrogen sulfide in oil and gas reservoirs. This BCX process is initiated and maintained by a new product, called Max-Well 2000, in which nutrients are custom designed to stimulate targeted beneficial microorganisms that live in every oil and gas reservoir. Rapid growth of these microorganisms excludes activity of harmful sulfide-producing bacteria and produces by-products that serve as effective tertiary oil recovery agents and as sulfide degradation agents. Oil and gas production is both increased and sweetened.
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Energy Technology Data Exchange (ETDEWEB)
2012-07-01
This fact sheet describes the technical assistance that the U.S. Department of Energy, through its National Renewable Energy Laboratory, provided to New Orleans, Louisiana, which helped the city incorporate energy efficiency into its rebuilding efforts for K-12 schools and homes following Hurricanes Katrina and Rita. NREL also provided support and analysis on energy policy efforts.
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... Stroke Heart Disease Cholesterol Salt Million Hearts® WISEWOMAN High Blood Pressure Facts Recommend on Facebook Tweet Share Compartir On ... Top of Page CDC Fact Sheets Related to High Blood Pressure High Blood Pressure Pulmonary Hypertension Heart Disease Signs ...
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Stell, I M
1996-01-01
Olecranon bursitis is relatively common. One third of episodes are septic. Most of the remainder are non-septic, with occasional rheumatological causes. Trauma can cause both septic and non-septic olecranon bursitis. Clinical features are helpful in separating septic from non-septic olecranon bursitis, but there may be local erythema in both. Aspiration should be carried out in all cases, and if the presence of infection is still in doubt, microscopy, Gram staining, and culture of the aspirate will resolve the issue. Septic olecranon bursitis should be treated by aspiration, which may need to be repeated, and a long course of antibiotics. Some cases will need admission, and a few will need surgical treatment. Non-septic olecranon bursitis can be managed with aspiration alone. Non-steroidal anti-inflammatory drugs probably hasten symptomatic improvement. Intrabursal corticosteroids produce a rapid resolution but concern remains over their long term local effects. Recovery from septic olecranon bursitis can take months. PMID:8894865
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Energy Technology Data Exchange (ETDEWEB)
2015-01-01
Dollars saved through energy efficiency can directly impact your bottom line. Whether you are planning for a major renovation or upgrading individual pieces of building equipment, these improvements can help reduce operating costs, save on utility bills, and boost profits. This fact sheet provides a guide for small businesses to find the resources to increase the energy efficiency of their buildings.
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International Nuclear Information System (INIS)
Pitchford, P.; Brown, T.
2001-01-01
This four-page fact sheet describes distributed energy resources for Federal facilities, which are being supported by the U.S. Department of Energy's (DOE's) Federal Energy Management Program (FEMP). Distributed energy resources include both existing and emerging energy technologies: advanced industrial turbines and microturbines; combined heat and power (CHP) systems; fuel cells; geothermal systems; natural gas reciprocating engines; photovoltaics and other solar systems; wind turbines; small, modular biopower; energy storage systems; and hybrid systems. DOE FEMP is investigating ways to use these alternative energy systems in government facilities to meet greater demand, to increase the reliability of the power-generation system, and to reduce the greenhouse gases associated with burning fossil fuels
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Rocky Mountain Research Station USDA Forest Service
2004-01-01
Many managers and policymakers guided by the National Environmental Policy Act process want to understand the scientific principles on which they can base fuel treatments for reducing the size and severity of wildfires. These Forest Structure and Fire Hazard fact sheets discuss how to estimate fire hazard, how to visualize fuel treatments, and how the role of...
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The Septic Shock 3.0 Definition and Trials: A Vasopressin and Septic Shock Trial Experience.
Russell, James A; Lee, Terry; Singer, Joel; Boyd, John H; Walley, Keith R
2017-06-01
The Septic Shock 3.0 definition could alter treatment comparisons in randomized controlled trials in septic shock. Our first hypothesis was that the vasopressin versus norepinephrine comparison and 28-day mortality of patients with Septic Shock 3.0 definition (lactate > 2 mmol/L) differ from vasopressin versus norepinephrine and mortality in Vasopressin and Septic Shock Trial. Our second hypothesis was that there are differences in plasma cytokine levels in Vasopressin and Septic Shock Trial for lactate less than or equal to 2 versus greater than 2 mmol/L. Retrospective analysis of randomized controlled trial. Multicenter ICUs. We compared vasopressin-to-norepinephrine group 28- and 90-day mortality in Vasopressin and Septic Shock Trial in lactate subgroups. We measured 39 cytokines to compare patients with lactate less than or equal to 2 versus greater than 2 mmol/L. Patients with septic shock with lactate greater than 2 mmol/L or less than or equal to 2 mmol/L, randomized to vasopressin or norepinephrine. Concealed vasopressin (0.03 U/min.) or norepinephrine infusions. The Septic Shock 3.0 definition would have decreased sample size by about half. The 28- and 90-day mortality rates were 10-12 % higher than the original Vasopressin and Septic Shock Trial mortality. There was a significantly (p = 0.028) lower mortality with vasopressin versus norepinephrine in lactate less than or equal to 2 mmol/L but no difference between treatment groups in lactate greater than 2 mmol/L. Nearly all cytokine levels were significantly higher in patients with lactate greater than 2 versus less than or equal to 2 mmol/L. The Septic Shock 3.0 definition decreased sample size by half and increased 28-day mortality rates by about 10%. Vasopressin lowered mortality versus norepinephrine if lactate was less than or equal to 2 mmol/L. Patients had higher plasma cytokines in lactate greater than 2 versus less than or equal to 2 mmol/L, a brisker cytokine response to infection. The Septic
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Facts for Families from the American Academy of Child and Adolescent Psychiatry [1991].
American Academy of Child and Adolescent Psychiatry, Washington, DC.
Nine fact sheets relevant to children's emotional well-being are presented in this document. The first fact sheet, "Teenagers with Eating Disorders" focuses on anorexia nervosa and bulimia. The second fact sheet, "Children and Grief" describes age-related responses to death, and ways of coping with a death in a family that…
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Facts for Families from the American Academy of Child and Adolescent Psychiatry [1989].
American Academy of Child and Adolescent Psychiatry, Washington, DC.
Six fact sheets on issues relevant to children's emotional well being are presented in this document. The first fact sheet, "Children and Divorce" provides information for parents to consider when getting a divorce. Parents are encouraged to be aware of the stress that the events surrounding a divorce cause for the child. The second fact sheet,…
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Energy Technology Data Exchange (ETDEWEB)
2015-01-01
Dollars saved through energy efficiency can directly impact your bottom line. Whether you are planning for a major renovation or upgrading individual pieces of building equipment, these improvements can help reduce operating costs, save on utility bills, and boost profits. This fact sheet provides guidelines for SBA lenders to understand the value of financing energy efficiency investments.
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William Elliot; David Hall
2005-01-01
The Water Erosion Prediction Project (WEPP) Fuel Management (FuMe) tool was developed to estimate sediment generated by fuel management activities. WEPP FuMe estimates sediment generated for 12 fuel-related conditions from a single input. This fact sheet identifies the intended users and uses, required inputs, what the model does, and tells the user how to obtain the...
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Case Management for Individuals with Mental Retardation. ARC Facts.
Association for Retarded Citizens, Arlington, TX.
A question-and-answer format is used in this fact sheet to provide information on case management for individuals with mental retardation. The fact sheet describes the major components of a case management system, the role of the case manager, the individual's or family's role in case management, providers of case management services and systems…
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General Accounting Office, Washington, DC. Div. of Human Resources.
This fact sheet on state laws governing the independent practice and reimbursement of services for clinical social workers contains information from questionnaires sent to the state agencies responsible for health insurance regulations and Medicaid and licensing activities. Information on Ohio, the only state which did not respond, is not…
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Energy Technology Data Exchange (ETDEWEB)
Coughlin, J.
2010-06-01
Property Assessed Clean Energy (PACE) financing is one of several new financial models broadening access to clean energy by addressing the barrier of initial capital cost. The majority of the PACE programs in the market today include PV as an eligible measure. PV appeals to homeowners as a way to reduce utility bills, self-generate sustainable power, increase energy independence and demonstrate a commitment to the environment. If substantial state incentives for PV exist, PV projects can be economic under PACE, especially when partnered with good net metering policies. At the same time, PV is expensive relative to other eligible measures with a return on investment horizon that might exceed program targets. This fact sheet reviews the benefits and potential challenges of including PV in PACE programs.
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National Clearinghouse for Professions in Special Education, Reston, VA.
Brought together are two fact sheets on the supply of and demand for physical therapists and occupational therapists. The fact sheets cite statistical data from the National Easter Seal Society, the American Physical Therapy Association, and the American Occupational Therapy Association. The cited facts focus on the need to recruit and retain…
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Septic tank additive impacts on microbial populations.
Pradhan, S; Hoover, M T; Clark, G H; Gumpertz, M; Wollum, A G; Cobb, C; Strock, J
2008-01-01
Environmental health specialists, other onsite wastewater professionals, scientists, and homeowners have questioned the effectiveness of septic tank additives. This paper describes an independent, third-party, field scale, research study of the effects of three liquid bacterial septic tank additives and a control (no additive) on septic tank microbial populations. Microbial populations were measured quarterly in a field study for 12 months in 48 full-size, functioning septic tanks. Bacterial populations in the 48 septic tanks were statistically analyzed with a mixed linear model. Additive effects were assessed for three septic tank maintenance levels (low, intermediate, and high). Dunnett's t-test for tank bacteria (alpha = .05) indicated that none of the treatments were significantly different, overall, from the control at the statistical level tested. In addition, the additives had no significant effects on septic tank bacterial populations at any of the septic tank maintenance levels. Additional controlled, field-based research iswarranted, however, to address additional additives and experimental conditions.
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Rocky Mountain Research Station USDA Forest Service
2004-01-01
Fuels management responsibilities may include providing local property owners with the information for taking responsibility for reducing fuels on their land. This fact sheet discusses three different types of information that may be useful in programs to engage property owners in fuel reduction activities.
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Elizabeth Reinhardt
2005-01-01
FFE-FVS is a model linking stand development, fuel dynamics, fire behavior and fire effects. It allows comparison of mid- to long-term effects of management alternatives including harvest, mechanical fuel treatment, prescribed fire, salvage, and no action. This fact sheet identifies the intended users and uses, required inputs, what the model does, and tells the user...
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[Proteus mirabilis septic arthritis].
Sbiti, Mohammed; Bouhamidi, Bahia; Louzi, Lhoussaine
2017-01-01
Acute septic arthritis is rare. It is associated with poor prognosis in terms of mortality and morbidity. We report the case of a 61-year old patient with spontaneous Proteus mirabilis septic arthritis. He suffered from complicated diabetes associated with positive blood cultures and synovial fluid cultures. Patient's evolution was favorable thanks to early diagnosis and initiation of adequate antibiotic therapy. Proteus mirabilis septic arthritis is rare. On that basis we conducted a literature review of cases of Proteus mirabilis pyogenic arthritis to highlight the risk factors, pathogenesis, treatment and evolution of these diseases. Diagnosis is commonly based on microbiological analysis, early articular puncture biopsy is performed before the initiation of antibiotic treatment, direct examination, culture and antibiogram which are useful as guidance for antibiotic therapy. Septic arthritis is a diagnostic and therapeutic emergency; early management of this disease allows total healing without after-effects.
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Energy Technology Data Exchange (ETDEWEB)
2010-11-01
This fact sheet describes the National Renewable Energy Laboratory's (NREL's) accomplishments in showcasing a Ford hydrogen-powered internal combustion engine (H2ICE) bus at The Taste of Colorado festival in Denver. NREL started using its U.S. Department of Energy-funded H2ICE bus in May 2010 as the primary shuttle vehicle for VIP visitors, members of the media, and new employees. In September 2010, NREL featured the bus at The Taste of Colorado. This was the first major outreach event for the bus. NREL's educational brochure, vehicle wrap designs, and outreach efforts serve as a model for other organizations with DOE-funded H2ICE buses. Work was performed by the Hydrogen Education Group and Market Transformation Group in the Hydrogen Technologies and Systems Center.
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Rocky Mountain Research Station USDA Forest Service
2004-01-01
In the course of work as a land manager, you will no doubt be involved in developing programs to achieve various objectives, including the improvement of fuels management on private lands. This fact sheet describes six steps that will help you plan and conduct a successful program.
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Sandia National Laboratories: News: Publications: Fact Sheets
Environmental Management System Pollution Prevention History 60 impacts Diversity Locations Facts & Figures Does Sandia Buy? Opportunities Small Business Procurement Technical Assistance Program (PTAP) Current Technology Partnerships Business, Industry, & Non-Profits Government Universities Center for
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Septic trochanteric bursitis in an adolescent.
Makki, Daoud; Watson, Alex James
2010-01-01
Trochanteric bursitis, whether septic or inflammatory in origin, is a condition that affects middle-aged patients. Here we report the rare case of an adolescent with septic trochanteric bursitis (treated successfully with intravenous antibiotics), review the available literature on septic bursitis, illustrate the importance of prompt recognition and treatment of this condition in any age group, and describe the clinical presentation and the radiologic findings.
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Septic bursitis in immunocompromised patients.
Roschmann, R A; Bell, C L
1987-10-01
A retrospective analysis of 29 patients with septic bursitis was undertaken to ascertain if immunocompromised patients differed in their clinical presentations, type of organisms cultured, and outcome when compared with their non-immunocompromised cohorts. Thirty episodes of septic bursitis occurred in 29 patients, 43 percent of which occurred in immunocompromised patients. Despite similar clinical presentations, the bursae of immunocompromised patients took three times longer to sterilize and had a much higher bursal white blood cell count when compared with the bursae of non-immunocompromised patients. The bacteriologic spectrum was essentially identical in both groups; there were no cases in which gram-negative organisms were recovered from infected bursae. No cases of septic bursitis were seen in neutropenic patients. The most common factors contributing to an immunocompromised state were alcoholism or steroid therapy. A successful resolution of septic bursitis was seen in all the patients in the immunocompromised groups.
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International Nuclear Information System (INIS)
Wiener, Edzard; Zanetti, Marco; Hodler, Juerg; Pfirrmann, Christian W.A.
2008-01-01
The aim of this study was to differentiate septic from non-septic arthritis by measuring lactate concentration with 1 H magnetic resonance spectroscopy (HMRS) and by estimating total protein content with the assessment of T 2 values. In 30 patients with acute arthritis, synovial fluid was aspirated. Lactate concentrations were analyzed with single voxel HMRS at 1.5 T. T 2 relaxation times were mapped with a multi-spin echo sequence. All samples underwent microbiological testing and routine laboratory analysis to quantify lactate concentration and total protein content. Values obtained in septic and non-septic arthritis were compared with a Mann-Whitney U test. Synovial fluid from patients with septic arthritis (n=10) had higher concentrations of lactate (11.4 ± 4.0 mmol/L) and higher total protein content (51.8 ± 10.7 g/L) than fluid obtained in non-septic arthritis (n=20; 5.2±1.1 mmol/L and 40.4±6.9 g/L, respectively, p 2 relaxation times (as an indicator of total protein content) were moderately correlated to laboratory-confirmed lactate concentration (r 2 =0.71) and total protein content (r 2 =0.73). Markedly increased lactate concentrations (>6 mmol/L) in combination with low T 2 values ( 2 may be of value in the differentiation of septic from non-septic arthritis. (orig.)
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Back Pain Facts and Statistics
... Marketing Patient Fact Sheets Contact the ACA State Licensing Boards Research JMPT Abstracts Latest Issue Evidence in ... Chiropractic Posture Backpack Safety Spinal Health Winter Activities Kids and Sports Exercising Outdoors with Baby Gardening Chronic ...
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Facts about food irradiation: Controlling the process
International Nuclear Information System (INIS)
1991-01-01
This fact sheet briefly reviews the procedures that exist to control the process of food irradiation. It also summarizes the difficulties in identifying irradiated food, which stem from the fact that irradiation does not physically change the food or cause significant chemical changes in foods. 4 refs
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Calcium uptake by sarcoplasmic reticulum isolated from hearts of septic rats
International Nuclear Information System (INIS)
McDonough, K.H.
1988-01-01
Myocardial sarcoplasmic reticulum (SR) plays a critical role in the regulation of the cytosolic calcium fluctuations that occur during the cardiac cycle. One function of the SR is to lower the calcium concentration so that myocardial relaxation and thus ventricular filling can occur. The aim of the present study was to determine if hyperdynamic sepsis induced a decrease in the capacity of SR to take up calcium. This defect would result in decreased ventricular filling and thus decreased cardiac output, as has previously been shown in isolated perfused working hearts removed from septic rats. Therefore, rats were anesthetized with ether, and sepsis was induced by the injection of an aliquot of a fecal homogenate into the peritoneal cavity. Control animals either underwent surgery and received an aliquot of sterilized fecal inoculum (sham) or were untreated (no surgery). On day 2 after surgery, animals were anesthetized with pentobarbital, and hearts were removed, weighted, and SR isolated. The rate of uptake of 45 Ca 2+ by SR from septic rats was not depressed compared to controls but in fact was elevated. Maximum 45 Ca 2+ accumulated by the SR and Ca 2+ -stimulated ATPase activity were similar in SR from control and septic hearts. These results suggest that the contractile dysfunction noted in the myocardium in early sepsis is probably not due to inadequate SR removal of Ca 2+ during diastole
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Miles, Barbara
This fact sheet discusses the importance of literacy for individuals who are deaf-blind, the social functions of reading and writing, and conditions necessary for the development of literacy. Strategies for promoting literacy among this population are described and include: (1) invite children and adults who are deaf-blind to observe as you use…
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CERN Quick Facts 2017 (French version)
Mobs, Esma
2017-01-01
Facts about CERN, the contributions of its Member States, its machines and experiments, the number of its employees and users, management structure, etc. Previously called "CERN General Information Sheet"
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CERN Quick Facts 2016 (French version)
AUTHOR|(CDS)2070305
2016-01-01
Facts about CERN, the contributions of its Member States, its machines and experiments, the number of its employees and users, management structure, etc. Previously called "CERN General Information Sheet"
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CERN Quick Facts 2016 (English version)
AUTHOR|(CDS)2070305
2016-01-01
Facts about CERN, the contributions of its Member States, its machines and experiments, the number of its employees and users, management structure, etc. Previously called "CERN General Information Sheet"
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CERN Quick Facts 2017 (English version)
Mobs, Esma
2017-01-01
Facts about CERN, the contributions of its Member States, its machines and experiments, the number of its employees and users, management structure, etc. Previously called "CERN General Information Sheet"
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Emotional Disturbance. NICHCY Disability Fact Sheet #5
National Dissemination Center for Children with Disabilities, 2010
2010-01-01
The mental health of our children is a natural and important concern for us all. The fact is, many mental disorders have their beginnings in childhood or adolescence, yet may go undiagnosed and untreated for years. "Umbrella" terms such as emotional disturbance, behavioral disorders, or mental illness are used to refer to mental…
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Enhanced sludge reduction in septic tanks by increasing temperature.
Pussayanavin, Tatchai; Koottatep, Thammarat; Eamrat, Rawintra; Polprasert, Chongrak
2015-01-01
Septic tanks in most developing countries are constructed without drainage trenches or leaching fields to treat toilet wastewater and /or grey water. Due to the short hydraulic retention time, effluents of these septic tanks are still highly polluted, and there is usually high accumulation of septic tank sludge or septage containing high levels of organics and pathogens that requires frequent desludging and subsequent treatment. This study aimed to reduce sludge accumulation in septic tanks by increasing temperatures of the septic tank content. An experimental study employing two laboratory-scale septic tanks fed with diluted septage and operating at temperatures of 40 and 30°C was conducted. At steady-state conditions, there were more methanogenic activities occurring in the sludge layer of the septic tank operating at the temperature of 40°C, resulting in less total volatile solids (TVS) or sludge accumulation and more methane (CH4) production than in the unit operating at 30°C. Molecular analysis found more abundance and diversity of methanogenic microorganisms in the septic tank sludge operating at 40°C than at 30°C. The reduced TVS accumulation in the 40°C septic tank would lengthen the period of septage removal, resulting in a cost-saving in desluging and septage treatment. Cost-benefit analysis of increasing temperatures in septic tanks was discussed.
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Facts about Volunteers. NCJW Center for the Child Fact Sheet Number 5.
National Council of Jewish Women, New York, NY. Center for the Child.
Volunteering is a vital and widespread activity in the United States; in fact, volunteers perform many essential community functions. Those who believe that most volunteers are women with time on their hands, that volunteers just do "charity work," and that volunteers are a source of cheap labor who can replace paid professionals and…
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Energy Technology Data Exchange (ETDEWEB)
Weber, W.; Henkes, H.; Kuehne, D. [Alfried-Krupp-Krankenhaus Essen (Germany). Klinik fuer Radiologie und Neuroradiologie; Felber, S. [Universitaetsklinik Innsbruck (Austria). Klinische Abt. der Radiologie I; Jaenisch, W. [Freie Univ. Berlin (Germany). Inst. fuer Neuropathologie; Woitalla, D. [Bochum Univ. (Germany). St. Josef-Hospital
2000-11-01
The hematogeneous spread of bacteria, fungi and protozoa may also reach the brain vessels, which happens mostly through septic emboli. >From such an embolus a metastatic focal encephalitis and later a septic-embolic brain abscess may arise. The most frequently underlying infections that may cause septic emboli are bacterial endocarditis as well as bacterial infections of artificial heart valve prostheses. Congenital heart malformations with a right-to-left shunt also play here a certain role. Basically, however, all septic conditions and bacteriemias may cause septic-embolic brain abscesses. They occur frequently as multiple lesions. MRI is superior to CT in depicting the different stages of evolution from focal encephalitis, through the hardly encapsulated early abscess, to the formation of a membrane and later a dense fibrous capsule. The medical treatment of a brain abscess requires properly performed CT or MRI follow-up examinations in order to realize early enough a possible growing of such a lesion. (orig.) [German] Die haemoatogene Ausbreitung von Bakterien, Pilzen oder Protozoen bis in die Hirngefaesse erfolgt meist durch eine septische Embolie. Es entstehen eine metastatische Herdenzephalitis und im weiteren Verlauf daraus ein septisch-embolischer Hirnabszess. Die haeufigste Grunderkrankung die zu septischen Embolien fuehrt, ist die bakterielle Endokarditis sowie die bakterielle Infektion von Herzklappenprothesen. Eine besondere Bedeutung kommt hier den angeborenen kardialen Fehlbildungen mit Rechts-Links-Shunt zu. Grundsaetzlich koennen jedoch alle Bakteriaemien zu septisch-embolischen Hirnabszessen fuehren. Septisch-embolische Hirnabszesse treten aufgrund ihres Entstehungsmechanismus haeufig multipel auf. Die CT und besser noch die MRT erlauben die Darstellung aller Entwicklungsstadien von der Herdenzephalitis ueber den kaum abgegrenzten Abszess, die Membranbildung bis zur Entstehung einer dicken, die eitergefuellte Hoehle allseits umgebenden
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An interesting septic embolism
Directory of Open Access Journals (Sweden)
Funda Uluorman
2014-01-01
Full Text Available Septic pulmonary embolism is a rare disease but mortality and morbidity of it is high. Septic pulmonary emboli comes from infected heart valves, thrombophlebitis, and pulmonary artery catheter or infected pacemaker wires as many sources [1,2]. In recent years, pacemaker is a common treatment of the bradiarrhythmia that is persisted in the etiology of septic embolism, its applications has started to pick up [3]. There is the growing number of patients with pacemaker, according to this the frequency of pacemaker lead infection and the number of patients at risk for right-sided endocarditis increase [4]. The patients don't have specific clinical and radiological features because of this it is very difficult to define, so the diagnosis is often delayed [5]. A detailed medical history, a detailed physical examination in diagnosis and evaluation of good additional imaging methods is very important. Early diagnosis and proper treatment, the implementation of the management, can provide good results.
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Domestic wells have high probability of pumping septic tank leachate
Bremer, J. E.; Harter, T.
2012-08-01
Onsite wastewater treatment systems are common in rural and semi-rural areas around the world; in the US, about 25-30% of households are served by a septic (onsite) wastewater treatment system, and many property owners also operate their own domestic well nearby. Site-specific conditions and local groundwater flow are often ignored when installing septic systems and wells. In areas with small lots (thus high spatial septic system densities), shallow domestic wells are prone to contamination by septic system leachate. Mass balance approaches have been used to determine a maximum septic system density that would prevent contamination of groundwater resources. In this study, a source area model based on detailed groundwater flow and transport modeling is applied for a stochastic analysis of domestic well contamination by septic leachate. Specifically, we determine the probability that a source area overlaps with a septic system drainfield as a function of aquifer properties, septic system density and drainfield size. We show that high spatial septic system density poses a high probability of pumping septic system leachate. The hydraulic conductivity of the aquifer has a strong influence on the intersection probability. We find that mass balance calculations applied on a regional scale underestimate the contamination risk of individual drinking water wells by septic systems. This is particularly relevant for contaminants released at high concentrations, for substances that experience limited attenuation, and those that are harmful even at low concentrations (e.g., pathogens).
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Domestic wells have high probability of pumping septic tank leachate
Directory of Open Access Journals (Sweden)
J. E. Bremer
2012-08-01
Full Text Available Onsite wastewater treatment systems are common in rural and semi-rural areas around the world; in the US, about 25–30% of households are served by a septic (onsite wastewater treatment system, and many property owners also operate their own domestic well nearby. Site-specific conditions and local groundwater flow are often ignored when installing septic systems and wells. In areas with small lots (thus high spatial septic system densities, shallow domestic wells are prone to contamination by septic system leachate. Mass balance approaches have been used to determine a maximum septic system density that would prevent contamination of groundwater resources. In this study, a source area model based on detailed groundwater flow and transport modeling is applied for a stochastic analysis of domestic well contamination by septic leachate. Specifically, we determine the probability that a source area overlaps with a septic system drainfield as a function of aquifer properties, septic system density and drainfield size. We show that high spatial septic system density poses a high probability of pumping septic system leachate. The hydraulic conductivity of the aquifer has a strong influence on the intersection probability. We find that mass balance calculations applied on a regional scale underestimate the contamination risk of individual drinking water wells by septic systems. This is particularly relevant for contaminants released at high concentrations, for substances that experience limited attenuation, and those that are harmful even at low concentrations (e.g., pathogens.
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More Cancer Types - SEER Cancer Stat Facts
Cancer Statistical Fact Sheets are summaries of common cancer types developed to provide an overview of frequently-requested cancer statistics including incidence, mortality, survival, stage, prevalence, and lifetime risk.
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The Impact of the Sepsis-3 Septic Shock Definition on Previously Defined Septic Shock Patients.
Sterling, Sarah A; Puskarich, Michael A; Glass, Andrew F; Guirgis, Faheem; Jones, Alan E
2017-09-01
The Third International Consensus Definitions Task Force (Sepsis-3) recently recommended changes to the definitions of sepsis. The impact of these changes remains unclear. Our objective was to determine the outcomes of patients meeting Sepsis-3 septic shock criteria versus patients meeting the "old" (1991) criteria of septic shock only. Secondary analysis of two clinical trials of early septic shock resuscitation. Large academic emergency departments in the United States. Patients with suspected infection, more than or equal to two systemic inflammatory response syndrome criteria, and systolic blood pressure less than 90 mm Hg after fluid resuscitation. Patients were further categorized as Sepsis-3 septic shock if they demonstrated hypotension, received vasopressors, and exhibited a lactate greater than 2 mmol/L. We compared in-hospital mortality in patients who met the old definition only with those who met the Sepsis-3 criteria. Four hundred seventy patients were included in the present analysis. Two hundred (42.5%) met Sepsis-3 criteria, whereas 270 (57.4%) met only the old definition. Patients meeting Sepsis-3 criteria demonstrated higher severity of illness by Sequential Organ Failure Assessment score (9 vs 5; p definition demonstrated significant mortality benefit following implementation of a quantitative resuscitation protocol (35% vs 10%; p = 0.006). In this analysis, 57% of patients meeting old definition for septic shock did not meet Sepsis-3 criteria. Although Sepsis-3 criteria identified a group of patients with increased organ failure and higher mortality, those patients who met the old criteria and not Sepsis-3 criteria still demonstrated significant organ failure and 14% mortality rate.
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Energy Technology Data Exchange (ETDEWEB)
NONE
2013-03-15
The reason for this fact sheet is the revision of the drinking water regulations, including the regulations for the prevention of legionella, July 1, 2011. Many market parties consider the regulations as complex, even after the revision. This fact sheet provides more clarity [Dutch] Aanleiding voor dit informatieblad is de op 1 juli 2011 herziene drinkwaterregelgeving, inclusief de voor legionellapreventie relevante bepalingen. Veel marktpartijen ervaren deze regelgeving, ook na herziening, als complex. Dit informatieblad verschaft meer duidelijkheid.
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Directory of Open Access Journals (Sweden)
Larissa Staurengo-Ferrari
2018-05-01
Full Text Available The ST2 receptor is a member of the Toll/IL-1R superfamily and interleukin-33 (IL-33 is its agonist. Recently, it has been demonstrated that IL-33/ST2 axis plays key roles in inflammation and immune mediated diseases. Here, we investigated the effect of ST2 deficiency in Staphylococcus aureus-induced septic arthritis physiopathology. Synovial fluid samples from septic arthritis and osteoarthritis individuals were assessed regarding IL-33 and soluble (s ST2 levels. The IL-33 levels in samples from synovial fluid were significantly increased, whereas no sST2 levels were detected in patients with septic arthritis when compared with osteoarthritis individuals. The intra-articular injection of 1 × 107 colony-forming unity/10 μl of S. aureus American Type Culture Collection 6538 in wild-type (WT mice induced IL-33 and sST2 production with a profile resembling the observation in the synovial fluid of septic arthritis patients. Data using WT, and ST2 deficient (−/− and interferon-γ (IFN-γ−/− mice showed that ST2 deficiency shifts the immune balance toward a type 1 immune response that contributes to eliminating the infection due to enhanced microbicide effect via NO production by neutrophils and macrophages. In fact, the treatment of ST2−/− bone marrow-derived macrophage cells with anti-IFN-γ abrogates the beneficial phenotype in the absence of ST2, which confirms that ST2 deficiency leads to IFN-γ expression and boosts the bacterial killing activity of macrophages against S. aureus. In agreement, WT cells achieved similar immune response to ST2 deficiency by IFN-γ treatment. The present results unveil a previously unrecognized beneficial effect of ST2 deficiency in S. aureus-induced septic arthritis.
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Duker, Laurie, Ed.
Minimal federal regulations on firearm sales have facilitated the proliferation of guns, gun owners, and gun dealers in the United States. This fact sheet offers data on the growing number of firearm dealers, the relative ease of obtaining and keeping a license to sell guns from the Federal Bureau of Alcohol, Tobacco, and Firearms, the lack of…
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Effect of temperature increments in septic tank efficiency
International Nuclear Information System (INIS)
Chi-Tec, M.; Caballero-Arzapalo, N.; Giacoman Vallejo, G.; Mendez-Novelo, R.; Quintal-Franco, C.
2009-01-01
Septic tanks are the main sewage disposal system used in Yucatan, Mexico. Septic tank content is stabilized under anaerobic conditions and is considered the temperature has a significant effect on the efficiency. This work was developed in order asses the feasibility to improve communal septic tanks efficiency by increasing content temperature. Temperatures inside the tank were increased using a hybrid heater system (solar and electricity). (Author)
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Clinical characteristics and outcomes of septic bursitis.
Lieber, Sarah B; Fowler, Mary Louise; Zhu, Clara; Moore, Andrew; Shmerling, Robert H; Paz, Ziv
2017-12-01
Limited data guide practice in evaluation and treatment of septic bursitis. We aimed to characterize clinical characteristics, microbiology, and outcomes of patients with septic bursitis stratified by bursal involvement, presence of trauma, and management type. We conducted a retrospective cohort study of adult patients admitted to a single center from 1998 to 2015 with culture-proven olecranon and patellar septic bursitis. Baseline characteristics, clinical features, microbial profiles, operative interventions, hospitalization lengths, and 60-day readmission rates were determined. Patients were stratified by bursitis site, presence or absence of trauma, and operative or non-operative management. Of 44 cases of septic bursitis, patients with olecranon and patellar bursitis were similar with respect to age, male predominance, and frequency of bursal trauma; patients managed operatively were younger (p = 0.05). Clinical features at presentation and comorbidities were similar despite bursitis site, history of trauma, or management. The most common organism isolated from bursal fluid was Staphylococcus aureus. Patients managed operatively were discharged to rehabilitation less frequently (p = 0.04). This study of septic bursitis is among the largest reported. We were unable to identify presenting clinical features that differentiated patients treated surgically from those treated conservatively. There was no clear relationship between preceding trauma or bursitis site and clinical course, management, or outcomes. Patients with bursitis treated surgically were younger. Additional study is needed to identify patients who would benefit from early surgical intervention for septic bursitis.
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Fact sheets relating to use of geothermal energy in the United States
Energy Technology Data Exchange (ETDEWEB)
None
1980-12-01
A compilation of data relating to geothermal energy in each of the 50 states is presented. The data are summarized on one page for each state. All summary data sheets use a common format. Following the summary data sheet there are additional data on the geology of each state pertaining to possible hydrothermal/geothermal resources. Also there is a list of some of the reports available pertaining to the state and state energy contacts. The intent of these documents is to present in a concise form reference data for planning by the Department of Energy.
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Brain Drain: A Child's Brain on Poverty. Poverty Fact Sheet
Damron, Neil
2015-01-01
"Brain Drain: A Child's Brain on Poverty," released in March 2015 and prepared by intern Neil Damron, explores the brain's basic anatomy and recent research findings suggesting that poverty affects the brain development of infants and young children and the potential lifelong effects of the changes. The sheet draws from a variety of…
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African Americans: College Majors and Earnings. Fact Sheet
Carnevale, Anthony P.; Fasules, Megan L.; Porter, Andrea; Landis-Santos Jennifer
2016-01-01
Access to college for African Americans has increased, but African Americans are highly concentrated in lower-paying majors. The college major, which has critical economic consequences throughout life, reflects personal choices but also reflects the fact that African-American students are concentrated in open-access four-year institutions that…
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Salmonella enteridis Septic Arthritis: A Report of Two Cases
Directory of Open Access Journals (Sweden)
Esat Uygur
2013-01-01
Full Text Available Introduction. Nontyphoidal salmonellosis causes significant morbidity, is transmitted via fecal-oral route, and is a worldwide cause of gastroenteritis, bacteremia, and local infections. Salmonella is a less common etiologic factor for septic arthritis compared with other gram-negative bacteria. Cases. We present two septic arthritis cases with Salmonella enteridis as a confirmed pathogen and also discuss the predisposing factors and treatment. Discussion. Septic arthritis is an orthopedic emergency. The gold standard treatment of septic arthritis is joint debridement, antibiotic therapy according to the culture results, and physiotherapy, which should start in the early postoperative period to prevent limitation of motion. Salmonella is an atypical agent for septic arthritis. It must be particularly kept in mind as an etiologic factor for the acute arthritis of a patient with sickle cell anemia and systemic lupus erythematosus. Clinicians should be cautious that the white blood cell count in synovial fluid can be under 50.000/mm3 in immune compromised individuals with septic arthritis. The inflammatory response can be deficient, or the microorganism may be atypical. Conclusion. Atypical bacteria such as Salmonella species in immune compromised patients can cause joint infections. Therefore, Salmonella species must always be kept in mind for the differential diagnosis of septic arthritis in a clinically relevant setting.
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Technetium phosphate bone scan in the diagnosis of septic arthritis in childhood
International Nuclear Information System (INIS)
Sundberg, S.B.; Savage, J.P.; Foster, B.K.
1989-01-01
The technetium phosphate bone scans of 106 children with suspected septic arthritis were reviewed to determine whether the bone scan can accurately differentiate septic from nonseptic arthropathy. Only 13% of children with proved septic arthritis had correct blind scan interpretation. The clinically adjusted interpretation did not identify septic arthritis in 30%. Septic arthritis was incorrectly identified in 32% of children with no evidence of septic arthritis. No statistically significant differences were noted between the scan findings in the septic and nonseptic groups and no scan findings correlated specifically with the presence or absence of joint sepsis
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Pseudomonas Septic Arthritis | Thanni | Nigerian Journal of ...
African Journals Online (AJOL)
BACKGROUND: Septic arthritis due to pseudomonas species is unusual and when it occurs, there is often an underlying cause like immune depression, intravenous drug abuse or a penetrating injury. PATIENT AND METHOD: We report a case of pseudomonas septic arthritis complicating cannulation of a leg vein following ...
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Septic arthritis of the sacroiliac joint
Sebastian, Agata; Błach, Katarzyna; Silicki, Jurand; Wiland, Piotr
2018-01-01
Septic arthritis is an inflammation of a joint caused directly by various microorganisms. It is often characterized by many unspecific symptoms. Bacteria is the most often etiological factor. We present a case report of a 76-years old woman with a unilateral septic arthritis of the sacroiliac joint. Bacterial sacroiliitis should be taken into account in patients with sacroiliitis and fever onset. Proper diagnosis can be very often difficult and delayed but fast implementation of antibiotic therapy is extremely important in the treatment process. Diagnostic imaging is crucial to the diagnosis and monitoring of septic arthritis. Magnetic resonance imaging is the most relevant tool for the detection of sacroiliitis, allowing the institution of therapeutic strategies to impede the progression of the disease. PMID:29686444
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Leucocyte esterase in the rapid diagnosis of paediatric septic arthritis.
LENUS (Irish Health Repository)
Kelly, E G
2013-02-01
Septic arthritis may affect any age group but is more common in the paediatric population. Infection is generally bacterial in nature. Prompt diagnosis is crucial, as delayed treatment is associated with lifelong joint dysfunction. A clinical history and application of Kocher\\'s criteria may indicate that there is a septic arthritis. However, definitive diagnosis is made on culture of septic synovial fluid. The culture process can take over 24h for the initial culture to yield bacterial colonies. Leucocyte esterase is released by leucocytes at the site of an infection. We hypothesise that leucocyte esterase can be utilized in the rapid diagnosis of septic arthritis and shorten the time to decisive treatment whilst simultaneously decreasing unnecessary treatment of non-septic joints.
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Yang, Yun-Ya; Toor, Gurpal S; Wilson, P Chris; Williams, Clinton F
2016-10-01
Septic systems, a common type of onsite wastewater treatment systems, can be an important source of micropollutants in the environment. We investigated the fate and mass balance of 17 micropollutants, including wastewater markers, hormones, pharmaceuticals and personal care products (PPCPs) in the drainfield of a septic system. Drainfields were replicated in lysimeters (1.5m length, 0.9m width, 0.9m height) and managed similar to the field practice. In each lysimeter, a drip line dispersed 9L of septic tank effluent (STE) per day (equivalent to 32.29L/m(2) per day). Fourteen micropollutants in the STE and 12 in the leachate from drainfields were detected over eight months. Concentrations of most micropollutants in the leachate were low (85% of the added micropollutants except for sucralose were attenuated in the drainfield. We discovered that sorption was the key mechanism for retention of carbamazepine and partially for sulfamethoxazole, whereas microbial degradation likely attenuated acetaminophen in the drainfield. This data suggests that sorption and microbial degradation limited transport of micropollutants from the drainfields. However, the leaching of small amounts of micropollutants indicate that septic systems are hot-spots of micropollutants in the environment and a better understanding of micropollutants in septic systems is needed to protect groundwater quality. Copyright © 2016 Elsevier B.V. All rights reserved.
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Modern tactics of observation the postpartum purulent-septic complications
Directory of Open Access Journals (Sweden)
O. M. Slinko
2014-04-01
Full Text Available Introduction. Postpartum purulent-septic diseases remain an urgent problem of modern obstetrics and are one of the important causes of maternal mortality. The presence of lethal proceeds from septic complications in the postpartum period is above all due to late diagnosis of this complication, delayed acceptance decision on the need and extent of surgery, inadequate capacity of syndromic and intensive care. The aim of research. The clinical analysis of different methods of diagnosis and treatment of patients with postpartum purulent-septic complications, obtained during the period from January 2011 to June 2013, based on work of gynecological department of Zaporozhye Regional Clinical Hospital. Materials and methods. During the period from January 2011 to June 2013 in the gynecological department of Zaporozhye Regional Clinical Hospital specialized medical care of 30 patients with purulent-septic complications in the postpartum period have been provided. 5 women in labor (16.67% were transferred from the maternity homes of Zaporozhye city and the rest (83.33% from different regions. Results. All patients admitted to gynecology department of Zaporozhye Regional Clinical Hospital were conducted massive antibiotic, syndromic therapy. 11 additional patients had an operation vacuum aspiration contents of the uterus, and 5 mothers had absolute indications for surgery: hysterectomy with uterine tube (2 patients diagnosed - septic condition, 3 cases - failure scar on the uterus after cesarean. Conclusion. 1. Delivery by cesarean section surgery significantly increases the risk of developing pyo-septic complications. Prompt delivery should be made according to strict indications, using modern sutures , intraoperative blood loss objective assessment (if necessary with timely appointment of replacement therapy and anti-anemic , with mandatory drainage of the abdominal cavity with repeated cesarean operations . 2. Using the entire set of clinical
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A collection of septic systems case studies to help community planners, elected officials, health department staff, state officials, and interested citizens explore alternatives for managing their decentralized wastewater treatment systems.
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Probiotics improve survival of septic rats by suppressing conditioned pathogens in ascites
Liu, Da-Quan; Gao, Qiao-Ying; Liu, Hong-Bin; Li, Dong-Hua; Wu, Shang-Wei
2013-01-01
AIM: To investigate the benefits of probiotics treatment in septic rats. METHODS: The septic rats were induced by cecal ligation and puncture. The animals of control, septic model and probiotics treated groups were treated with vehicle and mixed probiotics, respectively. The mixture of probiotics included Bifidobacterium longum, Lactobacillus bulgaricus and Streptococcus thermophilus. We observed the survival of septic rats using different amounts of mixed probiotics. We also detected the bacterial population in ascites and blood of experimental sepsis using cultivation and real-time polymerase chain reaction. The severity of mucosal inflammation in colonic tissues was determined. RESULTS: Probiotics treatment improved survival of the rats significantly and this effect was dose dependent. The survival rate was 30% for vehicle-treated septic model group. However, 1 and 1/4 doses of probiotics treatment increased survival rate significantly compared with septic model group (80% and 55% vs 30%, P probiotics treated group compared with septic model group (5.20 ± 0.57 vs 9.81 ± 0.67, P probiotics treated group compared with septic model group (33.3% vs 100.0%, P probiotics treated group were decreased significantly compared with that of septic model group (3.93 ± 0.73 vs 8.80 ± 0.83, P probiotics treatment, there was a decrease in the scores of inflammatory cell infiltration into the intestinal mucosa in septic animals (1.50 ± 0.25 vs 2.88 ± 0.14, P Probiotics improve survival of septic rats by suppressing these conditioned pathogens. PMID:23840152
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Retainment of the antimicrobial agent triclosan in a septic tank
DEFF Research Database (Denmark)
Kirjanova, Ala; Rimeika, Mindaugas; Vollertsen, Jes
2014-01-01
Laboratory experiments were conducted to investigate the fate of the antimicrobial agent triclosan (TCS) in a conventional septic tank. The main mechanism of TCS removal from wastewater was identified to be rapid TCS sorption to suspended particles followed by settling of these particles...... to the bottom of the septic tank. Sorption to particles was completed within minutes while the settling took several days. Therefore, in a septic tank the removal of TCS from wastewater is mainly determined by the removal of suspended particles by sedimentation. Over 5 days of hydraulic residence time...... subsequent sorption onto the septic sludge....
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Herpes Can Happen to Anyone: Share Facts, Not Fears
... promiscuous. Links Oral Herpes Sexually Transmitted Diseases Genital Herpes (CDC) Genital Herpes Fact Sheet (CDC) What You Need to Know About Genital Herpes Video (CDC) References Vaccination to Reduce Reactivation of ...
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Stremel, Kathleen
This document consists of three separately published fact sheets combined here because of the close relationship of their subject matter. The first fact sheet, "Communication Interactions: It Takes Two" (Kathleen Stremel), defines communication; suggests ways to find opportunities for interactive communication; offers specific suggestions for…
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Enhancing Tribal Energy Security and Clean Energy (Fact Sheet)
Energy Technology Data Exchange (ETDEWEB)
2013-07-01
This fact provides information on the Strategic Technical Assistance Response Team (START) Program, a U.S. Department of Energy Office of Indian Energy Policy and Programs (DOE-IE) initiative to provide technical expertise to support the development of next-generation energy projects in Indian Country.
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Septic arthritis caused by Peptostreptococcus asaccharolyticus
Directory of Open Access Journals (Sweden)
Carlos Costa
2016-07-01
Full Text Available Peptostreptococcus spp are commensal organisms, usually involved in periodontal disease. Peptostreptococcus asaccharolyticus is an anaerobic gram-negative cocci, difficult to isolate due to its slow growth. Septic arthritis by this microorganism is a rare entity, but it can occur by hematogenous dissemination from a distant focus. Colonization and growth are more likely to occur in an already damaged articulation. We report the case of a 57 year-old woman with peripheral spondyloarthritis who developed knee septic arthritis by Peptostreptococcus asaccharolyticus.
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Dopamine versus noradrenaline in septic shock
Directory of Open Access Journals (Sweden)
Bo Xu
2011-10-01
Full Text Available BackgroundThe ‘Surviving Sepsis’ Campaign guidelines recommend theuse of dopamine or noradrenaline as the first vasopressor inseptic shock. However, information that guides clinicians inchoosing between dopamine and noradrenaline as the firstvasopressor in patients with septic shock is limited.ObjectiveThis article presents a review of the literature regarding theuse of dopamine versus noradrenaline in patients with septicshock.ResultsTwo randomised controlled trials (RCT and two largeprospective cohort studies were analysed. RCT data showeddopamine was associated with increased arrhythmic events.One cohort study found dopamine was associated with higher30-day mortality. The other cohort study found noradrenalinewas associated with higher 28-day mortality.DiscussionData on the use of dopamine versus noradrenaline in patientswith septic shock is limited. Following the recent SOAP IIstudy, there is now strong evidence that the use of dopaminein septic shock is associated with significantly morecardiovascular adverse events, compared tonoradrenaline.ConclusionNoradrenaline should be used as the initial vasopressor inseptic shock to avoid the arrhythmic events associatedwith dopamine.
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Sepsis and Septic Shock Strategies.
Armstrong, Bracken A; Betzold, Richard D; May, Addison K
2017-12-01
Three therapeutic principles most substantially improve organ dysfunction and survival in sepsis: early, appropriate antimicrobial therapy; restoration of adequate cellular perfusion; timely source control. The new definitions of sepsis and septic shock reflect the inadequate sensitivity, specify, and lack of prognostication of systemic inflammatory response syndrome criteria. Sequential (sepsis-related) organ failure assessment more effectively prognosticates in sepsis and critical illness. Inadequate cellular perfusion accelerates injury and reestablishing perfusion limits injury. Multiple organ systems are affected by sepsis and septic shock and an evidence-based multipronged approach to systems-based therapy in critical illness results in improve outcomes. Copyright © 2017 Elsevier Inc. All rights reserved.
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Evaluation of Coagulation Profiles in Dogs with Septic Shock
YILMAZ, Zeki; YALÇIN, Ebru
2002-01-01
The aim of the this study was to observe possible changes in coagulation profiles in dogs with septic shock. A total of 30 dogs (control group n=10, test group n=20) were used as materials in this study. Although different diseases leading to septic shock were diagnosed in dogs in the test group, dogs were selected on the basis of septic shock criteria such as fever or hypothermia, hypotension, leukopenia or leukocytosis and thrombocytopenia. In addition to the results of rutine clinical and...
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Facts about food irradiation: Nutritional quality of irradiated foods
International Nuclear Information System (INIS)
1991-01-01
This fact sheet briefly considers the nutritional value of irradiated foods. Micronutrients, especially vitamins, are sensitive to any food processing method, but irradiation does not cause any special nutritional problems in food. 4 refs
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Rocky Mountain Research Station USDA Forest Service
2005-01-01
The Guide to Fuel Treatments analyzes a range of potential silvicultural thinnings and surface fuel treatments for 25 representative dry-forest stands in the Western United States. The guide provides quantitative guidelines and visualization for treatment based on scientific principles identified for reducing potential crown fires. This fact sheet identifies the...
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Caloric requirement of the critically ill septic patient
International Nuclear Information System (INIS)
Shizgal, H.M.; Martin, M.F.
1988-01-01
The caloric requirement of the critically ill septic patient was determined by measuring body composition, by multiple isotope dilution, before and at 2-wk intervals while receiving total parenteral nutrition (TPN) in 86 septic and 57 nonseptic malnourished patients. All patients received a TPN solution containing 25% dextrose and 2.75% crystalline amino acids. The body composition of the nonseptic patients, who received 51.9 +/- 1.5 kcal/kg.day, improved significantly, while that of the septic patients, receiving 46.8 +/- 1.1 kcal/kg.day was only maintained. The relationship between caloric intake and the restoration of a malnourished body cell mass (BCM) was determined for each group by correlating, using multiple linear regression, the mean daily change in the BCM with the caloric intake and the nutritional state, as determined by body composition. According to the resultant regressions, an intake of 35.1 and 50.7 kcal/kg.day was required to maintain the BCM of the septic and nonseptic patients, respectively. To restore a depleted BCM, caloric intakes in excess of this amount are required
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Facts about food irradiation: Chemical changes in irradiated foods
International Nuclear Information System (INIS)
1991-01-01
This fact sheet addresses the safety of irradiated food. The irradiation process produces very little chemical change in food, and laboratory experiments have shown no harmful effects in animals fed with irradiated milk powder. 3 refs
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Control groups in recent septic shock trials
DEFF Research Database (Denmark)
Pettilä, Ville; Hjortrup, Peter B; Jakob, Stephan M
2016-01-01
PURPOSE: The interpretation of septic shock trial data is profoundly affected by patients, control intervention, co-interventions and selected outcome measures. We evaluated the reporting of control groups in recent septic shock trials. METHODS: We searched for original articles presenting......, and mortality outcomes, and calculated a data completeness score to provide an overall view of quality of reporting. RESULTS: A total of 24 RCTs were included (mean n = 287 patients and 71 % of eligible patients were randomized). Of the 24 studies, 14 (58 %) presented baseline data on vasopressors and 58...... % the proportion of patients with elevated lactate values. Five studies (21 %) provided data to estimate the proportion of septic shock patients fulfilling the Sepsis-3 definition. The mean data completeness score was 19 out of 36 (range 8-32). Of 18 predefined control group characteristics, a mean of 8 (range 2...
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Septic arthritis and subsequent fatal septic shock caused by Vibrio vulnificus infection
DEFF Research Database (Denmark)
Emamifar, Amir; Asmussen Andreasen, Rikke; Andersen, Nanna Skaarup
2015-01-01
Vibrio vulnificus is a rare but potential fatal bacterium that can cause severe infections. Wound infections, primary sepsis and gastroenteritis are the most common clinical features. Septic arthritis caused by V. vulnificus is an atypical presentation that has been reported in only two case...
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International Nuclear Information System (INIS)
Anderson, O.A.; Baker, W.R.; Ise, J. Jr.; Kunkel, W.B.; Pyle, R.V.; Stone, J.M.
1958-01-01
Three types of sheet-like discharges are being studied at Berkeley. The first of these, which has been given the name 'Triax', consists of a cylindrical plasma sleeve contained between two coaxial conducting cylinders A theoretical analysis of the stability of the cylindrical sheet plasma predicts the existence of a 'sausage-mode' instability which is, however, expected to grow more slowly than in the case of the unstabilized linear pinch (by the ratio of the radial dimensions). The second pinch device employs a disk shaped discharge with radial current guided between flat metal plates, this configuration being identical to that of the flat hydromagnetic capacitor without external magnetic field. A significant feature of these configurations is the absence of a plasma edge, i.e., there are no regions of sharply curved magnetic field lines anywhere in these discharges. The importance of this fact for stability is not yet fully investigated theoretically. As a third configuration a rectangular, flat pinch tube has been constructed, and the behaviour of a flat plasma sheet with edges is being studied experimentally
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Preliminary characterization of abandoned septic tank systems. Volume 1
International Nuclear Information System (INIS)
1995-12-01
This report documents the activities and findings of the Phase I Preliminary Characterization of Abandoned Septic Tank Systems. The purpose of the preliminary characterization activity was to investigate the Tiger Team abandoned septic systems (tanks and associated leachfields) for the purpose of identifying waste streams for closure at a later date. The work performed was not to fully characterize or remediate the sites. The abandoned systems potentially received wastes or effluent from buildings which could have discharged non-domestic, petroleum hydrocarbons, hazardous, radioactive and/or mixed wastes. A total of 20 sites were investigated for the preliminary characterization of identified abandoned septic systems. Of the 20 sites, 19 were located and characterized through samples collected from each tank(s) and, where applicable, associated leachfields. The abandoned septic tank systems are located in Areas 5, 12, 15, 25, and 26 on the Nevada Test Site
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Facts about food irradiation: Packaging of irradiated foods
International Nuclear Information System (INIS)
1991-01-01
This fact sheet considers the effects on packaging materials of food irradiation. Extensive research has shown that almost all commonly used food packaging materials toted are suitable for use. Furthermore, many packaging materials are themselves routinely sterilized by irradiation before being used. 2 refs
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[Surgical intensive care medicine. Current therapy concepts for septic diseases].
Niederbichler, A D; Ipaktchi, K; Jokuszies, A; Hirsch, T; Altintas, M A; Handschin, A E; Busch, K H; Gellert, M; Steinau, H-U; Vogt, P M; Steinsträsser, L
2009-10-01
The clinical appearance of septic disorders is characterized by an enormous dynamic. The sepsis-induced dysbalance of the immune system necessitates immediate and aggressive therapeutic interventions to prevent further damage progression of the disease to septic shock and multiple organ failure. This includes supportive therapy to normalize and maintain organ and tissue perfusion as well as the identification of the infection focus. In cases where an infectious focus is identified, surgical source control frequently is a key element of the treatment strategy besides pharmacologic and supportive measures. The integrative approach of the management of septic patients requires rapid communication between the involved medical disciplines and the nursing personnel. Therefore, this article outlines current therapeutic concepts of septic diseases as well as central nursing aspects.
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Complex world-sheets from N=2 strings
International Nuclear Information System (INIS)
Barbon, J.L.F.
1996-01-01
We study some properties of target space strings constructed from (2,1) heterotic strings. We argue that world-sheet complexification is a general property of the bosonic sector of such target world-sheets. We give a target space interpretation of this fact and relate it to the non-gaussian nature of free string field theory. We provide several one-loop calculations supporting the stringy construction of critical world-sheets in terms of (2,1) models. Using finite-temperature boundary conditions in the underlying (2,1) string we obtain non-chiral target space spin structures, and point out some of the problems arising for chiral spin structures, such as the heterotic world-sheet. To this end, we study the torus partition function of the corresponding asymmetric orbifold of the (2,1) string. (orig.)
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Facts about food irradiation: Status and trends
International Nuclear Information System (INIS)
1991-01-01
This fact sheet introduces the concept of irradiating food to reduce post-harvest losses from infestation, contamination and spoilage, to lower the incidence of foodborne diseases and to assist international trade in food products by offering an alternative to fumigation or some other treatments that may not be acceptable to the importing countries
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Radiologic findings of cerebral septic embolism
Energy Technology Data Exchange (ETDEWEB)
Lee, Jee Young; Kim, Sang Joon; Kim Tae Hoon; Kim, Seung Chul; Kim, Jae Seung; Pai, Hyun Joo [Dankook Univ., Seoul (Korea, Republic of). Coll. of Medicine; Kim, Dong Ik [Yonsei Univ., Seoul (Korea, Republic of). Coll. of Medicine; Chang, Kee Hyun [Seoul National Univ. (Korea, Republic of). Coll. of Medicine; Choi, Woo Suk [Kyung Hee Univ., Seoul (Korea, Republic of). Coll. of Medicine
1998-01-01
To determine the MR and CT findings which differentiate cerebral septic embolism from thrombotic infarction. Cerebral septic embolism was confirmed by blood culture in six patients and autopsy in two. The number, size, distribution, contrast enhancement, and hemorrhage of the lesions, as seen on MR and CT, were retrospectively analyzed, and four patients were followed up for between one week and seven months. In a total of eight patients, infective endocarditis (n=5) and sepsis (n=3) caused cerebral septic embolism. The number, of lesions was 3 {approx} 7 in six patients, over 10 in one, and innumerable in one: these varied in size from punctate to 6 cm and were distributed in various areas of the brain. Gyral infarction was noted in five patients: non-enhancing patchy lesions involving the basal ganglia or white matter were found in five, tiny isolated nodular or ring-enhancing small lesions involving the cortex and white matter in three, peripheral rim-enhancing large lesions in one, and numerous enhancing nodules disseminated in the cortex in one. Hemorrhage had occurred in six. follow-up studies in four patients showed that initial lesions had enlarged in two and regressed in two: new lesions had appeared in two. Multiple lesions of different sizes and various patterns which include gyral infarction, patchy or nodular lesion in the cortex, white mater of basal ganglia, and isolated small ring-like or nodular enhancement or frequent hemorrhage are findings which could be helpful in the radiologic diagnosis of cerebral septic embolism. (author). 8 refs., 5 figs.
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Radiologic findings of cerebral septic embolism
International Nuclear Information System (INIS)
Lee, Jee Young; Kim, Sang Joon; Kim Tae Hoon; Kim, Seung Chul; Kim, Jae Seung; Pai, Hyun Joo; Kim, Dong Ik; Chang, Kee Hyun; Choi, Woo Suk
1998-01-01
To determine the MR and CT findings which differentiate cerebral septic embolism from thrombotic infarction. Cerebral septic embolism was confirmed by blood culture in six patients and autopsy in two. The number, size, distribution, contrast enhancement, and hemorrhage of the lesions, as seen on MR and CT, were retrospectively analyzed, and four patients were followed up for between one week and seven months. In a total of eight patients, infective endocarditis (n=5) and sepsis (n=3) caused cerebral septic embolism. The number, of lesions was 3 ∼ 7 in six patients, over 10 in one, and innumerable in one: these varied in size from punctate to 6 cm and were distributed in various areas of the brain. Gyral infarction was noted in five patients: non-enhancing patchy lesions involving the basal ganglia or white matter were found in five, tiny isolated nodular or ring-enhancing small lesions involving the cortex and white matter in three, peripheral rim-enhancing large lesions in one, and numerous enhancing nodules disseminated in the cortex in one. Hemorrhage had occurred in six. follow-up studies in four patients showed that initial lesions had enlarged in two and regressed in two: new lesions had appeared in two. Multiple lesions of different sizes and various patterns which include gyral infarction, patchy or nodular lesion in the cortex, white mater of basal ganglia, and isolated small ring-like or nodular enhancement or frequent hemorrhage are findings which could be helpful in the radiologic diagnosis of cerebral septic embolism. (author). 8 refs., 5 figs
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Enhancement of a UASB-septic tank performance for decentralised treatment of strong domestic sewage.
Mahmoud, Nidal; van Lier, Jules B
2011-01-01
The possibility of enhancing the process performance of the UASB-septic tank for treating strong sewage in Palestine by means of inoculating the reactor with well adapted anaerobic sludge and/or adding a packing media to the upper part of the reactor, creating an anaerobic hybrid (AH)-septic tank, was investigated. To achieve these objectives, two community onsite UASB-septic tank and AH-septic tank were operated in parallel at 2 days HRT for around 8 months overlapping the cold and hot periods of the year in Palestine. The achieved removal efficiencies of CODtot in the UASB-septic tank and AH-septic tank during the first months of operation, coinciding with the cold period and the subsequent hot period, were respectively 50 (+/- 15)% and 48 (+/- 15)% and 66 (+/- 8)% and 55 (+/- 8)%. This shows that the UASB-septic tank performed significantly better (p septic tank after rather long periods of operation. The difference in the CODtot removal efficiency was mainly due to the better CODss removal efficiencies in the UASB-septic tank. The removal efficiencies over the last 50 days of operation for CODtot, CODsus, CODcol and CODdis were 70, 72, 77 and 55% and 53, 54, 78 and 45% for the UASB-septic tank and AH-septic tank, respectively. Comparing the here achieved COD removal efficiencies with previously reported efficiencies of UASB-septic tanks operated in Palestine shows that the reactor performance in terms of COD removal and conversion, during the first 8 months of operation, has improved substantially by being started with well adapted anaerobic sludge, simulating and predicting long-term performance. Adding packing media did not lead to an improvement.
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Cote, Mark P
2018-03-01
Septic arthritis is a rare but potentially devastating complication after anterior cruciate ligament (ACL) reconstruction. Studies examining surgical treatment options including graft retention and removal are largely inconclusive. Although the literature indicated that 43.8% of patients who have the graft removed later go on to have a revision ACL reconstruction compared with only 6.5% among those whose graft is retained, this expected-value decision analysis found removal to be the optimal treatment for patients with septic arthritis after ACL reconstruction. This is largely based on patient preference to avoid a late reoperation for residual knee infection. These findings support the concept of utility when considering treatment options for patients with a septic knee. For some, avoiding a late reoperation for a persistent infection is the most important factor and as such graft removal may be the most appropriate treatment to produce a positive outcome among these patients despite the fact that currently, an attempt at graft retention could represent the generally preferred treatment option among practicing surgeons. Copyright © 2017. Published by Elsevier Inc.
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Directory of Open Access Journals (Sweden)
Neda Hashemi-Sadraei
2014-01-01
Full Text Available Infective endocarditis (IE is infrequently associated with septic arthritis. Moreover, septic arthritis of the acromioclavicular (AC joint is rarely reported in the literature. We report a case of Streptococcus pneumoniae IE in a patient who presented with bilateral AC joint septic arthritis and we review the literature on the topic.
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MR imaging of transient synovitis: differentiation from septic arthritis
International Nuclear Information System (INIS)
Yang, W.J.; Im, S.A.; Lim, G.Y.; Chun, H.J.; Jung, N.Y.; Sung, M.S.; Choi, B.G.
2006-01-01
Transient synovitis is the most common cause of acute hip pain in children. However, MR imaging findings in transient synovitis and the role of MR imaging in differentiating transient synovitis from septic arthritis have not been fully reported. To describe the MR findings of transient synovitis and to determine whether the MR characteristics can differentiate this disease entity from septic arthritis. Clinical findings and MR images of 49 patients with transient synovitis (male/female 36/13, mean age 6.1 years) and 18 patients with septic arthritis (male/female 10/8, mean age 4.9 years) were retrospectively reviewed. MR findings of transient synovitis were symptomatic joint effusion, synovial enhancement, contralateral joint effusion, synovial thickening, and signal intensity (SI) alterations and enhancement in surrounding soft tissue. Among these, SI alterations and enhancement in bone marrow and soft tissue, contralateral joint effusion, and synovial thickening were statistically significant MR findings in differentiating transient synovitis from septic arthritis. The statistically significant MR findings in transient synovitis are contralateral (asymptomatic) joint effusions and the absence of SI abnormalities of the bone marrow. It is less common to have SI alterations and contrast enhancement of the soft tissues. The statistically significant MR findings in septic arthritis are SI alterations of the bone marrow, and SI alterations and contrast enhancement of the soft tissue. Ipsilateral effusion and synovial thickening and enhancement are present in both diseases
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Septic wastewater treatment using recycled rubber particles as biofiltration media.
Oh, Jin Hwan; Park, Jaeyoung; Ellis, Timothy G
2014-01-01
Performance of the laboratory-scale recycled rubber particles (RRP) biofilter was compared to a conventional gravel system and a peat biofilter for treatment of septic tank effluent. During the study, the RRP biofilter provided similar or better performance than other systems in terms of organic removal and hydraulic capacity. After the start-up period, RRP biofilter achieved removal efficiencies for BOD5, total suspended solids (TSS), ammonia nitrogen of 96%, 93%, and 90%, respectively, over the range of hydraulic loading rates of 57-204 L/m2/d. On the other hand, the peat biofilter failed hydraulically and the gravel system showed high TSS concentrations in the effluent. RRP provided high surface area and sufficient time for biological treatment. In addition, RRP was observed to provide ammonia adsorption capacity. The results showed that RRP has the potential to be used as substitutes for natural aggregate such as gravel in septic system drainfields. The RRP biofilter can be used as alternative septic systems for the sites where an existing septic system has failed or site conditions, such as high groundwater table or small lot size, are not suitable for the installation of conventional septic systems.
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Facts about food irradiation: Irradiation and food additives and residues
International Nuclear Information System (INIS)
1991-01-01
This fact sheet considers the issue of the irradiation of food containing food additives or pesticide residues. The conclusion is that there is no health hazard posed by radiolytic products of pesticides or food additives. 1 ref
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Higher vs. lower haemoglobin threshold for transfusion in septic shock
DEFF Research Database (Denmark)
Rygård, S L; Holst, L B; Wetterslev, J
2017-01-01
. a lower haemoglobin threshold. METHODS: In post-hoc analyses of the full trial population of 998 patients from the Transfusion Requirements in Septic Shock (TRISS) trial, we investigated the intervention effect on 90-day mortality in patients with severe comorbidity (chronic lung disease, haematological......BACKGROUND: Using a restrictive transfusion strategy appears to be safe in sepsis, but there may be subgroups of patients who benefit from transfusion at a higher haemoglobin level. We explored if subgroups of patients with septic shock and anaemia had better outcome when transfused at a higher vs.......51), in those who had undergone surgery (P = 0.99) or in patients with septic shock by the new definition (P = 0.20). CONCLUSION: In exploratory analyses of a randomized trial in patients with septic shock and anaemia, we observed no survival benefit in any subgroups of transfusion at a haemoglobin threshold...
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Simple deterministic model of the hydraulic buffer effect in septic tanks
Forquet, N.; Dufresne, M.
2015-01-01
Septic tanks are widely used in on-site wastewater treatment systems. In addition to anaerobic pre-treatment, hydraulic buffering is one of the roles attributed to septic tanks. However there is still no tool for assessing it, especially in dynamic conditions. For gravity fed system, it could help both researchers and system designers. This technical note reports a simple mechanistic model based on the assumption of flow transition between the septic tank and the outflow pipe. The only parame...
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Treatment of domestic wastewater using conventional and baffled septic tanks.
Nasr, Fayza Aly; Mikhaeil, Basem
2013-01-01
The main theme of the study was a comparative study of domestic wastewater treatment using conventional and baffled septic tanks. The septic tanks were fed continuously with domestic wastewater at three different hydraulic retention times (HRTs). The HRTs chosen were 24, 48 and 72 h with corresponding organic loads of 0.321, 0.436 and 0.885 kg chemical oxygen demand (COD) per m3 per day, respectively. The performance of the septic tanks at the three HRTs gave satisfactory results. For the conventional septic tank, COD removal was 53.4%, 56% and 65.3%, at an HRT of 24, 48 and 72 h, respectively, with residual COD of 412, 380 and 334mg/l, respectively. At HRTs of 72, 48 and 24 h, the following percentages removals were realized for: biochemical oxygen demand (BOD), 68.4%, 57, 53.5%; total suspended solid (TSS), 65.3%, 58.3, 55%; phosphorus, 29.3%, 26.9, 25.6%; total Kjeldahl nitrogen 26.8%, 20.8, 17.7%, respectively. On the contrary, ammonia concentrations increased by 7.1%, 5.2 and 4.2% under the same conditions. Consequently, the results showed that the removal of fecal coliform at all HRTs was less than one log. The two baffled septic tanks exhibited superior results at HRTs of 72, 48 and 24 h. Comparing the treated domestic wastewater quality produced by the two types of septic tanks in terms of physico-chemical and biological characteristics, better results were obtained using the two baffles type.
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Directory of Open Access Journals (Sweden)
A.B. Johan Groeneveld
2016-03-01
Conclusions: In septic and non-septic shock, NT-proBNP elevations reflect systolic left ventricular dysfunction and are associated with a poor outcome. They may help recognition of cardiac dysfunction in shock and its management when invasive hemodynamic monitoring is not yet instituted.
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Arrubla, Juan Pablo; Cubillos, Janneth A.; Ramírez Vargas, Carlos Andrés; Arredondo, Jhon Alexander; Arias, Carlos A.; Paredes, Diego
2016-01-01
In several countries around the world, Pharmaceutical and Personal Care Products (PPCPs) exist in aquatic environments, a fact that increases the awareness within the scientific community with respect to their possible fate and environment effects. This research presents a preliminary monitoring of use, consumption and presence of PPCPs in wastewater from a treatment plant in a rural area of Pereira (Colombia). Domestic sewage is treated in a septic tank followed by an Up-Flow Anaerobic Filte...
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Red blood cell transfusion during septic shock in the ICU
DEFF Research Database (Denmark)
Perner, A; Smith, S H; Carlsen, S
2012-01-01
Transfusion of red blood cells (RBCs) remains controversial in patients with septic shock, but current practice is unknown. Our aim was to evaluate RBC transfusion practice in septic shock in the intensive care unit (ICU), and patient characteristics and outcome associated with RBC transfusion....
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Facts about food irradiation: Food irradiation costs
International Nuclear Information System (INIS)
1991-01-01
This fact sheet gives the cost of a typical food irradiation facility (US $1 million to US $3 million) and of the food irradiation process (US $10-15 per tonne for low-dose applications; US $100-250 per tonne for high-dose applications). These treatments also bring consumer benefits in terms of availability, storage life and improved hygiene. 2 refs
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Retainment of the antimicrobial agent triclosan in a septic tank.
Kirjanova, Ala; Rimeika, Mindaugas; Vollertsen, Jes; Nielsen, Asbjørn Haaning
2014-01-01
Laboratory experiments were conducted to investigate the fate of the antimicrobial agent triclosan (TCS) in a conventional septic tank. The main mechanism of TCS removal from wastewater was identified to be rapid TCS sorption to suspended particles followed by settling of these particles to the bottom of the septic tank. Sorption to particles was completed within minutes while the settling took several days. Therefore, in a septic tank the removal of TCS from wastewater is mainly determined by the removal of suspended particles by sedimentation. Over 5 days of hydraulic residence time the initial dissolved TCS concentration of 100 μg L(-1) was reduced by 87 ± 8%. During the first 24 hours, 66-86% of all removed TCS was retained, whereas during the remainder of the experiment a slight but steady decrease in TCS concentration was observed. This was most likely caused by TCS diffusion and its subsequent sorption onto the septic sludge.
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The septic versus nonseptic inflamed joint: MRI characteristics
International Nuclear Information System (INIS)
Graif, M.; Schweitzer, M.E.; Deely, D.; Matteucci, T.
1999-01-01
Objective. To differentiate the MR features of septic versus nonseptic inflamed joints.Design and patients. Thirty patients were referred for MRI with inflamed joints (19 were subsequently found to be septic and 11 nonseptic). At 1.5 T enhanced MRI five groups of signs related to joint space, synovium, cartilage, bone and peri-articular soft tissue respectively were assessed and compared between the septic and nonseptic groups.Results. The prevalence of MRI findings in septic versus nonseptic joints (respectively) was as follows: effusion (79% vs 82%), fluid outpouching (79% vs 73%), fluid heterogeneity (21% vs 27%), synovial thickening (68% vs 55%), synovial periedema (63% vs 55%), synovial enhancement (94% vs 88%), cartilage loss (53% vs 30%), bone erosions (79% vs 38%), bone erosions enhancement (77% vs 43%), bone marrow edema (74% vs 38%), bone marrow enhancement (67% vs 50%), soft tissue edema (63% vs 78%), soft tissue enhancement (67% vs 71%), periosteal edema (11% vs. 10%). The presence of bone erosions appeared to be an indicator for an infected joint (P=0.072); coexistence of bone marrow edema slightly improves the significance (0.068). A similar trend was obtained when combining bone erosions with either synovial thickening, synovial periedema, bone marrow enhancement or soft tissue edema (P=0.075).Conclusions. The combination of bone erosions with marrow edema is highly suggestive for a septic articulation; the additional coexistence of synovial thickening, synovial edema, soft tissue edema or bone marrow enhancement increases the above level of confidence. Similar to conventional radiography, the single sign that appeared to show a significant trend was the presence of bone erosions. However, no single sign or combination could either be considered pathognomonic or exclude the presence of a joint infection. (orig.)
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Microbial Load in Septic and Aseptic Procedure Rooms.
Harnoss, Julian-Camill; Assadian, Ojan; Diener, Markus Karl; Müller, Thomas; Baguhl, Romy; Dettenkofer, Markus; Scheerer, Lukas; Kohlmann, Thomas; Heidecke, Claus-Dieter; Gessner, Stephan; Büchler, Markus Wolfgang; Kramer, Axel
2017-07-10
Highly effective measures to prevent surgical wound infections have been established over the last two decades. We studied whether the strict separation of septic and aseptic procedure rooms is still necessary. In an exploratory, prospective observational study, the microbial concentration in an operating room without a room ventilating system (RVS) was analyzed during 16 septic and 14 aseptic operations with the aid of an air sampler (50 cm and 1 m from the operative field) and sedimentation plates (1 m from the operative field, and contact culture on the walls). The means and standard deviations of the microbial loads were compared with the aid of GEE models (generalized estimation equations). In the comparison of septic and aseptic operations, no relevant differences were found with respect to the overall microbial concentration in the room air (401.7 ± 176.3 versus 388.2 ± 178.3 CFU/m 3 ; p = 0.692 [CFU, colony-forming units]) or sedimentation 1 m from the operative field (45.3 ± 22.0 versus 48.7 ± 18.5 CFU/m 2 /min; p = 0.603) and on the walls (35.7 ± 43.7 versus 29.0 ± 49.4 CFU/m 2 /min; p = 0.685). The only relevant differences between the microbial spectra associated with the two types of procedure were a small amount of sedimentation of Escherichia coli and Enterococcus faecalis in septic operations, and of staphylococcus aureus and pseudomonas stutzeri in aseptic operations, up to 30 minutes after the end of the procedure. These data do not suggest that septic and aseptic procedure rooms need to be separated. In interpreting the findings, one should recall that the study was not planned as an equivalence or non-inferiority study. Wherever patient safety is concerned, high-level safety concepts should only be demoted to lower levels if new and convincing evidence becomes available.
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Septic Arthritis of The Hip Joint presenting as Acute Abdomen ...
African Journals Online (AJOL)
These cases illustrate the maxim that any painful movement of the hip joint with associated unexplained fever should raise suspicion of septic arthritis. The close relationship of the hip joint to the pelvis sometimes confuses hip diseases with pelvic pathologies. Key Words: Septic arthritis, acute abdomen, pathological ...
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Anaerobic treatment of domestic sewage in modified septic tanks at low temperature.
Chen, Zhiqiang; Wen, Qinxue; Guan, Huabin; Bakke, Rune; Ren, Nanqi
2014-01-01
Three laboratory-scale septic tanks, an anaerobic baffled reactor (ABR)-septic tank (R1), a Yuhuan drawing three-dimensional-carrier-septic tank (R2) and a conventional septic tank (R3), were operated in parallel over half a year under hydraulic retention times (HRTs) of 36, 24 and 12 h, with a sewage temperature of 16 degrees C. The removal efficiencies of total chemical oxygen demand (CODtot) achieved in R1 and R2 increased by 14%, 21% and 12% and 18%, 3% and 16%, respectively, under three different HRTs, as compared to those in R3. The total nitrogen and phosphorus removal efficiencies were negligible. R1 sludges had a higher specific methane production rate as compared to that of R2 and R3 sludges. The results indicated that the two modified septic tanks can improve the performance in terms of COD and total solids removal, both were suitable technologies for domestic sewage (pre) treatment at low temperature in northern China.
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Edul, Vanina S. Kanoore; Enrico, Carolina; Laviolle, Bruno; Vazquez, Alejandro Risso; Ince, Can; Dubin, Arnaldo
2012-01-01
The microcirculation of septic patients has been characterized only semiquantitatively. Our goal was to characterize the sublingual microcirculation in healthy volunteers and patients with septic shock quantitatively. Our hypotheses were that 1) hyperdynamic blood flow is absent in septic shock; 2)
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Asthma and Environment Fact Sheet for Parents and Schools. Revised
Healthy Schools Network, Inc., 2012
2012-01-01
Important facts about asthma and the environment include: (1) Asthma has reached epidemic proportions in the United States, affecting about 25 million people of all ages and races, including about 7 million children; (2) Nearly one in 10 school-aged children has asthma, and the percentage of children with asthma is rising more rapidly in…
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Facts about food irradiation: Irradiated foods and the consumer
International Nuclear Information System (INIS)
1991-01-01
This fact sheet discusses market testing of irradiate food, consumer response to irradiated products has always been positive, and in some countries commercial quantities of some irradiated food items have been sold on a regular basis. Consumers have shown no reluctance to buy irradiated food products. 4 refs
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Energy Technology Data Exchange (ETDEWEB)
2012-07-01
This fact sheet describes how the SJ3 solar cell was invented, explains how the technology works, and why it won an R&D 100 Award. Based on NREL and Solar Junction technology, the commercial SJ3 concentrator solar cell - with 43.5% conversion efficiency at 418 suns - uses a lattice-matched multijunction architecture that has near-term potential for cells with {approx}50% efficiency. Multijunction solar cells have higher conversion efficiencies than any other type of solar cell. But developers of utility-scale and space applications crave even better efficiencies at lower costs to be both cost-effective and able to meet the demand for power. The SJ3 multijunction cell, developed by Solar Junction with assistance from foundational technological advances by the National Renewable Energy Laboratory, has the highest efficiency to date - almost 2% absolute more than the current industry standard multijunction cell-yet at a comparable cost. So what did it take to create this cell having 43.5% efficiency at 418-sun concentration? A combination of materials with carefully designed properties, a manufacturing technique allowing precise control, and an optimized device design.
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Facts about food irradiation: Irradiation and food safety
International Nuclear Information System (INIS)
1991-01-01
This fact sheet focusses on the question of whether irradiation can be used to make spoiled food good. No food processing procedures can substitute for good hygienic practices, and good manufacturing practices must be followed in the preparation of food whether or not the food is intended for further processing by irradiation or any other means. 3 refs
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Yang, Yun-Ya; Toor, Gurpal S; Wilson, P Chris; Williams, Clinton F
2017-10-15
Septic systems may contribute micropollutants to shallow groundwater and surface water. We constructed two in situ conventional drainfields (drip dispersal and gravel trench) and an advanced drainfield of septic systems to investigate the fate and transport of micropollutants to shallow groundwater. Unsaturated soil-water and groundwater samples were collected, over 32 sampling events (January 2013 to June 2014), from the drainfields (0.31-1.07 m deep) and piezometers (3.1-3.4 m deep). In addition to soil-water and groundwater, effluent samples collected from the septic tank were also analyzed for 20 selected micropollutants, including wastewater markers, hormones, pharmaceuticals and personal care products (PPCPs), a plasticizer, and their transformation products. The removal efficiencies of micropollutants from septic tank effluent to groundwater were similar among three septic systems and were 51-89% for sucralose and 53->99% for other micropollutants. Even with high removal rates within the drainfields, six PPCPs and sucralose with concentrations ranging from septic systems to ecosystem and human health is warranted for the long-term sustainability of septic systems. Copyright © 2017 Elsevier Ltd. All rights reserved.
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Early fluid loading for septic patients: Any safety limit needed?
Gong, Yi-Chun; Liu, Jing-Tao; Ma, Peng-Lin
2018-02-01
Early adequate fluid loading was the corner stone of hemodynamic optimization for sepsis and septic shock. Meanwhile, recent recommended protocol for fluid resuscitation was increasingly debated on hemodynamic stability vs risk of overloading. In recent publications, it was found that a priority was often given to hemodynamic stability rather than organ function alternation in the early fluid resuscitation of sepsis. However, no safety limits were used at all in most of these reports. In this article, the rationality and safety of early aggressive fluid loading for septic patients were discussed. It was concluded that early aggressive fluid loading improved hemodynamics transitorily, but was probably traded off with a follow-up organ function impairment, such as worsening oxygenation by reduction of lung aeration, in a part of septic patients at least. Thus, a safeguard is needed against unnecessary excessive fluids in early aggressive fluid loading for septic patients. Copyright © 2017 Daping Hospital and the Research Institute of Surgery of the Third Military Medical University. Production and hosting by Elsevier B.V. All rights reserved.
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Mycotic aneurysm of the superior mesenteric artery after septic embolism
International Nuclear Information System (INIS)
Schmidt, F.; Dinkel, H.P.
2002-01-01
Mycotic aneurysms of the aorta and the visceral arteries are life-threatening diseases, due to potential rupture and organ or limb ischemia. They occur in endocarditis, immunodeficiency, bacteremia and fungemia, and have a poor prognosis.We report on a case of a 54-year-old male patient suffering from abdominal angina after mitral valve replacement for septic mycotic endocarditis. In presence of a mycotic-embolic occlusion of the left popliteal artery and multiple septic organ infarctions a mycotic aneurysm of the superior mesenteric artery was found in abdominal spiral-CT.Based on sequential spiral-CT examinations, this case demonstrates the development of a septic aneurysm of the superior mesenteric artery. (orig.) [de
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Effluent migration from septic tank systems in two different lithologies, Broward County, Florida
Waller, B.G.; Howie, Barbara; Causaras, C.R.
1987-01-01
Two septic tank test sites, one in sand and one in limestone, in Broward County, Florida, were analyzed for effluent migration. Groundwater from shallow wells, both in background areas and hydraulically down-gradient of the septic tank system, was sampled during a 16-month period from April 1983 through August 1984. Water quality indicators were used to determine the effluent affected zone near the septic tank systems. Specific conductance levels and concentrations of chloride, sulfate, ammonium, and nitrate indicated effluent movement primarily in a vertical direction with abrupt dilution as it moved down-gradient. Effluent was detected in the sand to a depth more than 20 ft below the septic tank outlet, but was diluted to near background conditions 50 ft down-gradient from the tank. Effluent in the limestone was detected in all three observation wells to depths exceeding 25 ft below the septic tank outlet and was diluted, but still detectable, 40 ft down-gradient. The primary controls on effluent movement from septic tank systems in Broward County are the lithology and layering of the geologic materials, hydraulic gradients, and the volume and type of use the system receives. (Author 's abstract)
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Inhibition of skeletal muscle protein synthesis in septic intra-abdominal abscess
International Nuclear Information System (INIS)
Vary, T.C.; Siegel, J.H.; Tall, B.D.; Morris, J.G.; Smith, J.A.
1988-01-01
Chronic sepsis is always associated with profound wasting leading to increased release of amino acids from skeletal muscle. Net protein catabolism may be due to decreased rate of synthesis, increased rate of degradation, or both. To determine whether protein synthesis is altered in chronic sepsis, the rate of protein synthesis in vivo was estimated by measuring the incorporation of [ 3 H]-phenylalanine in skeletal muscle protein in a chronic (5-day) septic rat model induced by creation of a stable intra-abdominal abscess using an E. coli + B. fragilis-infected sterile fecal-agar pellet as foreign body nidus. Septic rats failed to gain weight at rates similar to control animals, therefore control animals were weight matched to the septic animals. The skeletal muscle protein content in septic animals was significantly reduced relative to control animals (0.18 +/- 0.01 vs. 0.21 +/- 0.01 mg protein/gm wet wt; p less than 0.02). The rate of incorporation of [ 3 H]-phenylalanine into skeletal muscle protein from control animals was 39 +/- 4 nmole/gm wet wt/hr or a fractional synthetic rate of 5.2 +/- 0.5%/day. In contrast to control animals, the fractional synthetic rate in septic animals (2.6 +/- 0.2%/day) was reduced by 50% compared to control animals (p less than 0.005). The decreased rate of protein synthesis in sepsis was not due to an energy deficit, as high-energy phosphates and ATP/ADP ratio were not altered. This decrease in protein synthesis occurred even though septic animals consumed as much food as control animals
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[Septic pylephlebitis associated with Enterobacter cloacae septicemia].
Amezyane, T; Abouzahir, A; El Kharrass, A; Bassou, D; Fatihi, J; Hammi, S; Mahassin, F; Ghafir, D; Ohayon, V
2010-02-01
Septic pylephlebitis or purulent thrombosis of the portal venous system generally results from a progressive extension of suppurated thrombophlebitis, secondary to an intrabdominal infection. Germs most often found are Escherichia coli and Streptococcus, isolation of Enterobacter cloacae is unusual. We report a particular observation of septic pylephlebitis associated with E. cloacae bacteremia, without biliary, digestive or pancreatic lesion on the CT-scan. The antibiotic sensitivity pattern of the isolated germ and the negative epidemiologic investigation pled in favour of community acquired infection. The infection resolved with antibiotics and anticoagulation, followed by total repermeation of the portal system. Copyright 2009 Elsevier Masson SAS. All rights reserved.
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Glucose utilisation in the lungs of septic rats
International Nuclear Information System (INIS)
Hansson, L.; Jeppsson, B.; Ohlsson, T.; Sandell, A.; Valind, S.; Luts, A.; Wollmer, P.
1999-01-01
Sequestration and degranulation of leucocytes in the pulmonary microcirculation is considered to be a key event in the development of acute respiratory distress syndrome in patients with sepsis. Glucose serves as the main source of energy in activated leucocytes. The aim of this study was to assess whether glucose utilisation in the lungs can be used as an indicator of pulmonary leucocyte accumulation in an experimental model of sepsis of intra-abdominal origin. Sepsis was induced in rats by abdominal implantation of a gelatine capsule containing bacteria and rat colonic contents. Empty gelatine capsules were implanted in control animals. Animals were studied 6 and 12 h after sepsis induction. Glucose utilisation was measured as the tissue uptake of fluorine-18-fluorodeoxyglucose ( 18 FDG) 1 h after intravenous injection of the tracer. Micro-autoradiography was also performed after injection of tritiated deoxyglucose. We found increased uptake of 18 FDG in the lungs of septic animals. The uptake also increased with time after sepsis induction. 18 FDG uptake in circulating leucocytes was increased in septic animals compared with controls, and micro-autoradiography showed intense accumulation of deoxyglucose in leucocytes in the lungs of septic animals. We conclude that glucose utilisation is increased in the lungs of septic rats. Measurements of pulmonary glucose utilisation as an index of leucocyte metabolic activity may open new possibilities for studies of the pathophysiology of sepsis and for evaluation of therapeutic interventions. (orig.)
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IL-1B rs16944 polymorphism is related to septic shock and death.
Jiménez-Sousa, María Ángeles; Medrano, Luz M; Liu, Pilar; Almansa, Raquel; Fernández-Rodríguez, Amanda; Gómez-Sánchez, Esther; Rico, Lucía; Heredia-Rodríguez, María; Gómez-Pesquera, Estefanía; Tamayo, Eduardo; Resino, Salvador
2017-01-01
IL-1β is a primary mediator of systemic inflammatory response syndrome (SIRS) and it may lead to shock septic. Our aim was to analyse whether IL-1B rs16944 polymorphism is associated with the onset of septic shock and death after major surgery. We performed a case-control study on 467 patients who underwent major cardiac or abdominal surgery. Of them, 205 patients developed septic shock (cases, SS group) and 262 patients developed SIRS (controls, SIRS group). The primary outcome variables were the development of septic shock and death within 90 days after diagnosis of septic shock. The IL-1B rs16944 polymorphism was genotyped by Sequenom's MassARRAY platform. The association analysis was performed under a recessive genetic model (AA vs. GG/GC). The frequency of septic shock was higher in patients with IL-1B rs16944 AA genotype than in patients with IL-1B rs16944 GG/AG genotype when all patients were taken into account (63·6% vs. 41·8%; P = 0·006), cardiac surgery (52·2% vs. 33·3%; P = 0·072) and abdominal surgery (76·2% vs. 50·2%; P = 0·023). However, the IL-1B rs16944 AA genotype was only associated with higher likelihood of septic shock in the analysis of all population [adjusted odds ratio (aOR) = 2·26 (95%CI = 1·03; 4·97; P = 0·042], but not when it was stratified by cardiac surgery (P = 0·175) or abdominal surgery (P = 0·467). Similarly, IL-1B rs16944 AA genotype was also associated with higher likelihood of septic shock-related death in all population [aOR = 2·67 (95%CI = 1·07; 4·97); P = 0·035]. IL-1B rs16944 AA genotype seems to be related to the onset of septic shock and death in patients who underwent major surgery. © 2016 Stichting European Society for Clinical Investigation Journal Foundation.
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Bi-directional electrons in the near-Earth plasma sheet
Directory of Open Access Journals (Sweden)
K. Shiokawa
2003-07-01
Full Text Available We have studied the occurrence characteristics of bi-directional electron pitch angle anisotropy (enhanced flux in field-aligned directions, F^ /F|| > 1.5 at energies of 0.1–30 keV using plasma and magnetic field data from the AMPTE/IRM satellite in the near-Earth plasma sheet. The occurrence rate increases in the tailward direction from XGSM = - 9 RE to - 19 RE . The occurrence rate is also enhanced in the midnight sector, and furthermore, whenever the elevation angle of the magnetic field is large while the magnetic field intensity is small, B ~ 15 nT. From these facts, we conclude that the bi-directional electrons in the central plasma sheet are produced mainly in the vicinity of the neutral sheet and that the contribution from ionospheric electrons is minor. A high occurrence is also found after earthward high-speed ion flows, suggesting Fermi-type field-aligned electron acceleration in the neutral sheet. Occurrence characteristics of bi-directional electrons in the plasma sheet boundary layer are also discussed.Key words. Magnetospheric physics (magnetospheric configuration and dynamics; magnetotail; plasma sheet
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DEFF Research Database (Denmark)
Holst, Lars B; Haase, Nicolai; Wetterslev, Jørn
2013-01-01
Requirements in Septic Shock (TRISS) trial is a multicenter trial with assessor-blinded outcome assessment, randomising 1,000 patients with septic shock in 30 Scandinavian ICUs to receive transfusion with pre-storage leuko-depleted RBC suspended in saline-adenine-glucose and mannitol (SAGM) at haemoglobin...
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Numerical and experimental analysis of resistance projection welding of square nuts to sheets
DEFF Research Database (Denmark)
Nielsen, Chris Valentin; Zhang, Wenqi; Martins, Paulo A.F.
2014-01-01
Projection welding of nuts to sheets is a widely utilized manufacturing process in the automotive industry. The process entails challenges due the necessity of joining different sheet thicknesses and nut sizes made from dissimilar materials, and due to the fact of experiencing large local deforma...... of the square nut to the sheet under different operating conditions. © 2014 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license...
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Changes in muscle tissue oxygenation during stagnant ischemia in septic patients.
Pareznik, Roman; Knezevic, Rajko; Voga, Gorazd; Podbregar, Matej
2006-01-01
To determine changes in the rate of thenar muscles tissue deoxygenation during stagnant ischemia in patients with severe sepsis and septic shock. Prospective observational study in the medical ICU of a general hospital. Consecutive patients admitted to ICU with septic shock (n=6), severe sepsis (n=6), localized infection (n=3), and healthy volunteers (n=15). Upper limb ischemia was induced by rapid automatic pneumatic cuff inflation around upper arm. Thenar muscle tissue oxygen saturation (StO2) was measured continuously by near-infrared spectroscopy before and during upper limb ischemia. StO(2) before intervention was comparable in patients with septic shock, severe sepsis, or localized infection and healthy volunteers (89 [65, 92]% vs. 82 [72, 91]% vs. 87 [85, 92]% vs. 83 [79, 93]%, respectively; p>0.1). The rate of StO(2) decrease during stagnant ischemia after initial hemodynamic stabilization was slower in septic shock patients than in those with severe sepsis or localized infection and in controls (-7.0 [-3.6, -11.0] %/min vs. -10.4 [-7.8, -13.3] %/min vs. -19.5 [-12.3, -23.3] vs. -37.4 [-27.3, -56.2] %/min, respectively; p=0.041). At ICU discharge the rate of StO2 decrease did not differ between the septic shock, severe sepsis, and localized infection groups (-17.0 [-9.3, -28.9] %/min vs. -19.9 [-13.3, -23.6] %/min vs. -23.1 [-20.7, -26.2] %/min, respectively), but remained slower than in controls (p<0.01). The rate of StO2 decrease was correlated with Sequential Organ Failure Assessment (SOFA) score (r=0.739, p<0.001). After hemodynamic stabilization thenar muscle tissue oxygen saturation during stagnant ischemia decreases slower in septic shock patients than in patients with severe sepsis or localized infection and in healthy volunteers. During ICU stay and improvement of sepsis the muscle tissue deoxygenation rate increases in survivors of both septic shock and severe sepsis and was correlated with SOFA score.
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Kasch, Richard; Merk, Sebastian; Assmann, Grit; Lahm, Andreas; Napp, Matthias; Merk, Harry; Flessa, Steffen
2017-01-01
Background The most common intermediate and long-term complications of total knee arthroplasty (TKA) include aseptic and septic failure of prosthetic joints. These complications cause suffering, and their management is expensive. In the future the number of revision TKA will increase, which involves a greater financial burden. Little concrete data about direct costs for aseptic and two-stage septic knee revisions with an in depth-analysis of septic explantation and implantation is available. Questions/Purposes A retrospective consecutive analysis of the major partial costs involved in revision TKA for aseptic and septic failure was undertaken to compare 1) demographic and clinical characteristics, and 2) variable direct costs (from a hospital department’s perspective) between patients who underwent single-stage aseptic and two-stage septic revision of TKA in a hospital providing maximum care. We separately analyze the explantation and implantation procedures in septic revision cases and identify the major cost drivers of knee revision operations. Methods A total of 106 consecutive patients (71 aseptic and 35 septic) was included. All direct costs of diagnosis, surgery, and treatment from the hospital department’s perspective were calculated as real purchase prices. Personnel involvement was calculated in units of minutes. Results Aseptic versus septic revisions differed significantly in terms of length of hospital stay (15.2 vs. 39.9 days), number of reported secondary diagnoses (6.3 vs. 9.8) and incision-suture time (108.3 min vs. 193.2 min). The management of septic revision TKA was significantly more expensive than that of aseptic failure ($12,223.79 vs. $6,749.43) (p costs of explantation stage ($4,540.46) were lower than aseptic revision TKA ($6,749.43) which were again lower than those of the septic implantation stage ($7,683.33). All mean costs of stays were not comparable as they differ significantly (p cost drivers were the cost of the implant and
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MR imaging of septic sacroiliitis
Energy Technology Data Exchange (ETDEWEB)
Stuerzenbecher, A.; Hamm, B.; Bollow, M. [Humboldt-Universitaet, Berlin (DD). Bereich Medizin (Charite); Braun, J. [Freie Univ. Berlin (Germany). Universitaetsklinikum Benjamin Franklin; Paris, S. [Unfallkrankenhaus Berlin (Germany). Dept. of Radiology; Biedermann, T. [Krankenhaus Berlin-Buch (Germany). II. Kinderklinik
2000-08-01
Objective. To investigate the diagnostic value of magnetic resonance (MR) imaging in detecting septic sacroiliitis and to determine whether the MR characteristics allow this entity to be differentiated from sacroiliitis in spondylarthropathy (SpA).Patients and design. The imaging findings of 11 patients with septic sacroiliitis were retrospectively analyzed by two experienced radiologists. Radiographic surveys of the pelvis as well as computed tomography (CT) and MR images of the sacroiliac joints were available in all cases. Seven of the patients additionally underwent a follow-up MR examination. The MR imaging protocol comprised combinations of coronal and transverse T1-weighted spin-echo (SE) or fast SE sequences, T2-weighted gradient-echo (GE) sequences and short tau inversion recovery sequence (STIR) sequences as well as dynamic contrast- enhanced T1-weighted acquisitions.Results. Three patients with a short disease history showed anterior and/or posterior subperiosteal infiltrations (''lava cleft phenomenon''), transcapsular infiltrations of juxta-articular muscle layers, which obscured the fasciae, and periarticular bone marrow edema. The eight patients with more advanced stages of sacroiliitis additionally showed abscess formation, sequestration, and erosion. At follow-up MR examination (n=7) under systemic antibiotic treatment, the morphologic characteristics showed progression (n=1), regression (n=4), unchanged findings (n=1), or a mixed response (n=1). Clinical improvement precedes resolution of the MR findings.Conclusions. Anterior and/or posterior subperiosteal infiltrations and transcapsular infiltrations of juxta-articular muscle layers were depicted in all patients. These MR imaging findings are characteristic of septic sacroiliitis and may be used to differentiate this entity from sacroiliitis in SpA. (orig.)
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The Analysis of Septic Tank Performance in Regard to Suspended Solids and Organic Matter Removal
Directory of Open Access Journals (Sweden)
Ala Kirjanova
2011-12-01
Full Text Available Abstract 117 The aim of this work was to evaluate the removal of suspended solids (SS and 7-day biochemical oxygen demand (BOD7 in a three chamber septic tank depending on theoretical wastewater retention time and the degree of septic tank cleanliness. It was found out that the performance of the septic tank depended on the degree of its cleanliness: when the septic tank was clean and retention time was three days, SS and BOS7 removal efficiency was 77±10% and 67±14% respectively, whereas two months later, after septic tank desludging, SS removal efficiency decreased to 53±22% and BOD7 to 32±31%. The performance of the septic tank also depended on theoretical wastewater retention time: when some amount of solids was accumulated at the bottom of the septic tank and wastewater retention time was one day, SS and BOS7 removal efficiency was 45±40% and 33±16% respectively; when retention time was three days, SS removal efficiency increased to 53±22% but BOD7 removal efficiency remained similar to one day retention time, i.e. 32±31%.Article in Lithuanian
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Acute hematogenous septic arthritis of the knee in adults.
Sreenivas, T; Nataraj, A R; Menon, Jagdish
2013-10-01
To evaluate the factors associated with acute hematogenous septic arthritis of the knee in adults and to assess the outcome after open knee arthrotomy. We performed a prospective evaluation of 26 adult patients with acute nongonococcal septic arthritis of the knee presenting within 7 days. All patients underwent open knee arthrotomy, and final evaluation by means of Knee society score of the affected knee was compared with the contra lateral normal knee. The average duration of symptoms at the time of presentation was 3.9 days. Staphylococcus aureus was the commonest bacteria isolated in 17 (65.4 %) patients. The average duration of follow-up in our study was 18.5 months. In our study, Knee society score decreases as the age of the patient advances (P < 0.05) and also it was found to be low (P < 0.05) in the affected knee as compared to contra lateral normal knee. Our study shows that age of the patient at presentation is critical as it shows significant reduction in knee score. This explains that the septic arthritis may contribute to the progression of age-related degeneration of the knee joint. There appears to be no definite contributing factors or conditions associated with acute hematogenous septic arthritis of the knee in adults, although further study may be warranted regarding this matter.
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Almomani, Fares
2016-01-01
This study investigates the effect of hydraulic mixing on anaerobic digestion and sludge accumulation in a septic tank. The performance of a septic tank equipped with a hydraulic mixer was compared with that of a similar standard septic tank over a period of 10 months. The study was conducted in two phases: Phase-I--from May to November 2013 (6 months); Phase-II--from January to May 2014 (4 months). Hydraulic mixing effectively reduced the effluent biological oxygen demand (BOD) and total suspended solids, and reduced the sludge accumulation rate in the septic tank. The BOD removal efficiencies during Phase-II were 65% and 75% in the standard septic tank and a septic tank equipped with hydraulic mixer (Smart Digester™), respectively. The effect of hydraulic mixing reduced the rate of sludge accumulation from 0.64 cm/day to 0.27 cm/day, and increased the pump-out interval by a factor of 3.
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Facts about food irradiation: Safety of irradiation facilities
International Nuclear Information System (INIS)
1991-01-01
This fact sheet considers the safety of industrial irradiation facilities. Although there have been accidents, none of them has endangered public health or environmental safety, and the radiation processing industry is considered to have a very good safety record. Gamma irradiators do not produce radioactive waste, and the radiation sources at the facilities cannot explode nor in any other way release radioactivity into the environment. 3 refs
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Ice sheet hydrology - a review
International Nuclear Information System (INIS)
Jansson, Peter; Naeslund, Jens-Ove; Rodhe, Lars
2007-03-01
This report summarizes the theoretical knowledge on water flow in and beneath glaciers and ice sheets and how these theories are applied in models to simulate the hydrology of ice sheets. The purpose is to present the state of knowledge and, perhaps more importantly, identify the gaps in our understanding of ice sheet hydrology. Many general concepts in hydrology and hydraulics are applicable to water flow in glaciers. However, the unique situation of having the liquid phase flowing in conduits of the solid phase of the same material, water, is not a commonly occurring phenomena. This situation means that the heat exchange between the phases and the resulting phase changes also have to be accounted for in the analysis. The fact that the solidus in the pressure-temperature dependent phase diagram of water has a negative slope provides further complications. Ice can thus melt or freeze from both temperature and pressure variations or variations in both. In order to provide details of the current understanding of water flow in conjunction with deforming ice and to provide understanding for the development of ideas and models, emphasis has been put on the mathematical treatments, which are reproduced in detail. Qualitative results corroborating theory or, perhaps more often, questioning the simplifications made in theory, are also given. The overarching problem with our knowledge of glacier hydrology is the gap between the local theories of processes and the general flow of water in glaciers and ice sheets. Water is often channelized in non-stationary conduits through the ice, features which due to their minute size relative to the size of glaciers and ice sheets are difficult to incorporate in spatially larger models. Since the dynamic response of ice sheets to global warming is becoming a key issue in, e.g. sea-level change studies, the problems of the coupling between the hydrology of an ice sheet and its dynamics is steadily gaining interest. New work is emerging
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Ice sheet hydrology - a review
Energy Technology Data Exchange (ETDEWEB)
Jansson, Peter; Naeslund, Jens-Ove [Dept. of Physical Geography and Quaternary Geology, Stockholm Univ., Stockholm (Sweden); Rodhe, Lars [Geological Survey of Sweden, Uppsala (Sweden)
2007-03-15
This report summarizes the theoretical knowledge on water flow in and beneath glaciers and ice sheets and how these theories are applied in models to simulate the hydrology of ice sheets. The purpose is to present the state of knowledge and, perhaps more importantly, identify the gaps in our understanding of ice sheet hydrology. Many general concepts in hydrology and hydraulics are applicable to water flow in glaciers. However, the unique situation of having the liquid phase flowing in conduits of the solid phase of the same material, water, is not a commonly occurring phenomena. This situation means that the heat exchange between the phases and the resulting phase changes also have to be accounted for in the analysis. The fact that the solidus in the pressure-temperature dependent phase diagram of water has a negative slope provides further complications. Ice can thus melt or freeze from both temperature and pressure variations or variations in both. In order to provide details of the current understanding of water flow in conjunction with deforming ice and to provide understanding for the development of ideas and models, emphasis has been put on the mathematical treatments, which are reproduced in detail. Qualitative results corroborating theory or, perhaps more often, questioning the simplifications made in theory, are also given. The overarching problem with our knowledge of glacier hydrology is the gap between the local theories of processes and the general flow of water in glaciers and ice sheets. Water is often channelized in non-stationary conduits through the ice, features which due to their minute size relative to the size of glaciers and ice sheets are difficult to incorporate in spatially larger models. Since the dynamic response of ice sheets to global warming is becoming a key issue in, e.g. sea-level change studies, the problems of the coupling between the hydrology of an ice sheet and its dynamics is steadily gaining interest. New work is emerging
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Renal Blood Flow, Glomerular Filtration Rate, and Renal Oxygenation in Early Clinical Septic Shock.
Skytte Larsson, Jenny; Krumbholz, Vitus; Enskog, Anders; Bragadottir, Gudrun; Redfors, Bengt; Ricksten, Sven-Erik
2018-06-01
Data on renal hemodynamics, function, and oxygenation in early clinical septic shock are lacking. We therefore measured renal blood flow, glomerular filtration rate, renal oxygen consumption, and oxygenation in patients with early septic shock. Prospective comparative study. General and cardiothoracic ICUs. Patients with norepinephrine-dependent early septic shock (n = 8) were studied within 24 hours after arrival in the ICU and compared with postcardiac surgery patients without acute kidney injury (comparator group, n = 58). None. Data on systemic hemodynamics and renal variables were obtained during two 30-minute periods. Renal blood flow was measured by the infusion clearance of para-aminohippuric acid, corrected for renal extraction of para-aminohippuric acid. Renal filtration fraction was measured by renal extraction of chromium-51 labeled EDTA. Renal oxygenation was estimated from renal oxygen extraction. Renal oxygen delivery (-24%; p = 0.037) and the renal blood flow-to-cardiac index ratio (-21%; p = 0.018) were lower, renal vascular resistance was higher (26%; p = 0.027), whereas renal blood flow tended to be lower (-19%; p = 0.068) in the septic group. Glomerular filtration rate (-32%; p = 0.006) and renal sodium reabsorption (-29%; p = 0.014) were both lower in the septic group. Neither renal filtration fraction nor renal oxygen consumption differed significantly between groups. Renal oxygen extraction was significantly higher in the septic group (28%; p = 0.022). In the septic group, markers of tubular injury were elevated. In early clinical septic shock, renal function was lower, which was accompanied by renal vasoconstriction, a lower renal oxygen delivery, impaired renal oxygenation, and tubular sodium reabsorption at a high oxygen cost compared with controls.
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Genetics and morphology of Aedes aegypti (Diptera: Culicidae) in septic tanks in Puerto Rico.
Somers, Gerard; Brown, Julia E; Barrera, Roberto; Powell, Jeffrey R
2011-11-01
Dengue viruses, primarily transmitted by the mosquito Aedes aegypti (L.), affect an estimated 50-100 million people yearly. Traditional approaches to control mosquito population numbers, such as the use of pesticides, have had only limited success. Atypical mosquito behavior may be one reason why current vector control efforts have been less efficacious than expected. In Puerto Rico, for example, adult Ae. aegypti have been observed emerging from septic tanks. Interestingly, adults emerging from septic tanks are larger on average than adults collected from surface containers. To determine whether adults colonizing septic tanks constitute a separate Ae. aegypti population, we used 12 previously validated microsatellite loci to examine adult mosquitoes collected from both septic tanks and surface containers, but found no evidence to suggest genetic differentiation. Size differences between septic tank and surface mosquitoes were reduced when nutrient levels were held constant across experimental groups. Despite the absence of evidence suggesting a genetic difference between experimental groups in this study, Ae. aegypti emerging from septic tanks may still represent a more dangerous phenotype and should be given special consideration when developing vector control programs and designing public health interventions in the future.
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Septic thrombosis of the inferior vena cava treated with percutaneous mechanical thrombectomy
Burgmans, Mark C.; Rommes, Johannes H.; Spronk, Peter E.; van Nidek, Robert J. P. Brouerius; Bouma, Wim H.; Gratama, Jan Willem C.
2006-01-01
The present report describes a patient with septic thrombosis of the inferior vena cava (IVC) related to a subhepatic abscess adjacent to the IVC. Despite prolonged antimicrobial therapy and systemic anticoagulation, sepsis and septic embolism persisted while the size of the thrombus increased.
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Evidence-based diagnostics: adult septic arthritis.
Carpenter, Christopher R; Schuur, Jeremiah D; Everett, Worth W; Pines, Jesse M
2011-08-01
Acutely swollen or painful joints are common complaints in the emergency department (ED). Septic arthritis in adults is a challenging diagnosis, but prompt differentiation of a bacterial etiology is crucial to minimize morbidity and mortality. The objective was to perform a systematic review describing the diagnostic characteristics of history, physical examination, and bedside laboratory tests for nongonococcal septic arthritis. A secondary objective was to quantify test and treatment thresholds using derived estimates of sensitivity and specificity, as well as best-evidence diagnostic and treatment risks and anticipated benefits from appropriate therapy. Two electronic search engines (PUBMED and EMBASE) were used in conjunction with a selected bibliography and scientific abstract hand search. Inclusion criteria included adult trials of patients presenting with monoarticular complaints if they reported sufficient detail to reconstruct partial or complete 2 × 2 contingency tables for experimental diagnostic test characteristics using an acceptable criterion standard. Evidence was rated by two investigators using the Quality Assessment Tool for Diagnostic Accuracy Studies (QUADAS). When more than one similarly designed trial existed for a diagnostic test, meta-analysis was conducted using a random effects model. Interval likelihood ratios (LRs) were computed when possible. To illustrate one method to quantify theoretical points in the probability of disease whereby clinicians might cease testing altogether and either withhold treatment (test threshold) or initiate definitive therapy in lieu of further diagnostics (treatment threshold), an interactive spreadsheet was designed and sample calculations were provided based on research estimates of diagnostic accuracy, diagnostic risk, and therapeutic risk/benefits. The prevalence of nongonococcal septic arthritis in ED patients with a single acutely painful joint is approximately 27% (95% confidence interval [CI] = 17
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Gram staining in the diagnosis of acute septic arthritis.
Faraj, A A; Omonbude, O D; Godwin, P
2002-10-01
This study aimed at determining the sensitivity and specificity of Gram staining of synovial fluid as a diagnostic tool in acute septic arthritis. A retrospective study was made of 22 patients who had arthroscopic lavage following a provisional diagnosis of acute septic arthritis of the knee joint. Gram stains and cultures of the knee aspirates were compared with the clinical and laboratory parameters, to evaluate their usefulness in diagnosing acute arthritis. All patients who had septic arthritis had pain, swelling and limitation of movement. CRP was elevated in 90% of patients. The incidence of elevated white blood cell count was higher in the group of patients with a positive Gram stain study (60%) as compared to patients with a negative Gram stain study (33%). Gram staining sensitivity was 45%. Its specificity was however 100%. Gram staining is an unreliable tool in early decision making in patients requiring urgent surgical drainage and washout.
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Characterization of human septic sera induced gene expression modulation in human myocytes
Hussein, Shaimaa; Michael, Paul; Brabant, Danielle; Omri, Abdelwahab; Narain, Ravin; Passi, Kalpdrum; Ramana, Chilakamarti V.; Parrillo, Joseph E.; Kumar, Anand; Parissenti, Amadeo; Kumar, Aseem
2009-01-01
To gain a better understanding of the gene expression changes that occurs during sepsis, we have performed a cDNA microarray study utilizing a tissue culture model that mimics human sepsis. This study utilized an in vitro model of cultured human fetal cardiac myocytes treated with 10% sera from septic patients or 10% sera from healthy volunteers. A 1700 cDNA expression microarray was used to compare the transcription profile from human cardiac myocytes treated with septic sera vs normal sera. Septic sera treatment of myocytes resulted in the down-regulation of 178 genes and the up-regulation of 4 genes. Our data indicate that septic sera induced cell cycle, metabolic, transcription factor and apoptotic gene expression changes in human myocytes. Identification and characterization of gene expression changes that occur during sepsis may lead to the development of novel therapeutics and diagnostics. PMID:19684886
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Facts about food irradiation: Genetic studies
International Nuclear Information System (INIS)
1991-01-01
Results published in the mid-1970s from the National Institute of Nutrition (NIN) in India showed increased numbers of polyploid cells in rats, mice, monkeys and malnourished children fed irradiated wheat products. This fact sheet considers the validity of these results. A large number of independent studies have been subsequently performed, and in none of these have results been obtained that support the NIN findings. The conclusion is that there is no evidence to link the consumption of irradiated food with any mutagenic effect. 3 refs
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Waller, Travis; Marcus, Ian M; Walker, Sharon L
2018-06-04
Engineered nanomaterials (ENMs) are commonly incorporated into food and consumer applications to enhance a specific product aspect (i.e., optical properties). Life cycle analyses revealed ENMs can be released from products during usage and reach wastewater treatment plants (WWTPs), with titanium dioxide (TiO 2 ) accounting for a large fraction. As such, food grade (FG) TiO 2 , a more common form of TiO 2 in wastewater, was used in this study. Nanomaterials in WWTPs have been well characterized, although the problematic septic system has been neglected. Elution and bioaccumulation of TiO 2 ENMs from WTTPs in downriver sediments and microorganisms has been observed; however, little is known about mechanisms governing the elution of FG TiO 2 from the septic drainage system. This study characterized the transport behavior and mechanisms of FG TiO 2 particles in porous media conditions after septic waste treatment. FG and industrial grade (IG) TiO 2 (more commonly studied) were introduced to septic tank effluent and low-ionic strength electrolyte solutions prior to column transport experiments. Results indicate that FG TiO 2 aggregate size (200-400 nm) remained consistent across solutions. Additionally, elution of FG and IG TiO 2 was greatest in septic effluent at the higher nanoparticle concentration (100 ppm). FG TiO 2 was well retained at the low (2 ppm) concentration in septic effluent, suggesting that particles that escape the septic system may still be retained in drainage field before reaching the groundwater system, although eluted particles are highly stabilized. Findings provide valuable insight into the significance of the solution environment at mediating differences observed between uniquely engineered nanomaterials. Graphical abstract.
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International Nuclear Information System (INIS)
Boeck, J.C.; Eichstaedt, H.; Barker, B.C.; Lewis, F.R.; Lim, A.D.; Pollycove, M.
1990-01-01
To study the effect of septic pulmonary hypertension on right/left ventricular intrapericardial interactions thirteen trauma patients, seven septic and six nonseptic controls, were compared. Ventricular volumes were derived from firstpass or gated equilibrium radionuclide angiocardiography, and related to body surface area. Systemic and pulmonary pressures were measured invasively. Pulmonary arterial pressure was significantly increased in the sepsis group. Although right ventricular end-diastolic volumes were higher in sepsis, left ventricular end-diastolic volumes were not decreased. In terms of intrapericardial right/left ventricular interactions these results indicate that the right and left ventricles operate independently in septic pulmonary hypertension. (orig.) [de
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Burke, R; Barrera, R; Lewis, M; Kluchinsky, T; Claborn, D
2010-06-01
Adult Aedes aegypti (Linnaeus) (Diptera: Culicidae) were previously recovered from emergence traps on septic tanks in southeastern Puerto Rico. In this study we quantified immature mosquito abundance and its relationship with structural variables of the septic tanks and chemical properties of the water containing raw sewage. A miniaturized floating funnel trap was used to sample 89 septic tanks for larvae in the Puerto Rican community of Playa-Playita. Aedes aegypti larvae were recovered from 18% of the sampled tanks (10.3 larvae per septic tank per day). Larval presence was positively associated with cracking of the septic tank walls and uncovered access ports. Larval abundance was positively associated with cracking of the septic tank walls and larger tank surface areas, and inversely associated with the total dissolved solids (TDS). Culex quinquefasciatus (Say) larvae were also recovered from 74% of the septic tanks (129.6 larvae per septic tank per day). Larval presence was negatively associated with TDS in the water and larval abundance was positively associated with cracking of the septic tank walls. A screened, plastic emergence trap was used to sample 93 septic tanks within the community for Ae. aegypti and Cx. quinquefasciatus adults. Aedes aegypti adults were recovered from 49% of the sampled tanks (8.7 adults per septic tank per day) and Cx. quinquefasciatus adults were recovered from 97% of the sampled tanks (155.5 adults per septic tank per day). Aedes aegypti adult presence was positively associated with cracking, uncapped openings and septic water pH. The Ae. aegypti adult counts were positively associated with cracking and inversely associated with TDS and conductivity. This study marks the first published record of the recovery of Ae. aegypti larvae from holding tanks containing raw sewage in the Caribbean region. Our study indicates that Ae. aegypti larvae are present in sewage water and that septic tanks have at least the potential to maintain
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International Nuclear Information System (INIS)
Ognibene, F.P.; Parker, M.M.; Natanson, C.; Shelhamer, J.H.; Parrillo, J.E.
1988-01-01
Volume infusion, to increase preload and to enhance ventricular performance, is accepted as initial management of septic shock. Recent evidence has demonstrated depressed myocardial function in human septic shock. We analyzed left ventricular performance during volume infusion using serial data from simultaneously obtained pulmonary artery catheter hemodynamic measurements and radionuclide cineangiography. Critically ill control subjects (n = 14), patients with sepsis but without shock (n = 21), and patients with septic shock (n = 21) had prevolume infusion hemodynamic measurements determined and received statistically similar volumes of fluid resulting in similar increases in pulmonary capillary wedge pressure. There was a strong trend (p = 0.004) toward less of a change in left ventricular stroke work index (LVSWI) after volume infusion in patients with sepsis and septic shock compared with control subjects. The LVSWI response after volume infusion was significantly less in patients with septic shock when compared with critically ill control subjects (p less than 0.05). These data demonstrate significantly altered ventricular performance, as measured by LVSWI, in response to volume infusion in patients with septic shock
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Streptococcus agalactiae: an emerging cause of septic arthritis.
Louthrenoo, Worawit; Kasitanon, Nuntana; Wangkaew, Suparaporn; Hongsongkiat, Sith; Sukitawut, Waraporn; Wichainun, Ramjai
2014-03-01
Invasive Streptococcus agalactiae infection in nonpregnant women has been reported increasingly worldwide. This study reports the clinical features and outcome of S. agalactiae septic arthritis in Thai patients. The medical records of cases with septic arthritis seen between July 1990 and December 2010 were reviewed. Only those with S. agalactiae were included in this study. From 244 cases of septic arthritis, 38 (15.57%, 13 men and 25 women) were caused by S. agalactiae, with 34 of them (89.48%) occurring between 2008 and 2010. Their mean age was 52.89 (SD, 18.95) years. Twenty-four of the 38 patients (63.16%) had 1 or more underlying disease that might predispose to joint infection. Fever and joint pain were the most common symptoms presented. Eleven cases (28.95%) presented monoarthritis, 15 (39.47%) oligoarthritis, and 12 (31.58%) polyarthritis, with a mean joint involvement of 3.34 (SD, 2.35) joints (range, 1-8). Cellulitis was seen in 27 cases (71.05%). Blood cultures were positive in 31 patients (81.58%). Thirty-five of the 38 synovial fluid specimens obtained were enough for cultures and stain smears, with 24 (68.57%) growing S. agalactiae and 19 (54.29%) showing gram-positive cocci. All isolates were sensitive to penicillin. Ten patients (26.31%) received arthroscopic drainage. The articular outcome was good in 11 patients, fair in 24, and poor in 3. There were no deaths. Streptococcus agalactiae is an emerging cause of septic arthritis in Thai patients. Physicians should be especially aware of this condition in patients presenting with acute oligopolyarthritis and prominent cellulitis.
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Lower versus Higher Hemoglobin Threshold for Transfusion in Septic Shock
DEFF Research Database (Denmark)
Holst, Lars B; Haase, Nicolai; Wetterslev, Jørn
2014-01-01
BACKGROUND: Blood transfusions are frequently given to patients with septic shock. However, the benefits and harms of different hemoglobin thresholds for transfusion have not been established. METHODS: In this multicenter, parallel-group trial, we randomly assigned patients in the intensive care...... unit (ICU) who had septic shock and a hemoglobin concentration of 9 g per deciliter or less to receive 1 unit of leukoreduced red cells when the hemoglobin level was 7 g per deciliter or less (lower threshold) or when the level was 9 g per deciliter or less (higher threshold) during the ICU stay...... were similar in the two intervention groups. CONCLUSIONS: Among patients with septic shock, mortality at 90 days and rates of ischemic events and use of life support were similar among those assigned to blood transfusion at a higher hemoglobin threshold and those assigned to blood transfusion...
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Directory of Open Access Journals (Sweden)
Lefeng Wang
2017-01-01
Full Text Available Sepsis is characterized by injury of the pulmonary microvasculature and the pulmonary microvascular endothelial cells (PMVEC, leading to barrier dysfunction and acute respiratory distress syndrome (ARDS. Our recent work identified a strong correlation between PMVEC apoptosis and microvascular leak in septic mice in vivo, but the specific role of apoptosis in septic PMVEC barrier dysfunction remains unclear. Thus, we hypothesize that PMVEC apoptosis is likely required for PMVEC barrier dysfunction under septic conditions in vitro. Septic stimulation (mixture of tumour necrosis factor α, interleukin 1β, and interferon γ [cytomix] of isolated murine PMVEC resulted in a significant loss of barrier function as early as 4 h after stimulation, which persisted until 24 h. PMVEC apoptosis, as reflected by caspase activation, DNA fragmentation, and loss of membrane polarity, was first apparent at 8 h after cytomix. Pretreatment of PMVEC with the pan-caspase inhibitor Q-VD significantly decreased septic PMVEC apoptosis and was associated with reestablishment of PMVEC barrier function at 16 and 24 h after stimulation but had no effect on septic PMVEC barrier dysfunction over the first 8 h. Collectively, our data suggest that early septic murine PMVEC barrier dysfunction driven by proinflammatory cytokines is not mediated through apoptosis, but PMVEC apoptosis contributes to late septic PMVEC barrier dysfunction.
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Directory of Open Access Journals (Sweden)
Anders G Kjærgaard
Full Text Available BACKGROUND: The diagnosis of sepsis is challenging and there is an unmet need for sensitive and specific diagnostic and prognostic biomarkers. Following activation of macrophages and monocytes, the haptoglobin-haemoglobin receptor (CD163 and the mannose receptor (MR are shed into the circulation (sCD163 and sMR. OBJECTIVE: We investigated monocyte expression of CD163 and MR, and levels of sCD163 and sMR in septic and non-septic patients, and in healthy controls. We hypothesised that these receptors are elevated during sepsis and can be used diagnostic and prognostic. METHODS: Twenty-one patients with severe sepsis or septic shock and 15 critically ill non-septic patients were included in this prospective observational study at three ICUs at Aarhus University Hospital and Randers Regional Hospital, Denmark. Fifteen age- and gender-matched healthy volunteers served as controls. Levels of sCD163 and sMR were measured using a sandwich ELISA and monocyte expression of CD163 and MR was evaluated by flow cytometry during the first four days of ICU stay. The diagnostic and prognostic values of the receptors were assessed using AUROC curves. RESULTS: At ICU admission and during the observation period, monocyte expression of CD163 and levels of sCD163 and sMR were significantly higher in septic patients compared with non-septic patients and healthy controls (p<0.01 for all comparisons. Monocytes did not express MR. The diagnostic values estimated by AUROC were 1.00 for sMR, 0.95 for sCD163, 0.87 for CRP, and 0.75 for monocyte-bound CD163. Among the septic patients, monocyte expression of CD163 was higher in non-survivors compared with survivors at ICU admission (p = 0.02 and during the observation period (p = 0.006. The prognostic value of monocyte-bound CD163 estimated by AUROC at ICU admission was 0.82. CONCLUSION: The macrophage-specific markers CD163, sCD163, and sMR are increased in septic patients. Particularly sMR is a promising new
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[Clinical picture and complex treatment of septic thromboses of the cavernous sinuses].
Mozhaev, S V; Zubkov, Iu N; Ponomarev, A M; Shimchenko, P Ia
1980-07-01
Under analysis are etiology, clinical picture and diagnosis of a septic thrombosis of cavernous sinuses in 28 patients. The authors have shown the interrelationship between local manifestations of the disease, injuries of the brain and its sheaths and septic complications (abscessing pneumonia as the most severe of them). A scheme of the complex treatment of patients with thrombosis of the cavernous sinus is proposed. The leading role in this treatment is played by intracarotid infusion of antibiotics in combination with anticoagulant drugs, vasodilatatory agents and novocaine as well as the therapy of septic complications (abscesses of the face and hairy part of the head, meningoencephalitis, pneumonia).
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Baldwin, Keith D; Brusalis, Christopher M; Nduaguba, Afamefuna M; Sankar, Wudbhav N
2016-05-04
Differentiating between septic arthritis and Lyme disease of the knee in endemic areas can be challenging and has major implications for patient management. The purpose of this study was to identify a prediction rule to differentiate septic arthritis from Lyme disease in children presenting with knee pain and effusion. We retrospectively reviewed the records of patients younger than 18 years of age with knee effusions who underwent arthrocentesis at our institution from 2005 to 2013. Patients with either septic arthritis (positive joint fluid culture or synovial white blood-cell count of >60,000 white blood cells/mm(3) with negative Lyme titer) or Lyme disease (positive Lyme immunoglobulin G on Western blot analysis) were included. To avoid misclassification bias, undiagnosed knee effusions and joints with both a positive culture and positive Lyme titers were excluded. Historical, clinical, and laboratory data were compared between groups to identify variables for comparison. Binary logistic regression analysis was used to identify independent predictive variables. One hundred and eighty-nine patients were studied: 23 with culture-positive septic arthritis, 26 with culture-negative septic arthritis, and 140 with Lyme disease. Multivariate binary logistic regression identified pain with short arc motion, history of fever reported by the patient or a family member, C-reactive protein of >4 mg/L, and age younger than 2 years as independent predictive factors for septic arthritis. A simpler model was developed that showed that the risk of septic arthritis with none of these factors was 2%, with 1 of these factors was 18%, with 2 of these factors was 45%, with 3 of these factors was 84%, or with all 4 of these factors was 100%. Although septic arthritis of the knee and Lyme monoarthritis share common features that can make them difficult to distinguish clinically, the presence of pain with short arc motion, C-reactive protein of >4.0 mg/L, patient-reported history of
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Facts about food irradiation: Microbiological safety of irradiated food
International Nuclear Information System (INIS)
1991-01-01
This fact sheet considers the microbiological safety of irradiated food, with especial reference to Clostridium botulinum. Irradiated food, as food treated by any ''sub-sterilizing'' process, must be handled, packaged and stored following good manufacturing practices to prevent growth and toxin production of C. botulinum. Food irradiation does not lead to increased microbiological hazards, nor can it be used to save already spoiled foods. 4 refs
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SEPTIC TANK SETBACK DISTANCES: A WAY TO MINIMIZE VIRUS CONTAMINATION OF DRINKING WATER
Septic tanks are the most frequently reported causes of contamination in ground-water disease outbreaks associated with the consumption of untreated ground water in the United States. The placement of septic tanks is generally controlled by county-wide or state-wide regulations, ...
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Clinical presentation and treatment of septic arthritis in children.
Moro-Lago, I; Talavera, G; Moraleda, L; González-Morán, G
The aim of this study is to determine the epidemiological features, clinical presentation, and treatment of children with septic arthritis. A retrospective review was conducted on a total of 141 children with septic arthritis treated in Hospital Universitario La Paz (Madrid) between the years 2000 to 2013. The patient data collected included, the joint affected, the clinical presentation, the laboratory results, the appearance, Gram stain result, and the joint fluid culture, as well as the imaging tests and the treatment. Most (94%) of the patients were less than 2 years-old. The most common location was the knee (52%), followed by the hip (21%). The septic arthritis was confirmed in 53%. No type of fever was initially observed in 49% of them, and 18% had an ESR (mm/h) or CRP (mg/l) less than 30 in the initial laboratory analysis. The joint fluid was purulent in 45% and turbid in 12%. The Gram stain showed bacteria in 4%. The fluid culture was positive in 17%. Staphylococcus aureus was the most common pathogen found, followed by Streptococcus agalactiae, Streptococcus pneumoniae, and Kingella kingae. Antibiotic treatment was intravenous administration for 7 days, followed by 21 days orally. Surgery was performed in 18% of cases. The diagnosis was only confirmed in 53% of the patients. Some of the confirmed septic arthritis did not present with the classical clinical/analytical signs, demonstrating that the traumatologist or paediatrician requires a high initial level of clinical suspicion of the disease. Copyright © 2017 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.
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Load limit of a UASB fed septic tank-treated domestic wastewater.
Lohani, Sunil Prasad; Bakke, Rune; Khanal, Sanjay N
2015-01-01
Performance of a 250 L pilot-scale up-flow anaerobic sludge blanket (UASB) reactor, operated at ambient temperatures, fed septic tank effluents intermittently, was monitored for hydraulic retention time (HRT) from 18 h to 4 h. The total suspended solids (TSS), total chemical oxygen demand (CODT), dissolved chemical oxygen demand (CODdis) and suspended chemical oxygen demand (CODss) removal efficiencies ranged from 20 to 63%, 15 to 56%, 8 to 35% and 22 to 72%, respectively, for the HRT range tested. Above 60% TSS and 47% CODT removal were obtained in the combined septic tank and UASB process. The process established stable UASB treatment at HRT≥6 h, indicating a hydraulic load design limit. The tested septic tank-UASB combined system can be a low-cost and effective on-site sanitation solution.
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On the structure of finite-sheeted coverings of compact connected groups
Grigorian, S. A.; Gumerov, R. N.
2004-01-01
Finite-sheeted covering mappings onto compact connected groups are studied. It is shown that a finite-sheeted covering mapping from a connected Hausdorff topological space onto a compact connected abelian group G must be a homeomorphism provided that the character group of G admits division by the degree of given covering mapping. Using this result, we obtain criteria of triviality for finite coverings of G in terms of its character group and means on G. In order to establish these facts, for...
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Arthroscopic Treatment of Septic Arthritis of the Elbow in a 4-Year-Old Girl
Directory of Open Access Journals (Sweden)
Masashi Koide
2015-01-01
Full Text Available Pediatric septic arthritis is uncommon and has been traditionally treated by joint aspiration or open arthrotomy. There are some reports about arthroscopic surgery in pediatric septic arthritis of the knee, hip, and shoulder. However, there is no report for the case of elbow. We report a case of pediatric septic arthritis of elbow treated with arthroscopically with good clinical condition at 3-year follow-up. This paper is based on a report first published in Japanese (Tojo (2012.
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The race against the "septic shark".
Westphal, Martin; Kampmeier, Tim
2015-01-01
Great white sharks are responsible for about 10 cases of death annually worldwide, as compared with millions of deaths caused by sepsis. However, the basic principles of avoiding shark attacks and fighting sepsis seem to be similar: avoidance, attention, and speed, if necessary. The present review discusses the current status of the systemic inflammatory response syndrome (SIRS) criteria, which are actually content for discussion because of their low specificity. Current data suggest that one in eight patients with severe sepsis does not fulfill the SIRS criteria and is consequently missed, and therefore the calls for new definitions of sepsis are getting louder. Furthermore, the need for early treatment of sepsis and fast admission to an intensive care unit (ICU) with experienced stuff is reviewed as well as the early and appropriate initiation of therapy, namely antibiotic and volume therapy. A key feature is the analysis of the studies from the so-called "Sepsis Trilogy" (ProCESS, ARISE, and ProMiSe studies), with a focus on the status of early goal-directed therapy (EGDT). The authors of the "Sepsis Trilogy" concluded that there is no benefit regarding survival in septic patients by using EGDT as compared with standard therapy. However, the low mortality of the control groups within the "Sepsis Trilogy" studies as compared with the Rivers et al. study from 2001 leads to the conclusion that there has been an improvement in the therapy of septic patients, most probably due to the early initiation of therapy as a kind of "standard" in sepsis therapy. Finally, the phenomenon of a "large trial disease" is discussed, exemplary in a trial which investigated the maintenance of the "right" mean arterial pressure in sepsis patients. Even if the result of a large randomized trial might be that there is no difference between two study groups, the real exercise is to identify the patient collectives who might benefit or experience harm due to an intervention. In summary, as
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Septic arthritis due to Legionella cincinnatiensis: case report and review of the literature.
Banderet, Florian; Blaich, Annette; Soleman, Evelin; Gaia, Valeria; Osthoff, Michael
2017-08-01
Legionella spp. are an important cause of pulmonary and rarely extrapulmonary infections. L. cincinnatiensis has only been implicated in five cases to date. We herein report the first case of L. cincinnatiensis septic arthritis in a 90-year old lady with a past medical history of chronic kidney disease. She developed septic arthritis of her left wrist after having received intraarticular corticosteroid injections and oral corticosteroids administered for presumed chondrocalcinosis. Appropriate antimicrobial treatment of L. cincinnatiensis septic arthritis was delayed until identification of this organism in joint biopsies by broad-range bacterial PCR targeting the 16S rRNA gene with subsequent rDNA sequence analysis and by culture on special media. Reviewing all reported cases of septic arthritis caused by Legionella spp. other than L. cincinnatiensis it is notable that diagnosis was established by PCR in the majority of cases and only subsequently confirmed by special culture. Although most patients were immunosuppressed, outcome was favourable. Treatment consisted of a fluoroquinolone alone or in combination with rifampicin or a macrolide. Our case highlights the need for a high index of suspicion for infections with unusual/fastidious organisms when symptoms are suggestive of septic arthritis but conventional methods fail to identify a causative organism.
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EARLY GOAL DIRECTED THERAPY AT SEPTIC SYOK
Directory of Open Access Journals (Sweden)
Ayu Widyanti
2013-04-01
Full Text Available Sepsis is the most commom cause of death in children with critically ill. Using WHO criteria (severe sepsis defined as sepsis with acidosis, hypotension or both, it was determined that in 1995 there were more than 42.000 cases of severe sepsis in children in the United States with mortality rate was 10.3%. To answer that finding, evicende based protocol was made, it called early goal directed therapy (EGDT. EGDT is a comprehensive strategy to evaluate patient with septic shock include, challenge of fluid, antibiotic, vasopressor, measurement of central vein oxygen saturation, PRC transfusion, administering inotropic dan mechanic ventilation. All of these must be done in the first 6 hours since sepsis or septic shock was found, because if there is a delay of resuscitation, anything we do to increase oxygenation level of the cell will be useless.
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Initial fluid resuscitation of patients with septic shock in the intensive care unit
DEFF Research Database (Denmark)
Carlsen, Sarah; Perner, A
2011-01-01
Fluid is the mainstay of resuscitation of patients with septic shock, but the optimal composition and volume are unknown. Our aim was to evaluate the current initial fluid resuscitation practice in patients with septic shock in the intensive care unit (ICU) and patient characteristics and outcome...
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International Nuclear Information System (INIS)
1987-01-01
This folder contains twelve two-page leaflets (fact sheets) which answer questions posed about UK NIREX Ltd, its operations and radioactive waste. NIREX (the Nuclear Industry Radioactive Waste Executive) is the organisation responsible for implementing the British Government's policy for the disposal of most low- and intermediate-level radioactive waste produced in the United Kingdom. The questions posed are; what is NIREX. What is radioactivity. What is radioactive waste. Radioactive waste, what are the options. What is a radioactive waste repository. Some aspects of such a repository are then explained - how engineered barriers work, how geological barriers work, how long can concrete last, how is the radioactive waste transported, how are repository sites identified. The last two leaflets consider why do we need research, and look at radioactive waste management worldwide. The answers are in non-technical language and are short. (UK)
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Short- and long-term mortality in patients with community-acquired severe sepsis and septic shock
DEFF Research Database (Denmark)
Storgaard, Merete; Hallas, Jesper; Gahrn-Hansen, Bente
2013-01-01
Background: Severe sepsis and septic shock have a high 30-day mortality (10-50%), but the long-term mortality is not well described. The purpose of this study was to describe long-term mortality among patients with community-acquired severe sepsis or septic shock compared to a population-based re......Background: Severe sepsis and septic shock have a high 30-day mortality (10-50%), but the long-term mortality is not well described. The purpose of this study was to describe long-term mortality among patients with community-acquired severe sepsis or septic shock compared to a population...... extracted from the National Danish Patient Registry. We analyzed the hazard ratio for mortality at predefined intervals. Results: Absolute mortality within the first 30 days was 69/211 (33%, 95% confidence interval (CI) 25-41%), with a cumulative mortality of 121/211 (57%, 95% CI 48-69%) for the entire...... follow-up. Among septic patients who survived the first 30 days, the mortality hazard ratio was 2.7 (95% CI 1.7-4.3) until day 365, and among septic patients who survived the first year, the 1-4 y mortality hazard ratio was 2.3 (95% CI 1.7-3.3), compared to the community-based reference persons...
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Edaravone Improves Septic Cardiac Function by Inducing an HIF-1α/HO-1 Pathway
Directory of Open Access Journals (Sweden)
Chao He
2018-01-01
Full Text Available Septic myocardial dysfunction remains prevalent and raises mortality rate in patients with sepsis. During sepsis, tissues undergo tremendous oxidative stress which contributes critically to organ dysfunction. Edaravone, a potent radical scavenger, has been proved beneficial in ischemic injuries involving hypoxia-inducible factor- (HIF- 1, a key regulator of a prominent antioxidative protein heme oxygenase- (HO- 1. However, its effect in septic myocardial dysfunction remains unclarified. We hypothesized that edaravone may prevent septic myocardial dysfunction by inducing the HIF-1/HO-1 pathway. Rats were subjected to cecal ligation and puncture (CLP with or without edaravone infusion at three doses (50, 100, or 200 mg/kg, resp. before CLP and intraperitoneal injection of the HIF-1α antagonist, ME (15 mg/kg, after CLP. After CLP, rats had cardiac dysfunction, which was associated with deformed myocardium, augmented lipid peroxidation, and increased myocardial apoptosis and inflammation, along with decreased activities of catalase, HIF-1α, and HO-1 in the myocardium. Edaravone pretreatment dose-dependently reversed the changes, of which high dose most effectively improved cardiac function and survival rate of septic rats. However, inhibition of HIF-1α by ME demolished the beneficial effects of edaravone at high dose, reducing the survival rate of the septic rats without treatments. Taken together, edaravone, by inducing the HIF-1α/HO-1 pathway, suppressed oxidative stress and protected the heart against septic myocardial injury and dysfunction.
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Risk of septic knee following retrograde intramedullary nailing of open and closed femur fractures
Directory of Open Access Journals (Sweden)
Halvorson Jason J
2012-02-01
Full Text Available Abstract Background One potential complication of retrograde femoral nailing in the treatment of femur fractures is the risk of septic knee. This risk theoretically increases in open fractures as a contaminated fracture site has the potential to seed the instrumentation being passed in and out of the sterile intraarticular starting point. There are few studies examining this potential complication in a relatively commonly practiced technique. Methods All patients who received a retrograde femoral nail for femur fracture between September 1996 and November 2006 at a Level 1 trauma center were retrospectively reviewed. This yielded 143 closed fractures, 38 open fractures and 4 closed fractures with an ipsilateral traumatic knee arthrotomy. Patient follow-up records were reviewed for documentation of septic knee via operative notes, wound culture or knee aspirate data, or the administration of antibiotics for suspected septic knee. Results No evidence of septic knee was found in the 185 fractures examined in the dataset. Utilizing the Wilson confidence interval, the rate of septic knee based on our population was no greater than 2%, with that of the open fracture group alone being 9%. Conclusions Based on these results and review of the literature, the risk of septic knee in retrograde femoral nailing of both open and closed femoral shaft fractures appears low but potentially not insignificant. Funding There was no outside source of funding from either industry or other organization for this study.
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Timing, method and discontinuation of hydrocortisone administration for septic shock patients
Ibarra-Estrada, Miguel A; Ch?vez-Pe?a, Quetzalc?atl; Reynoso-Estrella, Claudia I; Rios-Zerme?o, Jorge; Aguilera-Gonz?lez, P?vel E; Garc?a-Soto, Miguel A; Aguirre-Avalos, Guadalupe
2017-01-01
AIM To characterize the prescribing patterns for hydrocortisone for patients with septic shock and perform an exploratory analysis in order to identify the variables associated with better outcomes. METHODS This prospective cohort study included 59 patients with septic shock who received stress-dose hydrocortisone. It was performed at 2 critical care units in academic hospitals from June 1st, 2015, to July 31st, 2016. Demographic data, comorbidities, medical management details, adverse effect...
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Arthroscopy of septic carpitis in donkeys (Equus asinus
Directory of Open Access Journals (Sweden)
A.H. Elkasapy
2014-11-01
Full Text Available Experimental septic arthritis was induced in the radiocarpal joint of 18 donkeys by intra-articular injection of Staphylococcus aureus (3-4X106 CFU. The inoculated animals were divided into three groups (6 donkeys in each group. The arthroscopic examination was carried out before induction of septic carpitis and 3 days (group I, 14 days (group II, and 28 days (group III after induction of infection. The arthroscopic examination of group I revealed hyperemia of synovial membrane and hypertrophied villi. In group II, severe hyperemia of synovial membrane, hypertrophied villi, pannus in the joint cavity and beginning of articular cartilage erosion were found. In group III, severe hyperemia of synovial membrane, hypertrophied villi and more prominent articular cartilage erosion were present.
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Fate of effluent-borne contaminants beneath septic tank drainfields overlying a Karst aquifer.
Katz, Brian G; Griffin, Dale W; McMahon, Peter B; Harden, Harmon S; Wade, Edgar; Hicks, Richard W; Chanton, Jeffrey P
2010-01-01
Groundwater quality effects from septic tanks were investigated in the Woodville Karst Plain, an area that contains numerous sinkholes and a thin veneer of sands and clays overlying the Upper Floridan aquifer (UFA). Concerns have emerged about elevated nitrate concentrations in the UFA, which is the source of water supply in this area of northern Florida. At three sites during dry and wet periods in 2007-2008, water samples were collected from the septic tank, shallow and deep lysimeters, and drainfield and background wells in the UFA and analyzed for multiple chemical indicators including nutrients, nitrate isotopes, organic wastewater compounds (OWCs), pharmaceutical compounds, and microbiological indicators (bacteria and viruses). Median NO3-N concentration in groundwater beneath the septic tank drainfields was 20 mg L(-1) (8.0-26 mg L(-1)). After adjusting for dilution, about 25 to 40% N loss (from denitrification, ammonium sorption, and ammonia volatilization) occurs as septic tank effluent moves through the unsaturated zone to the water table. Nitrogen loading rates to groundwater were highly variable at each site (3.9-12 kg N yr(-1)), as were N and chloride depth profiles in the unsaturated zone. Most OWCs and pharmaceutical compounds were highly attenuated beneath the drainfields; however, five Cs (caffeine, 1,7-dimethylxanthine, phenol, galaxolide, and tris(dichloroisotopropyl)phosphate) and two pharmaceutical compounds (acetaminophen and sulfamethoxazole) were detected in groundwater samples. Indicator bacteria and human enteric viruses were detected in septic tank effluent samples but only intermittently in soil water and groundwater. Contaminant movement to groundwater beneath each septic tank system also was related to water use and differences in lithology at each site.
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Assisted crack tip flipping under Mode I thin sheet tearing
DEFF Research Database (Denmark)
Felter, Christian Lotz; Nielsen, Kim Lau
2017-01-01
Crack tip flipping, where the fracture surface alternates from side to side in roughly 45° shear bands, seems to be an overlooked propagation mode in Mode I thin sheet tearing. In fact, observations of crack tip flipping is rarely found in the literature. Unlike the already established modes...
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MR findings of septic cavernous sinus thrombosis
Energy Technology Data Exchange (ETDEWEB)
Lee, Hyeong Lae; Lee, Nam Joon; Lee, Jung Hee; Pyo, Hyeon Soon; Eo, Geun; Kim, Kyo Nam; Kim, Young Soon; Kim, Jang Min [Kwang Myung Sung Ae Hospital, Kwang Myung (Korea, Republic of); Lee, Don Young [Korea University Anam Hospital, Seoul (Korea, Republic of)
2000-08-01
To evaluate the MR findings of septic thrombosis of the cavernous sinus. Eleven MR images of six patients with septic cavernous sinus thrombosis obtained over a five-year period and proven clinically or radiologically were retrospectively reviewed. The contour and enhancement pattern of the cavernous sinus, changes in the internal carotid artery, orbit, pituitary gland and sphenoid sinus, and intracranial abnormalities were analyzed and compared with the findings of follow-up studies. In all six patients, contrast study revealed asymmetrical enlargement of the ipsilateral cavernous sinus and multiple irregular filling defects within it. Narrowing of the cavernous portion of the ipsilateral internal carotid artery was noted in five patients, upward displacement of the ipsilateral internal carotid artery in four, ipsilateral proptosis with engorgement of the superior ophthalmic vein in two, pituitary enlargement in five, and inflammatory change in the sphenoid sinus in six. Associated intracranial abnormalities included edema and enhancement in the meninx, temporal lobe, or pons adjacent to the cavernous sinus in four patients, hydrocephalus in one, and cerebral infarction in one. Follow-up MR imaging indicated that the extent of asymmetrical enlargement of the cavernous sinus, filling defects within it, as seen on contrast study, and enlarged pituitary glands had all decreased, without significant interval change. MR imaging is useful in the diagnosis of septic cavernous sinus thrombosis. Asymmetrical enlargement of the cavernous sinus, multiple irregular filling defect within it, as seen on contrast study, and changes in the internal carotid artery are characteristic findings. (author)
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MRI findings of treated bacterial septic arthritis
International Nuclear Information System (INIS)
Bierry, Guillaume; Huang, Ambrose J.; Chang, Connie Y.; Torriani, Martin; Bredella, Miriam A.
2012-01-01
The purpose of this study was to report the MRI findings that can be encountered in successfully treated bacterial septic arthritis. The study included 12 patients (8 male and 4 female; mean age 38 years, range 9-85) with 13 proven cases of bacterial septic arthritis. The joints involved were hip (n = 3), knee (n = 3), shoulder (n = 2), sacroiliac (n = 2), ankle (n = 1), wrist (n = 1), and elbow (n = 1). MRI examinations following surgical debridement and at initiation of antibiotic therapy and after successful treatment were compared for changes in effusion, synovium, bone, and periarticular soft tissues. Imaging findings were correlated with microbiological and clinical findings. Joint effusions were present in all joints at baseline and regressed significantly at follow-up MRI (p = 0.001). Abscesses were present in 5 cases (38 %), and their sizes decreased significantly at follow-up (p = 0.001). Synovial enhancement and thickening were observed in all joints at both baseline and follow-up MRI. Myositis/cellulitis was present in 10 cases (77 %) at baseline and in 8 cases (62 %) at follow-up MRI. Bone marrow edema was present in 10 joints (77 %) at baseline and persisted in 8 joints (62 %). Bone erosions were found in 8 joints (62 %) and persisted at follow-up MRI in all cases. The sizes of joint effusions and abscesses appear to be the factors with the most potential for monitoring therapy for septic arthritis, since both decreased significantly following successful treatment. Synovial thickening and enhancement, periarticular myositis/cellulitis, and bone marrow edema can persist even after resolution of the infection. (orig.)
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MRI findings of treated bacterial septic arthritis
Energy Technology Data Exchange (ETDEWEB)
Bierry, Guillaume; Huang, Ambrose J.; Chang, Connie Y.; Torriani, Martin; Bredella, Miriam A. [Massachusetts General Hospital and Harvard Medical School, Musculoskeletal Imaging and Intervention, Department of Radiology, Boston, MA (United States)
2012-12-15
The purpose of this study was to report the MRI findings that can be encountered in successfully treated bacterial septic arthritis. The study included 12 patients (8 male and 4 female; mean age 38 years, range 9-85) with 13 proven cases of bacterial septic arthritis. The joints involved were hip (n = 3), knee (n = 3), shoulder (n = 2), sacroiliac (n = 2), ankle (n = 1), wrist (n = 1), and elbow (n = 1). MRI examinations following surgical debridement and at initiation of antibiotic therapy and after successful treatment were compared for changes in effusion, synovium, bone, and periarticular soft tissues. Imaging findings were correlated with microbiological and clinical findings. Joint effusions were present in all joints at baseline and regressed significantly at follow-up MRI (p = 0.001). Abscesses were present in 5 cases (38 %), and their sizes decreased significantly at follow-up (p = 0.001). Synovial enhancement and thickening were observed in all joints at both baseline and follow-up MRI. Myositis/cellulitis was present in 10 cases (77 %) at baseline and in 8 cases (62 %) at follow-up MRI. Bone marrow edema was present in 10 joints (77 %) at baseline and persisted in 8 joints (62 %). Bone erosions were found in 8 joints (62 %) and persisted at follow-up MRI in all cases. The sizes of joint effusions and abscesses appear to be the factors with the most potential for monitoring therapy for septic arthritis, since both decreased significantly following successful treatment. Synovial thickening and enhancement, periarticular myositis/cellulitis, and bone marrow edema can persist even after resolution of the infection. (orig.)
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Zamalloa, Carlos; Arends, Jan B A; Boon, Nico; Verstraete, Willy
2013-06-25
Septic tanks are used for the removal of organic particulates in wastewaters by physical accumulation instead of through the biological production of biogas. Improved biogas production in septic tanks is crucial to increase the potential of this system for both energy generation and organic matter removal. In this study, the effect on the biogas production and biogas quality of coupling a 20 L lab-scale septic tank with a microbial electrolysis cell (MEC) was investigated and compared with a standard septic tank. Both reactors were operated at a volumetric organic loading rate of 0.5gCOD/Ld and a hydraulic retention time between 20 and 40 days using black water as an input under mesophilic conditions for a period of 3 months. The MEC-septic tank was operated at an applied voltage of 2.0±0.1V and the current experienced ranged from 40 mA (0.9A/m(2) projected electrode area) to 180 mA (5A/m(2) projected electrode area). The COD removal was of the order of 85% and the concentration of residual COD was not different between both reactors. Yet, the total phosphorous in the output was on average 39% lower in the MEC-septic tank. Moreover, the biogas production rate in the MEC-septic tank was a factor of 5 higher than in the control reactor and the H2S concentration in the biogas was a factor of 2.5 lower. The extra electricity supplied to the MEC-septic tank was recovered as extra biogas produced. Overall, it appears that the combination of MEC and a septic tank offers perspectives in terms of lower discharge of phosphorus and H2S, nutrient recuperation and a more reliable supply of biogas. Copyright © 2013 Elsevier B.V. All rights reserved.
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Chou, Deng-Wei; Wu, Shu-Ling; Chung, Kuo-Mou; Han, Shu-Chen; Cheung, Bruno Man-Hon
2016-01-01
OBJECTIVES: Septic pulmonary embolism is an uncommon but life-threatening disorder. However, data on patients with septic pulmonary embolism who require critical care have not been well reported. This study elucidated the clinicoradiological spectrum, causative pathogens and outcomes of septic pulmonary embolism in patients requiring critical care. METHODS: The electronic medical records of 20 patients with septic pulmonary embolism who required intensive care unit admission between January 2005 and December 2013 were reviewed. RESULTS: Multiple organ dysfunction syndrome developed in 85% of the patients, and acute respiratory failure was the most common organ failure (75%). The most common computed tomographic findings included a feeding vessel sign (90%), peripheral nodules without cavities (80%) or with cavities (65%), and peripheral wedge-shaped opacities (75%). The most common primary source of infection was liver abscess (40%), followed by pneumonia (25%). The two most frequent causative pathogens were Klebsiella pneumoniae (50%) and Staphylococcus aureus (35%). Compared with survivors, nonsurvivors had significantly higher serum creatinine, arterial partial pressure of carbon dioxide, and Acute Physiology and Chronic Health Evaluation II and Sequential Organ Failure Assessment scores, and they were significantly more likely to have acute kidney injury, disseminated intravascular coagulation and lung abscesses. The in-hospital mortality rate was 30%. Pneumonia was the most common cause of death, followed by liver abscess. CONCLUSIONS: Patients with septic pulmonary embolism who require critical care, especially those with pneumonia and liver abscess, are associated with high mortality. Early diagnosis, appropriate antibiotic therapy, surgical intervention and respiratory support are essential. PMID:27759843
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Directory of Open Access Journals (Sweden)
Deng-Wei Chou
Full Text Available OBJECTIVES: Septic pulmonary embolism is an uncommon but life-threatening disorder. However, data on patients with septic pulmonary embolism who require critical care have not been well reported. This study elucidated the clinicoradiological spectrum, causative pathogens and outcomes of septic pulmonary embolism in patients requiring critical care. METHODS: The electronic medical records of 20 patients with septic pulmonary embolism who required intensive care unit admission between January 2005 and December 2013 were reviewed. RESULTS: Multiple organ dysfunction syndrome developed in 85% of the patients, and acute respiratory failure was the most common organ failure (75%. The most common computed tomographic findings included a feeding vessel sign (90%, peripheral nodules without cavities (80% or with cavities (65%, and peripheral wedge-shaped opacities (75%. The most common primary source of infection was liver abscess (40%, followed by pneumonia (25%. The two most frequent causative pathogens were Klebsiella pneumoniae (50% and Staphylococcus aureus (35%. Compared with survivors, nonsurvivors had significantly higher serum creatinine, arterial partial pressure of carbon dioxide, and Acute Physiology and Chronic Health Evaluation II and Sequential Organ Failure Assessment scores, and they were significantly more likely to have acute kidney injury, disseminated intravascular coagulation and lung abscesses. The in-hospital mortality rate was 30%. Pneumonia was the most common cause of death, followed by liver abscess. CONCLUSIONS: Patients with septic pulmonary embolism who require critical care, especially those with pneumonia and liver abscess, are associated with high mortality. Early diagnosis, appropriate antibiotic therapy, surgical intervention and respiratory support are essential.
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Norovirus outbreak caused by a new septic system in a dolomite aquifer
Borchardt, M. A.; Bradbury, K.R.; Alexander, E.C.; Kolberg, R.J.; Alexander, S.C.; Archer, John R.; Braatz, L.A.; Forest, B.M.; Green, J.A.; Spencer, S. K.
2011-01-01
Septic systems that are built in compliance with regulations are generally not expected to be the cause of groundwater borne disease outbreaks, especially in areas with thick vadose zones. However, this case study demonstrates that a disease outbreak can occur in such a setting and outlines the combination of epidemiological, microbiological, and hydrogeological methods used to confirm the source of the outbreak. In early June 2007, 229 patrons and employees of a new restaurant in northeastern Wisconsin were affected by acute gastroenteritis; 6 people were hospitalized. Epidemiological case-control analysis indicated that drinking the restaurant's well water was associated with illness (odds ratio = 3.2, 95% confidence interval = 0.9 to 11.4, P = 0.06). Microbiological analysis (quantitative reverse transcription-polymerase chain reaction) measured 50 genomic copies per liter of norovirus genogroup I in the well water. Nucleotide sequencing determined the genotype as GI.2 and further showed the identical virus was present in patrons' stool specimens and in the septic tank. Tracer tests using dyes injected at two points in the septic system showed that effluent was traveling from the tanks (through a leaking fitting) and infiltration field to the well in 6 and 15 d, respectively. The restaurant septic system and well (85-m deep, in a fractured dolomite aquifer) both conformed to state building codes. The early arrival of dye in the well, which was 188 m from the septic field and located beneath a 35-m thick vadose zone, demonstrates that in highly vulnerable hydrogeological settings, compliance with regulations may not provide adequate protection from fecal pathogens.
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Effect of temperature on anaerobic treatment of black water in UASB-septic tank systems
Luostarinen, S.; Sanders, W.T.M.; Kujawa-Roeleveld, K.; Zeeman, G.
2007-01-01
The effect of northern European seasonal temperature changes and low temperature on the performance of upflow anaerobic sludge blanket (UASB)-septic tanks treating black water was studied. Three UASB-septic tanks were monitored with different operational parameters and at different temperatures. The
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Changes in Insulin-like Growth Factor-1 Level in Patients with Sepsis and Septic Shock
Directory of Open Access Journals (Sweden)
Sang Hoon Lee
2016-11-01
Full Text Available Background Despite many ongoing, prospective studies on the topic, sepsis still remains one of the main causes of death in hospital. The hormone insulin-like growth factor 1 (IGF-1 has a similar molecular structure to that of insulin. IGF-1 exerts anabolic effects and plays important roles in both normal physiology and pathologic processes. Previous studies have observed low serum IGF-1 level in patients with critical illnesses. Here, we evaluated changes in IGF-1 level based on survival of septic patients. Methods We evaluated 140 patients with sepsis and septic shock (21 with sepsis and 119 with septic shock admitted to the intensive care unit of a university-affiliated hospital in Korea. Serum IGF-1 level was measured on days 0, 1, 3, and 7. Patients with liver disease were excluded from this study. All data were analyzed using SPSS version 20 (SPSS Inc., Chicago, IL, USA. Results Patients with septic shock had significantly lower serum IGF-1 level on days 1 and 3 than patients without septic shock (p = 0.002 and p = 0.007, respectively. Generally, there was a negative relationship between IGF-1 and serum cortisol levels; however, this relationship was only significant on day 3 (p = 0.029. Furthermore, renin showed significantly negative correlation with IGF-1 on day 3 (p = 0.038. IGF-1 level did not show significant difference between survivors and non-survivors. Conclusions Our results showed that IGF-1 was associated with septic shock, and that the IGF-1 axis is severely disrupted in septic patients. Additionally, serum cortisol and renin levels were associated with IGF-1 level.
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Hernández Poblete, G.W.
2013-01-01
A fundamental challenge in septic shock resuscitation is to evaluate tissue perfusion. In this thesis, we review the basic foundations for the development of a comprehensive and holistic model for perfusion assessment in septic shock, and outline its application to evaluate the impact of
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Quantifying the impact of septic tank systems on eutrophication risk in rural headwaters.
Withers, P J A; Jarvie, H P; Stoate, C
2011-04-01
Septic tank systems (STS) are a potential source of nutrient emissions to surface waters but few data exist in the UK to quantify their significance for eutrophication. We monitored the impact of STS on nutrient concentrations in a stream network around a typical English village over a 1-year period. Septic tank effluent discharging via a pipe directly into one stream was highly concentrated in soluble N (8-63mgL(-1)) and P (septic tank systems. The very high concentrations, intercorrelation and dilution patterns of SRP, NH(4)-N and the effluent markers Na and B suggested that soakaways in the heavy clay catchment soils were not retaining and treating the septic tank effluents efficiently, with profound implications for stream biodiversity. Water companies, water regulators and rural communities therefore need to be made more aware of the potential impacts of STS on water quality so that their management can be optimised to reduce the risk of potential eutrophication and toxicity to aquatic ecosystems during summer low flow periods. Copyright © 2011 Elsevier Ltd. All rights reserved.
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Low flow water quality in rivers; septic tank systems and high-resolution phosphorus signals
International Nuclear Information System (INIS)
Macintosh, K.A.; Jordan, P.; Cassidy, R.; Arnscheidt, J.; Ward, C.
2011-01-01
Rural point sources of phosphorus (P), including septic tank systems, provide a small part of the overall phosphorus budget to surface waters in agricultural catchments but can have a disproportionate impact on the low flow P concentration of receiving rivers. This has particular importance as the discharges are approximately constant into receiving waters and these have restricted dilution capacity during ecologically sensitive summer periods. In this study, a number of identified high impact septic systems were replaced with modern sequential batch reactors in three rural catchments during a monitoring period of 4 years. Sub-hourly P monitoring was conducted using bankside-analysers. Results show that strategic replacement of defective septic tank systems with modern systems and polishing filters decreased the low flow P concentration of one catchment stream by 0.032 mg TP L −1 (0.018 mg TRP L −1 ) over the 4 years. However two of the catchment mitigation efforts were offset by continued new-builds that increased the density of septic systems from 3.4 km −2 to 4.6 km −2 and 13.8 km −2 to 17.2 km −2 and subsequently increased low flow P concentrations. Future considerations for septic system mitigation should include catchment carrying capacity as well as technology changes.
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Closure Report for Corrective Action Unit 563: Septic Systems, Nevada Test Site, Nevada
International Nuclear Information System (INIS)
2010-01-01
Corrective Action Unit (CAU) 563 is identified in the Federal Facility Agreement and Consent Order (FFACO) as 'Septic Systems' and consists of the following four Corrective Action Sites (CASs), located in Areas 3 and 12 of the Nevada Test Site: (1) CAS 03-04-02, Area 3 Subdock Septic Tank; (2) CAS 03-59-05, Area 3 Subdock Cesspool; (3) CAS 12-59-01, Drilling/Welding Shop Septic Tanks; and (4) CAS 12-60-01, Drilling/Welding Shop Outfalls Closure activities were conducted from September to November 2009 in accordance with the FFACO (1996, as amended February 2008) and the Corrective Action Plan for CAU 563. The corrective action alternatives included No Further Action and Clean Closure.
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Directory of Open Access Journals (Sweden)
Young Kun Lee
2015-08-01
Full Text Available Conventional medical therapies have not been very successful in treating adults with refractory septic shock. The effects of direct hemoperfusion using polymyxin B and veno-arterial extracorporeal membrane oxygenation (ECMO for refractory septic shock remain uncertain. A 66-year-old man was admitted to the emergency department and suffered from sepsis-induced hemodynamic collapse. For hemodynamic improvement, we performed direct hemoperfusion using polymyxin B. Computed tomography scan of this patient revealed emphysematous pyelonephritis (EPN, for which he underwent emergent nephrectomy with veno-arterial ECMO support. To the best of our knowledge, this is the first report of successful treatment of EPN with refractory septic shock using polymyxin B hemoperfusion and nephrectomy under the support of ECMO.
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Closure Report for Corrective Action Unit 563: Septic Systems, Nevada Test Site, Nevada
Energy Technology Data Exchange (ETDEWEB)
NSTec Environmental Restoration
2010-02-28
Corrective Action Unit (CAU) 563 is identified in the Federal Facility Agreement and Consent Order (FFACO) as “Septic Systems” and consists of the following four Corrective Action Sites (CASs), located in Areas 3 and 12 of the Nevada Test Site: · CAS 03-04-02, Area 3 Subdock Septic Tank · CAS 03-59-05, Area 3 Subdock Cesspool · CAS 12-59-01, Drilling/Welding Shop Septic Tanks · CAS 12-60-01, Drilling/Welding Shop Outfalls Closure activities were conducted from September to November 2009 in accordance with the FFACO (1996, as amended February 2008) and the Corrective Action Plan for CAU 563. The corrective action alternatives included No Further Action and Clean Closure.
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Continuation of Statin Therapy and Vasopressor Use in Septic Shock.
Zechmeister, Carrie; Hurren, Jeff; McNorton, Kelly
2015-07-01
Studies have evaluated the use of statins in sepsis; however, no human studies have explored their effect on vasopressor requirements in septic shock. The primary objective was to determine the effect of prehospital statin continuation on duration of vasopressor therapy in patients with septic shock. Secondary objectives included maximum and average vasopressor dose and in-hospital mortality. This was a retrospective, institutional board-approved, observational cohort study in a community teaching hospital; 119 adult intensive care unit (ICU) patients with an ICD-9 code for septic shock and prehospital statin therapy were evaluated. Multivariate analyses were performed to address confounders. Of the 1229 patients screened, 119 (10%) met inclusion criteria; 73 patients (61%) had a statin continued within 24 hours of ICU admission. Crude analysis demonstrated no difference in vasopressor duration in the statin versus no statin group (3.3 vs 4.8 days; P = 0.21). There was no difference in either maximum (17.9 ± 16.1 vs 23.8 ± 21.7 µg/min norepinephrine equivalents [NEQs]; P = 0.1) or average vasopressor dose (9.5 ± 8.4 vs 12.1 ± 11.5 µg/min NEQ; P = 0.17). There was a decrease in mortality in the statin patients (43% vs 67 %; P = 0.05). On adjustment for potential confounders, there was no difference in any outcome, with a persistent trend toward lower mortality in the statin group. Continuation of prehospital statin therapy decreased neither duration nor dose of vasopressors in patients with septic shock but yielded a trend toward decreased mortality. © The Author(s) 2015.
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Evolution in Many-Sheeted Space-time
Pitkänen, Matti
2010-01-01
The topics of the article has been restricted to those, which seem to represent the most well-established ideas about evolution in many-sheeted space-time. a) Basic facts about and TGD based model for pre-biotic evolution are discussed. b) A model for the ATP-ADP process based on DNA as topological quantum computer vision, the identification of universal metabolic energy quanta in terms of zero point kinetic energies, and the notion of remote metabolism is discussed. c) A model f...
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The intensive care medicine research agenda on septic shock
DEFF Research Database (Denmark)
Perner, Anders; Gordon, Anthony C; Angus, Derek C
2017-01-01
Septic shock remains a global health challenge with millions of cases every year, high rates of mortality and morbidity, impaired quality of life among survivors and relatives, and high resource use both in developed and developing nations. Care and outcomes are improving through organisational i...... and translational work. In this review, international experts summarize the current position of clinical research in septic shock and propose a research agenda to advance this field....... initiatives and updated clinical practice guidelines based on clinical research mainly carried out by large collaborative networks. This progress is likely to continue through the collaborative work of the established and merging trials groups in many parts of the world and through refined trial methodology...
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Microcirculatory monitoring in septic patients: Where do we stand?
Gruartmoner, G; Mesquida, J; Ince, C
Microcirculatory alterations play a pivotal role in sepsis-related morbidity and mortality. However, since the microcirculation has been a "black box", current hemodynamic management of septic patients is still guided by macrocirculatory parameters. In the last decades, the development of several technologies has shed some light on microcirculatory evaluation and monitoring, and the possibility of incorporating microcirculatory variables to clinical practice no longer seems to be beyond reach. The present review provides a brief summary of the current technologies for microcirculatory evaluation, and attempts to explore the potential role and benefits of their integration to the resuscitation process in critically ill septic patients. Copyright © 2016 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.
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Update on the Management of Pediatric Acute Osteomyelitis and Septic Arthritis
Directory of Open Access Journals (Sweden)
Luca Castellazzi
2016-06-01
Full Text Available Acute osteomyelitis and septic arthritis are two infections whose frequencies are increasing in pediatric patients. Acute osteomyelitis and septic arthritis need to be carefully assessed, diagnosed, and treated to avoid devastating sequelae. Traditionally, the treatment of acute osteoarticular infection in pediatrics was based on prolonged intravenous anti-infective therapy. However, results from clinical trials have suggested that in uncomplicated cases, a short course of a few days of parenteral antibiotics followed by oral therapy is safe and effective. The aim of this review is to provide clinicians an update on recent controversies and advances regarding the management of acute osteomyelitis and septic arthritis in children. In recent years, the emergence of bacterial species resistant to commonly used antibiotics that are particularly aggressive highlights the necessity for further research to optimize treatment approaches and to develop new molecules able to fight the war against acute osteoarticular infection in pediatric patients.
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THE INVESTIGATION OF DENSITY CURRENTS AND RATE OF OUTFLOW FROM A SEPTIC TANK
Directory of Open Access Journals (Sweden)
Maciej Pawlak
2015-09-01
Full Text Available The aim of the study was to verify the possibility of the existence of preferential flow paths in a septic tank and the effect of using various types of inlet and outlet in this context. Two of the most unfavourable variants of favoured flow paths for different types of inlet and outlet were analysed. The first variant was related to the occurrence of the privileged flow path below the water surface level directly to the outlet and the second variant – to the so-called boiling phenomenon in a septic tank. During the study, the intensity of outflow from the septic tank was measured. The time between successive doses also was measured. These studies were carried out using several inlet and outlet structures combinations. It was observed that by introducing a suitable outlet it is possible to limit and in the case of the particular type of filtering basket – to eliminate the unwanted phenomenon of preferential flow paths after hot water introduction. The phenomenon of boiling in the septic tank may occur due to the introduction of wastewater of higher density containing a higher concentration of the suspension. The effect of cooler water introduction on this phenomenon was not observed. The limitation of the maximum intensity of outflow from the septic tank can be achieved by filtering basket using at the outlet, which increases the flow resistance thanks to the low porosity.
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Inhibition of histone deacetylases protects septic mice from lung and splenic apoptosis.
Takebe, Mariko; Oishi, Hirofumi; Taguchi, Kumiko; Aoki, Yuta; Takashina, Michinori; Tomita, Kengo; Yokoo, Hiroki; Takano, Yasuo; Yamazaki, Mitsuaki; Hattori, Yuichi
2014-04-01
Epigenetic programming, dynamically regulated by histone acetylation, may play a key role in the pathophysiology of sepsis. We examined whether histone deacetylase (HDAC) can contribute to sepsis-associated inflammation and apoptosis. Polymicrobial sepsis was induced by cecal ligation and puncture (CLP) in BALB/c mice. An intraperitoneal injection of CG200745 (10 mg/kg), a novel broad-spectrum HDAC inhibitor, or valproic acid (500 mg/kg), a predominant inhibitor of class I HDACs, was given 3 h before surgery. HDAC1, HDAC2, and HDAC3 protein levels were decreased in lungs after CLP. Furthermore, CLP-induced sepsis increased both histone H3 and H4 acetylation levels in lungs. When CG200745 was given, apoptosis induction was strongly suppressed in lungs and spleens of septic mice. This antiapoptotic effect of CG200745 was not accompanied by upregulation of antiapoptotic and downregulation of proapoptotic Bcl-2 family member proteins. Treatment with CG200745 failed to inhibit elevated levels of serum cytokines and prevent lung inflammation in septic mice. Valproic acid also showed antiapoptotic but not anti-inflammatory effects in septic mice. These findings imply that HDAC inhibitors are a unique agent to prevent cell apoptosis in sepsis at their doses that do not improve inflammatory features, indicating that septic inflammation and apoptosis may not necessarily be essential for one another's existence. This study also represents the first report that CLP-induced sepsis downregulates HDACs. Nevertheless, the data with HDAC inhibitors suggest that imbalance in histone acetylation may play a contributory role in expression or repression of genes involved in septic cell apoptosis. Copyright © 2014 Elsevier Inc. All rights reserved.
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... Institutes of Health (NIH), the leading supporter of biomedical research in the world. The NINDS, along with several ... Testimony Legislative Updates Impact NINDS Contributions to Approved Therapies ... Director, Division of Intramural Research
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... 6, 2014 Content source: National Institute for Occupational Safety and Health Education and Information Division Email Recommend Tweet YouTube Instagram Listen Watch RSS ABOUT About CDC Jobs Funding LEGAL Policies Privacy FOIA No Fear Act OIG 1600 Clifton Road Atlanta , GA 30329-4027 USA 800-CDC-INFO ( ...
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National Court Appointed Special Advocate Association, Seattle WA.
Each year nearly 400,000 children in the United States are thrust into court through no fault of their own. Often these children also become victims of the United States' overburdened child welfare system. A Court Appointed Special Advocate (CASA) volunteer is a trained citizen who is appointed by a judge to represent the best interests of a child…
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... all prescription drugs. For example, it converts the painkiller codeine into its active form, morphine. There are ... patients by providing guidance on dose, possible side effects, or differences in effectiveness for people with certain ...
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Flotsam and Jetsam: A Newsletter for Massachusetts Marine Educators, 1985
1985-01-01
Presents factual information on penguins using an outline format. Includes descriptions of physical characteristics, behavioral mechanisms, geographical distribution, and physiological processes. Provides separate bibliographies for teachers and students. (ML)
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... federal government website managed by the Office on Women's Health in the Office of the Assistant Secretary for Health at the U.S. Department of Health and Human Services . 200 Independence Avenue, S.W., Washington, DC 20201 1-800-994- ...
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... federal government website managed by the Office on Women's Health in the Office of the Assistant Secretary for Health at the U.S. Department of Health and Human Services . 200 Independence Avenue, S.W., Washington, DC 20201 1-800-994- ...
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... federal government website managed by the Office on Women's Health in the Office of the Assistant Secretary for Health at the U.S. Department of Health and Human Services . 200 Independence Avenue, S.W., Washington, DC 20201 1-800-994- ...
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... this site from a secured browser on the server. Please enable scripts and reload this page. Sign ... disease. Please consult with a qualified health care professional for answers to personal medical questions. NIGMS is ...
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... this site from a secured browser on the server. Please enable scripts and reload this page. Sign ... disease. Please consult with a qualified health care professional for answers to personal medical questions. NIGMS is ...
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Vermunt, Lindy C.; Buysse, Corinne M.; Joosten, Koen F.; Duivenvoorden, Hugo J.; Hazelzet, Jan A.; Verhulst, Frank C.; Utens, Elisabeth M.
2011-01-01
To investigate long-term psychosocial outcomes in young adults who survived septic shock caused by Neisseria meningitidis (meningococcal septic shock) during childhood. A cross-sectional study. The psychological investigation took place in the department of Child and Adolescent Psychiatry of the
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Vermunt, Lindy C.; Buysse, Corinne M.; Joosten, Koen F.; Duivenvoorden, Hugo J.; Hazelzet, Jan A.; Verhulst, Frank C.; Utens, Elisabeth M.
Objective: To investigate long-term psychosocial outcomes in young adults who survived septic shock caused by Neisseria meningitidis (meningococcal septic shock) during childhood. Design: A cross-sectional study. Setting: The psychological investigation took place in the department of Child and
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Safety and vasopressor effect of rosuvastatin in septic patients
Directory of Open Access Journals (Sweden)
Hanaa A. El Gendy
2014-07-01
Conclusions: Rosuvastatin 20 mg/day in septic patients increased number ABPSPD, decreased time to initial ABPSPD, norepinephrine dose and duration, with no significant elevation in transaminases or CPK.
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Chen, Qiyi; Li, Ning; Zhu, Weiming; Li, Weiqin; Tang, Shaoqiu; Yu, Wenkui; Gao, Tao; Zhang, Juanjuan; Li, Jieshou
2011-06-03
Hypercatabolism is common under septic conditions. Skeletal muscle is the main target organ for hypercatabolism, and this phenomenon is a vital factor in the deterioration of recovery in septic patients. In skeletal muscle, activation of the ubiquitin-proteasome system plays an important role in hypercatabolism under septic status. Insulin is a vital anticatabolic hormone and previous evidence suggests that insulin administration inhibits various steps in the ubiquitin-proteasome system. However, whether insulin can alleviate the degradation of skeletal muscle protein by inhibiting the ubiquitin-proteasome system under septic condition is unclear. This paper confirmed that mRNA and protein levels of the ubiquitin-proteasome system were upregulated and molecular markers of skeletal muscle proteolysis (tyrosine and 3-methylhistidine) simultaneously increased in the skeletal muscle of septic rats. Septic rats were infused with insulin at a constant rate of 2.4 mU.kg-1.min-1 for 8 hours. Concentrations of mRNA and proteins of the ubiquitin-proteasome system and molecular markers of skeletal muscle proteolysis were mildly affected. When the insulin infusion dose increased to 4.8 mU.kg-1.min-1, mRNA for ubiquitin, E2-14 KDa, and the C2 subunit were all sharply downregulated. At the same time, the levels of ubiquitinated proteins, E2-14KDa, and the C2 subunit protein were significantly reduced. Tyrosine and 3-methylhistidine decreased significantly. We concluded that the ubiquitin-proteasome system is important skeletal muscle hypercatabolism in septic rats. Infusion of insulin can reverse the detrimental metabolism of skeletal muscle by inhibiting the ubiquitin-proteasome system, and the effect is proportional to the insulin infusion dose.
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Morin, Luc; Ray, Samiran; Wilson, Clare; Remy, Solenn; Benissa, Mohamed Rida; Jansen, Nicolaas J. G.; Javouhey, Etienne; Peters, Mark J.; Kneyber, Martin; De Luca, Daniele; Nadel, Simon; Schlapbach, Luregn Jan; Maclaren, Graeme; Tissieres, Pierre
2016-01-01
Purpose Although overall paediatric septic shock mortality is decreasing, refractory septic shock (RSS) is still associated with high mortality. A definition for RSS is urgently needed to facilitate earlier identification and treatment. We aim to establish a European society of paediatric and
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Morin, Luc; Ray, Samiran; Wilson, Clare; Remy, Solenn; Benissa, Mohamed Rida; Jansen, Nicolaas J. G.; Javouhey, Etienne; Peters, Mark J.; Kneyber, Martin; De Luca, Daniele; Nadel, Simon; Schlapbach, Luregn Jan; Maclaren, Graeme; Tissieres, Pierre
2016-01-01
Although overall paediatric septic shock mortality is decreasing, refractory septic shock (RSS) is still associated with high mortality. A definition for RSS is urgently needed to facilitate earlier identification and treatment. We aim to establish a European society of paediatric and neonatal
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Bilateral septic arthritis of the temporo mandibular joint: case report.
Ayachi, Samia; Mziou, Zouha; Moatemri, Ramzi; Khochtali, Habib
2016-01-01
Septic arthritis of the temporo-mandibular joint (TMJ) is a rare disease that has been reported infrequently. To the best of the authors' knowledge, only one case of bilateral TMJ septic arthritis has been reported. The contamination may result from direct extension of adjacent infection (dental or ENT), from hematogenous spread of blood-borne organisms or from direct inoculation. The most common presenting are trismus and pain, although swelling, tenderness and erythema have also been described. In addition, patients may develop fever, regional lymphadenopathy and malocclusion. Through a successively bilateral case of TMJ arthritis, without obvious portal of entry of the bacteria, we will analyze characteristics and treatment of this disease.
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Diagnostic and prognostic value of procalcitonin in patients with septic shock.
Clec'h, Christophe; Ferriere, Françoise; Karoubi, Philippe; Fosse, Jean P; Cupa, Michel; Hoang, Philippe; Cohen, Yves
2004-05-01
To determine whether procalcitonin is a reliable diagnostic and prognostic marker in septic shock compared with nonseptic shock. Prospective controlled trial. Intensive care unit of the Avicenne Teaching Hospital, Bobigny, France. All patients admitted to our intensive care unit over a 12-month period with clinical evidence of shock. None. Echocardiography or pulmonary artery flotation catheter measurements were used to assess hemodynamics, and multiple specimens were obtained for microbiological studies. Standard criteria were used to diagnose septic shock. Serum concentrations of procalcitonin, C-reactive protein, and lactate were determined on the day of shock onset (day 1) and on days 3, 7, and 10. Seventy-five patients were included, 62 in the septic shock group and 13 in the cardiogenic shock group. Serum procalcitonin on day 1 was significantly higher in patients with than without septic shock (median, 14 [0.3-767] ng/mL vs. 1 [0.5-36] ng/mL, p < .01). A cutoff value of 1 ng/mL had 95% sensitivity and 54% specificity for separating patients with and without sepsis. C-reactive protein failed to discriminate between these two groups. Among patients with sepsis, procalcitonin concentrations were significantly higher in those who died than in the survivors, at all four measurement time points (median, 16 [0.15-767] ng/mL vs. 6 [0.2-123] ng/mL, p = .045 on day 1; 6.5 [0.3-135] ng/mL vs. 1.05 [0.11-53] ng/mL, p = .02 on day 10). A cutoff value of 6 ng/mL on day 1 separated patients who died from those who survived with 87.5% sensitivity and 45% specificity. C-reactive protein was not helpful for predicting mortality. Serum lactate was a nonspecific prognostic marker. These data indicate that procalcitonin may be a valuable early diagnostic and prognostic marker in patients with septic shock.
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Survival of Primates in Lethal Septic Shock Following Delayed Treatment with Steroid.
1981-02-26
TECHNICAL REPORT NO. 142 SURVIVAL OF PRIMATES IN LETHAL SEPTIC SHOCK FOLLOWING DELAYED TREAMENT WIn STEROID L. B. Hinshaw, L. T. Archer, B. K. Belier ...2. Schumer W: Steroids in the treatment of clinical septic shock. Ann Surg 184:333-341, 1976. 3. Hinshaw LB, Belier PK, Archer LT, Flournoy DJ, White...not preventable by antibiotic alone. Infect Immun ZS:538-5)7, 1979. 6. Hinshaw LB, Archer LT, Belier -Todd BK, Coalson .JJ, Flournoy DL, Passey R
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Severe sepsis and septic shock [author's reply
Angus, Derek C.; van der Poll, Tom
2013-01-01
To the Editor: We would like to address two potentially confusing issues concerning venous oxygen saturation (Svo(2)) as presented in Table 1 of the review by Angus and van der Poll (Aug. 29 issue).(1) First, Table 1 suggests that Svo(2) is raised in sepsis, severe sepsis, and septic shock.
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Effect of temperature on anaerobic treatment of black water in UASB-septic tank systems.
Luostarinen, Sari; Sanders, Wendy; Kujawa-Roeleveld, Katarzyna; Zeeman, Grietje
2007-03-01
The effect of northern European seasonal temperature changes and low temperature on the performance of upflow anaerobic sludge blanket (UASB)-septic tanks treating black water was studied. Three UASB-septic tanks were monitored with different operational parameters and at different temperatures. The results indicated the feasibility of the UASB-septic tank for (pre)treatment of black water at low temperatures with respect to removal of suspended solids and dissolved organic material. Inoculum sludge had little effect on COD(ss) removal, though in the start-up phase some poorly adapted inoculum disintegrated and washed out, thus requiring consideration when designing the process. Removal of COD(dis) was at first negative, but improved as the sludge adapted to low temperature. The UASB-septic tank alone did not comply with Finnish or Dutch treatment requirements and should therefore be considered mainly as a pre-treatment method. However, measuring the requirements as mgCOD l(-1) may not always be the best method, as the volume of the effluent discharged is also an important factor in the final amount of COD entering the receiving water bodies.
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Effect of micro-aeration on anaerobic digestion of primary sludge under septic tank conditions.
Diak, James; Örmeci, Banu; Kennedy, Kevin J
2013-04-01
Micro-aeration, which refers to the addition of very small amounts of air, is a simple technology that can potentially be incorporated in septic tanks to improve the digestion performance. The purpose of this study was to investigate and compare the effects of micro-aeration on anaerobic digestion of primary sludge under septic tank conditions. 1.6 L batch reactor experiments were carried out in duplicate using raw primary sludge, with 4.1 % total solids, and diluted primary sludge, with 2.1 % total solids. Reactors were operated for 5 weeks at room temperature to simulate septic tank conditions. Micro-aeration rate of 0.00156 vvm effectively solubilised chemical oxygen demand (COD) and improved the subsequent degradation of COD. Micro-aeration also increased the generation of ammonia and soluble proteins, but did not improve the reduction in total and volatile solids, or the reduction in carbohydrates. Experiments using diluted sludge samples showed similar trends as the experiments with raw sludge, which suggest that initial solids concentration did not have a significant effect on the degradation of primary sludge under septic tank conditions.
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Drotrecogin alfa (activated) in adults with septic shock.
Ranieri, V.M.; Thompson, B.T.; Barie, P.S.; Dhainaut, J.F.; Douglas, I.S.; Finfer, S.; Gardlund, B.; Marshall, J.C.; Rhodes, A.; Artigas, A.; Payen, D.; Tenhunen, J.; Al-Khalidi, H.R.; Thompson, V.; Janes, J.; Macias, W.L.; Vangerow, B.; Williams, M.D.; Pickkers, P.; Raemaekers, J.M.; et al.,
2012-01-01
BACKGROUND: There have been conflicting reports on the efficacy of recombinant human activated protein C, or drotrecogin alfa (activated) (DrotAA), for the treatment of patients with septic shock. METHODS: In this randomized, double-blind, placebo-controlled, multicenter trial, we assigned 1697
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COLLOIDS IN SEPTIC TANK EFFLUENT AND THEIR INFLUENCE ON FILTER PERMEABILITY
Directory of Open Access Journals (Sweden)
Marcin Spychała
2015-09-01
Full Text Available The aim of the study was to evaluate the content of colloids in septic tank effluent and their impact on textile filter permeability. Measurements were performed on septic tank effluent without suspended solids but containing colloids and without colloids - including only dissolved substances (filtered by micro-filters and centrifuged. The study was conducted on unclogged and clogged textile filter coupons. During the study the following measurements were determined: turbidity, chemical oxygen demand and hydraulic conductivity of textile filter coupons. The colloid size range was assumed to be less than 1.2 microns according to the literature. Despite the relatively low content in the septic tank effluent the colloids played an important role in the clogging process. Both the filtering media, filled with low (unclogged and high content of biomass (clogged were sensitive to the clogging process of colloid acceleration due to the possibility of small diameter pore closure and oxygen access termination. Moreover, small size pores were probably sensitive to closing or bridging by small size colloidal particles.
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Directory of Open Access Journals (Sweden)
Ahmed A. EL‐Nawawy
2018-01-01
Conclusion: Serial echocardiography provided crucial data for early recognition of septic myocardial dysfunction and hypovolemia that was not apparent on clinical assessment, allowing a timely management and resulting in shock reversal time reduction among children with septic shock.
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Designing and testing computer based screening engine for severe sepsis/septic shock.
Herasevich, V; Afessa, B; Chute, C G; Gajic, O
2008-11-06
This study addresses the role of a sepsis "sniffer", an automatic screening tool for the timely identification of patients with severe sepsis/septic shock, based electronic medical records. During the two months prospective implementation in a medical intensive care unit, 37 of 320 consecutive patients developed severe sepsis/septic shock. The sniffer demonstrated a sensitivity of 48% and specificity of 86%, and positive predictive value 32%. Further improvements are needed prior to the implementation of sepsis sniffer in clinical practice and research.
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Characterization of human septic sera induced gene expression modulation in human myocytes
Hussein, Shaimaa; Michael, Paul; Brabant, Danielle; Omri, Abdelwahab; Narain, Ravin; Passi, Kalpdrum; Ramana, Chilakamarti V.; Parrillo, Joseph E.; Kumar, Anand; Parissenti, Amadeo; Kumar, Aseem
2009-01-01
To gain a better understanding of the gene expression changes that occurs during sepsis, we have performed a cDNA microarray study utilizing a tissue culture model that mimics human sepsis. This study utilized an in vitro model of cultured human fetal cardiac myocytes treated with 10% sera from septic patients or 10% sera from healthy volunteers. A 1700 cDNA expression microarray was used to compare the transcription profile from human cardiac myocytes treated with septic sera vs normal sera....
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Zamalloa Nalvarte, Carlos Enrique; Arends, Jan; Boon, Nico; Verstraete, Willy
2013-01-01
Septic tanks are used for the removal of organic particulates in wastewaters by physical accumulation instead of through the biological production of biogas. Improved biogas production in septic tanks is crucial to increase the potential of this system for both energy generation and organic matter removal. In this study, the effect on the biogas production and biogas quality of coupling a 20 L lab-scale septic tank with a microbial electrolysis cell (MEC) was investigated and compared with a ...
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A model of Staphylococcus aureus bacteremia, septic arthritis, and osteomyelitis in chickens.
Daum, R S; Davis, W H; Farris, K B; Campeau, R J; Mulvihill, D M; Shane, S M
1990-11-01
We studied the occurrence, magnitude, and kinetics of bacteremia and the resultant osteomyelitis and septic arthritis in an avian model of Staphylococcus aureus infection. Thirty-day-old male broiler chicks were inoculated i.v. with 10(5), 10(6), or 10(7) cfu of strain Duntravis, a beta-hemolytic, coagulase-producing, capsular type 8 isolate from the synovial fluid of a 2-year-old black boy. Bacteremia occurred in 80%, 90%, and 100% of animals inoculated with 10(5), 10(6), or 10(7) cfu, respectively. The magnitude of bacteremia in surviving, bacteremic animals increased for 96 hours after inoculation and then decreased after a plateau phase. Osteomyelitis and septic arthritis occurred only in chicks that were continuously bacteremic. The occurrence of osteomyelitis was uniform among continuously bacteremic animals and developed 1 to 23 hours after inoculation. Chickens are susceptible to systemic infections with S. aureus. Bacteremia, osteomyelitis, and septic arthritis may be induced in healthy chickens without prior manipulations that depress their resistance.
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Aquatic Plant/microbial Filters for Treating Septic Tank Effluent
Wolverton, B. C.
1988-01-01
The use of natural biological processes for treating many types of wastewater have been developed by NASA at the John C. Stennis Space Center, NSTL, Mississippi, during the past 15 years. The simplest form of this technology involves the use of aquatic plant/marsh filters for treatment of septic tank effluent. Septic tank effluent from single home units can be treated to advanced secondary levels and beyond by using a 37.2 sq m (400 sq ft) surface area washed gravel filter. This filter is generally 0.3 m (1 ft) deep with a surface cover of approximately 0.15 m (6 in.) of gravel. The plants in this filter are usually aesthetic or ornamental such as calla lily (Zantedeschia aethiopica), canna lily (Canna flaccida), elephant ear (Colocasia esculenta), and water iris (Iris pseudacorus).
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Cystatin C as an early marker of acute kidney injury in septic shock.
Ortuño-Andériz, F; Cabello-Clotet, N; Vidart-Simón, N; Postigo-Hernández, C; Domingo-Marín, S; Sánchez-García, M
2015-03-01
To describe the utility of determining plasma cystatinC concentrations in the diagnosis of acute incident kidney injury in septic shock. Prospective series of 50 patients with septic shock and plasma creatinine levels <2mg/dL hospitalized in an intensive care unit. Clinical and laboratory follow-ups were conducted, with measurements of cystatinC, urea and plasma creatinine levels from the diagnosis of septic shock to 5days later. The severity of the septic shock was assessed with the RIFLE scale. Twenty patients (40%) developed acute kidney injury: 8 (16%) were categorized as RIFLE-R, 5 (10%) as RIFLE-I and 7 (14%) as RIFLE-F. All patients categorized as RIFLE-F required extracorporeal renal clearance. Eighteen (36%) patients died, 8 (20%) of whom had developed acute kidney injury in their evolution. There was poor correlation between plasma creatinine and cystatin C levels (r=.501; P=.001), which disappeared upon reaching any degree of renal impairment on the RIFLE scale. CystatinC levels increased earlier and were better able to identify patients who would develop serious renal function impairment (RIFLE-F) than creatinine and urea levels. The initial cystatinC levels were related to mortality at 30days (OR=1.16; 95%CI: 03-.85). For patients who developed acute septic kidney injury, the plasma cystatinC levels increased before the classical markers of renal function. CystatinC also constitutes a severity biomarker that correlates with progression to RIFLE-F, the need for extrarenal clearance and, ultimately, mortality. This precocity could be useful for starting measures that prevent the progression of renal dysfunction. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.
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International Nuclear Information System (INIS)
Oner, Ali Yusuf; Ucar, Murat; Akpek, Sergin; Tokgoz, Nil
2007-01-01
FMF arthritis is generally monoarticular in origin. The affected joint is hot, tender, red and mimics septic arthritis. Conventional imaging findings, including magnetic resonance imaging (MRI) and ultrasound, do not help differentiate between these two entities. The final diagnosis depends on culture of the synovial fluid, and therefore initiation of proper drug therapy can be delayed. Diffusion weighted imaging (DWI), with its ability to detect altered water-proton mobility, might play an important role as a fast and non-invasive problem-solving tool in this setting. We here present MRI and DWI findings of a case of FMF arthritis mimicking septic arthritis. (orig.)
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Adrenal gland volume measurement in septic shock and control patients: a pilot study
Energy Technology Data Exchange (ETDEWEB)
Nougaret, Stephanie; Aufort, S.; Gallix, B. [Hopital Saint Eloi, Department of Abdominal Imaging, CHU Montpellier, Montpellier, Cedex 5 (France); Jung, B.; Chanques, G.; Jaber, S. [Hopital Saint Eloi, Intensive Care Unit, Department of Critical Care and Anesthesiology: DAR B, CHU Montpellier, Montpellier, Cedex 5 (France)
2010-10-15
To compare adrenal gland volume in septic shock patients and control patients by using semi-automated volumetry. Adrenal gland volume and its inter-observer variability were measured with tomodensitometry using semi-automated software in 104 septic shock patients and in 40 control patients. The volumes of control and septic shock patients were compared and the relationship between volume and outcome in intensive care was studied. The mean total volume of both adrenal glands was 7.2 {+-} 2.0 cm{sup 3} in control subjects and 13.3 {+-} 4.7 cm{sup 3} for total adrenal gland volume in septic shock patients (p < 0.0001). Measurement reproducibility was excellent with a concordance correlation coefficient value of 0.87. The increasing adrenal gland volume was associated with a higher rate of survival in intensive care. The present study reports that with semi-automated software, adrenal gland volume can be measured easily and reproducibly. Adrenal gland volume was found to be nearly double in sepsis compared with control patients. The absence of increased volume during sepsis would appear to be associated with a higher rate of mortality and may represent a prognosis factor which may help the clinician to guide their strategy. (orig.)
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Adrenal gland volume measurement in septic shock and control patients: a pilot study
International Nuclear Information System (INIS)
Nougaret, Stephanie; Aufort, S.; Gallix, B.; Jung, B.; Chanques, G.; Jaber, S.
2010-01-01
To compare adrenal gland volume in septic shock patients and control patients by using semi-automated volumetry. Adrenal gland volume and its inter-observer variability were measured with tomodensitometry using semi-automated software in 104 septic shock patients and in 40 control patients. The volumes of control and septic shock patients were compared and the relationship between volume and outcome in intensive care was studied. The mean total volume of both adrenal glands was 7.2 ± 2.0 cm 3 in control subjects and 13.3 ± 4.7 cm 3 for total adrenal gland volume in septic shock patients (p < 0.0001). Measurement reproducibility was excellent with a concordance correlation coefficient value of 0.87. The increasing adrenal gland volume was associated with a higher rate of survival in intensive care. The present study reports that with semi-automated software, adrenal gland volume can be measured easily and reproducibly. Adrenal gland volume was found to be nearly double in sepsis compared with control patients. The absence of increased volume during sepsis would appear to be associated with a higher rate of mortality and may represent a prognosis factor which may help the clinician to guide their strategy. (orig.)
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A Case of Acinetobacter Septic Pulmonary Embolism in an Infant
Directory of Open Access Journals (Sweden)
Poonam Wade
2016-01-01
Full Text Available Case Characteristics. An 11-month-old girl presented with fever and breathlessness for 5 days. Patient had respiratory distress with bilateral coarse crepitations. Chest radiograph revealed diffuse infiltrations in the right lung with thick walled cavities in mid and lower zone. Computed tomography showed multiple cystic spaces and emboli. Blood culture grew Acinetobacter species. Intervention. Patient was treated with Meropenem and Vancomycin. Outcome. Complete clinical and radiological recovery was seen in child. Message. Blood cultures and CT of the chest are invaluable in the evaluation of a patient with suspected septic pulmonary embolism. With early diagnosis and appropriate antimicrobial therapy, complete recovery can be expected in patients with septic pulmonary embolism.
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Current Opinions in Pediatric Septic Shock
Directory of Open Access Journals (Sweden)
José Irazuzta
2009-11-01
Full Text Available Objectives: Our aim is to describe the current clinical practice related to the management of septic shock (SS. Methods: Review of medical literature using the MEDLINE database. Articles were selected according to their relevancy to the objective and according to the author’s opinion. Summary of the findings: The outcome from SS is dependent on an early recognition and a sequential implementation of time-sensitive goal-directed therapies. The goals of the resuscitation are rapid restoration of micro circulation and improved organ tissue perfusion. Clinical and laboratory markers are needed to assess the adequacy of the treatments. Initial resuscitation involves the use of isotonic solutions (>60ml/kg either crystalloid (normal saline or colloid infusion often followed by vasoactive medications. Altered pharmacokinetics and pharmacodynamics responses dictate that vasoactive agents should be adjusted to achieve predetermined goals. An assessment of central venous pressure complements clinical and serological findings to tailor therapies. Elective airway instrumentation and mechanical ventilation as well as adjunctive therapy with stress dose of corticosteroid are indicated in selected populations. In neonates, a special attention to the presence of electrolyte imbalance and increase pulmonary vascular resistance needs to be considered early. Conclusions: Septic shock hemodynamic is a changing process that requires frequent assessment and therapeutic adjustments.
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Tension pneumocephalus mimicking septic shock: a case report.
Miranda, Caroline; Mahta, Ali; Wheeler, Lee Adam; Tsiouris, A John; Kamel, Hooman
2018-02-01
Tension pneumocephalus can lead to rapid neurologic deterioration. We report for the first time its association with aseptic systemic inflammatory response syndrome mimicking septic shock and the efficacy of prompt neurosurgical intervention and critical care support in treating this condition. A 64-year-old man underwent 2-stage olfactory groove meningioma resection. The patient developed altered mental status and gait instability on postoperative day 6. Imaging showed significant pneumocephalus. The patient subsequently developed worsening mental status, respiratory failure, and profound shock requiring multiple vasopressors. Bedside needle decompression, identification and repair of the cranial fossa defect, and critical care support led to improved mental status and reversal of shock and multiorgan dysfunction. Thorough evaluation revealed no evidence of an underlying infection. In this case, tension pneumocephalus incited an aseptic systemic inflammatory response syndrome mimicking septic shock. Prompt neurosurgical correction of pneumocephalus and critical care support not only improved neurologic status, but also reversed shock. Such a complication indicates the importance of close monitoring of patients with progressive pneumocephalus.
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Drug sensitivity patterns of bacterial isolates from septic post ...
African Journals Online (AJOL)
Background: Wound infections have been a problem in the field of surgery for a long time.Advances in control of infections have not completely eradicated this ... of bacterial isolates from septic postoperative wounds in Jinja hospital, Uganda.
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UASB-septic tank as an alternative for decentralized wastewater treatment in Mexico.
Santiago-Díaz, Ángel L; García-Albortante, Julisa; Salazar-Peláez, Mónica L
2018-02-05
The aim of this work was to evaluate the performance of a UASB-septic tank as a decentralized treatment of high-strength municipal wastewater under two different HRTs (48 and 72 h). Thus, a lab-scale (44.85 L) UASB-septic tank constituted by three compartments was operated under HRT 72 and 48 h. Removal efficiencies of total chemical oxygen demand (COD), biological oxygen demand (BOD 5 ) and suspended solids (SS) ranged from 60% to 80% for the first two parameters and from 70% to 90% for the last one. According to the statistical analysis, it was established that decreasing HRT from 72 to 48 h did not affect the performance of the UASB-septic tank; therefore, the latter HRT is recommended to be used for operation. In the first compartment, most of the organic matter removal was carried out, while the other two compartments served as polishing. Over the course of six months, the VS concentration and VS/TS ratio in sludge blanket decreased, indicating digestion and stabilization of the retained solids. Also, an increase of 4% in sludge volume was observed; thus, time for desludging would be approximately five years. Comparison of the UASB-septic tank and the UASB reactor showed that both systems had similar performance regarding effluent concentrations of organic matter and solids. Thus, under low volumetric organic load conditions (less than 20 mg COD/L h), the former is an attractive option for municipal wastewater treatment.
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Effects of elevated temperature on protein breakdown in muscles from septic rats
International Nuclear Information System (INIS)
Hall-Angeras, M.A.; Angeras, U.H.; Hasselgren, P.O.; Fischer, J.E.
1990-01-01
Elevated temperature has been proposed to contribute to accelerated muscle protein degradation during fever and sepsis. The present study examined the effect of increased temperature in vitro on protein turnover in skeletal muscles from septic and control rats. Sepsis was induced by cecal ligation and puncture (CLP); control rats were sham operated. After 16 h, the extensor digitorum longus (EDL) and soleus (SOL) muscles were incubated at 37 or 40 degrees C. Protein synthesis was determined by measuring incorporation of [14C]phenylalanine into protein. Total and myofibrillar protein breakdown was assessed from release of tyrosine and 3-methylhistidine (3-MH), respectively. Total protein breakdown was increased at 40 degrees C by 15% in EDL and by 29% in SOL from control rats, whereas 3-MH release was not affected. In muscles from septic rats, total and myofibrillar protein breakdown was increased by 22 and 30%, respectively, at 40 degrees C in EDL but was not altered in SOL. Protein synthesis was unaffected by high temperature both in septic and nonseptic muscles. The present results suggest that high temperature is not the primary mechanism of increased muscle protein breakdown in sepsis because the typical response to sepsis, i.e., a predominant increase in myofibrillar protein breakdown, was not induced by elevated temperature in normal muscle. It is possible, however, that increased temperature may potentiate protein breakdown that is already stimulated by sepsis because elevated temperature increased both total and myofibrillar protein breakdown in EDL from septic rats
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Directory of Open Access Journals (Sweden)
Sriwong Chaval
2015-01-01
Full Text Available The AC/TiO2/Rubber (ACTR composite sheets weresuccessfully fabricated by a simply mixing of fixed TiO2 suspension and natural rubber latex (60% HA contents withthe varyingamounts of activated carbon (AC suspension, followed by stirring, pouring into apetri dish mold, drying at room temperature (RT, after that taking out from a mold, reversing and drying again at RT. Then, the as-fabricated ACTR composite sheets were characterized by X-ray diffractometer (XRD, attenuated total reflection Fourier transform infrared spectroscopy (ATR-FTIR, energy dispersive X-ray spectroscopy (EDS and scanning electron microscopy (SEMtechniques. The photocatalytic efficiencies of all ACTR composite sheet samples were evaluated by photo degrading of methylene blue (MB dye solution under UV light irradiation. The results showed that the photocatalytic activity of ACTR sheet with10.0wt%AC loading has the highest efficiency for the photo degradation of MB dye than the other sheets. This is due to the fact that it is relatively with the synergistic effect of well-combined titanium dioxide catalyst and activated carbon adsorbent.
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Directory of Open Access Journals (Sweden)
Odetokun, I. A.
2011-01-01
Full Text Available In Nigeria, inadequate supply of pipe borne water is a major concern; hence many homes have wells as a source of water for household uses. The groundwater of forty wells in Agbowo community was assessed for Total Aerobic Bacteria Counts (TABC and Total Coliform Counts (TCC. The location and distances of wells from septic tanks were determined using the Global Positioning System (GPS device and a tape rule respectively. All the wells sampled had high TABC (4.76 ± 1.41 log CFU/mL and TCC (2.2 9± 0.67 log CFU/mL counts which exceeded the international standard of 0 per 100 mL of potable water. There were no significant differences in the bacterial counts between covered and uncovered wells (p>0.05. The mean distance (8.93±3.61m of wells from the septic tanks was below the limit (15.24 m or 50 ft set by United State Environmental Protection Agency (USEPA. TABC increased with a decrease in distance between the wells and septic tanks though not significant (p<0.05. A very weak positive correlation (r2 =0.021 ensued between the distance from septic tank and CC, while a weak negative correlation (r2 = ‒0.261 was obtained between the TCC and TABC. This study accentuates the need to set standards for the siting of wells from septic tanks while considering all possible sources of well contamination as well as treatment of ground water before use.
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Experimental models of sepsis and septic shock: an overview
Directory of Open Access Journals (Sweden)
Garrido Alejandra G.
2004-01-01
Full Text Available Sepsis remains a major cause of morbidity and mortality in surgical patients and trauma victims, mainly due to sepsis-induced multiple organ dysfunction. In contrast to preclinical studies, most clinical trials of promising new treatment strategies for sepsis have fails to demonstrate efficacy. Although many reasons could account for this discrepancy, the misinterpretation of preclinical data obtained from experimental studies, and especially the use of animal models that do not adequately mimic human sepsis may have been contributing factors. In this review, the benefits and limitations of various animal models of sepsis are discussed to clarify the extend to which findings are relevant to human sepsis, particularly with respect to the subsequent design and execution of clinical trials. Such models include intravascular infusion of endotoxin or live bacteria, bacterial peritonitis, cecal ligation and perforation, soft tissue infection, pneumonia or meningitis models, using different animal species including rats, mice, rabbits, dogs, pigs, sheep and nonhuman primates. Despite several limitations, animal models remain essential in the development of all new therapies for sepsis and septic shock, because they provide fundamental information about the pharmacokinetics, toxicity, and mechanism of drug action that cannot be duplicated by other methods. New therapeutic agents should be studies in infection models, even after the initiation of the septic process. Furthermore, debility conditions need to be reproduced to avoid the exclusive use of healthy animals, which often do not represent the human septic patient.
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The UASB reactor as an alternative for the septic tank for on-site sewage treatment.
Coelho, A L S S; do Nascimento, M B H; Cavalcanti, P F F; van Haandel, A C
2003-01-01
Although septic tanks are amply used for on site sewage treatment, these units have serious drawbacks: the removal efficiency of organic material and suspended solids is low, the units are costly and occupy a large area and operational cost is high due to the need for periodic desludging. In this paper an innovative variant of the UASB reactor is proposed as an alternative for the septic tank. This alternative has several important advantages in comparison with the conventional septic tank: (1) Although the volume of the UASB reactor was about 4 times smaller than the septic tank, its effluent quality was superior, even though small sludge particles were present, (2) desludging of the UASB reactor is unnecessary and even counterproductive, as the sludge mass guarantees proper performance, (3) the UASB reactor is easily transportable (compact and light) and therefore can be produced in series, strongly reducing construction costs and (4) since the concentration of colloids in the UASB effluent is much smaller than in the ST effluent, it is expected that the infiltration of the effluent will be much less problematic.
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Prevention of lymphocyte apoptosis in septic mice with cancer increases mortality.
Fox, Amy C; Breed, Elise R; Liang, Zhe; Clark, Andrew T; Zee-Cheng, Brendan R; Chang, Katherine C; Dominguez, Jessica A; Jung, Enjae; Dunne, W Michael; Burd, Eileen M; Farris, Alton B; Linehan, David C; Coopersmith, Craig M
2011-08-15
Lymphocyte apoptosis is thought to have a major role in the pathophysiology of sepsis. However, there is a disconnect between animal models of sepsis and patients with the disease, because the former use subjects that were healthy prior to the onset of infection while most patients have underlying comorbidities. The purpose of this study was to determine whether lymphocyte apoptosis prevention is effective in preventing mortality in septic mice with preexisting cancer. Mice with lymphocyte Bcl-2 overexpression (Bcl-2-Ig) and wild type (WT) mice were injected with a transplantable pancreatic adenocarcinoma cell line. Three weeks later, after development of palpable tumors, all animals received an intratracheal injection of Pseudomonas aeruginosa. Despite having decreased sepsis-induced T and B lymphocyte apoptosis, Bcl-2-Ig mice had markedly increased mortality compared with WT mice following P. aeruginosa pneumonia (85 versus 44% 7-d mortality; p = 0.004). The worsened survival in Bcl-2-Ig mice was associated with increases in Th1 cytokines TNF-α and IFN-γ in bronchoalveolar lavage fluid and decreased production of the Th2 cytokine IL-10 in stimulated splenocytes. There were no differences in tumor size or pulmonary pathology between Bcl-2-Ig and WT mice. To verify that the mortality difference was not specific to Bcl-2 overexpression, similar experiments were performed in Bim(-/-) mice. Septic Bim(-/-) mice with cancer also had increased mortality compared with septic WT mice with cancer. These data demonstrate that, despite overwhelming evidence that prevention of lymphocyte apoptosis is beneficial in septic hosts without comorbidities, the same strategy worsens survival in mice with cancer that are given pneumonia.
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Effects of copper particles on a model septic system's function and microbial community.
Taylor, Alicia A; Walker, Sharon L
2016-03-15
There is concern surrounding the addition of nanoparticles into consumer products due to toxicity potential and the increased risk of human and environmental exposures to these particles. Copper nanoparticles are found in many common consumer goods; therefore, the disposal and subsequent interactions between potentially toxic Cu-based nanoparticles and microbial communities may have detrimental impacts on wastewater treatment processes. This study investigates the effects of three copper particles (micron- and nano-scale Cu particles, and a nano-scale Cu(OH)2-based fungicide) on the function and operation of a model septic tank. Septic system analyses included water quality evaluations and microbial community characterizations to detect changes in and relationships between the septic tank function and microbial community phenotype/genotype. As would be expected for optimal wastewater treatment, biological oxygen demand (BOD5) was reduced by at least 63% during nano-scale Cu exposure, indicating normal function. pH was reduced to below the optimum anaerobic fermentation range during the micro Cu exposure, suggesting incomplete degradation of organic waste may have occurred. The copper fungicide, Cu(OH)2, caused a 57% increase in total organic carbon (TOC), which is well above the typical range for septic systems and also corresponded to increased BOD5 during the majority of the Cu(OH)2 exposure. The changes in TOC and BOD5 demonstrate that the system was improperly treating waste. Overall, results imply individual exposures to the three Cu particles caused distinct disruptions in septic tank function. However, it was observed that the system was able to recover to typical operating conditions after three weeks post-exposure. These results imply that during periods of Cu introduction, there are likely pulses of improper removal of total organic carbon and significant changes in pH not in the optimal range for the system. Copyright © 2016 Elsevier Ltd. All rights
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Successful staged hip replacement in septic hip osteoarthritis in osteopetrosis: a case report
Directory of Open Access Journals (Sweden)
Manzi Giovanni
2012-04-01
Full Text Available Abstract Background Osteopetrosis is a rare, inherited, bone disorder, characterized by osteosclerosis, obliteration of the medullary cavity and calcified cartilage. The autosomal dominant form is compatible with a normal life span, although fractures often result from minimal trauma, due to the pathologic nature of bone. Osteomyelitis is common in patients with osteopetrosis because of a reduced resistance to infection, attributed to the lack of marrow vascularity and impairment of white cell function. Only one case of osteomyelitis of the proximal third of the femur has been previously reported, treated with several repeated debridements and finally with femoral head resection. Here we present for the first time a case of a staged implant of a cementless total hip prosthesis for the treatment of a septic hip in femoral neck nonunion in osteopetrosis. Case presentation A 36-years-old woman, affected by autosomal dominant osteopetrosis was referred to our department because of a septic hip arthritis associated with femoral neck septic non-union, with draining fistulas. The infection occurred early after a plate osteosynthesis for a closed perthrocanteric fracture of the femur and persisted in spite of osteosynthesis removal, surgical debridement and external fixation. In our hospital the patient underwent accurate debridement, femoral head and greater trochanter resection, preparation of the diaphyseal intramedullary canal and implant of an antibiotic-loaded cement spacer. The spacer was exchanged after one month, due to infection recurrence and four months later, a cementless total hip arthroplasty was implanted, with no clinical and laboratory signs of infection recurrence at two years follow-up. Conclusions In case of hip septic arthritis and proximal femur septic non-union, femoral head resection may not be the only option available and staged total hip arthroplasty can be considered.
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Differential diagnostic value of procalcitonin in surgical and medical patients with septic shock.
Clec'h, Christophe; Fosse, Jean-Philippe; Karoubi, Philippe; Vincent, Francois; Chouahi, Imad; Hamza, Lilia; Cupa, Michel; Cohen, Yves
2006-01-01
To assess whether different diagnostic and prognostic cutoff values of procalcitonin should be considered in surgical and in medical patients with septic shock. Prospective observational study. Intensive care unit of the Avicenne teaching hospital, France. All patients with septic shock or noninfectious systemic inflammatory response syndrome within 48 hrs after admission. None. Patients were allocated to one of the following groups: group 1 (surgical patients with septic shock), group 2 (surgical patients with noninfectious systemic inflammatory response syndrome), group 3 (medical patients with septic shock), and group 4 (medical patients with noninfectious systemic inflammatory response syndrome). Procalcitonin at study entry was compared between group 1 and group 2 and between group 3 and group 4 to determine the diagnostic cutoff value in surgical and in medical patients, respectively. Procalcitonin was compared between survivors and nonsurvivors from group 1 and group 3 to determine its prognostic cutoff value. One hundred forty-three patients were included: 31 in group 1, 36 in group 2, 36 in group 3, and 40 in group 4. Median procalcitonin levels (ng/mL [interquartile range]) were higher in group 1 than in group 3 (34.00 [7.10-76.00] vs. 8.40 [3.63-24.70], p = .01). In surgical patients, the best diagnostic cutoff value was 9.70 ng/mL, with 91.7% sensitivity and 74.2% specificity. In medical patients, the best diagnostic cutoff value was 1.00 ng/mL, with 80% sensitivity and 94% specificity. Procalcitonin was a reliable early prognostic marker in medical but not in surgical patients with septic shock. A cutoff value of 6.00 ng/mL had 76% sensitivity and 72.7% specificity for separating survivors from nonsurvivors. The diagnostic cutoff value of procalcitonin was higher in surgical than in medical patients. Early procalcitonin was of prognostic interest in medical patients.
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Kasch, R; Assmann, G; Merk, S; Barz, T; Melloh, M; Hofer, A; Merk, H; Flessa, S
2016-03-01
The number of septic total hip arthroplasty (THA) revisions is increasing continuously, placing a growing financial burden on hospitals. Orthopedic departments performing septic THA revisions have no basis for decision making regarding resource allocation as the costs of this procedure for the departments are unknown. It is widely assumed that septic THA procedures can only be performed at a loss for the department. Therefore, the purpose of this study was to investigate whether this assumption is true by performing a detailed analysis of the costs and revenues for two-stage septic THA revision. Patients who underwent revision THA for septic loosening in two sessions from January 2009 through March 2012 were included in this retrospective, consecutive cost study from the orthopedic department's point of view. We analyzed variable and case-fixed costs for septic revision THA with special regard to implantation and explantation stay. By using marginal costing approach we neglected hospital-fixed costs. Outcome measures include reimbursement and daily contribution margins. The average direct costs (reimbursement) incurred for septic two-stage revision THA was €10,828 (€24,201). The difference in cost and contribution margins per day was significant (p cost for septic revision THA performed in two sessions. Disregarding hospital-fixed costs the included variable and case fixed-costs were covered by revenues. This study provides cost data, which will be guidance for health care decision makers.
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Hinkle, S.R.; Böhlke, J.K.; Fisher, L.H.
2008-01-01
Septic tank systems are an important source of NO3- to many aquifers, yet characterization of N mass balance and isotope systematics following septic tank effluent discharge into unsaturated sediments has received limited attention. In this study, samples of septic tank effluent before and after transport through single-pass packed-bed filters (sand filters) were evaluated to elucidate mass balance and isotope effects associated with septic tank effluent discharge to unsaturated sediments. Chemical and isotopic data from five newly installed pairs and ten established pairs of septic tanks and packed-bed filters serving single homes in Oregon indicate that aqueous solute concentrations are affected by variations in recharge (precipitation, evapotranspiration), NH4+ sorption (primarily in immature systems), nitrification, and gaseous N loss via NH3 volatilization and(or) N2 or N2O release during nitrification/denitrification. Substantial NH4+ sorption capacity was also observed in laboratory columns with synthetic effluent. Septic tank effluent ??15N-NH4+ values were almost constant and averaged + 4.9??? ?? 0.4??? (1 ??). In contrast, ??15N values of NO3- leaving mature packed-bed filters were variable (+ 0.8 to + 14.4???) and averaged + 7.2??? ?? 2.6???. Net N loss in the two networks of packed-bed filters was indicated by average 10-30% decreases in Cl--normalized N concentrations and 2-3??? increases in ??15N, consistent with fractionation accompanying gaseous N losses and corroborating established links between septic tank effluent and NO3- in a local, shallow aquifer. Values of ??18O-NO3- leaving mature packed-bed filters ranged from - 10.2 to - 2.3??? (mean - 6.4??? ?? 1.8???), and were intermediate between a 2/3 H2O-O + 1/3 O2-O conceptualization and a 100% H2O-O conceptualization of ??18O-NO3- generation during nitrification.
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Gill, L W; O'Luanaigh, N; Johnston, P M; Misstear, B D R; O'Suilleabhain, C
2009-06-01
The performance of six separate percolation areas was intensively monitored to ascertain the attenuation effects of unsaturated subsoils with respect to on-site wastewater effluent: three sites receiving septic tank effluent, the other three sites receiving secondary treated effluent. The development of a biomat across the percolation areas receiving secondary treated effluent was restricted on these sites compared to those sites receiving septic tank effluent and this created significant differences in terms of the potential nitrogen loading to groundwater. The average nitrogen loading per capita at 1.0m depth of unsaturated subsoil equated to 3.9 g total-N/d for the sites receiving secondary treated effluent, compared to 2.1 g total-N/d for the sites receiving septic tank effluent. Relatively high nitrogen loading was, however, found on the septic tank sites discharging effluent into highly permeable subsoil that counteracted any significant denitrification. Phosphorus removal was generally very good on all of the sites although a clear relationship to the soil mineralogy was determined.
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Raoultella planticola bacteremia-induced fatal septic shock following burn injury.
Yumoto, Tetsuya; Naito, Hiromichi; Ihoriya, Hiromi; Tsukahara, Kohei; Ota, Tomoyuki; Watanabe, Toshiyuki; Nakao, Atsunori
2018-05-04
Raoultella planticola, a Gram-negative, aerobic bacillus commonly isolated from soil and water, rarely causes invasive infections in humans. Septic shock from R. planticola after burn injury has not been previously reported. A 79-year-old male was admitted to the emergency intensive care unit after extensive flame burn injury. He accidently caught fire while burning trash and plunged into a nearby tank filled with contaminated rainwater to extinguish the fire. The patient developed septic shock on day 10. The blood culture detected R. planticola, which was identified using the VITEK-2 biochemical identification system. Although appropriate antibiotic treatment was continued, the patient died on day 12. Clinicians should be aware of fatal infections in patients with burn injury complicated by exposure to contaminated water.
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Microcirculatory monitoring in septic patients: Where do we stand?
Gruartmoner, G.; Mesquida, J.; Ince, C.
2017-01-01
Microcirculatory alterations play a pivotal role in sepsis-related morbidity and mortality. However, since the microcirculation has been a "black box", current hemodynamic management of septic patients is still guided by nnacrocirculatory parameters. In the last decades, the development of several
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A pilot study evaluating the prognostic utility of platelet indices in dogs with septic peritonitis.
Llewellyn, Efa A; Todd, Jeffrey M; Sharkey, Leslie C; Rendahl, Aaron
2017-09-01
To characterize platelet indices at time of diagnosis of septic peritonitis in dogs and to assess the relationship between platelet parameter data and survival to discharge in dogs treated surgically. Retrospective, observational, descriptive pilot study from 2009 to 2014. University teaching hospital. Forty-eight dogs diagnosed with septic peritonitis were included in this study. Thirty-six dogs had surgical source control. Blood samples from 46 healthy control dogs were used for reference interval (RI) generation. None. Dogs with septic peritonitis had significantly increased mean values for mean platelet volume (MPV), plateletcrit (PCT), and platelet distribution width (PDW) with increased proportions of dogs having values above the RI compared to healthy dogs. A significantly increased proportion of dogs with septic peritonitis had platelet counts above (12.5%) and below (8.3%) the RI, with no significant difference in mean platelet count compared to healthy dogs. No significant differences in the mean platelet count, MPV, PCT, or PDW were found between survivors and nonsurvivors in dogs with surgical source control; however, dogs with MPV values above the RI had significantly increased mortality compared to dogs within the RI (P = 0.025). Values outside the RI for other platelet parameters were not associated with significant differences in mortality. Dogs with septic peritonitis have increased frequency of thrombocytosis and thrombocytopenia with increased MPV, PCT, and PDW. An increased MPV may be a useful indicator of increased risk of mortality in dogs treated surgically. © Veterinary Emergency and Critical Care Society 2017.
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Kaempferol and Chrysin Synergies to Improve Septic Mice Survival.
Harasstani, Omar A; Tham, Chau Ling; Israf, Daud A
2017-01-06
Previously, we reported the role of synergy between two flavonoids-namely, chrysin and kaempferol-in inhibiting the secretion of a few major proinflammatory mediators such as tumor necrosis factor -alpha (TNF-α), prostaglandin E₂ (PGE₂) , and nitric oxide (NO) from lipopolysaccharide (LPS)-induced RAW 264.7 cells. The present study aims to evaluate the effects of this combination on a murine model of polymicrobial sepsis induced by cecal ligation and puncture (CLP). Severe sepsis was induced in male ICR mice ( n = 7) via the CLP procedure. The effects of chrysin and kaempferol combination treatment on septic mice were investigated using a 7-day survival study. The levels of key proinflammatory mediators and markers-such as aspartate aminotransferase (AST), TNF-α, and NO-in the sera samples of the septic mice were determined via ELISA and fluorescence determination at different time point intervals post-CLP challenge. Liver tissue samples from septic mice were harvested to measure myeloperoxidase (MPO) levels using a spectrophotometer. Moreover, intraperitoneal fluid (IPF) bacterial clearance and total leukocyte count were also assessed to detect any antibacterial effects exerted by chrysin and kaempferol, individually and in combination. Kaempferol treatment improved the survival rate of CLP-challenged mice by up to 16%. During this treatment, kaempferol expressed antibacterial, antiapoptotic and antioxidant activities through the attenuation of bacterial forming units, AST and NO levels, and increased polymorphonuclear leukocyte (PMN) count in the IPF. On the other hand, the chrysin treatment significantly reduced serum TNF-α levels. However, it failed to significantly improve the survival rate of the CLP-challenged mice. Subsequently, the kaempferol/chrysin combination treatment significantly improved the overall 7-day survival rate by 2-fold-up to 29%. Kaempferol and chrysin revealed some synergistic effects by acting individually upon multiple
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Protein phosphorylation in isolated hepatocytes of septic and endotoxemic rats
International Nuclear Information System (INIS)
Deaciuc, I.V.; Spitzer, J.A.
1989-01-01
The purpose of this study was to investigate possible alterations induced by sepsis and endotoxicosis in the late phase of Ca2+-dependent signaling in rat liver. Hepatocytes isolated from septic or chronically endotoxin (ET)-treated rats were labeled with [32P]H3PO4 and stimulated with various agents. Proteins were resolved by one-dimensional polyacrylamide gel electrophoresis and autoradiographed. Vasopressin (VP)- and phenylephrine (PE)-induced responses were attenuated in both septic and ET-treated rats for cytosolic and membrane proteins compared with their respective controls. Glucagon and 12-O-myristate phorbol-13-acetate (TPA) affected only the phosphorylation of membrane proteins. Glucagon-induced changes in the phosphorylation of membrane proteins were affected by both sepsis and endotoxicosis, whereas TPA-stimulated phosphorylation was lowered only in endotoxicosis. Response to the Ca2+ ionophore A23187 was depressed in septic rats for cytosolic proteins. The phosphorylation of two cytosolic proteins, i.e., 93 and 61 kDa (previously identified as glycogen phosphorylase and pyruvate kinase, respectively), in response to VP, PE, and A23187 was severely impaired by endotoxicosis and sepsis. TPA did not affect the phosphorylation state of these two proteins. The results show that sepsis and endotoxicosis produce perturbations of the phosphorylation step in Ca2+ transmembrane signaling. Such changes can explain alterations of glycogenolysis and gluconeogenesis associated with sepsis and endotoxicosis
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Suspected infection in afebrile patients : Are they septic?
Martins, Fernanda de Souza; Guedes, Gisele Giuliane; Santos, Thiago Martins; de Carvalho-Filho, Marco A
We prospectively evaluated afebrile patients admitted to an emergency department (ED), with suspected infection and only tachycardia or tachypnea.The white blood cell count (WBC) was obtained, and patients were considered septic if leukocyte count was >12,000 μL-1 or <4000 μL-1 or with >10% of band
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Effect of enzymes on anaerobic digestion of primary sludge and septic tank performance.
Diak, James; Örmeci, Banu; Kennedy, Kevin J
2012-11-01
Enzyme additives are believed to improve septic tank performance by increasing the hydrolysis and digestion rates and maintaining a healthy microbial population. Previous studies reported mixed results on the effectiveness of enzymes on mesophilic and thermophilic digestion, and it is not clear whether enzymes would be effective under septic tank conditions where there is no heating or mixing, quantities of enzymes added are small, and they can be washed out quickly. In this study, batch reactors and continuous-flow reactors designed and operated as septic tanks were used to evaluate whether enzymatic treatment would increase the hydrolysis and digestion rates in primary sludge. Total solids, volatile solids, total suspended solids, total and soluble chemical oxygen demand, concentrations of protein, carbohydrate, ammonia and volatile acids in sludge and effluent samples were measured to determine the differences in digestion rates in the presence and absence of enzymes. Overall, no significant improvement was observed in enzyme-treated reactors compared with the control reactors.
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Endoscopic bursectomy for the treatment of septic pre-patellar bursitis: a case series.
Dillon, John P; Freedman, Ilan; Tan, James S M; Mitchell, David; English, Shaun
2012-07-01
Operative treatment for septic pre-patellar bursitis generally involves open debridement in addition to an extended course of intravenous antibiotics. Skin necrosis and wound breakdown are potential complications of this procedure in addition to scar sensitivity and a prolonged recovery. We report endoscopic bursectomy for the treatment of septic pre-patellar bursitis in eight patients over a 3-year period. All patients had microbiological confirmation of an infective process. The average age was 36 years (23-68 years). The average hospital stay was 6 days (4-9 days). No patient had a recurrence or complained of tenderness or hypoaesthesia around their wound. No patient experienced wound complications or skin necrosis. The average return to work time was 18 days (7-22 days). We conclude that endoscopic bursectomy is a safe and effective treatment for septic pre-patellar bursitis with a shortened hospital stay and a quicker return to work than conventional open debridement.
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Herasevich, Vitaly; Pieper, Matthew S; Pulido, Juan; Gajic, Ognjen
2011-01-01
Recruitment of patients into time sensitive clinical trials in intensive care units (ICU) poses a significant challenge. Enrollment is limited by delayed recognition and late notification of research personnel. The objective of the present study was to evaluate the effectiveness of the implementation of electronic screening (septic shock sniffer) regarding enrollment into a time sensitive (24 h after onset) clinical study of echocardiography in severe sepsis and septic shock. We developed and tested a near-real time computerized alert system, the septic shock sniffer, based on established severe sepsis/septic shock diagnostic criteria. A sniffer scanned patients' data in the electronic medical records and notified the research coordinator on call through an institutional paging system of potentially eligible patients. The performance of the septic shock sniffer was assessed. The septic shock sniffer performed well with a positive predictive value of 34%. Electronic screening doubled enrollment, with 68 of 4460 ICU admissions enrolled during the 9 months after implementation versus 37 of 4149 ICU admissions before sniffer implementation (p<0.05). Efficiency was limited by study coordinator availability (not available at nights or weekends). Automated electronic medical records screening improves the efficiency of enrollment and should be a routine tool for the recruitment of patients into time sensitive clinical trials in the ICU setting.
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Hamed, Sonja; Behnes, Michael; Pauly, Dominic; Lepiorz, Dominic; Barre, Max; Becher, Tobias; Lang, Siegfried; Akin, Ibrahim; Borggrefe, Martin; Bertsch, Thomas; Hoffmann, Ursula
2017-08-09
Pentraxin-3 (PTX-3) is an acute-phase protein involved in inflammatory and infectious processes. This study assesses its diagnostic and prognostic value in patients with sepsis or septic shock in a medical intensive care unit (ICU). The study includes 213 ICU patients with clinical criteria of sepsis and septic shock. 77 donors served as controls. Plasma levels of PTX-3, procalcitonin (PCT) and interleukin-6 were measured on day 1, 3 and 8. PTX-3 correlated with higher lactate levels as well as with APACHE II and SOFA scores (p = 0.0001). PTX-3 levels of patients with sepsis or septic shock were consistently significantly higher than in the control group (p ≤ 0.001). Plasma levels were able to discriminate sepsis and septic shock significantly on day 1, 3 and 8 (range of AUC 0.73-0.92, p = 0.0001). Uniform cut-off levels were defined at ≥5 ng/ml for at least sepsis, ≥9 ng/ml for septic shock (p = 0.0001). PTX-3 reveals diagnostic value for sepsis and septic shock during the first week of intensive care treatment, comparable to interleukin-6 according to latest Sepsis-3 definitions. NCT01535534 . Registered 14.02.2012.
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International Nuclear Information System (INIS)
Lavergne, R.; Meuric, L.; Scherrer, S.; Paquel, V.; Louati, S.; Thienard, H.
2005-01-01
This document gathers a series of articles dedicated to the situation of the energy sector in France at the end of 2004: -) the energy balance sheet, -) the trend concerning energy consumption since 1973, -) the energy bill, -) figures about electrical power, -) figures about natural gas, -) figures about solid fossil fuels, -) figures about oil, and -) figures about renewable energies. The important fact to note is that the energy bill has soared by 24.1% to reach 28.35 milliard euros which represents 1.75% of the gross national product (PIB). The evolution over the year 2004 of the factors that contribute to the level of the energy bill is: - the import-export energy quantity differential: +7.5%, - the import-export energy cost differential (in Usa dollar): +27.1%, and - the fall of the dollar: -9.1%. (A.C.)
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Ockenden, M C; Quinton, J N; Favaretto, N; Deasy, C; Surridge, B
2014-07-01
Surface water quality in the UK and much of Western Europe has improved in recent decades, in response to better point source controls and the regulation of fertilizer, manure and slurry use. However, diffuse sources of pollution, such as leaching or runoff of nutrients from agricultural fields, and micro-point sources including farmyards, manure heaps and septic tank sewerage systems, particularly systems without soil adsorption beds, are now hypothesised to contribute a significant proportion of the nutrients delivered to surface watercourses. Tackling such sources in an integrated manner is vital, if improvements in freshwater quality are to continue. In this research, we consider the combined effect of constructing small field wetlands and improving a septic tank system on stream water quality within an agricultural catchment in Cumbria, UK. Water quality in the ditch-wetland system was monitored by manual sampling at fortnightly intervals (April-October 2011 and February-October 2012), with the septic tank improvement taking place in February 2012. Reductions in nutrient concentrations were observed through the catchment, by up to 60% when considering total phosphorus (TP) entering and leaving a wetland with a long residence time. Average fluxes of TP, soluble reactive phosphorus (SRP) and ammonium-N (NH4-N) at the head of the ditch system in 2011 (before septic tank improvement) compared to 2012 (after septic tank improvement) were reduced by 28%, 9% and 37% respectively. However, TP concentration data continue to show a clear dilution with increasing flow, indicating that the system remained point source dominated even after the septic tank improvement.
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Electronic work sheets for nuclear equipment dimensioning according to AD-Merkblaetter
International Nuclear Information System (INIS)
Rodrigues, P.R.B.
1994-01-01
The purpose of this paper is to show the capability of Work sheet applications in solving engineering problems in a much easier way than by using languages such as Fortran, BASIC etc., once many routines that would have to be developed in these languages for printing and display on screen, just to give a few instances, are already included in the Work sheet application. It is also worth mentioning the fact the never version of the Excel, version 5,0, includes the Object-oriented language Visual Basic, thus making it possible to develop routines for customization as well as compiling interactive routines speeding up the program. (author). 2 refs, 8 figs, 2 tabs
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Candida septic arthritis with rice body formation: A case report and review of literature
International Nuclear Information System (INIS)
Jeong, Yu Mi; Cho, Hyun Yee; Lee, Sheen Woo; Hwang, Yun Mi; Kim, Young Kyu
2013-01-01
Rice body formation in a joint or bursa is a rare condition, and is usually associated with rheumatoid arthritis or tuberculous arthritis. Here we describe a case of multiple rice body formation in a shoulder joint and in adjacent bursae, which was confirmed to be due to septic arthritis by Candida species. To the best of our knowledge, rice body formation in Candida septic arthritis in an immune-competent patient has not been previously reported.
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Candida septic arthritis with rice body formation: A case report and review of literature
Energy Technology Data Exchange (ETDEWEB)
Jeong, Yu Mi; Cho, Hyun Yee; Lee, Sheen Woo; Hwang, Yun Mi; Kim, Young Kyu [Gachon University, Gil Hospital, Incheon (Korea, Republic of)
2013-06-15
Rice body formation in a joint or bursa is a rare condition, and is usually associated with rheumatoid arthritis or tuberculous arthritis. Here we describe a case of multiple rice body formation in a shoulder joint and in adjacent bursae, which was confirmed to be due to septic arthritis by Candida species. To the best of our knowledge, rice body formation in Candida septic arthritis in an immune-competent patient has not been previously reported.
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Septic arthritis: a 12 years retrospective study in a rheumatological university clinic
Directory of Open Access Journals (Sweden)
L. Riato
2011-09-01
Full Text Available Background: Septic arthritis is a disabling and potentially life-threatening condition that requires prompt diagnosis and treatment. The most important risk factors are joint prosthesis, pre-existing joint disease and immunosuppressive drugs. The aim of our study therefore was to revaluate all septic arthritis cases discharged from our Rheumatologic Unit in the last 12 years, to assess the risk factors, the clinical and laboratory characteristics, the causative microorganisms and its possible increase in frequency. Methods: The medical records of 42 consecutive patients with septic arthritis discharged from our Rheumatology Unit between January 1995 and December 2006 were reviewed. The patients ranged in age from 23 to 90 and there isn’t gender predominance. Septic arthritis was diagnosed based on the finding of purulent material in the joint space and/or the isolation of a bacterial pathogen from joint fluid. Demographic data, risk factors, co-morbidity, clinical manifestations, time interval between symptoms onset and diagnosis, treatment and laboratory data including serum white blood cell count, erythrocyte sedimentation rate (ESR, C reactive protein (CRP, synovial white blood cells and culture results were analysed. We considered these parameters in the whole population and in two different age groups (≤60, >60 and tried to determine if there was a change of microorganisms involved in septic arthritis during the years. Results: Of 42 patients, 47% were aged 60 and younger. Only 10 patients were admitted to our unit before 2001. A predisposing factor was recorded in 90,5% of cases: 15 patients had rheumatoid arthritis, 8 were diabetic, 6 had seronegative arthritis, 4 had a connective tissue disease, 8 patients had a prosthetic infection and 3 were subjected recently to arthrocentesis. We found that patients aged 60 and younger were more frequently affected by joint disease and had a synovial white blood cell count lower than patients
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Geophysical Assessment of Two Collapsed and Concealed Septic ...
African Journals Online (AJOL)
... m and depth of about 2.9 m. The delineated clayey soils at shallow depths suggest that there could be seasonal soil swelling and shrinkages due to seasonal variation in moisture content of the clay. These most likely led to annual ground movements, cumulative soil creep and the subsequent collapse of the septic tanks.
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Immune-modulating interventions in critically ill septic patients: pharmacological options
DEFF Research Database (Denmark)
Toft, Palle; Tønnesen, Else
2011-01-01
Critically ill patients with severe sepsis and septic shock are characterized by a systemic inflammatory response consisting of pro- and anti-inflammatory mediators. Owing to the high mortality of severe sepsis, great efforts have been undertaken within the last 30 years to develop an immune...... insulin therapy have been shown to improve survival in septic patients. However, in later studies, it has been difficult to reproduce these beneficial effects. There appears to be a discrepancy between the promising effects of immune-modulating interventions in animal studies and the effects seen......-modulating therapy to improve survival. Relatively few pharmacological immune-modulating interventions have demonstrated a beneficial impact on survival, while other studies have shown a detrimental effect of such interventions. Among the immune-modulating interventions tested, activated protein C and intensive...
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Use of massive structural allograft in revision septic hip arthroplasty
International Nuclear Information System (INIS)
Imran Ilyas; Morgan, F.; David, A.
1999-01-01
The reconstruction of failed septic hip arthroplasty with the use of massive osseous allograft segments is reported in ten patients. All of these patients had a two-stage procedure with an interval Girdlestone arthroplasty separating the initial demolition from the subsequent reconstruction. The mean follow-up was 58 months (range 36 to 98 months) and the most common pathogen isolated was Staphylococcus epidermidis. The mean preoperative modified Harris hip score was 27 points (range 9 to 58) and the mean postoperative score was 73 points (range 53 to 92). There was one patient who required an additional procedure not related to allograft use. There has been no case of recurrence of infection. We conclude that the revision of septic hip arthroplasty in the use of massive allografts do not have to be mutually exclusive events
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64-year-old male with septic arthritis of the pubic symphysis
Directory of Open Access Journals (Sweden)
Mark Lee
2011-09-01
Full Text Available Septic arthritis of the pubic symphysis is a rare disease. Typical clinical features include fever, pubic or groin pain, pain with hip motion, and painful or waddling gait. Identified predisposing factors to develop an infection in pubic joint include female incontinence surgery or postpartum period; sports, especially soccer; pelvic malignancy; and intravenous drug abuse. The most often identified microorganisms were Staphylococcus aureus and Pseudomonas aeruginosa. Osteomyelitis complicates the majority of cases, and about half of the patients require surgical debridement along with a prolonged antibiotic treatment. We report a case of Streptococcus anginosus septic arthritis of the pubic symphysis. The patient did not have any of the above risk factors.
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64-year-old male with septic arthritis of the pubic symphysis
Directory of Open Access Journals (Sweden)
Ewa Konik
2011-10-01
Full Text Available Septic arthritis of the pubic symphysis is a rare disease. Typical clinical features include fever, pubic or groin pain, pain with hip motion, and painful or waddling gait. Identified predisposing factors to develop an infection in pubic joint include female incontinence surgery or postpartum period; sports, especially soccer; pelvic malignancy; and intravenous drug abuse. The most often identified microorganisms were Staphylococcus aureus and Pseudomonas aeruginosa. Osteomyelitis complicates the majority of cases, and about half of the patients require surgical debridement along with a prolonged antibiotic treatment. We report a case of Streptococcus anginosus septic arthritis of the pubic symphysis. The patient did not have any of the above risk factors.
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Tension pneumocephalus mimicking septic shock: a case report
Directory of Open Access Journals (Sweden)
Caroline Miranda, MD
2018-02-01
Full Text Available Tension pneumocephalus can lead to rapid neurologic deterioration. We report for the first time its association with aseptic systemic inflammatory response syndrome mimicking septic shock and the efficacy of prompt neurosurgical intervention and critical care support in treating this condition. A 64-year-old man underwent 2-stage olfactory groove meningioma resection. The patient developed altered mental status and gait instability on postoperative day 6. Imaging showed significant pneumocephalus. The patient subsequently developed worsening mental status, respiratory failure, and profound shock requiring multiple vasopressors. Bedside needle decompression, identification and repair of the cranial fossa defect, and critical care support led to improved mental status and reversal of shock and multiorgan dysfunction. Thorough evaluation revealed no evidence of an underlying infection. In this case, tension pneumocephalus incited an aseptic systemic inflammatory response syndrome mimicking septic shock. Prompt neurosurgical correction of pneumocephalus and critical care support not only improved neurologic status, but also reversed shock. Such a complication indicates the importance of close monitoring of patients with progressive pneumocephalus.
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Cultured alveolar epithelial cells from septic rats mimic in vivo septic lung.
Directory of Open Access Journals (Sweden)
Taylor S Cohen
2010-06-01
Full Text Available Sepsis results in the formation of pulmonary edema by increasing in epithelial permeability. Therefore we hypothesized that alveolar epithelial cells isolated from septic animals develop tight junctions with different protein composition and reduced barrier function relative to alveolar epithelial cells from healthy animals. Male rats (200-300 g were sacrificed 24 hours after cecal ligation and double puncture (2CLP or sham surgery. Alveolar epithelial cells were isolated and plated on fibronectin-coated flexible membranes or permeable, non-flexible transwell substrates. After a 5 day culture period, cells were either lysed for western analysis of tight junction protein expressin (claudin 3, 4, 5, 7, 8, and 18, occludin, ZO-1, and JAM-A and MAPk (JNK, ERK, an p38 signaling activation, or barrier function was examined by measuring transepithelial resistance (TER or the flux of two molecular tracers (5 and 20 A. Inhibitors of JNK (SP600125, 20 microM and ERK (U0126, 10 microM were used to determine the role of these pathways in sepsis induced epithelial barrier dysfunction. Expression of claudin 4, claudin 18, and occludin was significantly lower, and activation of JNK and ERK signaling pathways was significantly increased in 2CLP monolayers, relative to sham monolayers. Transepithelial resistance of the 2CLP monolayers was reduced significantly compared to sham (769 and 1234 ohm-cm(2, respectively, however no significant difference in the flux of either tracer was observed. Inhibition of ERK, not JNK, significantly increased TER and expression of claudin 4 in 2CLP monolayers, and prevented significant differences in claudin 18 expression between 2CLP and sham monolayers. We conclude that alveolar epithelial cells isolated from septic animals form confluent monolayers with impaired barrier function compared to healthy monolayers, and inhibition of ERK signaling partially reverses differences between these monolayers. This model provides a unique
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Rupture of nanoscaled water sheets in the presence of an applied electric field
Energy Technology Data Exchange (ETDEWEB)
Gopan, Nandu, E-mail: nandug@jncasr.ac.in [Engineering Mechanics Unit, Jawaharlal Nehru Centre for Advanced Scientific Research, Jakkur, Bangalore-560 064 (India)
2016-12-15
Understanding the behaviour of water sheets is relevant in numerous areas, such as thin film coating and atomisation. The rupture of planar liquid sheets are interesting due to the fact that they are objects of co-dimension 1. Previous work seems to suggest that a generic route to liquid structure fragmentation is via liquid sheets. The interplay between inertia, surface tension and viscosity is crucial in determining the dynamics of liquid sheets at a macro scale. At the nanoscale, where thermal fluctuations are expected to play a dominant role, the dynamics become more interesting. The stability and rupture dynamics of nanoscaled water sheets, at constant temperature, are studied using constrained molecular dynamics (MD) simulations. The SPC/E potential with long range electrostatics is used to simulate water molecules. The effect of an applied electric field on the stability of the nanoscaled water sheet forms the focus of this study. The effect of the initial configuration is studied by changing the random seed values used for velocity initialisation. The effect of sheet thickness on the rupture dynamics is also explored. It is seen that when large electric fields (5 V/nm) act across very thin sheets (1 layer), then breakup into multiple ellipsoidal structures is a possibility, and the response of the fluid structure to the applied electric field is non-linear. Furthermore, it is seen that Taylor's predictions for the critical electric field intensity, based on classical electro-hydrodynamics for the onset of instability in macroscopic drops, scales surprisingly well for the case of nanoscaled sheets. (paper)
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Energy Technology Data Exchange (ETDEWEB)
U.S. Department of Energy, Nevada Operations Office
2000-02-08
This Corrective Action Decision Document identifies and rationalizes the US Department of Energy, Nevada Operations Office's selection of a recommended corrective action alternative (CAA) appropriate to facilitate the closure of Corrective Action Unit (CAU) 428, Septic Waste Systems 1 and 5, under the Federal Facility Agreement and Consent Order. Located in Area 3 at the Tonopah Test Range (TTR) in Nevada, CAU 428 is comprised of two Corrective Action Sites (CASs): (1) CAS 03-05-002-SW01, Septic Waste System 1 and (2) CAS 03-05-002- SW05, Septic Waste System 5. A corrective action investigation performed in 1999 detected analyte concentrations that exceeded preliminary action levels; specifically, contaminants of concern (COCs) included benzo(a) pyrene in a septic tank integrity sample associated with Septic Tank 33-1A of Septic Waste System 1, and arsenic in a soil sample associated with Septic Waste System 5. During this investigation, three Corrective Action Objectives (CAOs) were identified to prevent or mitigate exposure to contents of the septic tanks and distribution box, to subsurface soil containing COCs, and the spread of COCs beyond the CAU. Based on these CAOs, a review of existing data, future use, and current operations in Area 3 of the TTR, three CAAs were developed for consideration: Alternative 1 - No Further Action; Alternative 2 - Closure in Place with Administrative Controls; and Alternative 3 - Clean Closure by Excavation and Disposal. These alternatives were evaluated based on four general corrective action standards and five remedy selection decision factors. Based on the results of the evaluation, the preferred CAA was Alternative 3. This alternative meets all applicable state and federal regulations for closure of the site and will eliminate potential future exposure pathways to the contaminated soils at the Area 3 Septic Waste Systems 1 and 5.
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The Use of Reactive Materials in Septic Systems for Pathogens and Nitrate Removal
Suhogusoff, A. V.; Hirata, R.; Aravena, R.; Stimson, J.; Robertson, W.
2009-05-01
The developing countries have an urgent need for cheap and efficient techniques for the improvement of sanitary conditions in areas without public water supply and sewerage system, especially in suburban regions or irregular occupation areas, where there is a great lack of social assistance. In this type of situations, the inhabitants use dug wells for water use and cesspits for disposal of sewage, which usually contaminates the groundwater with nitrate and microorganisms. As part of a study aiming to develop new sewage treatment systems in an irregular occupation area located at the District of Barragem, south region of the municipality of São Paulo (Brazil), a conventional cesspit (named as "Control") and an alternative septic system were constructed and monitored for a year. The design of the alternative septic system included a 1m thickness reactive barrier constituted by BOF (Budget Oxygen Furnace - a byproduct of the steel-making industry) for pathogens removal, then 1m sand package where the wastewater is oxidized and at the bottom the wastewater is in contact with a 0,5m thickness reactive barrier constituted by sawdust (carbon source), where redox conditions are very reducing and denitrification and even methanogenesis can take place. The chemical and biological data collected in the alternative septic system showed complete removal of the pathogens in the BOF barrier, then nitrification occurred between the BOF and the bottom of sand package. However denitrification in the sawdust barrier was incomplete because of the high pH caused by the BOF materials, which can reduced the number of denitrifiers bacteria present in the sawdust barrier. Isotope analyses that are been carried out in the residual nitrate will provided more information about the extent of the denitrification reaction in the alternative septic system. In case of the control cesspit, it was observed the occurrence of high concentration of ammonium, dissolved organic carbon, CO2, CH4 and low
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Yoseph, Benyam P; Breed, Elise; Overgaard, Christian E; Ward, Christina J; Liang, Zhe; Wagener, Maylene E; Lexcen, Daniel R; Lusczek, Elizabeth R; Beilman, Greg J; Burd, Eileen M; Farris, Alton B; Guidot, David M; Koval, Michael; Ford, Mandy L; Coopersmith, Craig M
2013-01-01
Patients admitted to the intensive care unit with alcohol use disorders have increased morbidity and mortality. The purpose of this study was to determine how chronic alcohol ingestion alters the host response to sepsis in mice. Mice were randomized to receive either alcohol or water for 12 weeks and then subjected to cecal ligation and puncture. Mice were sacrificed 24 hours post-operatively or followed seven days for survival. Septic alcohol-fed mice had a significantly higher mortality than septic water-fed mice (74% vs. 41%, p = 0.01). This was associated with worsened gut integrity in alcohol-fed mice with elevated intestinal epithelial apoptosis, decreased crypt proliferation and shortened villus length. Further, alcohol-fed mice had higher intestinal permeability with decreased ZO-1 and occludin protein expression in the intestinal tight junction. The frequency of splenic and bone marrow CD4+ T cells was similar between groups; however, splenic CD4+ T cells in septic alcohol-fed mice had a marked increase in both TNF and IFN-γ production following ex vivo stimulation. Neither the frequency nor function of CD8+ T cells differed between alcohol-fed and water-fed septic mice. NK cells were decreased in both the spleen and bone marrow of alcohol-fed septic mice. Pulmonary myeloperoxidase levels and BAL levels of G-CSF and TFG-β were higher in alcohol-fed mice. Pancreatic metabolomics demonstrated increased acetate, adenosine, xanthine, acetoacetate, 3-hydroxybutyrate and betaine in alcohol-fed mice and decreased cytidine, uracil, fumarate, creatine phosphate, creatine, and choline. Serum and peritoneal cytokines were generally similar between alcohol-fed and water-fed mice, and there were no differences in bacteremia, lung wet to dry weight, or pulmonary, liver or splenic histology. When subjected to the same septic insult, mice with chronic alcohol ingestion have increased mortality. Alterations in intestinal integrity, the host immune response, and
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Directory of Open Access Journals (Sweden)
Benyam P Yoseph
Full Text Available Patients admitted to the intensive care unit with alcohol use disorders have increased morbidity and mortality. The purpose of this study was to determine how chronic alcohol ingestion alters the host response to sepsis in mice.Mice were randomized to receive either alcohol or water for 12 weeks and then subjected to cecal ligation and puncture. Mice were sacrificed 24 hours post-operatively or followed seven days for survival.Septic alcohol-fed mice had a significantly higher mortality than septic water-fed mice (74% vs. 41%, p = 0.01. This was associated with worsened gut integrity in alcohol-fed mice with elevated intestinal epithelial apoptosis, decreased crypt proliferation and shortened villus length. Further, alcohol-fed mice had higher intestinal permeability with decreased ZO-1 and occludin protein expression in the intestinal tight junction. The frequency of splenic and bone marrow CD4+ T cells was similar between groups; however, splenic CD4+ T cells in septic alcohol-fed mice had a marked increase in both TNF and IFN-γ production following ex vivo stimulation. Neither the frequency nor function of CD8+ T cells differed between alcohol-fed and water-fed septic mice. NK cells were decreased in both the spleen and bone marrow of alcohol-fed septic mice. Pulmonary myeloperoxidase levels and BAL levels of G-CSF and TFG-β were higher in alcohol-fed mice. Pancreatic metabolomics demonstrated increased acetate, adenosine, xanthine, acetoacetate, 3-hydroxybutyrate and betaine in alcohol-fed mice and decreased cytidine, uracil, fumarate, creatine phosphate, creatine, and choline. Serum and peritoneal cytokines were generally similar between alcohol-fed and water-fed mice, and there were no differences in bacteremia, lung wet to dry weight, or pulmonary, liver or splenic histology.When subjected to the same septic insult, mice with chronic alcohol ingestion have increased mortality. Alterations in intestinal integrity, the host immune
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Actinomyces pyogenes septic arthritis in a diabetic farmer.
LENUS (Irish Health Repository)
Lynch, M
2012-02-03
We report a case of septic arthritis and osteomyelitis of the left ankle due to Actinomyces pyogenes in a diabetic farmer. Few confirmed human cases of A. pyogenes infection have been reported, partly because of inadequate identification of this bacterium. Bacteriological characteristics of the organism, which resembles Arcanobacterium haemolyticum, are described with a review of previous case reports.
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Directory of Open Access Journals (Sweden)
Leonardo Lorente
Full Text Available Apoptosis is increased in sepsis. Cytokeratin 18 (CK-18, a protein of the intermediate filament group present in most epithelial and parenchymal cells, is cleaved by the action of caspases and released into the blood as caspase-cleaved CK (CCCK-18 during apoptosis. Circulating levels of CCCK-18 have scarcely been explored in septic patients. In one study with 101 severe septic patients, the authors reported higher serum CCCK-18 levels in non-survivors than in survivors; however, the sample size was too small to demonstrate an association between serum CCCK-18 levels and early mortality and whether they could be used as a biomarker to predict outcomes in septic patients. Thus, these were the objectives of this study with a large series of patients.We performed a prospective, multicenter, observational study in six Spanish Intensive Care Units with 224 severe septic patients. Blood samples were collected at the time that severe sepsis was diagnosed to determine serum levels of CCCK-18, tumor necrosis factor (TNF-alpha, interleukin (IL-6 and IL-10. The end point was 30-day mortality.Non-surviving patients (n = 80 showed higher serum CCCK-18 levels (P391 u/L were associated with 30-day survival (Odds ratio = 2.687; 95% confidence interval = 1.449-4.983; P = 0.002, controlling for SOFA score, serum lactic acid levels and age. Kaplan-Meier survival analysis showed that the risk of death in septic patients with serum CCCK-18 levels >391 u/L was higher than in patients with lower values (Hazard Ratio = 3.1; 95% CI = 1.96-4.84; P<0.001. Serum CCCK-18 levels were positively associated with serum levels of IL-6 and lactic acid, and with SOFA and APACHE scores.The major novel finding of our study, the largest cohort of septic patients providing data on circulating CCCK-18 levels, was that serum CCCK-18 levels are associated with mortality in severe septic patients.
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Cefovecin (Convenia) for the treatment of septic peritonitis in a female lion (Panthera leo).
Steeil, James; Schumacher, Juergen; Seibert, Rachel; Tobias, Karen
2012-09-01
An 8-yr-old intact female African lion (Panthera leo) presented with a 3-day history of lethargy, anorexia, and vomiting. Hematologic and biochemical abnormalities included a leukocytosis, 41,700/microl (4,700-15,300) with a neutrophilia (37,530/microl; 2,000-9,200) and a left shift (1,250/microl bands; 0-300), and mild hypokalemia of 2.1 mEq/L (2.8-4.8). Abdominal radiographs revealed evidence of intestinal ileus, peritonitis, and the presence of effusion. An exploratory laparotomy was performed, and septic peritonitis due to a pyometra was diagnosed. The lion was treated with an ovariohysterectomy, abdominal lavage, fluid therapy, and a subcutaneous injection of cefovecin. The lion recovered, and clinical signs associated with septic peritonitis resolved within 36 hr. It was returned to conspecifics 3 wk later. Three months postoperatively, the lion showed no residual signs of septic peritonitis.
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International Nuclear Information System (INIS)
Hirose, Emiko; Kanesaki, Ken.
1995-01-01
The decontamination sheet of the present invention is formed by applying an adhesive on one surface of a polymer sheet and releasably appending a plurality of curing sheets. In addition, perforated lines are formed on the sheet, and a decontaminating agent is incorporated in the adhesive. This can reduce the number of curing operation steps when a plurality steps of operations for radiation decontamination equipments are performed, and further, the amount of wastes of the cured sheets, and operator's exposure are reduced, as well as an efficiency of the curing operation can be improved, and propagation of contamination can be prevented. (T.M.)
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CT of splenic and perisplenic abnormalities in septic patients
Energy Technology Data Exchange (ETDEWEB)
Balthazar, E.J.; Hilton, S.; Naidich, D.; Megibow, A.; Levine, R.
1985-01-01
Splenic and perisplenic pathology, demonstrated by CT examination in 14 septic patients, was correlated with the clinical course and with surgical and pathologic findings available. Twelve patients were intravenous drug addicts and two patients developed bacteremia associated with bacterial endocarditis. The CT fingings were divided into three groups: (1) Single wedge-shaped peripherally located defects were seen in five patients; there was good response to medical therapy without other complications. (2) Larger and/or multiple, rounded or oval lesions were present in five patients; two of these patients had splenic abscesses proven on subsequent splenectomy. (3) Multiple splenic lesions and fissures associated with perisplenic and subphrenic fluid collections were seen in four patients; infected splenic infarcts, splenic fractures, and infected perisplenic hemorrhagic fluid collections were found in this group of patients. The CT examination in septic patients can reliably demonstrate splenic and perisplenic pathology, and its appearance contributes greatly to the overall clinical assessment and surgical approach.
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CT of splenic and perisplenic abnormalities in septic patients
International Nuclear Information System (INIS)
Balthazar, E.J.; Hilton, S.; Naidich, D.; Megibow, A.; Levine, R.
1985-01-01
Splenic and perisplenic pathology, demonstrated by CT examination in 14 septic patients, was correlated with the clinical course and with surgical and pathologic findings available. Twelve patients were intravenous drug addicts and two patients developed bacteremia associated with bacterial endocarditis. The CT fingings were divided into three groups: (1) Single wedge-shaped peripherally located defects were seen in five patients; there was good response to medical therapy without other complications. (2) Larger and/or multiple, rounded or oval lesions were present in five patients; two of these patients had splenic abscesses proven on subsequent splenectomy. (3) Multiple splenic lesions and fissures associated with perisplenic and subphrenic fluid collections were seen in four patients; infected splenic infarcts, splenic fractures, and infected perisplenic hemorrhagic fluid collections were found in this group of patients. The CT examination in septic patients can reliably demonstrate splenic and perisplenic pathology, and its appearance contributes greatly to the overall clinical assessment and surgical approach
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Pieper, Matthew S; Pulido, Juan; Gajic, Ognjen
2011-01-01
Objective Recruitment of patients into time sensitive clinical trials in intensive care units (ICU) poses a significant challenge. Enrollment is limited by delayed recognition and late notification of research personnel. The objective of the present study was to evaluate the effectiveness of the implementation of electronic screening (septic shock sniffer) regarding enrollment into a time sensitive (24 h after onset) clinical study of echocardiography in severe sepsis and septic shock. Design We developed and tested a near-real time computerized alert system, the septic shock sniffer, based on established severe sepsis/septic shock diagnostic criteria. A sniffer scanned patients' data in the electronic medical records and notified the research coordinator on call through an institutional paging system of potentially eligible patients. Measurement The performance of the septic shock sniffer was assessed. Results The septic shock sniffer performed well with a positive predictive value of 34%. Electronic screening doubled enrollment, with 68 of 4460 ICU admissions enrolled during the 9 months after implementation versus 37 of 4149 ICU admissions before sniffer implementation (p<0.05). Efficiency was limited by study coordinator availability (not available at nights or weekends). Conclusions Automated electronic medical records screening improves the efficiency of enrollment and should be a routine tool for the recruitment of patients into time sensitive clinical trials in the ICU setting. PMID:21508415
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Valencia, R; den Hamer, D; Komboi, J; Lubberding, H J; Gijzen, H J
2009-02-01
Co-disposal of septic tank sludge had a positive effect on the municipal solid waste (MSW) stabilisation process in Bioreactor Landfill simulators. Co-disposal experiments were carried out using the Bioreactor Landfill approach aiming to solve the environmental problems caused by indiscriminate and inadequate disposal of MSW and especially of septic tank sludge. The simulator receiving septic tank sludge exhibited a 200 days shorter lag-phase as compared to the 350 days required by the control simulator to start the exponential biogas production. Additionally, the simulator with septic sludge apparently retained more moisture (>60% w/w), which enhanced the overall conversion of organic matter hence increasing the biogas production (0.60 m3 biogas kg(-1)VS(converted)) and removal efficiency of 60% for VS from the simulator. Alkaline pH values (pH>8.5) did not inhibit the biogas production; moreover it contributed to reduce partially the negative effects of NH(4)(+) (>2 g L(-1)) due to NH(3) volatilisation thus reducing the nitrogen content of the residues. Associated risks and hazards with septage disposal were practically eliminated as total coliform and faecal coliform contents were reduced by 99% and 100%, respectively at the end of the experiment. These results indicate that co-disposal has two direct benefits, including the safe and environmentally sound disposal of septic tank sludge and an improvement of the overall performance of the Bioreactor Landfill by increasing moisture retention and supplying a more acclimatised bacterial population.
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Sand filter clogging by septic tank effluent.
Spychała, M; Błazejewski, R
2003-01-01
The aim of this study was to characterise conditions and factors affecting fine sand clogging by septic tank effluent on the basis of physical modelling. The physical model consisted of 12 sand columns dosed with sewage from one household (5 persons), preliminary treated in a septic tank. Hydraulic loadings of the sand filters were equal to 82 mm/d. The mean discharge from sand columns, measured as the effluent volume collected during 10 minutes, decreased significantly over the experiment period from 34 cm3/min in August 2000 to 20 cm3/min in August 2001 at the same temperature of about 20 degrees C. First the columns clogged almost completely after 480 days in December 2001, however six columns had remained unclogged till the end of the experiment (March 2002). The temperature had a significant impact on hydraulic conductivity. A vertical distribution of accumulated mass and biomass was investigated in partly clogged sand. Microscopic survey of the clogging layer showed a presence of live micro-organisms, residuals of dead micro-organisms, particularly pieces of small animal armour and many fibres. These particles accelerated the accumulation of solids in the upper clogging layer. The study indicated that temperature impact on the filter hydraulic conductivity was more significant for biological activity, than for sewage viscosity.
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Maiden, Matthew J; Chapman, Marianne J; Torpy, David J; Kuchel, Timothy R; Clarke, Iain J; Nash, Coralie H; Fraser, Jonathan D; Ludbrook, Guy L
2016-06-01
Triiodothyronine concentration in plasma decreases during septic shock and may contribute to multiple organ dysfunction. We sought to determine the safety and efficacy of administering triiodothyronine, with and without hydrocortisone, in a model of septic shock. Randomized blinded placebo-controlled trial. Preclinical research laboratory. Thirty-two sheep rendered septic with IV Escherichia coli and receiving protocol-guided sedation, ventilation, IV fluids, and norepinephrine infusion. Two hours following induction of sepsis, 32 sheep received a 24-hour IV infusion of 1) placebo + placebo, 2) triiodothyronine + placebo, 3) hydrocortisone + placebo, or 4) triiodothyronine + hydrocortisone. Primary outcome was the total amount of norepinephrine required to maintain a target mean arterial pressure; secondary outcomes included hemodynamic and metabolic indices. Plasma triiodothyronine levels increased to supraphysiological concentrations with hormonal therapy. Following 24 hours of study drug infusion, the amount of norepinephrine required was no different between the study groups (mean ± SD μg/kg; placebo + placebo group 208 ± 392; triiodothyronine + placebo group 501 ± 370; hydrocortisone + placebo group 167 ± 286; triiodothyronine + hydrocortisone group 466 ± 495; p = 0.20). There was no significant treatment effect on any hemodynamic variable, metabolic parameter, or measure of organ function. A 24-hour infusion of triiodothyronine, with or without hydrocortisone, in an ovine model of septic shock did not markedly alter norepinephrine requirement or any other physiological parameter.
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[Septic shock in a patient with the Fournièr gangrene with fatal outcome].
Zonca, P; Mrázek, T; Matusek, A; Hajek, M; Stiglerová, S; Jurytko, A; Kucera, C; Nieslanik, M
2009-07-01
The authors present a case of a patient with developed Fournièr gangrene and septic shock. Fournièr gangrene belongs to the group of local non-specific infection of soft tissues (NSTI). Its incidence is relatively low, but the infection is extraordinary aggressive with a possible lethal end. 39 years old patient with 4 days history of Fournier gangrene's development was admitted in irreversible septic shock. The initial APACHE II score was 36. The delay in treatment was an important factor in the further course of illness with lethal end. Above the mentioned 39 years old patient died because of septic shock. The hemorrhagic cystitis was the original source of infection with further development of Fournièr gangrene according to the pathological record. We often come across all different kinds of stages of sepsis from the MODS to the septic shock for patients with Fournièr gangrene. Causal treatment should be started early. The local surgical excision and wide broad antibiotic administrations are basic treatments in the context of other treatment modalities according to the current patient's needs. The adjuvant hyperbaric oxygen treatment takes place in patients with Fournièr gangrene as well and is beneficial. The following factor even worsens the illness prognosis: delay in diagnostic, higher age, anorectal origin of infection, the amount of organ with dysfunction or failure, diabetes mellitus and significant immunodeficiency.
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Ultrasonographic findings of septic arthritis and osteomyelitis in neonatal hip
International Nuclear Information System (INIS)
Lee, Seung Hoon; Jung, Kun Sik; Koh, Jung Kon; Im, Myung Ah; Kwon, Kwi Ryun; Kim, Sung Soo
2000-01-01
To evaluate ultrasonographic findings of neonatal patients who confirmed and treated as hip joint septic arthritis and osteomyelitis. We retrospectively examined clinical feature and radiologic findings of 7 neonatal patients ranging from 8 to 28 days of age who were examined from January 1966 to December 1998 at nursery and were confirmed and treated on the diagnosis of septic arthritis and osteomyelitis. Clinical features of the patients were comparatively analyzed with radiologic findings including plain radiographs, ultrasonography, bone scan and MRI. We emphasized importance of ultrasonographic findings of these patients. Ultrasonography was performed first of all in all cases after the symptom onset. Other examinations were performed on the same day or a few days later after ultrasonography. Ultrasonography revealed abnormal finding in 85.7% (6/7) of all cases. Plain radiographs revealed abnormal findings in 28.6% (2/7). Bone scan revealed decreased uptake in 66.7%(2/3). MRI revealed abnormal signal intensity in 100%(3/3). Ultrasonographic findings of the patients were deep soft swelling in 85.7% (6/7) of all cases, periosteal elevation in 57.1% (4/7), synovial thickening in 42.8% (3/7), synovial effusion in 42.8%(3/7), echogenic debris or clot in 28.5% (2/7), cortical erosion in 28.5% (2/7), and subperiosteal abscess in 14.2% (1/7). Ultrasonography is a useful modality to diagnose septic arthritis and osteomyelitis in neonatal hip.
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Childhood Pyogenic Septic Arthritis as Seen in a Teaching Hospital ...
African Journals Online (AJOL)
accounted for 44 (83%) of the 53 patients seen with pyogenic septic arthritis. ... significantly more involved than the left and the left hip more than right. .... disease, malnutrition, and HIV were the predisposing and ..... fracture care in Nigeria.
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Pattern of Microbial Flora in Septic Incomplete Abortion in Port ...
African Journals Online (AJOL)
Alasia Datonye
organisms present in the endocervix and posterior vaginal fornix in 150 women with ... cultured in septic abortion in this environment. The infections are usually ... These are both major hospitals offering tertiary care in Port. Harcourt the capital ...
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Bayesian Inversion for Large Scale Antarctic Ice Sheet Flow
Ghattas, Omar
2015-01-07
The flow of ice from the interior of polar ice sheets is the primary contributor to projected sea level rise. One of the main difficulties faced in modeling ice sheet flow is the uncertain spatially-varying Robin boundary condition that describes the resistance to sliding at the base of the ice. Satellite observations of the surface ice flow velocity, along with a model of ice as a creeping incompressible shear-thinning fluid, can be used to infer this uncertain basal boundary condition. We cast this ill-posed inverse problem in the framework of Bayesian inference, which allows us to infer not only the basal sliding parameters, but also the associated uncertainty. To overcome the prohibitive nature of Bayesian methods for large-scale inverse problems, we exploit the fact that, despite the large size of observational data, they typically provide only sparse information on model parameters. We show results for Bayesian inversion of the basal sliding parameter field for the full Antarctic continent, and demonstrate that the work required to solve the inverse problem, measured in number of forward (and adjoint) ice sheet model solves, is independent of the parameter and data dimensions
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Bayesian Inversion for Large Scale Antarctic Ice Sheet Flow
Ghattas, Omar
2015-01-01
The flow of ice from the interior of polar ice sheets is the primary contributor to projected sea level rise. One of the main difficulties faced in modeling ice sheet flow is the uncertain spatially-varying Robin boundary condition that describes the resistance to sliding at the base of the ice. Satellite observations of the surface ice flow velocity, along with a model of ice as a creeping incompressible shear-thinning fluid, can be used to infer this uncertain basal boundary condition. We cast this ill-posed inverse problem in the framework of Bayesian inference, which allows us to infer not only the basal sliding parameters, but also the associated uncertainty. To overcome the prohibitive nature of Bayesian methods for large-scale inverse problems, we exploit the fact that, despite the large size of observational data, they typically provide only sparse information on model parameters. We show results for Bayesian inversion of the basal sliding parameter field for the full Antarctic continent, and demonstrate that the work required to solve the inverse problem, measured in number of forward (and adjoint) ice sheet model solves, is independent of the parameter and data dimensions
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Removal of nutrients from septic tank effluent with baffle subsurface-flow constructed wetlands.
Cui, Lihua; Ouyang, Ying; Yang, Weizhi; Huang, Zhujian; Xu, Qiaoling; Yu, Guangwei
2015-04-15
Three new baffle flow constructed wetlands (CWs), namely the baffle horizontal flow CW (Z1), baffle vertical flow CW (Z2) and baffle hybrid flow CW (Z3), along with one traditional horizontal subsurface flow CW (Z4) were designed to test the removal efficiency of nitrogen (N) and phosphorus (P) from the septic tank effluent under varying hydraulic retention times (HRTs). Results showed that the optimal HRT was two days for maximal removal of N and P from the septic tank effluent among the four CWs. At this HRT, the Z1, Z2, Z3 and Z4 CWs removed, respectively, 49.93, 58.50, 46.01 and 44.44% of TN as well as 87.82, 93.23, 95.97 and 91.30% of TP. Our study further revealed that the Z3 CW was the best design for overall removal of N and P from the septic tank effluent due to its hybrid flow directions with better oxygen supply inside the CW system. Copyright © 2015 Elsevier Ltd. All rights reserved.
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Septic osteitis of the distal phalanx: findings and surgical treatment in 18 cases
International Nuclear Information System (INIS)
Cauvin, E.R.J.; Munroe, G.A.
1998-01-01
Eighteen cases of septic osteitis of the distal phalanx were diagnosed clinically and confirmed at surgery over a 6 year period (1990-1996). Focal bone lysis was the most common radiographic finding. Sequestra were identified in 4 horses, one of which was associated with a fractured plantar process. All the horses were treated surgically with open debridement. The septic process recurred in 4 horses: one was subjected to euthanasia due to navicular bursa infection, secondary to a pathological fracture, the other 3 horses responded to further debridement. A pathological fracture occurred in another horse. All the survivors were not lame 3 months post operatively, although complete healing took 1-12 months. Long term follow up was available in 14 cases. One was retired, all the other horses were back in work at a similar level of performance. This series indicates that surgical treatment of septic pedal osteitis carries a fair to good prognosis despite a high rate of post operative complications and convalescence period of up to 12 months
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Utility of combined 99mTc-phosphate and 67Ga imaging in diagnosis of septic arthritis
International Nuclear Information System (INIS)
Seto, H.; Tonami, H.; Hisada, K.
1978-01-01
A case of septic arthritis diagnosed by combined 99m Tc-phosphate and 67 Ga imaging, which preceded positive cultures of the infecting organism, is presented. A previously healthy 10-year-old girl complained of pain in the left hip with persistent fever. Initial laboratory studies showed a normal white cell count and negative blood cultures. A septic process was not confirmed. Blood flow studies and bone images with 99mTc-phosphate showed markedly increased perfusion in the left hip joint without extension to bone. Subsequent 67 Ga images revealed a marked increase in radioactivity in the same region, indicating the presence of a septic process. Serial blood cultures and arthrocentesis showed Staphylococcus aureus. The patient improved on antibiotics
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[Application of polarized light in purulent-septic surgery].
Desiateryk, V I; Mikhno, S P; Kryvyts'kyĭ, Iu M; Kostiuk, S O
2002-09-01
Influence of polarized light on general state and healing of wounds and trophic ulcers in 57 patients with obliterating atherosclerosis of lower extremities, chronic venous insufficiency of extremities, purulent postoperative complications, purulent-septic complications in patients with diabetes mellitus was analyzed. Main mechanisms of the polarized light action in "Bioptron" apparatus were enlighted, effective schemes of its usage were determined.
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Harada, H; Dong, N T; Matsui, S
2008-01-01
Although many cities have planed to develop sewerages in developing countries, sewerage establishment still requires huge investment and engineering efforts. Improvement of existing sanitation facilities may contribute the betterment of urban sanitation before sewerage establishment. The purpose of this study is to propose a measure to improve urban sanitation in areas where a sewerage development plan is proposed but has not been yet established, based on a case study in Hanoi, Vietnam. We found that 90.5% of human excreta flowed into septic tanks. However, 89.6% of septic tanks have never been desludged in the past and their performance was observed to be at a low level. The study also showed that if they introduce regular desludging with a frequency of once a year, they can eliminate 72.8% of COD loads from septic tanks. It was indicated that the performance can be dramatically recovered by regular desludging, which could contribute urban sanitation improvement in Hanoi. In conclusion, the performance recovery of septic tanks by regular desludging was proposed as a provisional-and-urgent measure for urban sanitation improvement, together with the septage treatment in sewage sludge treatment facilities, which should be established earlier than other facilities of sewage treatment systems. IWA Publishing 2008.
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Costa, Nara Aline; Gut, Ana Lúcia; de Souza Dorna, Mariana; Pimentel, José Alexandre Coelho; Cozzolino, Silvia Maria Franciscato; Azevedo, Paula Schmidt; Fernandes, Ana Angélica Henrique; Zornoff, Leonardo Antonio Mamede; de Paiva, Sergio Alberto Rupp; Minicucci, Marcos Ferreira
2014-04-01
The purpose of the study is to determine the influence of serum thiamine, glutathione peroxidase (GPx) activity, and serum protein carbonyl concentrations in hospital mortality in patients with septic shock. This prospective study included all patients with septic shock on admission or during intensive care unit (ICU) stay, older than 18 years, admitted to 1 of the 3 ICUs of the Botucatu Medical School, from January to August 2012. Demographic information, clinical evaluation, and blood sample were taken within the first 72 hours of the patient's admission or within 72 hours after septic shock diagnosis for serum thiamine, GPx activity, and protein carbonyl determination. One hundred eight consecutive patients were evaluated. The mean age was 57.5 ± 16.0 years, 63% were male, 54.6% died in the ICU, and 71.3% had thiamine deficiency. Thiamine was not associated with oxidative stress. Neither vitamin B1 levels nor the GPx activity was associated with outcomes in these patients. However, protein carbonyl concentration was associated with increased mortality. In patients with septic shock, oxidative stress was associated with mortality. On the other hand, thiamine was not associated with oxidative stress or mortality in these patients. Copyright © 2014 Elsevier Inc. All rights reserved.
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Shankar-Hari, Manu; Phillips, Gary S.; Levy, Mitchell L.; Seymour, Christopher W.; Liu, Vincent X.; Deutschman, Clifford S.; Angus, Derek C.; Rubenfeld, Gordon D.; Singer, Mervyn; Angus, Derek; Annane, Djilalli; Bauer, Michael; Bellomo, Rinaldo; Bernard, Gordon; Chiche, Jean-Daniel; Coopersmith, Craig; Deutschman, Cliff; Hotchkiss, Richard; Levy, Mitchell; Marshall, John; Martin, Greg; Opal, Steve; Rubenfeld, Gordon; Seymour, Christopher; van der Poll, Tom; Vincent, Jean-Louis
2016-01-01
IMPORTANCE Septic shock currently refers to a state of acute circulatory failure associated with infection. Emerging biological insights and reported variation in epidemiology challenge the validity of this definition. OBJECTIVE To develop a new definition and clinical criteria for identifying
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Directory of Open Access Journals (Sweden)
A. Géloën
2015-01-01
Full Text Available Progress over the last 50 years has led to a decline in mortality from ≈70% to ≈20% in the best series of patients with septic shock. Nevertheless, refractory septic shock still carries a mortality close to 100%. In the best series, the mortality appears related to multiple organ failure linked to comorbidities and/or an intense inflammatory response: shortening the period that the subject is exposed to circulatory instability may further lower mortality. Treatment aims at reestablishing circulation within a “central” compartment (i.e., brain, heart, and lung but fails to reestablish a disorganized microcirculation or an adequate response to noradrenaline, the most widely used vasopressor. Indeed, steroids, nitric oxide synthase inhibitors, or donors have not achieved overwhelming acceptance in the setting of septic shock. Counterintuitively, α2-adrenoceptor agonists were shown to reduce noradrenaline requirements in two cases of human septic shock. This has been replicated in rat and sheep models of sepsis. In addition, some data show that α2-adrenoceptor agonists lead to an improvement in the microcirculation. Evidence-based documentation of the effects of alpha-2 agonists is needed in the setting of human septic shock.
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Energy Technology Data Exchange (ETDEWEB)
Mark Krauss
2004-08-01
The purpose of this CR is to document that closure activities have met the approved closure standards detailed in the NDEP-approved CAP for CAU 271. The purpose of the Errata Sheet is as follows: In Appendix G, Use Restriction (UR) Documentation, the UR form and drawing of the UR area do not reflect the correct coordinates. Since the original UR was put into place, the UR Form has been updated to include additional information that was not on the original form. This Errata Sheet replaces the original UR Form and drawing. In place of the drawing of the UR area, an aerial photograph is included which reflects the UR area and the correct coordinates for the UR area.
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Pylephlebitis and Crohn’s disease: A rare case of septic shock
Directory of Open Access Journals (Sweden)
Stefano Scaringi
2017-01-01
Conclusion: This case highlights the importance of promptly considerate and treat mesenteric pylephlebitis in presence of a septic shock in a Crohn’s disease patient who is not showing clinical signs of peritonitis.
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Directory of Open Access Journals (Sweden)
Chau-Chyun Sheu
2006-02-01
Full Text Available Infective endocarditis has been the major cause of morbidity and mortality among intravenous drug users (IDUs with infections, mostly involving the tricuspid valve and presenting multiple septic pulmonary embolisms. Numerous pulmonary complications of septic pulmonary embolism have been described, but only a few have reported spontaneous pneumothorax. Our patient, a 23-year-old heroin addict, was hospitalized for tricuspid endocarditis and septic pulmonary embolism. Acute onset of respiratory distress occurred on his seventh hospital day and rapidly resulted in hypoxemia. Immediate bedside chest radiograph demonstrated left pneumothorax. It was thought to be a spontaneous pneumothorax, because he had not undergone any invasive procedure before the occurrence of pneumothorax. His clinical condition improved after the insertion of an intercostal chest tube. He later underwent surgery to replace the tricuspid valve as a result of the large size of the vegetation and poor control of infection. He ultimately survived. Pneumothorax is a possible lethal complication of septic pulmonary embolism in IDUs with right-sided endocarditis and should be considered in such patients when respiratory distress occurs acutely during their hospitalization.
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Laboratory septic tank performance response to electrolytic stimulation.
Zaveri, Rahul M; Flora, Joseph R V
2002-11-01
This research investigated the effects of electrolytic stimulation on the performance of two laboratory-scale septic tanks. The tanks were fed a synthetic solution that included cellulose, peptone trypticase, beef extract, and urea. After a baseline period with no passed current, currents ranging from 100 to 500 mA were passed through the electrodes. The chemical oxygen demand (COD) removal efficiency from the tanks improved when a current was passed, with higher removal efficiencies observed at higher levels of passed current. Hydrolytic reactions resulted in ammonia and phosphate levels in the tanks that were higher than the influent. At currents > 300 mA, these hydrolytic reactions were suppressed, resulting in phosphate levels similar to the influent and ammonia levels lower than the influent because of the settling of ammonia-containing components of the feed solution. A slight increase in nitrate levels was observed when a current was passed, indicating minimal stimulation of nitrification activity. Abiotic studies confirmed that the COD can be removed via electrolysis and the removal was proportional to the passed current. Under the conditions of this study, the primary benefit of electrolytic stimulation of the septic tank is enhanced COD removal.
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Combined milrinone and enteral metoprolol therapy in patients with septic myocardial depression
Schmittinger, Christian A; Dünser, Martin W; Haller, Maria; Ulmer, Hanno; Luckner, Günter; Torgersen, Christian; Jochberger, Stefan; Hasibeder, Walter R
2008-01-01
Introduction The multifactorial etiology of septic cardiomyopathy is not fully elucidated. Recently, high catecholamine levels have been suggested to contribute to impaired myocardial function. Methods This retrospective analysis summarizes our preliminary clinical experience with the combined use of milrinone and enteral metoprolol therapy in 40 patients with septic shock and cardiac depression. Patients with other causes of shock or cardiac failure, patients with beta-blocker therapy initiated more than 48 hours after shock onset, and patients with pre-existent decompensated congestive heart failure were excluded. In all study patients, beta blockers were initiated only after stabilization of cardiovascular function (17.7 ± 15.5 hours after shock onset or intensive care unit admission) in order to decrease the heart rate to less than 95 beats per minute (bpm). Hemodynamic data and laboratory parameters were extracted from medical charts and documented before and 6, 12, 24, 48, 72, and 96 hours after the first metoprolol dosage. Adverse cardiovascular events were documented. Descriptive statistical methods and a linear mixed-effects model were used for statistical analysis. Results Heart rate control (65 to 95 bpm) was achieved in 97.5% of patients (n = 39) within 12.2 ± 12.4 hours. Heart rate, central venous pressure, and norepinephrine, arginine vasopressin, and milrinone dosages decreased (all P milrinone dosages were increased in nine (22.5%) and six (15%) patients, respectively. pH increased (P < 0.001) whereas arterial lactate (P < 0.001), serum C-reactive protein (P = 0.001), and creatinine (P = 0.02) levels decreased during the observation period. Twenty-eight-day mortality was 33%. Conclusion Low doses of enteral metoprolol in combination with phosphodiesterase inhibitors are feasible in patients with septic shock and cardiac depression but no overt heart failure. Future prospective controlled trials on the use of beta blockers for septic cardiomyopathy
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Impact of Dobutamine in Patients With Septic Shock: A Meta-Regression Analysis.
Nadeem, Rashid; Sockanathan, Shivani; Singh, Mukesh; Hussain, Tamseela; Kent, Patrick; AbuAlreesh, Sarah
2017-05-01
Septic shock frequently requires vasopressor agents. Conflicting evidence exists for use of inotropes in patients with septic shock. Data from English studies on human adult septic shock patients were collected. A total of 83 studies were reviewed, while 11 studies with 21 data sets including 239 patients were pooled for meta-regression analysis. For VO2, pooled difference in means (PDM) was 0.274. For cardiac index (CI), PDM was 0.783. For delivery of oxygen, PDM was -0.890. For heart rate, PDM was -0.714. For left ventricle stroke work index, PDM was 0.375. For mean arterial pressure, PDM was -0.204. For mean pulmonary artery pressure, PDM was 0.085. For O2 extraction, PDM was 0.647. For PaCO2, PDM was -0.053. For PaO2, PDM was 0.282. For pulmonary artery occlusive pressure, PDM was 0.270. For pulmonary capillary wedge pressure, PDM was 0.300. For PVO2, PDM was -0.492. For right atrial pressure, PDM was 0.246. For SaO2, PDM was 0.604. For stroke volume index, PDM was 0.446. For SvO2, PDM was -0.816. For systemic vascular resistance, PDM was -0.600. For systemic vascular resistance index, PDM was 0.319. Meta-regression analysis was performed for VO2, DO2, CI, and O2 extraction. Age was found to be significant confounding factor for CI, DO2, and O2 extraction. APACHE score was not found to be a significant confounding factor for any of the parameters. Dobutamine seems to have a positive effect on cardiovascular parameters in patients with septic shock. Prospective studies with larger samples are required to further validate this observation.
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Partial nitrification enhances natural attenuation of nitrogen in a septic system plume.
Caschetto, M; Robertson, W; Petitta, M; Aravena, R
2018-06-01
Natural attenuation of nitrogen (N) was investigated in a well characterized septic system plume at a campground in Ontario, Canada. Total inorganic N (TIN) concentrations in deeper portions of the plume were about one third of the septic tank value of 40.7mgL -1 . NH 4 + and NO 3 - isotopic characterization were used to provide insight into potential attenuation processes. Concentrations of NH 4 + and NO 3 - were highly variable in the plume, but approached the septic tank TIN value in some shallow zones and exhibited δ 15 N values like the tank value of +6‰. However, isotopic enrichment (up to +24‰ for NH 4 + and +45‰ for NO 3 - ) and declining TIN concentrations in the deeper zones indicated that anaerobic ammonium oxidation contributed to the TIN attenuation. The degree of isotopic enrichment increased at lower NH 4 + concentrations and was consistent with Rayleigh-type distillation with an enrichment factor (Ɛ) of -5.1‰. Additionally, decreasing DOC values with depth and the concomitant enrichment of δ 15 N NO3 and δ 18 O NO3 , suggested that denitrification was also active. The N attenuation observed in the Killarney plume was partly due to incomplete nitrification that occurred because of the shallow water table, which varied from only 0.2-0.7m below the tile bed infiltration pipes. Moreover, some of the monitoring locations with the shallowest water table distances from the infiltration pipes, had the highest degree of TIN attenuation (70-90%) in the plume. This behavior suggests that controlling water table distance from the infiltration pipes could be a useful mechanism for enhancing N attenuation in septic system plumes. Copyright © 2017 Elsevier B.V. All rights reserved.
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International Nuclear Information System (INIS)
Carlson, R.A.
2006-01-01
The 1607-D4 Septic System was a septic tank and tile field that received sanitary sewage from the 115-D/DR Gas Recirculation Facility. This septic system operated from 1944 to 1968. Decommissioning took place in 1985 and 1986 when all above-grade features were demolished and the tank backfilled. The results of verification sampling demonstrated that residual contaminant concentrations do not preclude any future uses and allow for unrestricted use of shallow zone soils. The results also showed that residual contaminant concentrations are protective of groundwater and the Columbia River
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Corrective Action Plan for Corrective Action Unit 563: Septic Systems, Nevada Test Site, Nevada
International Nuclear Information System (INIS)
2009-01-01
This Corrective Action Plan (CAP) has been prepared for Corrective Action Unit (CAU) 563, Septic Systems, in accordance with the Federal Facility Agreement and Consent Order. CAU 563 consists of four Corrective Action Sites (CASs) located in Areas 3 and 12 of the Nevada Test Site. CAU 563 consists of the following CASs: CAS 03-04-02, Area 3 Subdock Septic Tank CAS 03-59-05, Area 3 Subdock Cesspool CAS 12-59-01, Drilling/Welding Shop Septic Tanks CAS 12-60-01, Drilling/Welding Shop Outfalls Site characterization activities were performed in 2007, and the results are presented in Appendix A of the CAU 563 Corrective Action Decision Document. The scope of work required to implement the recommended closure alternatives is summarized below. CAS 03-04-02, Area 3 Subdock Septic Tank, contains no contaminants of concern (COCs) above action levels. No further action is required for this site; however, as a best management practice (BMP), all aboveground features (e.g., riser pipes and bumper posts) will be removed, the septic tank will be removed, and all open pipe ends will be sealed with grout. CAS 03-59-05, Area 3 Subdock Cesspool, contains no COCs above action levels. No further action is required for this site; however, as a BMP, all aboveground features (e.g., riser pipes and bumper posts) will be removed, the cesspool will be abandoned by filling it with sand or native soil, and all open pipe ends will be sealed with grout. CAS 12-59-01, Drilling/Welding Shop Septic Tanks, will be clean closed by excavating approximately 4 cubic yards (yd3) of arsenic- and chromium-impacted soil. In addition, as a BMP, the liquid in the South Tank will be removed, the North Tank will be removed or filled with grout and left in place, the South Tank will be filled with grout and left in place, all open pipe ends will be sealed with grout or similar material, approximately 10 yd3 of chlordane-impacted soil will be excavated, and debris within the CAS boundary will be removed. CAS 12
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Fact Sheet: Trigeminal Neuralgia
... Health, is the federal government’s leading supporter of biomedical research on disorders of the brain and nervous system. ... by the National Institute of Dental and Craniofacial Research. One ... mucosa). Current drug therapy is absorbed through the body, which may lead ...
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... of Health (NIH), the leading federal supporter of biomedical research in the world. As part of its mission, ... in postmenopausal women than in men. Estrogen replacement therapy reduces the ... research projects include studies of the effectiveness of microsurgical ...
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... help them maintain adequate weight. Special academic, social, vocational, and support services may be required in some ... Are Funded Small Business Grants Overview Areas of Interest Budget Information Grant Timeline Award Information Entrepreneurial Resources ...
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Marketing Transformation (Fact Sheet)
Energy Technology Data Exchange (ETDEWEB)
DOE Solar Energy Technologies Program
2011-10-13
Through the SunShot Initiative, the U.S. Department of Energy (DOE) works with manufacturers, communities, states, utilities, and other partners to enable the solar market by reducing non-hardware balance-of-system (BOS) costs, developing a skilled workforce, and eliminating market barriers to widespread adoption of solar technologies.
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Adolescent Literacy. Fact Sheet
Alliance for Excellent Education, 2011
2011-01-01
The nation's workforce is demanding ever more literate workers and citizens. As technology advances and the American economy grows increasingly knowledge based, individuals must be able to read, write, and communicate at higher levels in order to remain economic and social contributors. A student's level of literacy is a critical determinant of…
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Environmental Management Fact Sheets.
Department of Energy, Washington, DC.
In recent years, the need for nuclear materials has decreased and the Department of Energy (DOE) has focused greater attention on cleaning up contamination left from past activities. The Office of Environmental Management (EM) within DOE is responsible for managing waste and cleaning up contamination at DOE sites across the nation. This collection…
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Bremmer HJ; Veen MP van; LMB
2002-01-01
Mathematical models are available for the exposure assessment of compounds in consumer products. The computer program CONSEXPO is used for the calculations. Since the huge number of consumer products does not allow exposure assessment of every product separately, a limited number of main categories
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... or duplicated without permission of the Office on Women’s Health in the U.S. Department of Health and Human Services. Citation of the source is appreciated. Page last updated: March 14, 2018. About Us Who we are What ...
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... is caused by a virus transmitted primarily by Aedes mosquitoes. People with Zika virus disease can have symptoms including mild fever, skin ... framework. Q&A: Zika virus and complication ... mosquito from the Aedes genus, mainly Aedes aegypti in tropical regions. Aedes ...
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Dietary Supplement Fact Sheets
... Primary Mitochondrial Disorders Weight Loss A Acai Aloe Vera Anabolic Steroids Antioxidants (see Exercise and Athletic Performance ) ... Pills (see Weight Loss ) Dietary Supplements Vitamin D E Echinacea Ephedra Essiac/Flor-Essence European Elder Evening ...
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New requirements for buffer zones and sign posting contribute to soil fumigant mitigation and protection for workers and bystanders. The buffer provides distance between the pesticide application site and bystanders, reducing exposure risk.
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... federal government website managed by the Office on Women's Health in the Office of the Assistant Secretary for Health at the U.S. Department of Health and Human Services . 200 Independence Avenue, S.W., Washington, DC 20201 1-800-994- ...
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... federal government website managed by the Office on Women's Health in the Office of the Assistant Secretary for Health at the U.S. Department of Health and Human Services . 200 Independence Avenue, S.W., Washington, DC 20201 1-800-994- ...
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Directory of Open Access Journals (Sweden)
Shuo Wang
2017-01-01
Conclusions: In the present study, we developed a novel porcine model of septic shock induced by ARDS due to severe MRSA pneumonia with characteristic hyperdynamic and hypodynamic phases in 24 h, which mimicked the hemodynamic changing of septic shock in human.
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Zyubin, A.; Konstantinova, E.; Slezhkin, V.; Matveeva, K.; Samusev, I.; Bryukhanov, V.
2017-12-01
In this paper we perform results of conformational analysis of septic human serum albumin (HSA) carried out by Raman spectroscopy (RS), infrared (IR) spectroscopy and fluorescent spectroscopy. The main vibrational groups were identified and analyzed for septic HSA and its health control. Comparison between Raman and IR results were done. Fluorescent spectral changes of Trp-214 group were analyzed. Application of Raman, IR spectroscopy, fluorescent spectroscopy for conformational changes study of HSA during pathology were shown.
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Triglyceride kinetics in fasted and fed E.coli septic rats
International Nuclear Information System (INIS)
Lanza-Jacoby, S.; Tabares, A.
1990-01-01
The mechanism for the development of hypertriglyceridemia during gram-negative sepsis was studies by examining the liver production and clearance of very-low-density lipoprotein (VLDL) triglyceride (TG). To assess the liver output and peripheral clearance the kinetics of VLDL-TG were determined by a constant intravenous infusion of [2- 3 H] glycerol-labeled VLDL in fasted control, fasted E. coli-treated, fed control, and fed E.coli-treated rats. Lewis inbred rats, 275-300 g, were made septic with 8 x 10 7 live E.coli colonies per 100 g body weight. Twenty-four hours following E.coli injection serum TG of fasted E.coli-treated rats was elevated by 170% which was attributed to a 67% decrease in the clearance rate of VLDL-TG in fasted E.coli-treated rats compared with their fasted controls. The secretion of VLDL-TG declined by 31% in the livers of the fasted E.coli-treated rats which was accompanied by a 2-fold increase in the composition of liver TG. In a second series of experiments control and E.coli-treated rats were fed intragastrically (IG) a balanced solution containing glucose plus fat as the sources of nonprotein calories. Serum TG were 26% lower in the fed E.coli-treated rats because the clearance rate increased by 86%. The secretion of TG in the fed septic rats increased by 40% but this difference was not significant. In the septic rat the ability to clear triglycerides from the plasma depends upon the nutritional state
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Directory of Open Access Journals (Sweden)
Daniel P. Croft
2015-01-01
Full Text Available Lemierre's syndrome is a septic thrombophlebitis of the internal jugular vein, which can lead to severe systemic illness. We report a case of an otherwise healthy 26-year-old man who suffered from pharyngitis followed by septic shock requiring intubation and vasopressor support from Fusobacterium necrophorum bacteremia. The septic emboli to his lungs caused complicated bilateral parapneumonic effusions, which recurred after initial drainage. He required bilateral chest tubes and intrapleural tPA to successfully drain his effusions. His fever curve and overall condition improved with the resolution of his effusions and after a 33-day hospitalization, he recovered without significant disability. The severity of his illness and difficult to manage complicated parapneumonic effusions were the unique facets of this case. Using an evidence-based approach of tPA and DNase for complicated parapneumonic effusions in Lemierre's syndrome can be safe and effective.
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Directory of Open Access Journals (Sweden)
Deng-Wei Chou
2015-06-01
Full Text Available OBJECTIVES: Septic pulmonary embolism caused by a Klebsiella (K. pneumoniae liver abscess is rare but can cause considerable morbidity and mortality. However, clinical information regarding this condition is limited. This study was conducted to elucidate the full disease spectrum to improve its diagnosis and treatment. METHOD: We reviewed the clinical characteristics, imaging findings, and clinical courses of 14 patients diagnosed with septic pulmonary embolism caused by a K. pneumoniae liver abscess over a period of 9 years. RESULTS: The two most prevalent symptoms were fever and shortness of breath. Computed tomography findings included a feeding vessel sign (79%, nodules with or without cavities (79%, pleural effusions (71%, peripheral wedge-shaped opacities (64%, patchy ground-glass opacities (50%, air bronchograms within a nodule (36%, consolidations (21%, halo signs (14%, and lung abscesses (14%. Nine (64% of the patients developed severe complications and required intensive care. According to follow-up chest radiography, the infiltrates and consolidations were resolved within two weeks, and the nodular opacities were resolved within one month. Two (14% patients died of septic shock; one patient had metastatic meningitis, and the other had metastatic pericarditis. CONCLUSION: The clinical presentations ranged from insidious illness with fever and respiratory symptoms to respiratory failure and septic shock. A broad spectrum of imaging findings, ranging from nodules to multiple consolidations, was detected. Septic pulmonary embolism caused by a K. pneumoniae liver abscess combined with the metastatic infection of other vital organs confers a poor prognosis.
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Prowle, John R; Molan, Maurice P; Hornsey, Emma; Bellomo, Rinaldo
2012-06-01
In septic patients, decreased renal perfusion is considered to play a major role in the pathogenesis of acute kidney injury. However, the accurate measurement of renal blood flow in such patients is problematic and invasive. We sought to overcome such obstacles by measuring renal blood flow in septic patients with acute kidney injury using cine phase-contrast magnetic resonance imaging. Pilot observational study. University-affiliated general adult intensive care unit. Ten adult patients with established septic acute kidney injury and 11 normal volunteers. Cine phase-contrast magnetic resonance imaging measurement of renal blood flow and cardiac output. The median age of the study patients was 62.5 yrs and eight were male. At the time of magnetic resonance imaging, eight patients were mechanically ventilated, nine were on continuous hemofiltration, and five required vasopressors. Cine phase-contrast magnetic resonance imaging examinations were carried out without complication. Median renal blood flow was 482 mL/min (range 335-1137) in septic acute kidney injury and 1260 mL/min (range 791-1750) in healthy controls (p = .003). Renal blood flow indexed to body surface area was 244 mL/min/m2 (range 165-662) in septic acute kidney injury and 525 mL/min/m2 (range 438-869) in controls (p = .004). In patients with septic acute kidney injury, median cardiac index was 3.5 L/min/m2 (range 1.6-8.7), and median renal fraction of cardiac output was only 7.1% (range 4.4-10.8). There was no rank correlation between renal blood flow index and creatinine clearance in patients with septic acute kidney injury (r = .26, p = .45). Cine phase-contrast magnetic resonance imaging can be used to noninvasively and safely assess renal perfusion during critical illness in man. Near-simultaneous accurate measurement of cardiac output enables organ blood flow to be assessed in the context of the global circulation. Renal blood flow seems consistently reduced as a fraction of cardiac output in
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VMN hypothalamic dopamine and serotonin in anorectic septic rats.
Torelli, G F; Meguid, M M; Miyata, G; Fetissov, S O; Carter, J L; Kim, H J; Muscaritoli, M; Rossi Fanelli, F
2000-03-01
During sepsis, catabolism of proteins and associated changes in plasma amino acids occur. Tryptophan and tyrosine, and their derivatives serotonin (5-HT) and dopamine (DA), influence hypothalamic feeding-related areas and are associated with the onset of anorexia. We hypothesized that anorexia of sepsis is associated with changes in serotonin and dopamine in the ventromedial nucleus (VMN) of the hypothalamus. The aim of this study was to test our hypothesis by measuring intra-VMN changes of these two neurotransmitters at the onset of anorexia during sepsis. Fischer 344 male rats had an intracerebral guide cannula stereotaxically implanted into the VMN. Ten days later, in awake, overnight-food-deprived rats, a microdialysis probe was inserted through the in situ VMN cannula. Two hours thereafter, serial baseline serotonin and dopamine concentrations were measured. Then cecal ligation and puncture to induce sepsis or a control laparotomy was performed under isoflurane anesthesia. VMN microdialysis samples were serially collected every 30 min for 8 h after the surgical procedure to determine 5-HT and DA changes in response to sepsis. During the hypermetabolic response to sepsis, a strong association occurred between anorexia and a significant reduction of VMN dopamine concentration (P anorexia of sepsis. Six hours after operation, a single meal was offered for 20 min to assess the response of neurotransmitters to food ingestion. Food intake was minimal in anorectic septic rats (mean size of the after food-deprived meal in the Septic group was 0.03+/-0.01 g, that of the Control group was 1.27+/-0.14 g; P = 0.0001), while Control rats demonstrated anticipated changes in neurotransmitters in response to eating. We conclude that the onset of anorexia in septic rats is associated with a reduction in VMN dopamine.
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Multidrug resistant bacteria isolated from septic arthritis in horses
Directory of Open Access Journals (Sweden)
Rodrigo G. Motta
Full Text Available ABSTRACT: Septic arthritis is a debilitating joint infectious disease of equines that requires early diagnosis and immediate therapeutic intervention to prevent degenerative effects on the articular cartilage, as well as loss of athletic ability and work performance of the animals. Few studies have investigated the etiological complexity of this disease, as well as multidrug resistance of isolates. In this study, 60 horses with arthritis had synovial fluid samples aseptically collected, and tested by microbiological culture and in vitro susceptibility test (disk diffusion using nine antimicrobials belonging to six different pharmacological groups. Bacteria were isolated in 45 (75.0% samples, as follows: Streptococcus equi subsp. equi (11=18.3%, Escherichia coli (9=15.0%, Staphylococcus aureus (6=10.0%, Streptococcus equi subsp. zooepidemicus (5=8.3%, Staphylococcus intermedius (2=3.3%, Proteus vulgaris (2=3.3%, Trueperella pyogenes (2=3.3%, Pseudomonas aeruginosa (2=3.3%, Klebsiella pneumoniae (1=1.7%, Rhodococcus equi (1=1.7%, Staphylococcus epidermidis (1=1.7%, Klebsiella oxytoca (1=1.7%, Nocardia asteroides (1=1.7%, and Enterobacter cloacae (1=1.7%. Ceftiofur was the most effective drug (>70% efficacy against the pathogens in the disk diffusion test. In contrast, high resistance rate (>70% resistance was observed to penicillin (42.2%, enrofloxacin (33.3%, and amikacin (31.2%. Eleven (24.4% isolates were resistant to three or more different pharmacological groups and were considered multidrug resistant strains. The present study emphasizes the etiological complexity of equine septic arthritis, and highlights the need to institute treatment based on the in vitro susceptibility pattern, due to the multidrug resistance of isolates. According to the available literature, this is the first report in Brazil on the investigation of the etiology. of the septic arthritis in a great number of horses associated with multidrug resistance of the isolates.
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L.C.A.C. Vermunt (Lindy)
2008-01-01
textabstractSeptic shock, caused by Neisseria meningitidis with petechiae and/or purpura, also called Meningococcal Septic Shock (MSS), is the most serious form of meningococcal infection in early childhood. MSS is a life-threatening illness in mostly previously healthy children, with an unexpected
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Muller, Markus K; Wrann, Simon; Widmer, Jeannette; Klasen, Jennifer; Weber, Markus; Hahnloser, Dieter
2016-09-01
The surgical treatment for perforated peptic ulcers can be safely performed laparoscopically. The aim of the study was to define simple predictive factors for conversion and septic complications. This retrospective case-control study analyzed patients treated with either laparoscopic surgery or laparotomy for perforated peptic ulcers. A total of 71 patients were analyzed. Laparoscopically operated patients had a shorter hospital stay (13.7 vs. 15.1 days). In an intention-to-treat analysis, patients with conversion to open surgery (analyzed as subgroup from laparoscopic approach group) showed no prolonged hospital stay (15.3 days) compared to patients with a primary open approach. Complication and mortality rates were not different between the groups. The statistical analysis identified four intraoperative risk factors for conversion: Mannheim peritonitis index (MPI) > 21 (p = 0.02), generalized peritonitis (p = 0.04), adhesions, and perforations located in a region other than the duodenal anterior wall. We found seven predictive factors for septic complications: age >70 (p = 0.02), cardiopulmonary disease (p = 0.04), ASA > 3 (p = 0.002), CRP > 100 (p = 0.005), duration of symptoms >24 h (p = 0.02), MPI > 21(p = 0.008), and generalized peritonitis (p = 0.02). Our data suggest that a primary laparoscopic approach has no disadvantages. Factors necessitating conversions emerged during the procedure inhibiting a preoperative selection. Factors suggesting imminent septic complications can be assessed preoperatively. An assessment of the proposed parameters may help optimize the management of possible septic complications.
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Cetin, H; Yanikoglu, A; Kocak, O; Cilek, J E
2006-11-01
The larvicidal activity of chlorpyrifos-methyl and temephos was evaluated against Culex pipiens L. (Diptera: Culicidae) in septic tanks in Antalya, Turkey. Chlorpyrifos-methyl (Pyrifos MT 25 emulsifiable concentrate [EC] ) was evaluated at application rates of 0.04, 0.08, and 0.12 mg active ingredient (AI)/liter, and temephos (Temeguard 50 EC) was evaluated at 0.02, 0.04, and 0.06 mg (AI)/liter during a 21-d study. Generally, overall larval reduction in septic tanks from single- and multifamily dwellings treated with either larvicide was significantly greater than pretreatment levels and control tanks for the duration of the study. At 14 d posttreatment, duration of control was greatest in multifamily tanks treated with chlorpyrifos-methyl at the highest application rate with similar levels of control through 21 d for single-family dwellings (range 97-100%). Septic tanks from both types of family dwellings treated at the highest application rate of temephos resulted in >90% reduction through day 21 (range 91-100%). Laboratory bioassays of septic tank water treated at field application rates, without daily dilution, revealed that complete larval mortality was achieved for 21 d at each application rate and formulation. It is thought that daily addition of water and organic matter to the septic tanks in the single and multifamily dwellings influenced the duration of effectiveness of the larvicides.
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Directory of Open Access Journals (Sweden)
Francesca Bissolo
2012-10-01
Full Text Available Terlipressin, a synthetic long-acting analogue of vasopressin, has been investigated as a second line vasopressor in adults and children with refractory septic shock, i.e. not responding to fluid resuscitation and high-dose catecholamine administration. Little experience is available about the safety and efficacy of terlipressin in term and preterm newborns. We report the case of an extremely low birth weight infant with severe septic shock, unresponsive to fluids, noradrenalin and hydrocortisone, in whom terlipressin was attempted as a rescue drug. Despite three doses of terlipressin, administered 6-hourly, the patient remained profoundly hypotensive and eventually died. Further studies are required before any recommendation on the use of terlipressin in term or preterm newborns with septic shock can be made.
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Septic Thrombophlebitis of the Cephalic Vein Caused by a Peripherally Inserted Venous Catheter
Directory of Open Access Journals (Sweden)
M Mirmohammadsadeghi
2005-07-01
Full Text Available Septic thrombophlebitis of a vein is a rare but life-threatening complication of an intravascular (IV catheter placed percutaneously in the veins. Most published clinical experiences with IV catheters, mainly in the outpatient settings, have reported very low rates of catheter-related bloodstream infection compared to rates with central venous catheters placed in a subclavian or internal jugular vein. Most of the complications reported with IV catheters have been non-infectious, particularly sterile phlebitis or thrombosis. We report a case of cephalic vein suppurative thrombophlebitis from an intravascular catheter and offer guidelines for diagnosis and management of this complication. Key words: Septic thrombophlebitis, Intravascular catheter, Suppurative thrombophlebitis
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Tsirikos, Athanasios I; Subramanian, Ashok Sridhara
2011-10-15
A case report. We report septic shock as postoperative complication following an instrumented posterior spinal arthrodesis on a patient with multiple body piercings. The management of this potentially catastrophic complication and outcome of treatment is been discussed. Body piercing has become increasingly more common because of change in culture or as a fashion statement. This has been associated with local or generalized ill effects including tissue injury, skin and systemic infections, and septic shock. There is no clear guideline pathway regarding removal and reinsertion of body piercings in patients who undergo major surgery. Complications following orthopedic or spinal procedures associated with body piercing have not been reported. We reviewed the medical notes and radiographs of an adolescent patient with Scheuermann kyphosis and multiple body piercings who underwent a posterior spinal arthrodesis and developed septic shock. Septic shock developed on postoperative day 2 after reinsertion of all piercings following the patient's request. The patient became systemically very unwell and required intensive medical management, as well as a total course of antibiotics of 3 months. The piercings remained in situ. She did not develop a wound infection despite the presence of bacteremia and spinal instrumentation. The patient had no new piercings subsequent to her deformity procedure. Two and a half years after spinal surgery she reported no medical problems, had a balanced spine with no loss of kyphosis correction and no evidence of nonunion or recurrence of deformity. The development of septic shock as a result of piercing reinsertion in the postoperative period has not been previously reported. This is an important consideration to prevent potentially life-threatening complications following major spinal surgery.
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Septic Abortion Managed in a Tertiary Hospital in West Bengal
African Journals Online (AJOL)
a cross-sectional study carried out in Burdwan Medical College and Hospital in West ... beyond the uterus to the parametrium, tubes, and ovaries or pelvic peritoneum; grade III: Generalized peritonitis and/or ... 1297 cases of abortion were admitted among which 107 were septic ..... Obstetric infection disease emergencies.
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Cetin, H; Yanikoglu, A; Cilek, J E
2006-06-01
The mosquito Culex pipiens L. is an important pest in urban and suburban areas in many parts of the world. Septic tanks are the most important habitats supporting the production of this species in the city of Antalya, southwestern Turkey. Diflubenzuron, in a 25% wettable powder (Du-dim 25 WP), and a 4% granular formulation (Du-dim 4 G) was evaluated against late 2nd to early 3rd instars of Cx. pipiens in single-family septic tanks. Both formulations were tested at 0.01, 0.02, and 0.03 mg (AI)/liter. The results indicated that both formulations applied at the rate of 0.02 and 0.03 mg (AI)/liter achieved 100% adult inhibition, at intervals of 7, 14, 21, and 28 days after treatment. Septic tanks treated with 0.01 mg (AI)/liter WP formulation resulted in complete (100%) adult inhibition through 14 days, whereas the G formulation gave the same effect through 21 days posttreatment at this rate.
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Directory of Open Access Journals (Sweden)
Roodpeyma
2015-11-01
Full Text Available Introduction Infective endocarditis (IE causes serious complications in patients. Congenital heart disease (CHD is an important underlying condition in children. Septic pulmonary embolism is an uncommon syndrome, and pulmonary valve IE is rare. The current study presented a case of right-sided IE with pulmonary valve involvement and its complications as pulmonary septic emboli in a child with CHD. Case Presentation A 6-year-old girl with a ventricular septal defect (VSD was presented. Echocardiography revealed large vegetation in the right ventricular outflow tract near the pulmonary valve. The patient showed clinical symptoms of lung involvement, and radiologic investigation was compatible with a diagnosis of septic pulmonary emboli. She had good response to antibacterial therapy and underwent a successful surgical closure of the heart defect. Conclusions Children with CHD are at risk of severe complications with the involvement of other organs. long-term febrile illness should be taken seriously in these children. They need hospitalization and careful evaluation.
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Vallabhajosyula, Saraschandra; Kumar, Mukesh; Pandompatam, Govind; Sakhuja, Ankit; Kashyap, Rahul; Kashani, Kianoush; Gajic, Ognjen; Geske, Jeffrey B; Jentzer, Jacob C
2017-09-07
Echocardiographic myocardial dysfunction is reported commonly in sepsis and septic shock, but there are limited data on sepsis-related right ventricular dysfunction. This study sought to evaluate the association of right ventricular dysfunction with clinical outcomes in patients with severe sepsis and septic shock. Historical cohort study of adult patients admitted to all intensive care units at the Mayo Clinic from January 1, 2007 through December 31, 2014 for severe sepsis and septic shock, who had an echocardiogram performed within 72 h of admission. Patients with prior heart failure, cor-pulmonale, pulmonary hypertension and valvular disease were excluded. Right ventricular dysfunction was defined by the American Society of Echocardiography criteria. Outcomes included 1-year survival, in-hospital mortality and length of stay. Right ventricular dysfunction was present in 214 (55%) of 388 patients who met the inclusion criteria-isolated right ventricular dysfunction was seen in 100 (47%) and combined right and left ventricular dysfunction in 114 (53%). The baseline characteristics were similar between cohorts except for the higher mechanical ventilation use in patients with isolated right ventricular dysfunction. Echocardiographic findings demonstrated lower right ventricular and tricuspid valve velocities in patients with right ventricular dysfunction and lower left ventricular ejection fraction and increased mitral E/e' ratios in patients with combined right and left ventricular dysfunction. After adjustment for age, comorbidity, illness severity, septic shock and use of mechanical ventilation, isolated right ventricular dysfunction was independently associated with worse 1-year survival-hazard ratio 1.6 [95% confidence interval 1.2-2.1; p = 0.002) in patients with sepsis and septic shock. Isolated right ventricular dysfunction is seen commonly in sepsis and septic shock and is associated with worse long-term survival.
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Association between fluid balance and mortality in patients with septic shock
DEFF Research Database (Denmark)
Cronhjort, M; Hjortrup, P B; Holst, L B
2016-01-01
and a comparably low cumulative fluid balance, there was no association between fluid balance and mortality. However, the study design and the limited power preclude strong conclusions. There is an urgent need for high-quality trials assessing the benefit and harm of different fluid volume strategies in patients......BACKGROUND: Several studies have shown an association between a positive fluid balance and increased mortality in patients with septic shock. This may have led to a more restrictive use of intravenous fluids. The association between fluid accumulation and mortality in the setting of a more...... restrictive use of intravenous fluids, however, is uncertain. We therefore aimed to investigate the association between a cumulative fluid balance 3 days after randomization and 90-day mortality in a recent Nordic multicentre cohort of patients with septic shock. METHODS: A post hoc analysis of patients from...
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Cutibacterium acnes Septic Arthritis of the Nonoperated Knee: A Case Report
Okoroha, Kelechi R.; Gabbard, Michael D.; Fitts, Jamal; Banka, Trevor R.
2017-01-01
Cutibacterium (Propionibacterium) acnes , a gram-positive bacillus with low pathogenicity, is an uncommon but known cause of prosthetic joint infections, particularly related to shoulder surgery. C. acnes , however, is an extremely rare pathogen in the nonoperated knee joint. This report details an uncommon case of C. acnes septic knee arthritis after multiple intra-articular steroid injections in a 56-year-old male patient. After an indolent presentation and late diagnosis, the patient underwent surgical debridement with IV antibiotic management. This case illustrates that intra-articular corticosteroid injections for the management of osteoarthritis are not without risk. Literature supporting their use remains limited and clinicians should use proficient clinical judgment for appropriate patient selection for these injections. Vigilance following injections or aspirations of the knee should be maintained to identify the indolent clinical presentation of C. acnes septic arthritis. PMID:28825032
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Rumbus, Zoltan; Matics, Robert; Hegyi, Peter; Zsiboras, Csaba; Szabo, Imre; Illes, Anita; Petervari, Erika; Balasko, Marta; Marta, Katalin; Miko, Alexandra; Parniczky, Andrea; Tenk, Judit; Rostas, Ildiko; Solymar, Margit; Garami, Andras
2017-01-01
Sepsis is usually accompanied by changes of body temperature (Tb), but whether fever and hypothermia predict mortality equally or differently is not fully clarified. We aimed to find an association between Tb and mortality in septic patients with meta-analysis of clinical trials. We searched the PubMed, EMBASE, and Cochrane Controlled Trials Registry databases (from inception to February 2016). Human studies reporting Tb and mortality of patients with sepsis were included in the analyses. Average Tb with SEM and mortality rate of septic patient groups were extracted by two authors independently. Forty-two studies reported Tb and mortality ratios in septic patients (n = 10,834). Pearson correlation analysis revealed weak negative linear correlation (R2 = 0.2794) between Tb and mortality. With forest plot analysis, we found a 22.2% (CI, 19.2-25.5) mortality rate in septic patients with fever (Tb > 38.0°C), which was higher, 31.2% (CI, 25.7-37.3), in normothermic patients, and it was the highest, 47.3% (CI, 38.9-55.7), in hypothermic patients (Tb 75%).
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Disorders of nutritional status in sepsis – facts and myths
Directory of Open Access Journals (Sweden)
Katarzyna Kosałka
2017-06-01
Full Text Available The problem of diagnosing nutritional status disorders in septic patients remains unresolved. This is associated with the necessity of the introduction of newer and newer methods of assessing nutritional status, often requiring precise and expensive equipment as well as employment of professionals in this field in hospital wards, primarily including intensive care units (ICU. Methods that have been applied thus far for assessing nutritional status, also used in severely ill septic patients, have little impact on improving treatment results. This is due to the high dynamics of changes in nutritional status in these patients, healing process variability in individual patients, and the “mismatch” of methods for assessing nutritional status in relation to the patient’s clinical status. The diagnostic value of the traditional methods of assessing nutritional status, i.e. anthropometric analysis and selected laboratory tests, as markers of nutritional status disorders in septic patients, is still debatable. There is still no precise method that could become the “gold standard” allowing for early identification of malnutrition in these group of patients. Phase angle, bioelectrical impedance vector analysis (BIVA, and the “illness marker”, obtained directly from the resistance, reactance, and impedance, can be used as prognostic or nutritional indices in severely ill septic patients, but the intensity of research on this subject needs to be increased. Detailed assessment of nutritional status should include tests of selected inflammation markers (including TLC, HMGB1, IL-6, IL-10, IL-1ra, sTNFRI.
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Norepinephrine kinetics and dynamics in septic shock and trauma patients.
Beloeil, H; Mazoit, J-X; Benhamou, D; Duranteau, J
2005-12-01
There is considerable variability in the inter-patient response to norepinephrine. Pharmacokinetic studies of dopamine infusion in volunteers and in patients have also shown large variability. The purpose of this study was to define the pharmacokinetics of norepinephrine in septic shock and trauma patients. After Ethical Committee approval and written informed family consent, 12 patients with septic shock and 11 trauma patients requiring norepinephrine infusion were studied. Norepinephrine dose was increased in three successive steps of 0.1 mg kg(-1) min(-1) at 15-min intervals (20% maximum allowed increase in arterial pressure). Arterial blood was sampled before and at 0.5, 13, and 15 min after each infusion rate change and 30 s, 1, 2, 5, 10, and 15 min after return to baseline dosing. Norepinephrine was assayed by HPLC. The pharmacokinetics were modelled using NONMEM (one-compartment model). The effects of group, body weight (BW), gender and SAPS II (Simplified Acute Physiology Score II) [Le Gall JR, Lemeshow S, Saulnier F. A new Simplified Acute Physiology Score (SAPS II) based on a European/North American multicenter study. J Am Med Assoc 1993; 270: 2957-63] patients score on clearance (CL) and volume of distribution (V) were tested. Group, gender, and BW did not influence CL or V. CL was negatively related to SAPS II. CL and T(1/2) varied from 3 litre min(-1) and 2 min, respectively, when SAPS II=20 to 0.9 litre min(-1) and 6.8 min when SAPS II=60. In trauma patients and in septic shock patients, norepinephrine clearance is negatively related to SAPS II.
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An epidemiological study of septic arthritis in Kuala Lumpur Hospital.
Razak, M; Nasiruddin, J
1998-09-01
Forty-one patients with 42 joint infections were admitted to the hospital between June 1989 and June 1994. An overview on the behaviour of septic arthritis in both children and adults, at presentation and after various types of treatment was done. There were 32 knees, 7 hips, 2 elbows and 1 shoulder. Duration of symptoms, type of organism, type of joint drainage, presence of preexisting joint problems and presence of osteomyelitis are among the important factors with prognostic significance. Seventy three percent of patients with less than 7 days duration of symptoms had satisfactory results. Whereas when the duration of symptoms exceeded 7 days, 75% of the patients had unsatisfactory outcome. All cases with poor outcome had positive cultures. Staphylococcus aureus was responsible for 77% of the culture-positive cases. All Staphylococcus aureus in this study were penicillin-resistant but sensitive to cloxacillin. There were 3 instances where Staphylococcus became resistant to cloxacillin following recurrence of septic arthritis. However, they were still sensitive to third generation cephalosporin. Staphylococcus aureus was capable of producing poor results even when the case was treated early. Other organisms were gram-negative bacilli which infect patients with suppressed immune system, that is, intravenous drug abuser, systemic steroid therapy and diabetes mellitus. Open arthrotomy was the method of drainage used in all hip sepsis. This method was also the most reliable method of joint drainage in other joints compared to aspiration method when frank pus was already present. Most immuno-compromised patients recovered badly from septic arthritis. Associated adjacent osteomyelitis, preexisting chronic arthritis and recent intra-articular fractures were also noted to adversely affect the functional outcome.
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Septic arthritis of the adult ankle joint secondary to Salmonella enteritidis: a case report.
LENUS (Irish Health Repository)
Munigangaiah, Sudarshan
2011-09-01
Salmonella septic arthritis in healthy individuals is a rare phenomenon. However, septic arthritis of the native adult ankle joint in healthy patients has not been previously described in the published data. This is a case report of a 70-year-old farmer who presented with a 2-week history of a painful, swollen right ankle and an inability to bear weight. He had no history of ankle injury or any predisposing conditions. Joint aspirations were positive for Salmonella enteritidis that was successfully treated with right ankle arthrotomy and washout, along with a 6-week course of intravenous antibiotic therapy.
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First diagnosis of septic arthritis in a dinosaur.
Anné, Jennifer; Hedrick, Brandon P; Schein, Jason P
2016-08-01
Identification and interpretation of pathologies in the fossil record allows for unique insights into the life histories of extinct organisms. However, the rarity of such finds limits not only the sample size for palaeopathologic studies, but also the types of analyses that may be performed. In this study, we present the first occurrence of a palaeopathology in a vertebrate from the Mesozoic of the East Coast of North America (Appalachia), a pathologic ulna and radius of an indeterminate hadrosaur from the Navesink Formation (New Jersey). X-ray microtomography allowed for both detailed and more accurate diagnosis of the pathologic condition as well as virtual conservation of the specimen. Based on extant archosaurian comparisons, the hadrosaur was diagnosed with severe septic arthritis affecting the proximal ulna and radius. Diagnosis was based on erosion of the joint and highly reactive periosteal bone growth and fusion of the elements. To the best of our knowledge, this is the first recorded account of septic arthritis in dinosaurs. The severity of the pathology suggests the animal suffered with this condition for some time before death. Unfortunately, only the ulna and radius were found. Thus, the extent to which the condition spread to other parts of the body is unknown.
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First diagnosis of septic arthritis in a dinosaur
Anné, Jennifer; Hedrick, Brandon P.; Schein, Jason P.
2016-08-01
Identification and interpretation of pathologies in the fossil record allows for unique insights into the life histories of extinct organisms. However, the rarity of such finds limits not only the sample size for palaeopathologic studies, but also the types of analyses that may be performed. In this study, we present the first occurrence of a palaeopathology in a vertebrate from the Mesozoic of the East Coast of North America (Appalachia), a pathologic ulna and radius of an indeterminate hadrosaur from the Navesink Formation (New Jersey). X-ray microtomography allowed for both detailed and more accurate diagnosis of the pathologic condition as well as virtual conservation of the specimen. Based on extant archosaurian comparisons, the hadrosaur was diagnosed with severe septic arthritis affecting the proximal ulna and radius. Diagnosis was based on erosion of the joint and highly reactive periosteal bone growth and fusion of the elements. To the best of our knowledge, this is the first recorded account of septic arthritis in dinosaurs. The severity of the pathology suggests the animal suffered with this condition for some time before death. Unfortunately, only the ulna and radius were found. Thus, the extent to which the condition spread to other parts of the body is unknown.