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Sample records for feeding tube insertion

  1. Feeding tube insertion - gastrostomy

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/002937.htm Feeding tube insertion - gastrostomy To use the sharing features on this page, please enable JavaScript. A gastrostomy feeding tube insertion is the placement of a feeding ...

  2. Blind bedside insertion of small bowel feeding tubes.

    LENUS (Irish Health Repository)

    Duggan, SN

    2009-12-01

    The use of Naso-Jejunal (NJ) feeding is limited by difficulty in feeding tube placement. Patients have traditionally required transfer to Endoscopy or Radiology for insertion of small bowel feeding tubes, with clear resource implications. We hypothesised that the adoption of a simple bedside procedure would be effective and reduce cost. Clinical nutrition and nurse specialist personnel were trained in the 10\\/10\\/10 method of blind bedside NJ insertion.

  3. Respiratory Complications Associated with Insertion of Small-Bore Feeding Tube in Critically Ill Patients

    Directory of Open Access Journals (Sweden)

    Jeong Am Ryu

    2014-05-01

    Full Text Available Small-bore flexible feeding tubes decrease the risk of ulceration of the nose, pharynx, and stomach compared with large-bore and more rigid tubes. However, small-bore feeding tubes have more respiratory system complications, such as pneumothorax, hydropneumothorax, bronchopleural fistula, and pneumonia, which are associated with significant morbidity and mortality. Thus, it is important to confirm the correct position of feeding tubes. Chest X-ray is the gold standard to detect tracheal malpositioning of the feeding tube. We present three cases in which intubated patients exhibited an altered mental state. An assistant guide wire was used at the insertion of small-bore feeding tubes. These conditions are thought to be potential risk factors for tracheobronchial malpositioning of feeding tubes.

  4. Fluoroscopic insertion of post-pyloric feeding tubes: success rates and complications

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    Thurley, P.D.; Hopper, M.A. [Department of Clinical Radiology, Nottingham University Hospitals NHS Trust, Nottingham (United Kingdom); Jobling, J.C. [Department of Clinical Radiology, Nottingham University Hospitals NHS Trust, Nottingham (United Kingdom)], E-mail: craig.jobling@nuh.nhs.uk; Teahon, K. [Department of Clinical Radiology, Nottingham University Hospitals NHS Trust, Nottingham (United Kingdom)

    2008-05-15

    Aim: To examine the success and complication rates of radiological placement of post-pyloric feeding tubes, including those inserted with the assistance of a guide-wire. Materials and Methods: Two hundred referrals (156 patients), between the dates of 5 April 2002 and 10 September 2004, were identified retrospectively from computerized records. Subsequently, the radiology reports and patients' notes were reviewed to evaluate the indications for post-pyloric feeding, success of placement, use of a guide-wire, and any complications. Results: A post-pyloric tube was placed in the distal duodenum/jejunum in 183 (91.5%) patients and in the proximal duodenum or distal stomach in six (3%). A tube could not be inserted in 11 (5.5%) patients, and 51 (25.5%) of the insertions required the use of a guide-wire. Immediate complications were recorded in seven patients (3.5%): vomiting (n = 5); hypotension and apnoea requiring naloxone (n = 1) and hypoxia requiring endotracheal intubation (n = 1). Conclusion: Radiological placement of post-pyloric feeding tubes has a success rate comparable with endoscopically placed tubes, and it rarely involves significant technique-related complications.

  5. Chest tube insertion

    Science.gov (United States)

    ... tube insertion; Insertion of tube into chest; Tube thoracostomy; Pericardial drain ... Kirsch TD, Sax J. Tube thoracostomy. In: Roberts JR, ed. Roberts and ... . 6th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 10.

  6. Chest tube insertion - slideshow

    Science.gov (United States)

    ... presentations/100008.htm Chest tube insertion - series—Normal anatomy To use the sharing features ... pleural space is the space between the inner and outer lining of the lung. It is normally very thin, and lined only ...

  7. Ear tube insertion - slideshow

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/presentations/100045.htm Ear tube insertion - series—Normal anatomy To use the ... 4 Overview The eardrum (tympanic membrane) separates the ear canal from the middle ear. Review Date 8/ ...

  8. Enteral Tube Feeding and Pneumonia

    Science.gov (United States)

    Gray, David Sheridan; Kimmel, David

    2006-01-01

    To determine the effects of enteral tube feeding on the incidence of pneumonia, we performed a retrospective review of all clients at our institution who had gastrostomy or jejunostomy tubes placed over a 10-year period. Ninety-three subjects had a history of pneumonia before feeding tube insertion. Eighty had gastrostomy and 13, jejunostomy…

  9. Jejunostomy feeding tube

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/patientinstructions/000181.htm Jejunostomy feeding tube To use the sharing features on this ... vomiting Your child's stomach is bloated Alternate Names Feeding - jejunostomy tube; G-J tube; J-tube; Jejunum ...

  10. Feeding tube - infants

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/007235.htm Feeding tube - infants To use the sharing features on this page, please enable JavaScript. A feeding tube is a small, soft, plastic tube placed ...

  11. Nasogastric feeding tubes from a neonatal department yield high concentrations of potentially pathogenic bacteria- even 1 d after insertion

    DEFF Research Database (Denmark)

    Petersen, Sandra Meinich; Greisen, Gorm; Krogfelt, Karen Angeliki

    2016-01-01

    probiotic administration through the tube. RESULTS: Out of the 94 NG-tubes, 89% yielded more than 1,000 colony-forming units (CFU)/ml bacteria, and 55% yielded the potentially pathogenic Enterobacteriaceae and/or Staphylococcus aureus. The mean concentration in the yield was 5.3 (SD: 2.1, maximum 9.4) log10......BACKGROUND: Preterm infants are vulnerable to pathogens and at risk of developing necrotizing enterocolitis (NEC) or sepsis. Nasogastric feeding tubes (NG-tubes) might contaminate feeds given through them due to biofilm formation. We wanted to determine if there is a rationale in replacing NG-tubes...... more often to reduce contamination. METHODS: We conducted an observational study of used NG-tubes from a tertiary neonatal department. After removal, we flushed a 1-ml saline solution through the tube, determined the density of bacteria by culture, and related it to the duration of use and any...

  12. Nasogastric feeding tube

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/patientinstructions/000182.htm Nasogastric feeding tube To use the sharing features on this ... the nose. It can be used for all feedings or for giving a person extra calories. It ...

  13. A malfunctioning nasogastric feeding tube

    Directory of Open Access Journals (Sweden)

    Emanuele Cereda

    2013-02-01

    Full Text Available A critical point of nasogastric feeding tube placement, potentially resulting in an unsafe and/or non-effective operation of the device, is the monitoring of its proper placement into the stomach. A properly obtained and interpreted radiograph is currently recommended to confirm placement. We reported the case of a 68-year-old demented woman referred for complicated dysphagia. A nasogastric tube was blindly inserted and its placement was confirmed by the radiologist. Enteral nutrition was initiated but the patient began to vomit immediately. After reviewing the radiograph it was understood that a gastric loop in the tube and its tip pointing upwards did not allow a safe infusion of the feeding formula. It is not enough having the radiologist reporting that a nasogastric feeding tube is placed in the stomach; the inclusion in the report of specific warnings on any potential cause of malfunctioning of the device should be considered. The presence of a gastric loop should be taken into account as a cause of potential malfunctioning.

  14. Deadly pressure pneumothorax after withdrawal of misplaced feeding tube

    DEFF Research Database (Denmark)

    Andresen, Erik Nygaard; Frydland, Martin; Usinger, Lotte

    2016-01-01

    BACKGROUND: Many patients have a nasogastric feeding tube inserted during admission; however, misplacement is not uncommon. In this case report we present, to the best of our knowledge, the first documented fatality from pressure pneumothorax following nasogastric tube withdrawal. CASE PRESENTATION......: An 84-year-old Caucasian woman with dysphagia and at risk of aspiration underwent routine insertion of a nasogastric feeding tube; however, shortly after insertion she developed respiratory distress. A chest X-ray showed the tube had been misplaced into our patient's right lung. The tube was removed......, but our patient died less than an hour after withdrawal. The autopsy report stated that cause of death was tension pneumothorax, which developed following withdrawal of the misplaced feeding tube. CONCLUSIONS: The indications for insertion of nasogastric feeding tubes are many and the procedure...

  15. Eustachian tube function in children after insertion of ventilation tubes.

    NARCIS (Netherlands)

    Heerbeek, N. van; Ingels, K.J.A.O.; Snik, A.F.M.; Zielhuis, G.A.

    2001-01-01

    This study was performed to assess the effect of the insertion of ventilation tubes and the subsequent aeration of the middle ear on eustachian tube (ET) function in children. Manometric ET function tests were performed repeatedly for 3 months after the placement of ventilation tubes in 83 children

  16. Pneumothorax Following Feeding Tube Placement: Precaution and Treatment

    Directory of Open Access Journals (Sweden)

    Morteza Zahmatkesh

    2012-05-01

    Full Text Available Nasojejunal feeding tubes are being used at an increased frequency, but it is not without complications that could be life-threatening. We report two cases of pneumothorax following small-bore feeding tube insertion into the pleural cavity, resulting in pneumothorax. We further discuss the potential measures that can be taken to prevent and treat this serious complication.

  17. T-tube insertion for sclerotic subglottic stenosis.

    Science.gov (United States)

    Goto, Taichiro; Kato, Ryoichi

    2014-02-01

    T-tube insertion is effective treatment for subglottic stenosis, but it is generally difficult due to bending of the T-tube. In a 52-year-old woman with relapsing polychondritis, a T-tube was inserted after predilatation using Hegar dilators. We describe the details of our T-tube insertion methods for sclerotic subglottic stenosis.

  18. Deadly pressure pneumothorax after withdrawal of misplaced feeding tube

    DEFF Research Database (Denmark)

    Andresen, Erik Nygaard; Frydland, Martin; Usinger, Lotte

    2016-01-01

    BACKGROUND: Many patients have a nasogastric feeding tube inserted during admission; however, misplacement is not uncommon. In this case report we present, to the best of our knowledge, the first documented fatality from pressure pneumothorax following nasogastric tube withdrawal. CASE PRESENTATION...

  19. Fluoroscopically Guided Three-Tube Insertion for the Treatment of Postoperative Gastroesophageal Anastomotic Leakage

    Energy Technology Data Exchange (ETDEWEB)

    Yin, Guowen; Xu, Qingyu; Chen, Shixi; Bai, Xiangjun; Jiang, Feng; Zhang, Qin; Xu, Lin; Xu, Weidong [Cancer Hospital of Jiangsu Province, Nanjing (Korea, Republic of)

    2012-03-15

    To retrospectively evaluate the feasibility and effectiveness of three-tube insertion for the treatment of postoperative gastroesophageal anastomotic leakage (GEAL). From January 2007 to January 2011, 28 cases of postoperative GEAL after an esophagectomy with intrathoracic esophagogastric anastomotic procedures for esophageal and cardiac carcinoma were treated by the insertion of three tubes under fluoroscopic guidance. The three tubes consisted of a drainage tube through the leak, a nasogastric decompression tube, and a nasojejunum feeding tube. The study population consisted of 28 patients (18 males, 10 females) ranging in their ages from 36 to 72 years (mean: 59 years). We evaluated the feasibility of three-tube insertion to facilitate leakage site closure, and the patients' nutritional benefit by checking their serum albumin levels between pre- and post-enteral feeding via the feeding tube. The three tubes were successfully placed under fluoroscopic guidance in all twenty-eight patients (100%). The procedure times for the three tube insertion ranged from 30 to 70 minutes (mean time: 45 minutes). In 27 of 28 patients (96%), leakage site closure after three-tube insertion was achieved, while it was not attained in one patient who received stent implantation as a substitute. All patients showed good tolerance of the three-tube insertion in the nasal cavity. The mean time needed for leakage treatment was 21 {+-} 3.5 days. The serum albumin level change was significant, increasing from pre-enteral feeding (2.5 {+-} 0.40 g/dL) to post-enteral feeding (3.7 {+-} 0.51 g/dL) via the feeding tube (p < 0.001). The duration of follow-up ranged from 7 to 60 months (mean: 28 months). Based on the results of this study, the insertion of three tubes under fluoroscopic guidance is safe, and also provides effective relief from postesophagectomy GEAL. Moreover, our findings suggest that three-tube insertion may be used as the primary procedure to treat postoperative GEAL.

  20. Gastroenteric tube feeding: Techniques, problems and solutions

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    Blumenstein, Irina; Shastri, Yogesh M; Stein, Jürgen

    2014-01-01

    Gastroenteric tube feeding plays a major role in the management of patients with poor voluntary intake, chronic neurological or mechanical dysphagia or gut dysfunction, and patients who are critically ill. However, despite the benefits and widespread use of enteral tube feeding, some patients experience complications. This review aims to discuss and compare current knowledge regarding the clinical application of enteral tube feeding, together with associated complications and special aspects. We conducted an extensive literature search on PubMed, Embase and Medline using index terms relating to enteral access, enteral feeding/nutrition, tube feeding, percutaneous endoscopic gastrostomy/jejunostomy, endoscopic nasoenteric tube, nasogastric tube, and refeeding syndrome. The literature showed common routes of enteral access to include nasoenteral tube, gastrostomy and jejunostomy, while complications fall into four major categories: mechanical, e.g., tube blockage or removal; gastrointestinal, e.g., diarrhea; infectious e.g., aspiration pneumonia, tube site infection; and metabolic, e.g., refeeding syndrome, hyperglycemia. Although the type and frequency of complications arising from tube feeding vary considerably according to the chosen access route, gastrointestinal complications are without doubt the most common. Complications associated with enteral tube feeding can be reduced by careful observance of guidelines, including those related to food composition, administration rate, portion size, food temperature and patient supervision. PMID:25024606

  1. Gastroenteric tube feeding: techniques, problems and solutions.

    Science.gov (United States)

    Blumenstein, Irina; Shastri, Yogesh M; Stein, Jürgen

    2014-07-14

    Gastroenteric tube feeding plays a major role in the management of patients with poor voluntary intake, chronic neurological or mechanical dysphagia or gut dysfunction, and patients who are critically ill. However, despite the benefits and widespread use of enteral tube feeding, some patients experience complications. This review aims to discuss and compare current knowledge regarding the clinical application of enteral tube feeding, together with associated complications and special aspects. We conducted an extensive literature search on PubMed, Embase and Medline using index terms relating to enteral access, enteral feeding/nutrition, tube feeding, percutaneous endoscopic gastrostomy/jejunostomy, endoscopic nasoenteric tube, nasogastric tube, and refeeding syndrome. The literature showed common routes of enteral access to include nasoenteral tube, gastrostomy and jejunostomy, while complications fall into four major categories: mechanical, e.g., tube blockage or removal; gastrointestinal, e.g., diarrhea; infectious e.g., aspiration pneumonia, tube site infection; and metabolic, e.g., refeeding syndrome, hyperglycemia. Although the type and frequency of complications arising from tube feeding vary considerably according to the chosen access route, gastrointestinal complications are without doubt the most common. Complications associated with enteral tube feeding can be reduced by careful observance of guidelines, including those related to food composition, administration rate, portion size, food temperature and patient supervision.

  2. Advanced Illness: Feeding Tubes and Ventilators

    Science.gov (United States)

    ... the feedings may be difficult. There is some debate, for example, about whether feeding tubes actually extend ... pneumonia cannot, but people can now get a vaccination to prevent many kinds of viral pneumonia. Aspiration ...

  3. False-positive pH aspirates after nasogastric tube insertion in head and neck tumour.

    Science.gov (United States)

    Sellers, Claudia Kate

    2012-08-27

    Nasogastric (NG) feeding tubes are commonly inserted to supplement enteral nutrition in certain patient groups, including those with head and neck cancers where swallowing may be compromised. An NHS National Patient Safety Alert was released in 2011 detailing ongoing cases of significant morbidity and mortality attached to the incorrect placement of NG feeding tubes in hospital inpatients. Since 2005, there were 21 deaths and 79 cases of harm nationally due to feeding into the lung through misplaced tubes. pH testing remains the first-line method of placement confirmation, with chest x-ray used when no aspirate is gained or where pH testing fails to confirm suitable acidity. We present a case report describing false-positive NG tube placement confirmation tests in a patient with head and neck cancer, who was administered feed into lung parenchyma with significant morbidity. We discuss the case for specific NG tube placement protocols in head and neck cancer patients.

  4. Tension Pneumothorax and Subcutaneous Emphysema Complicating Insertion of Nasogastric Tube

    Directory of Open Access Journals (Sweden)

    Narjis AL Saif

    2015-01-01

    Full Text Available Nasogastric tube has a key role in the management of substantial number of hospitalized patients particularly the critically ill. In spite of the apparent simple insertion technique, nasogastric tube placement has its serious perhaps fatal complications which need to be carefully assessed. Pulmonary misplacement and associated complications are commonplace during nasogastric tube procedure. We present a case of tension pneumothorax and massive surgical emphysema in critically ill ventilated patient due to inadvertent nasogastric tube insertion and also discussed the risk factors, complication list, and arrays of techniques for safer tube placement.

  5. Tension Pneumothorax and Subcutaneous Emphysema Complicating Insertion of Nasogastric Tube.

    Science.gov (United States)

    Al Saif, Narjis; Hammodi, Adel; Al-Azem, M Ali; Al-Hubail, Rasheed

    2015-01-01

    Nasogastric tube has a key role in the management of substantial number of hospitalized patients particularly the critically ill. In spite of the apparent simple insertion technique, nasogastric tube placement has its serious perhaps fatal complications which need to be carefully assessed. Pulmonary misplacement and associated complications are commonplace during nasogastric tube procedure. We present a case of tension pneumothorax and massive surgical emphysema in critically ill ventilated patient due to inadvertent nasogastric tube insertion and also discussed the risk factors, complication list, and arrays of techniques for safer tube placement.

  6. Modified Seldinger technique for the insertion of standard chest tubes.

    Science.gov (United States)

    Altman, E; Ben-Nun, A; Curtis, W; Best, L A

    2001-04-01

    Closed tube thoracostomy is a standard procedure for the evacuation of air, blood, or other materials from the pleural space. This paper describes a modification of the Seldinger technique that facilitates chest tube insertion. Either a Nelaton or Thieman catheter is threaded into the side drainage hole and out the tip of a standard Argyle-type chest tube. After using the clamp to insert the catheter into the pleural space through a previously dissected tract, the catheter serves as a guide over which the chest tube is inserted. The technique is simple to use, effective, and safe. It employs standard, inexpensive materials to insert chest tubes in such a way as to minimize the potential traumatic complications inherent in other techniques.

  7. Air flow exploration of abrasive feed tube

    Science.gov (United States)

    Zhang, Shijin; Li, Xiaohong; Gu, Yilei

    2009-12-01

    An abrasive water-jet cutting process is one in which water pressure is raised to a very high pressure and forced through a very small orifice to form a very thin high speed jet beam. This thin jet beam is then directed through a chamber and then fed into a secondary nozzle, or mixing tube. During this process, a vacuum is generated in the chamber, and garnet abrasives and air are pulled into the chamber, through an abrasive feed tube, and mixes with this high speed stream of water. Because of the restrictions introduced by the abrasive feed tube geometry, a vacuum gradient is generated along the tube. Although this phenomenon has been recognized and utilized as a way to monitor nozzle condition and abrasive flowing conditions, yet, until now, conditions inside the abrasive feed line have not been completely understood. A possible reason is that conditions inside the abrasive feed line are complicated. Not only compressible flow but also multi-phase, multi-component flow has been involved in inside of abrasive feed tube. This paper explored various aspects of the vacuum creation process in both the mixing chamber and the abrasive feed tube. Based on an experimental exploration, an analytical framework is presented to allow theoretical calculations of vacuum conditions in the abrasive feed tube.

  8. [The Use of a Tracheal Tube for Guiding Nasogastric Tube Insertion].

    Science.gov (United States)

    Saima, Shunsuke; Asai, Takashi; Okuda, Yasuhisa

    2016-04-01

    An obese patient was scheduled for shoulder joint surgery under general anesthesia. After induction of anesthesia and tracheal intubation, insertion of a gastric tube was difficult. A new tracheal tube was prepared, the connecter was removed, and the tube was cut longitudinally. The tube was inserted orally into the esophagus. A gastric tube was passed through the nose, and its tip was taken out of the mouth. The tip of the gastric tube was passed through the tracheal tube, and its correct position in the stomach was confirmed by auscultation of the epigastrium. The tracheal tube was carefully taken out from the esophagus leaving the gastric tube in the stomach. The cut tracheal tube was peeled off from the gastric tube. Correct positioning of the gastric tube was re-confirmed.

  9. Is looped nasogastric tube feeding more effective than conventional nasogastric tube feeding for dysphagia in acute stroke?

    Directory of Open Access Journals (Sweden)

    Harwood Rowan

    2007-08-01

    Full Text Available Abstract Background Dysphagia occurs in up to 50% of patients admitted to hospital with acute strokes with up to 27% remaining by seven days. Up to 8% continue to have swallowing problems six months after their stroke with 1.7% still requiring enteral feeding. Nasogastric tubes (NGT are the most commonly used method for providing enteral nutrition in early stroke, however they are easily and frequently removed leading to inadequate nutrition, early PEG (Percutaneous Endoscopic Gastrostomy insertion or abandoning of feeding attempts. Looped nasogastric tube feeding may improve the delivery of nutrition to such patients. Methods Three centre, two arm randomised controlled trial, with 50 participants in each arm comparing loop (the intervention versus conventional nasogastric tube feeding. The primary outcome measure is proportion of intended feed delivered in the first 2 weeks. The study is designed to show a mean increase of feed delivery of 16% in the intervention group as compared with the control group, with 90% power at a 5% significance level. Secondary outcomes are treatment failures, mean volume of feed received, adverse events, cost-effectiveness, number of chest x-rays, number of nasogastric tubes and tolerability. Trial Registration ISRCTN Number: ISRCTN61174381

  10. Nasogastric tube feeding: a safe option for patients?

    Science.gov (United States)

    Williams, Trish

    2016-01-01

    This article will show that fine-bore nasogastric tube feeding can be facilitated for patients when long term percutaneous endoscopic gastrostomy (PEG) or radiologically inserted gastrostomy (RIG) options are not suitable. How the safe replacement of these tubes is facilitated, and what instructions the patient and the nursing home are given to support patient care and safety are also discussed. The decision to support this type of feeding must be completely individualised, considering home and external support agencies available to each patient. The risk assessment completed to facilitate this has been based on the patients' individual circumstances, and a nasogastric tube home passport developed to help in the assessment and decision-making process. For fine-bore nasogastric tube feeding to be safe, it does have to be supported once the patient is discharged from the hospital. A good knowledge of the home support and carer support agencies, and what is available, should be discussed. Multidisciplinary team support is essential in ensuring a safe discharge can be planned and managed. Good patient risk assessment and nursing considerations are discussed to show how the challenges that may prevent a patient discharge with this type of feed are managed. This article will show how two very different patients discharges were facilitated by safe fine-bore nasogastric tube feeding in the community. Patient assessment and nursing considerations are discussed, as well as the importance of a multidisciplinary approach to show how this was successfully achieved in a local district hospital.

  11. Fewer Advanced Alzheimer's Patients on Feeding Tubes

    Science.gov (United States)

    ... medlineplus.gov/news/fullstory_160456.html Fewer Advanced Alzheimer's Patients on Feeding Tubes Practice dropped by half ... organizations -- is declining, a new study finds. One Alzheimer's expert who reviewed the new findings was heartened ...

  12. Tube thoracostomy: Increased angle of insertion is associated with complications.

    Science.gov (United States)

    Hernandez, Matthew C; Laan, Danuel V; Zimmerman, Stacey L; Naik, Nimesh D; Schiller, Henry J; Aho, Johnathon M

    2016-08-01

    Tube thoracostomy (TT), considered a routine procedure, has significant complications. Current recommendations for placement rely on surface anatomy. There is no information to guide operators regarding angle of insertion relative to chest wall. We aim to determine if angle of insertion is associated with complications of TT. We performed a retrospective review of adult trauma patients who necessitated TT at a Level I trauma center over a 2-year period (January 2012 to December 2013). Tube thoracostomies performed intraoperatively or using radiological guidance were excluded. Thoracic anteroposterior or posteroanterior radiographs were reviewed to determine the angle of insertion of TT relative to the thoracic wall. A previously validated classification method was used to categorize complications. Descriptive and univariate statistics were used to compare angle of insertion and complicated versus uncomplicated TT. Review identified 154 patients who underwent a total of 246 TT placed for emergent trauma. All patients had a postprocedural chest x-ray. We identified 90 complications (37%) over the study period. One hundred forty-four of the TTs reviewed had an angle of insertion less than 45 degrees of which there were 27 complications (19%). One hundred two of the TTs had an angle greater than 45 degrees and 63 complications (62%); p thoracostomy insertion is inherently dangerous. Placement of TT using a higher angle of insertion greater than 45 degrees is associated with increased complications. Further prospective studies quantifying TT angle of insertion on outcomes are needed. Therapeutic study, level IV.

  13. Replacement of a feeding tube through the gastric tube in patients after esophagectomy with retrosternal reconstruction.

    Science.gov (United States)

    Ikeda, Yoshifumi; Morita, Naomi

    2009-04-01

    We present our technique of endoscopic replacement of the jejunostomy through the stomach conduit in patients after esophagectomy with retrosternal reconstruction. After an upper gastrointestinal tract endoscopy was performed, the stomach conduit was sufficiently inflated with air and the site of the previously removed gastric tube was confirmed by the puncture using 23 G needle. After an approximately 6-mm incision was made under local anesthesia, a 4-mm peel-off introducer sheath was advanced into the stomach conduit under endoscopic control. A 3-mm jejunostomy tube was inserted through the sheath and placed into the jejunum using the endoscopic guidance. Using endoscopy, the jejunostomy tube was confirmed to be placed without bending. Between 1998 and 2006, subtotal esophagectomy with retrosternal cervical esophagogastrostomy was performed in 48 patients. All patients were inserted with at least either jejunostomy tube or decompression tube through the stomach conduit. Among them, 11 patients (23%) were performed percutaneous replacement jejunostomy through the stomach conduit. There were 9 men and 2 women whose mean age was 67 years (range: 59 to 76 y). Replacement of the jejunostomy tube was successful in all patients. The procedure required about 30 minutes. There were no deaths and no procedural complications. After 24 hours, the tube was used for enteral feeding. No late complication occurred in our cases. We believe that the endoscopic percutaneous approach described in this report is safe and effective in patients after esophagectomy with retrosternal reconstruction.

  14. Otological Findings Ten Years after Myringotomy with Tympanostomy Tube Insertion

    Directory of Open Access Journals (Sweden)

    Ali Goljanian Tabrizi

    2011-01-01

    Full Text Available Introduction: To study the long-term complications of tympanostomy tube insertion in young children 10 years after surgery.   Materials and Methods: In September 2011, the medical records of all patients who had undergone myringotomy with tympanostomy tube insertion between February 2000 and March 2001 at the two general hospitals of Isfahan University of Medical Sciences were studied. Of the 98 patients who fulfilled the inclusion criteria, 82 patients agreed to participate and were enrolled in the study. The complications of the operation were evaluated in these patients.   Results: Of the 164 ears that were operated on, myringosclerosis was found in 17.1%, atrophy of the tympanic membrane in 1.2%, permanent perforation of the tympanic membrane in 0.6% and tympanic membrane atelectasis in 0.6%. None of the patients developed cholesteatoma as a complication of tympanostomy tube insertion.   Conclusion:  Considering the low risk of serious complications after 10 years, tympanostomy tube insertion is a safe and effective treatment option in the treatment of otitis media with effusion.

  15. How to insert a nasogastric tube and check gastric position at the bedside.

    Science.gov (United States)

    Best, Carolyn

    2016-05-18

    Rationale and key points A nasogastric tube (NG tube) can be used to aspirate stomach contents or to administer feed, medication or fluid into the stomach. ▶ A blind technique is used to insert the NG tube through the nostril, along the nasopharynx, through the oesophagus and into the stomach. ▶ It is important for nurses to be able to recognise problems that may arise when inserting a NG tube blindly, and to know what actions to take if it is suspected that the distal tip of the NG tube is not sitting in the stomach, or they are unable to identify its location. ▶ Misplacement and subsequent use of a NG tube to administer feed, medication or fluid is a 'never event' ( NHS England Patient Safety Domain 2015 ). Reflective activity Clinical skills articles can help update your practice and ensure it remains evidence based. Apply this article to your practice. Reflect on and write a short account of: 1. How you think this article will change your practice. 2. How you could use this resource to educate your colleagues. Subscribers can update their reflective accounts at rcni.com/portfolio.

  16. Gastrostomy tube feeding of children with cerebral palsy

    DEFF Research Database (Denmark)

    Dahlseng, Magnus O; Andersen, Guro L; DA Graca Andrada, Maria

    2012-01-01

    To compare the prevalence of gastrostomy tube feeding (GTF) of children with cerebral palsy (CP) in six European countries.......To compare the prevalence of gastrostomy tube feeding (GTF) of children with cerebral palsy (CP) in six European countries....

  17. Pericardial sac perforation: a rare complication of neonatal nasogastric tube feeding

    Energy Technology Data Exchange (ETDEWEB)

    El-Din Mahmoud Hanafy, Emad; Al Naqeeb, Niran [Al-Adan Hospital, Neonatal ICU, Department of Paediatrics, Hawally (Kuwait); Ashebu, Samuel D.; Bopaya Nanda, Harini [Al-Adan Hospital, Department of Diagnostic Radiology and Imaging, P.O. Box 43721, Hawally (Kuwait)

    2006-10-15

    The insertion of a nasogastric tube for feeding and gastric aspiration is a common practice in the care of newborns, especially if they are preterm and unwell. Esophageal perforation is a rare but serious complication of this procedure. Associated perforation of the pericardial sac is an unusual, severe, and previously unreported complication of nasogastric tube feeding in a neonate. We present an illustrative case. (orig.)

  18. Convective heat transfer enhancement inside tubes using inserted helical coils

    Science.gov (United States)

    Ali, R. K.; Sharafeldeen, M. A.; Berbish, N. S.; Moawed, M. A.

    2016-01-01

    Convective heat transfer was experimentally investigated in tubes with helical coils inserts in turbulent flow regime within Reynolds number range of 14400 ≤ Re ≤ 42900. The present work aims to extend the experimental data available on wire coil inserts to cover wire diameter ratio from 0.044 to 0.133 and coil pitch ratio from 1 to 5. Uniform heat flux was applied to the external surface of the tube and air was selected as fluid. The effects of Reynolds number and wire diameter and coil pitch ratios on the Nusselt number and friction factor were studied. The enhancement efficiency and performance criteria ranges are of (46.9-82.6%) and (100.1-128%) within the investigated range of the different parameters, respectively. Correlations are obtained for the average Nusselt number and friction factor utilizing the present measurements within the investigated range of geometrical parameters and Re.

  19. Knot formation in the feeding jejunostomy tube: A case report and review of the literature

    Institute of Scientific and Technical Information of China (English)

    Guo-Shiou Liao; Huan-Fa Hsieh; Meng-Hang Wu; Teng-Wei Chen; Jyh-Cherng Yu; Yao-Chi Liu

    2007-01-01

    Jejunostomy feeding tubes provide surgeons with an excellent method for providing nutritional support, but there are several complications associated with a tube jejunostomy, including complications resulting from placement of the tube, mechanical problems related to the location or function and development of focally thickened small-bowel folds. A 76-year old man who presented with multiple medical diseases was admitted to our hospital due to aspiration pneumonia with acute respiratory failure and septic shock. He underwent exploratory laparotomy with feeding jejunostomy using a 14-French nasogastric tube for nutritional support. However, occlusion of the feeding tube was found 30- d after operation, and a rare complication of knot formation in the tube occurred after a new tube was replaced. On the following day, the tube was removed and replaced with a similar tube, which was placed into the jejunum for only 15 cm. The patient's feedings were maintained smoothly for two months. Knot formation in the feeding tube seems to be very rare. To our knowledge, this is the third case in the literature review. Its incidence is probably related to the length of the tube inserted into the lumen.

  20. Improving the documentation of nasogastric tube insertion and adherence to local enteral nutrition guidelines.

    Science.gov (United States)

    Cole, Esther

    2015-01-01

    Fine bore nasogastric (NG) tubes are often required for patients who have insufficient nutrition to meet their daily requirements, as well as for feeding or medications when there are difficulties with swallowing. "Death or severe harm as a result of a naso […] gastric tubes being misplaced in the respiratory tract" is one of the Department of Health's list of "never events". Noble's Hospital, Isle of Man, has local guidelines based on the National Patient Safety Agency's 2005 guidelines and 2011 update, regarding the initial insertion and confirmation of placement of NG tubes. Retrospective baseline data looking at 13 case notes across 10 hospital wards showed that the majority of NG tube insertions took place on the stroke unit. A three-point quality of guidelines score showed that 8/13 (62%) cases were following guidelines appropriately. A seven-point quality of documentation score showed no case notes had full documentation. A teaching intervention for junior doctors and nurses was devised. However, there was no significant improvement in quality scores after 90 days (49 NG tube insertions). Therefore, an NG tube bundle, which included a pro forma for the case notes, information poster, and sticker for the nurse notes, was trialled on the stroke unit for six weeks. This showed that 10/12 (83%) cases were following guidelines appropriately. While only 2/12 (16%) of case notes had full documentation, this represented the two occasions when the pro forma was filled in and filed correctly. It is hoped that there could be a roll out of the intervention hospital-wide with identification of ways to improve usage of the NG tube bundle.

  1. Endoscopically placed nasogastrojejunal feeding tubes: a safe route for enteral nutrition in patients with hepatic encephalopathy.

    Science.gov (United States)

    Lee, Steven S; Mathiasen, Ronald A; Lipkin, Craig A; Colquhoun, Steven D; Margulies, Daniel R

    2002-02-01

    Patients with hepatic encephalopathy are at particular risk for aspiration when given oral or gastric feedings. An ideal strategy might combine distal enteral feeding with proximal gastric decompression, which is offered by a nasogastrojejunal (NGJ) feeding tube. One objective was to determine the efficacy and safety of endoscopically placed NGJ feeding tubes in patients with hepatic encephalopathy. Charts of patients who underwent NGJ tube placements between April 1997 and January 2000 were retrospectively reviewed. Two endoscopic techniques ("push" and "pull") were used. Eighteen patients (nine male and nine female) underwent 32 procedures. Twelve patients had undergone liver transplantation, four had decompensated cirrhosis, and two had fulminant hepatic failure. Twenty procedures used the push technique and 12 required the pull technique. The insertion time was shorter for the push technique compared with the pull technique (21.8 vs 39.6 min, P < 0.05). Enteral feedings were begun at an average of 5.2 hours after tube placement. The tubes remained in place for an average of 13.9 days. Complications related to the NGJ tubes included self-removal in eight, tube clogging in five, proximal migration in four, and intraduodenal migration of the gastric port in one. No aspiration episodes occurred. We conclude that NGJ feeding tubes may be placed endoscopically as a bedside procedure for patients with hepatic encephalopathy and provide a safe, efficacious, and rapid route for enteral nutrition in these patients.

  2. Pause before a PEG: A feeding tube may not be necessary in every candidate!

    Science.gov (United States)

    Aparanji, Krishna P; Dharmarajan, T S

    2010-07-01

    Percutaneous endoscopic gastrostomies (PEGs) are a means to provide nutrition in older adults incapable of normal adequate nutrient intake. Often decisions to insert a PEG in patients with illness and dementia are made hastily, before exhausting every means of feeding and full evaluation for the potential to regain capacity to feed normally. Further, ethical aspects often cloud such decisions, with data not supporting meaningful long-term improvement in outcomes or quality of life for the recipient of a PEG. Our case illustrates the story of a nursing home resident in whom an organized approach determined a reversible basis for his inability to feed and the potential to avoid tube insertion.

  3. American Geriatrics Society feeding tubes in advanced dementia position statement.

    Science.gov (United States)

    2014-08-01

    When eating difficulties arise, feeding tubes are not recommended for older adults with advanced dementia. Careful hand feeding should be offered because hand feeding has been shown to be as good as tube feeding for the outcomes of death, aspiration pneumonia, functional status, and comfort. Moreover, tube feeding is associated with agitation, greater use of physical and chemical restraints, healthcare use due to tube-related complications, and development of new pressure ulcers. Efforts to enhance oral feeding by altering the environment and creating patient-centered approaches to feeding should be part of usual care for older adults with advanced dementia. Tube feeding is a medical therapy that an individual's surrogate decision-maker can decline or accept in accordance with advance directives, previously stated wishes, or what it is thought the individual would want. It is the responsibility of all members of the healthcare team caring for residents in long-term care settings to understand any previously expressed wishes of the individuals (through review of advance directives and with surrogate caregivers) regarding tube feeding and to incorporate these wishes into the care plan. Institutions such as hospitals, nursing homes, and other care settings should promote choice, endorse shared and informed decision-making, and honor preferences regarding tube feeding. They should not impose obligations or exert pressure on individuals or providers to institute tube feeding. © 2014, Copyright the Author Journal compilation © 2014, The American Geriatrics Society.

  4. Why wait: early enteral feeding after pediatric gastrostomy tube placement.

    Science.gov (United States)

    Jensen, Amanda R; Renaud, Elizabeth; Drucker, Natalie A; Staszak, Jessica; Senay, Ayla; Umesh, Vaibhavi; Williams, Regan F; Markel, Troy A

    2017-06-27

    Early initiation of feedings after gastrostomy tube (GT) placement may reduce associated hospital costs, but many surgeons fear complications could result from earlier feeds. We hypothesized that, irrespective of placement method, starting feedings within the first 6h following GT placement would not result in a greater number of post-operative complications. An IRB-approved retrospective review of all GTs placed between January 2012 and December 2014 at three academic institutions was undertaken. Data was stratified by placement method and whether the patient was initiated on feeds at less than 6h or after. Baseline demographics, operative variables, post-operative management and complications were analyzed. Descriptive statistics were used and P-values <0.05 were considered significant. One thousand and forty-eight patients met inclusion criteria. GTs were inserted endoscopically (48.9%), laparoscopically (44.9%), or via an open approach (6.2%). Demographics were similar in early and late fed groups. When controlling for method of placement, those patients who were fed within the first 6h after gastrostomy placement had shorter lengths of stay compared to those fed greater than 6h after placement (P<0.05). Total post-operative outcomes were equivalent between feeding groups for all methods of placement (laparoscopic (P=0.87), PEG (P=0.94), open (P=0.81)). Early initiation of feedings following GT placement was not associated with an increase in complications. Feeds initiated earlier may shorten hospital stays and decrease overall hospital costs. Multi-institutional retrospective. III. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Nelaton catheter assisted versus standard nasogastric tube insertion: a randomized, clinical trial.

    Science.gov (United States)

    Ghaemi, M; Mousavinasab, N; Jalili, S

    2014-01-09

    It is sometimes difficult to insert a nasogastric tube in an anaesthetized patient. We evaluated the benefit of reinforcing the distal portion of the nasogastric tube with a Nelaton catheter: 8 and 10 French Nelaton catheters were inserted into 16 and 18 French nasogastric tubes respectively through the first proximal holes of tubes up to their tips. The patients anaesthetized were randomly allocated into either the control or the Nelaton groups, and nasogastric tube was inserted as deeply as the catheter length, then the catheter was withdrawn and the tube was inserted farther to reach the stomach. Eighty patients (40 in each group) were included in this study. The success rate of nasogastric tube insertion was 90% in the Nelaton group and 57% in the control group (P = 0.001). The mean insertion time was 80 (SD 43) and 92 (SD 35) seconds in the Nelaton and the control groups respectively.

  6. Feeding tube-related complications and problems in patients receiving long-term home enteral nutrition

    Directory of Open Access Journals (Sweden)

    Vasileios Alivizatos

    2015-04-01

    Full Text Available Aim: The aim of this study was to evaluate the long-term complications and problems related to gastrostomy and jejunostomy feeding tubes used for home enteral nutrition support and the effect these have on health care use. Materials and Methods: The medical records of 31 patients having gastrostomy (27 patients and jejunostomy (4 feeding tubes inserted in our Department were retrospectively studied. All were discharged on long-term (>3 months enteral nutrition and followed up at regular intervals by a dedicated nurse. Any problem or complication associated with tube feeding as well as the intervention, if any, that occurred, was recorded. Data were collected and analyzed. Results: All the patients were followed up for a mean of 17.5 months (4-78. The most frequent tube-related complications included inadvertent removal of the tube (broken tube, plugged tube; 45.1%, tube leakage (6.4%, dermatitis of the stoma (6.4%, and diarrhea (6.4%. There were 92 unscheduled health care contacts, with an average rate of such 2.9 contacts over the mean follow-up time of 17.5 months. Conclusion: In patients receiving long-term home enteral nutrition, feeding tube-related complications and problems are frequent and result in significant health care use. Further studies are needed to address their optimal prevention modalities and management.

  7. A Novel and Innovative Way of Nasogastric Tube Insertion in Anesthetized Intubated Patient

    Science.gov (United States)

    Sahu, Sandeep; Kishore, Kamal; Sachan, Vertika; Chatterjee, Arnidam

    2017-01-01

    Nasogastric tube (NGT) placement in anesthetized and intubated is sometimes very challenging with more than 50% failure rate in the first attempt. We describe a newer innovative Sahu's three in one, technique with use of GlideScope and forward placement of intubated trachea by external laryngeal maneuver, these both techniques lead to separation of trachea from esophagus so that endoscopic jejunal feeding tube guide wire strengthen NGT can be guided and manipulated to esophagus under direct vision. After informed consent, we used Sahu's three in one combo technique to insert NGT in adult anesthetized and intubated patients of both the sexes with high success in the first attempt. We found this technique easy, helpful, less time consuming with high success rate.

  8. Development and Technology Transfer of the Syncro Blue Tube (Gabriel) Magnetically GuidedFeeding Tube

    Science.gov (United States)

    2017-06-01

    pneumonias. Tube placement does not require costly fluroscopy or endoscopy. Any nurse who can place a nasogastric tube can place this feeding tube without...time required to secure FDA 510K 160787 clearance. FDA clearance was awarded August 9, 2016 for 510K160787 Table of Contents I. Introduction...small bowel feeding tube and developing a smaller version of the technology (8 Fr.). The basic design of the technology is to provide an easy and

  9. Placement of nasoenteral feeding tubes using magnetic guidance: retesting a new technique.

    Science.gov (United States)

    Ozdemir, B; Frost, M; Hayes, J; Sullivan, D H

    2000-08-01

    To study a new technique of intubating the small bowel using a newly developed nasoenteral feeding tube fitted with a magnet in its tip and guided for placement with an external magnet. The study was performed in medical and surgical wards of a university-affiliated Department of Veterans Affairs hospital on 42 patients referred by their attending physicians for tube placement. The newly designed feeding tube was inserted per nares into the stomach using traditional technique. As the tube was advanced, movement of the hand-held steering magnet was designed to guide the tip of the magnetic nasoenteral tube along the lesser curvature of the stomach, through the pyloric sphincter, and into the duodenum. Portable abdominal radiography confirmed the anatomic location of the tube tip. Fifty-one intubations were performed on 42 subjects. In 45 intubations (88%), tubes passed into the duodenum. Twenty-seven (53%) met criteria for optimal placement in the second portion of the duodenum or distally. Six of 11 tubes (55%) that were not optimally placed were advanced to the distal duodenum on repositioning. Median procedure time for the initial intubations was 30 minutes (interquartile range 15-40). Median procedure time for last 10 intubations improved to 13 minutes (interquartile range 5-20). No complications were related to the procedure. Enteral feeding tube placement using external magnetic guidance is a promising, novel technique which is deserving of further study.

  10. Iatrogenic velopharyngeal insufficiency caused by neonatal nasogastric feeding tube.

    Science.gov (United States)

    Pollack, Aron Z; Ward, Robert F; DeRowe, Ari; April, Max M

    2014-08-01

    Complications from a prolonged nasogastric tube intubation, though seldom reported, are well described. Herein we describe the first two reported cases of velopharyngeal insufficiency secondary to velopharyngeal scarring and immobility from repetitive nasogastric tube insertions and prolonged use. Differing only in location, the proposed pathophysiologic mechanism of injury is identical to that of the nasogastric tube syndrome, a rare and serious, well described entity consisting of bilateral vocal fold paralysis due to pressure-induced ulceration of the posterior cricoarytenoid musculature.

  11. A new technique for T tube insertion in severe subglottic stenosis.

    Science.gov (United States)

    Goto, Taichiro; Akanabe, Kumi; Oyamada, Yoshitaka; Kato, Ryoichi

    2011-06-01

    T tube insertion for subglottic stenosis is often difficult due to bending of the T tube itself. A T tube could be inserted safely and consistently in a patient with severe subglottic stenosis employing a method that we newly devised. Our method can be performed under local anesthesia without special instruments and is technically straightforward. And also, our method is considered to be applicable to marked stenosis and stenosis with a complex morphology. Herein we present an improved method for inserting a silicone T tube through a tracheostomy stoma in patients with severe subglottic stenosis.

  12. Peritonitis following percutaneous gastrostomy tube insertions in children.

    Science.gov (United States)

    Dookhoo, Leema; Mahant, Sanjay; Parra, Dimitri A; John, Philip R; Amaral, Joao G; Connolly, Bairbre L

    2016-09-01

    Percutaneous retrograde gastrostomy has a high success rate, low morbidity, and can be performed under different levels of sedation or local anesthesia in children. Despite its favourable safety profile, major complications can occur. Few studies have examined peritonitis following percutaneous retrograde gastrostomy in children. To identify potential risk factors and variables influencing the development and early diagnosis of peritonitis following percutaneous retrograde gastrostomy. We conducted a retrospective case-control study of children who developed peritonitis within 7 days of percutaneous retrograde gastrostomy between 2003 and 2012. From the 1,504 patients who underwent percutaneous retrograde gastrostomy, patients who developed peritonitis (group 1) were matched by closest date of procedure to those without peritonitis (group 2). Peritonitis was defined according to recognized clinical criteria. Demographic, clinical, procedural, management and outcomes data were collected. Thirty-eight of 1,504 children (2.5%; 95% confidence interval, 1.8-3.5) who underwent percutaneous retrograde gastrostomy developed peritonitis ≤7 days post procedure (group 1). Fever (89%), irritability (63%) and abdominal pain (55%) occurred on presentation of peritonitis. Group 1 patients were all treated with antibiotics; 41% underwent additional interventions: tube readjustments (8%), aspiration of pneumoperitoneum (23%), laparotomy (10%) and intensive care unit admission (10%). In group 1, enteral feeds started on average 3 days later and patients were discharged 5 days later than patients in group 2. There were two deaths not directly related to peritonitis. Neither age, gender, weight, underlying diagnoses nor operator was identified as a risk factor. Peritonitis following percutaneous retrograde gastrostomy in children occurs in approximately 2.5% of cases. No risk factors for its development were identified. Medical management is usually sufficient for a good outcome

  13. Peritonitis following percutaneous gastrostomy tube insertions in children

    Energy Technology Data Exchange (ETDEWEB)

    Dookhoo, Leema [The Hospital for Sick Children, Department of Diagnostic Imaging, Toronto, ON (Canada); University of Toronto, Faculty of Medicine, Toronto, ON (Canada); Mahant, Sanjay [The Hospital for Sick Children, Department of Pediatrics, Toronto, ON (Canada); Parra, Dimitri A.; John, Philip R.; Amaral, Joao G.; Connolly, Bairbre L. [The Hospital for Sick Children, Department of Diagnostic Imaging, Toronto, ON (Canada)

    2016-09-15

    Percutaneous retrograde gastrostomy has a high success rate, low morbidity, and can be performed under different levels of sedation or local anesthesia in children. Despite its favourable safety profile, major complications can occur. Few studies have examined peritonitis following percutaneous retrograde gastrostomy in children. To identify potential risk factors and variables influencing the development and early diagnosis of peritonitis following percutaneous retrograde gastrostomy. We conducted a retrospective case-control study of children who developed peritonitis within 7 days of percutaneous retrograde gastrostomy between 2003 and 2012. From the 1,504 patients who underwent percutaneous retrograde gastrostomy, patients who developed peritonitis (group 1) were matched by closest date of procedure to those without peritonitis (group 2). Peritonitis was defined according to recognized clinical criteria. Demographic, clinical, procedural, management and outcomes data were collected. Thirty-eight of 1,504 children (2.5%; 95% confidence interval, 1.8-3.5) who underwent percutaneous retrograde gastrostomy developed peritonitis ≤7 days post procedure (group 1). Fever (89%), irritability (63%) and abdominal pain (55%) occurred on presentation of peritonitis. Group 1 patients were all treated with antibiotics; 41% underwent additional interventions: tube readjustments (8%), aspiration of pneumoperitoneum (23%), laparotomy (10%) and intensive care unit admission (10%). In group 1, enteral feeds started on average 3 days later and patients were discharged 5 days later than patients in group 2. There were two deaths not directly related to peritonitis. Neither age, gender, weight, underlying diagnoses nor operator was identified as a risk factor. Peritonitis following percutaneous retrograde gastrostomy in children occurs in approximately 2.5% of cases. No risk factors for its development were identified. Medical management is usually sufficient for a good outcome

  14. “Nutrothorax” complicating a misplaced nasogastric feeding tube in a severely ill patient

    Directory of Open Access Journals (Sweden)

    Aloísio Felipe-Silva

    2012-03-01

    Full Text Available Introduction of nasogastric feeding tubes is usually blindly performed and isgenerally considered a safe procedure. However, the rate of complications ofa blind insertion technique varies from 0.3 to 15%, and is usually related toinadvertent insertion of nasogastric tubes into the trachea and distal airways.The main predisposing factors related to tube malpositioning and complicationsare altered mental status with decreased cough or gag reflex, a preexistingendotracheal tube and severe illness. Complications include severe aspirationpneumonia, hydrothorax, hemothorax, empyema and pneumothorax. Themortality related to misplacement of a nasogastric tube is around 0.1-0.3% ofthe procedures. This 61-year old female had a history of poor appetite, weightloss, dyspnea and fever. A chest axial computerized tomography showedenlarged mediastinal lymph nodes. Laboratory showed hypercalcemia withnormal PTH and hypokalemia. As the patient remained anorectic, a nasogastricfeeding tube was placed, through which the administration of enteral diet, bycontinuous infusion pump, was started. After 12 hours the patient developeddyspnea, hypoxemia and hypotension. During orotracheal intubation, itwas disclosed the presence of the nasogastric tube in the trachea as wellas the infused diet within the respiratory tract. Autopsy revealed an unusualcomplication of a nasogastric tube misplacement, which led to a massivecollection of enteral nutrition fluid into the pleural space – a “nutrothorax”.Additionally, an underlying stage IV anaplastic large cell lymphoma withinterstitial lung and bronchial mucosa involvement was diagnosed.

  15. Experimental Study on Heat Transfer Characteristics of Shell and Tube Heat Exchanger Using Hitran Wire Matrix Turbulators As Tube Inserts.

    Directory of Open Access Journals (Sweden)

    Manoj

    2014-06-01

    Full Text Available Shell and tube heat exchangers are extensively used in boilers, oil coolers, pre-heaters, condensers etc. They are also having special importance in process application as well as refrigeration and air conditioning industries. The present paper emphasizes on heat transfer characteristics of shell and tube heat exchangers with the aid of hiTRAN wire matrix inserts is been studied. Investigations were made on effect of mass flow rate of water on heat transfer characteristics in case of plain tube without inserts. When hiTRAN wire matrix tube inserts are used, which effectively increases the turbulence of tube side flow due to the hydrodynamic and thermal agitation of boundary layer in turns increases additional pressure drop is available in the system. This results in increase in the wall shear, reduced wall temperature which enhances substantial increase in tube side heat transfer characteristics. Heat and cooling processes streams is a standard operation in many industries this operation is often performed in heat exchangers where the heated or cold fluid flows under laminar conditions inside the tubes the mechanisms of under those flow conditions are complex poorly understood since they can involve both forced and natural convection making accurate prediction for heat exchanger. Heat transfer in laminar flow regimes is low by default but can be greatly increased by the use of passive heat transfer enhancement such as tube inserts. The present analysis the hiTRAN wire matrix turbulators were used and increased heat transfer characteristics as expected outcomes.

  16. Novel Visual Nasogastric Tube Insertion System: A Feasibility and Efficiency Study in a Manikin.

    Science.gov (United States)

    Li, Qiaoya; Xie, Juan; Wu, Jinxing; Guo, Rui; Ma, Wenwen; Xu, Gang; Yang, Min; Deng, Huisheng

    2016-01-01

    Background. Conventional nasogastric tube placement is an essential clinical procedure; however, complications may arise from blind manipulation. We tested the feasibility and efficiency of a visual nasogastric tube insertion system (VNGS) using a manikin. Methods. A microimaging fiber (0.8 mm) was integrated into the nasogastric tube to create the VNGS. Twenty inexperienced physicians were enrolled and assigned to the visual or conventional group. Each physician performed 10 repeated nasogastric tube insertions with visual guidance or the conventional method; another 20 inexperienced medical students received nasogastric tube insertion training using visual guidance or the conventional method. Results. The nasogastric tube successfully reached the stomach and the narrow anatomic structures were visualized with the VNGS. Time required for insertion was significantly shorter in the visual group compared to the conventional group (22.56 ± 3.08 versus 37.30 ± 4.12 seconds, P visual group. Less mucosal damage was noted in the visual group (3.43 ± 1.63 versus 9.86 ± 2.31 cm(2)). Medical students performed better NGT insertions (shorter insertion time and less procedure-related complications) after undergoing the visual guidance training. Conclusions. The VNGS may provide a new technique for nasogastric tube insertion applicable to clinical use or simulation training.

  17. Withdrawing method of the stiffening tube incidentally inserted into the descending colon

    Institute of Scientific and Technical Information of China (English)

    Shinsaku Fukuda; Tatsuya Mikami; Tadashi Shimoyama; Norihiro Hanabata; Hideki Iwamura; Akihiro Munakata

    2005-01-01

    We experienced a very rare complication of colonoscopy,a migration of stiffening tube into the colorectum. We herein introduce a withdrawing method of migrating stiffening tube incidentally inserted into the colorectum.A 65-year-old Japanese woman underwent colonoscopy because of abdominal discomfort. We used stiffening tube to insert the scope to the proximal colon because of her redundant sigmoid colon. When withdrawing the scope,we realized that the tube was fully inside the colorectum.We could not remove the tube instantly, and it reached the splenic flexure, finally. We reinserted the scope through the migrating tube, straightened the scope, and withdrew it holding a slight angle of the scope over the proximal end of the tube. Then, we could safely remove the tube along with the scope through the anus.

  18. Chest tube insertion is one important factor leading to intercostal nerve impairment in thoracic surgery.

    Science.gov (United States)

    Miyazaki, Takuro; Sakai, Tetsuya; Yamasaki, Naoya; Tsuchiya, Tomoshi; Matsumoto, Keitaro; Tagawa, Tsutomu; Hatachi, Go; Tomoshige, Koichi; Mine, Mariko; Nagayasu, Takeshi

    2014-01-01

    Chest tube insertion seems to be one important factor leading to intercostal nerve impairment. The purpose of this prospective study was to objectively evaluate intercostal nerve damage using current perception threshold testing in association with chest tube insertion. Sixteen patients were enrolled in this study. Intercostal nerve function was assessed with a series of 2000-Hz (Aβ fiber), 250-Hz (Aδ fiber), and 5-Hz (C fiber) stimuli using current perception threshold testing (Neurometer CPT/C(®)). Current perception threshold values at chest tube insertion were measured before surgery, during chest tube insertion and after removal of the chest tube. Intensities of ongoing pain were also assessed using a numeric rating scale (0-10). Current perception thresholds at each frequency after surgery were significantly higher than before surgery. Numeric rating scale scores for pain were significantly reduced from 3.3 to 1.9 after removal of the chest tube (p = 0.004). The correlation between current perception threshold value at 2000 Hz and intensity of ongoing pain was marginally significant (p = 0.058). This is the first study to objectively evaluate intercostal nerve damage at chest tube insertion. The results confirmed that chest tube insertion has clearly deleterious effects on intercostal nerve function.

  19. Consideration of alternative designs for a Percutaneous Endoscopic Gastrostomy feeding tube

    Science.gov (United States)

    Yerrabolu, Santosh Rohit

    The inability of some people to chew or swallow foods (but can digest foods) due to problems associated with various diseases and complications leads them to insufficient nutritional intake and loss of quality of life. These individuals are generally provided with nutritional support by means of injecting or infusing food directly into their stomachs or small intestines via feeding tubes. Gastrostomy feeding tubes (G-tubes) are used when such nutritional support is required for over 3-6 weeks. Percutaneous Endoscopic Gastrostomy (PEG) tubes are one of the most widely used G- Tubes and devices which are inserted via an incision through the abdominal wall either through a pull or push method. This investigation proposes conceptual alternative Percutaneous Endoscopy Gastrostomy (PEG) feeding tube designs with optimized materials selection to be used for their construction. The candidate materials were chosen from 18 commercial catheters, 2 reference grade polymers and a commercial polymer; using tissue-catheter-friction testing and surface chemistry characterization (Infrared spectroscopy and Critical Surface Tension approximation). The main objectives considered were to minimize slipping/dislodgement of gastrostomy tube/seal, to reduce peristomal leakage, and to attain size variability of PEG tubes while maintaining a low profile. Scanning Electron Microscope- Energy Dispersive X-ray Spectroscopy was employed to further determine the filler materials used in the samples. Nylon coated with fatty ester and filled with Barium sulphate was determined as the optimum material for the construction of the tube part of the feeding tubes to reduce slipping/dislodgment of gastrostomy tube/seal and to minimize peristomal leakage. Nylon coated with fatty ester and filled with Silica is the suggested as a candidate material for construction of the bumper/mushroom sections of the feeding tubes to avoid the Buried Bumper Syndrome. Fused Deposition Modeling, Selective Laser Sintering

  20. Testing of a Complete Training Model for Chest Tube Insertion in Traumatic Pneumothorax.

    Science.gov (United States)

    Ghazali, Aiham; Breque, Cyril; Léger, Alexandre; Scépi, Michel; Oriot, Denis

    2015-08-01

    Chest tube insertion is a frequent procedure in cases of traumatic pneumothorax, but severe complications can occur if not well performed. Although simulation-based training in chest tube insertion has improved performance, an affordable and realistic model for surgical insertion of a chest tube is lacking. The objective was to design a model for surgical chest tube insertion that would be realistic, affordable, and transportable and that would reflect all extrathoracic and intrathoracic steps of the procedure. The model was a task trainer designed by 4 experts in our simulation laboratory combining plastic, electronic, and biologic material. The cost of supplies needed for construction was evaluated. The model was used and tested over 30 months on 56 participants, of whom 44 were surveyed regarding the realism of the model. The model involved a half chest wall (lamb) on a plastic box, connected to a webcam facilitating assessment of the extrathoracic and intrathoracic steps of the procedure, for a cost of €60. Chest tubes, water seal package, and sterile instruments costed €200. All anatomic structures were represented during surgical insertion of chest tube. The demonstration contributed to teaching small groups of up to 8 participants and was reproducible over 30 months of diversely located courses. Anatomic correlation, realism, and learning experience were highly rated by users. This model for surgical chest tube insertion in traumatic pneumothorax was found to be realistic, affordable, and transportable. Furthermore, it allowed comprehensive assessment of the extrathoracic and intrathoracic procedural steps.

  1. [Long-term follow-up after tympanostomy tube insertion in children with serous otitis media].

    Science.gov (United States)

    Fekete-Szabó, Gabriella; Kiss, Fekete; Rovó, László

    2015-11-15

    The authors report about the efficacy of inserted tympanostomy tube in children with serous otitis media. The aim of the authors was to assess the status of eardrum, the function of Eustachian tube and hearing level 10 years after the use of tympanostomy tube. Patients filled out a questionnaire and microscopic examination of tympanic membrane, tympanometry, Eustachian tube function examination, and audiometry tests were performed. In the period of 2003-2004, ventilation tube insertion was performed in 711 patients in the ENT Department of Pediatric Health Center of University of Szeged. In 349 patients adenotomy and tympanostomy tube insertion, in 18 cases tonsillectomy and grommet insertion and in 344 patients only typmanostomy tube insertion were performed. Due to objective difficulties (address change, no phone number) 453 patients were asked for control test and 312 persons accepted the invitation. Normal hearing level was found in 84.6% of patients and normal tympanometry result occurred in 82%. Tympanic ventilation disorder, perforation of tympanic membrane, sensorineural hearing loss and sensorineural hearing loss due to noise exposure were diagnosed. Application of tympanostomy tube is effective in the treatment of serous otitis media resulting from ventilation disorder. The authors draw attention to the importance of tympanometry examination to prevent the adhesive processes and cholesteatoma in chronic ventilation disorder of the middle ear.

  2. Impact of Pneumococcal Conjugate Vaccine on Pediatric Tympanostomy Tube Insertion in Partial Immunized Population

    Directory of Open Access Journals (Sweden)

    Mao-Che Wang

    2015-01-01

    Full Text Available Objective. To investigate the impact of seven-valent pneumococcal conjugate vaccine on tube insertions in a partial immunized pediatric population. Study Design. Retrospective ecological study. Methods. This study used Taiwan National Health Insurance Research Database for the period 2000–2009. Every child under 17 years old who received tubes during this 10-year period was identified and analyzed. The tube insertion rates in different age groups and the risk to receive tubes in different birth cohorts before and after the release of the vaccine in 2005 were compared. Results. The tube insertion rates for children under 17 years of age ranged from 21.6 to 31.9 for 100,000 persons/year. The tube insertion rate of children under 2 years old decreased significantly after 2005 in period effect analysis (β = −0.074, P < 0.05, and the negative β value means a downward trend and increased in children 2 to 9 years old throughout the study period (positive β values which mean upward trends, P < 0.05. The rate of tube insertion was lower in 2004-2005 and 2006-2007 birth cohorts than that of 2002-2003 birth cohort (RR = 0.90 and 0.21, 95% CI 0.83–0.97 and 0.19–0.23, resp.. Conclusion. The seven-valent pneumococcal conjugate vaccine may reduce the risk of tube insertion for children of later birth cohorts. The vaccine may have the protective effect on tube insertions in a partial immunized pediatric population.

  3. Sonotubometry in children with otitis media with effusion before and after insertion of ventilation tubes.

    NARCIS (Netherlands)

    Avoort, S.J.C.; Heerbeek, N. van; Zielhuis, G.A.; Cremers, C.W.R.J.

    2009-01-01

    OBJECTIVES: To test the outcome of sonotubometric measurement in children with otitis media with effusion (OME) before and after insertion of ventilation tubes. DESIGN: Eustachian tube ventilatory function was tested in children with OME. To test validity, sonotubometric testing took place before in

  4. Investigation of the effect of using tube inserts for the intensification of heat transfer

    Science.gov (United States)

    Goodarzi, K.; Goudarzi, S. Y.; Zendehbudi, Gh.

    2015-01-01

    In this work, heat transfer in channels containing inserts of different shapes was investigated using computational fluid dynamics (CFD) modeling techniques taking a gaslight water heater as an example. Three types of devices inserted in the water heater tube (flow swirlers) were investigated: star-shaped, coiled wire, and classic ones in the form of twisted tapes. In the present study, the RNG k-ɛ turbulence model is used to model the turbulent flow regime. This numerical simulation has been performed over a Reynolds number range of 5800-18500. In the studied range of Reynolds number the maximum thermal performance factor was obtained by the starry inserts with A star/ A inlet = 0.50. The results have exposed that also the use of all tube inserts leads to a considerable increase in heat transfer and pressure drop over the smooth tube. In addition, the results revealed that both heat transfer rate and friction factor in the tube equipped with starry insert were significantly higher than those in the tube fitted with the coiled wire inserts and classic twisted tape.

  5. "Comparison of recovery rate and sequelae of various location of ventilation tube insertion "

    Directory of Open Access Journals (Sweden)

    Abbas Safavi Naini S

    2002-08-01

    Full Text Available Ventilation tube (VT insertion is the most common otologic operations performed in children, which has great importance in recovery and prevention of hearing loss in children with Eustachian tube dysfunction in critical ages of growth development. The location of the VT insertion varies in different studies; the differences are in recovery rates and sequelae of VT insertion. This study is performed to compare results of various locations of VT insertion in hearing recovery rate and postoperative sequelae in the Booali Hospital from 1999 to 2000 (one-year period. This investigation is a clinical trial in 34 patients with Eustachian tube dysfunction; cases were selected according to history, otologic examination, adenoid radiography, audiometry (SRT, PTA-GAP and tympanometry. The operating time consumed in the VT insertion and postoperative sequelae were recorded. Recovery rates of SAR and PTA-Gap were 25.14 dB and 18.41 dB in anterosuperior (AS versus 18/67 dB and 14/85 dB in anteroinferior (AT VT insertion respectively. Obstruction and otorrhea after VT insertion were 0, 4 and 13, 11 in AS and AI, respectively. Time difference in the AS versus AI was not significant. The assessment confirmed that anterosuperior VT insertion has better hearing recovery rate and lower postoperative sequelae.

  6. The protective effect of adenoidectomy on pediatric tympanostomy tube re-insertions: a population-based birth cohort study.

    Directory of Open Access Journals (Sweden)

    Mao-Che Wang

    Full Text Available Adenoidectomy in conjunction with tympanostomy tube insertion for treating pediatric otitis media with effusion and recurrent acute otitis media has been debated for decades. Practice differed surgeon from surgeon. This study used population-based data to determine the protective effect of adenoidectomy in preventing tympanostomy tube re-insertion and tried to provide more evidence based information for surgeons when they do decision making.Retrospective birth cohort study.This study used the National Health Insurance Research Database for the period 2000-2009 in Taiwan. The tube reinsertion rate and time to tube re-insertion among children who received tympanostomy tubes with or without adenoidectomy were compared. Age stratification analysis was also done to explore the effects of age.Adenoidectomy showed protective effects on preventing tube re-insertion compared to tympanostomy tubes alone in children who needed tubes for the first time (tube re-insertion rate 9% versus 5.1%, p = 0.002 and longer time to re-insertions, p = 0.01, especially those aged over 4 years when they had their first tube surgery. After controlling the effect of age, adenoidectomy reduced the rate of re-insertion by 40% compared to tympanostomy tubes alone (aHR: 0.60; 95% CI: 0.41-0.89. However, the protective effect of conjunction adenoidectomy was not obvious among children with a second tympanostomy tube insertion. Children who needed their first tube surgery at the age 2-4 years were most prone to have tube re-insertions, followed by the age group of 4-6 years.Adenoidectomy has protective effect in preventing tympanostomy tube re-insertions compared to tympanostomy tubes alone, especially for children older than 4 years old and who needed tubes for the first time. Nonetheless, clinicians should still weigh the pros and cons of the procedure for their pediatric patients.

  7. Transition from Tube to Oral Feeding in the School Setting

    Science.gov (United States)

    McKirdy, Laura S.; Sheppard, Justine J.; Osborne, Mary L.; Payne, Pamela

    2008-01-01

    Purpose: A school-based treatment program for tube-fed children with medically complex conditions and food refusal was implemented to facilitate the children's transition to oral feeding and advance their eating skills. Method: The program combined educational and therapeutic goals. It was implemented in a regional public school for children with…

  8. Investigation of Aluminum-Copper Tube Hydroforming with Axial Feeding

    Science.gov (United States)

    Parto D., M.; Seyedkashi, S. M. H.; Liaghat, Gh.; Naeini, H. Moslemi; Panahizadeh R., V.

    2011-01-01

    Hydroforming of a two-layered Aluminum-Copper tube is investigated numerically and experimentally. Pressure is applied through a nonlinear path along with symmetrical axial feeding. ABAQUS/Explicit commercial code is used for finite element simulation of the process. ASTM C11000 Copper alloy is used as inner layer and ASTM AA1050A Aluminum alloy is used as outer layer. The simulation results show that the part can be successfully formed under internal pressure of 40 MPa with 8 mm axial displacement. Stress distributions on both inner and outer tubes are compared and maximum thinning on their wall is also discussed. Different friction conditions are applied on the process using different coefficients of friction and their effects are investigated on thinning percentage of inner and outer tubes and also on axial feeding. It is observed that finite element results are in good agreement with experimental results.

  9. Evaluation of Tube Wall Thickness of Feed Water Heater

    Science.gov (United States)

    Uchikura, Takahisa; Morisaki, Koichi; Hamada, Seiichi

    With regard to the high pressure (HP) feed water heater of thermal power plant at Tokyo Electric Power Company (TEPCO) sites, inspection of feed water (FW) tubes wall thickness are conducted whenever required such that frequent tube leak occurs. As a standard inspection methodology, FW heater is disassembled during planned outage, tube wall thickness is measured by the ultrasonic pulse techique (UT), then plugs are installed at the both ends of FW tube if its measured wall thickness is found below calculated threshold. However, the root causes of wall thinning of FW tube are various such as erosion and corrosion, based on wall thinning condition, the above threshold is not applied but utilizing the other technically well-grounded evaluation method is sometimes more rational. Therefore, TEPCO classified wall-thinning condition based on inspection data and established technically well-grounded and rational evaluation methodologies of FW tube wall thickness to suite each wall thinning condition. Moreover, with recent improvement of inspection technique, technology enabled faster, larger amount, and more accurate data acquisition, TEPCO has developed the systematized evaluation methodology that can transact data acquisition and evaluation simultaneously. This article introduces the logic of evaluation methods and examined algorithms to make them systematized.

  10. Nutrition with Gastrostomy Feeding Tubes for Amyotrophic Lateral Sclerosis in Canada.

    Science.gov (United States)

    Benstead, Timothy; Jackson-Tarlton, Caitlin; Leddin, Desmond

    2016-11-01

    Amyotrophic lateral sclerosis (ALS) is a rapidly progressing degenerative motor neuron disease that results in significant muscle weakness. Defects in energy metabolism and difficulties in swallowing eventually lead to a reduction in body mass. Weight loss exacerbates symptoms and serves as an independent negative prognostic factor. Percutaneous endoscopic gastrostomy (PEG) is often inserted in patients with ALS to either supplement or replace oral feeding. However, the criteria for PEG placement and timing of insertion are important clinical decisions that have not been fully studied. Given the absence of guiding evidence, the aim of this project was to better understand how Canadian ALS clinics make decisions regarding gastrostomy feeding. ALS clinical directors across Canada were asked if they had written guidelines for timing of PEG insertion and if not, what criteria they use to make this decision. Responses from 10 of 17 centres contacted were received. The approach to supplemental nutrition management in Canadian clinics varies in the absence of formal guidelines. Only one centre has a written set of centre-specific protocols in place. Most clinics considered some combination of respiratory decline, weight loss, dysphagia and/or patient readiness when reaching a decision. However, the absolute threshold and mechanism of measuring the individual criteria differed between clinics. Practices generally reflect international published recommendations but vary on the emphasis of specific criteria. Further research is required to determine the optimal timing and criteria to place gastrostomy feeding tubes in the ALS population.

  11. Feeding difficulties in neonates following cardiac surgery: determinants of prolonged feeding-tube use.

    Science.gov (United States)

    McKean, Elissa B; Kasparian, Nadine A; Batra, Shweta; Sholler, Gary F; Winlaw, David S; Dalby-Payne, Jacqueline

    2017-08-01

    Aim The aims of this study were to examine the prevalence and potential correlates of feeding difficulties in infants who underwent cardiac surgery in the neonatal period and to investigate resource utilisation by infants with feeding difficulties. All neonates who underwent their first cardiac surgery at the Heart Centre for Children, The Children's Hospital at Westmead, between January and December, 2009 were included. Demographic, preoperative, intraoperative, and postoperative data were collected via electronic medical records. For the purpose of this study, feeding difficulty was defined as the requirement for ongoing tube feeding at the time of discharge home or transfer to another hospital. Out of a total of 79 neonates, 24 (30%) were discharged home or transferred to another hospital with a feeding tube. Feeding difficulties were associated with the presence of a genetic syndrome (pcardiac clinical nurse consultants (M=1.2, SD=1.4) compared with those without feeding difficulties. This study identified factors that can be used in the early recognition of infant feeding difficulties, to help guide the direction of limited health resources, as well as being focal points for future research and clinical practice improvement.

  12. Esophagojejunostomy Feeding Tube Placement in 5 Dogs with Pancreatitis and Anorexia

    Directory of Open Access Journals (Sweden)

    Forrest Cummings

    2014-01-01

    Full Text Available Enteral feeding tube placement has been described in veterinary medicine for several years. Indications include oral, esophageal, gastrointestinal, pancreatic, hepatic, and neurologic diseases. In this paper, endoscopically assisted placement of an esophagojejunostomy (EJ feeding tube in dogs with pancreatitis and prolonged anorexia is described. To the author’s knowledge there are no published reports of this procedure. Esophagojejunostomy feeding tubes provide an alternative to other forms of postgastric feeding tube placement (e.g., nasojejunal, gastrojejunostomy, and jejunostomy tubes without the associated complications of patient discomfort, sneezing, epistaxis, and peritonitis. Tube occlusion, transient vomiting and loose stool were the most commonly reported complications.

  13. Enteral tube feeding for individuals with cystic fibrosis: Cystic Fibrosis Foundation evidence-informed guidelines.

    Science.gov (United States)

    Schwarzenberg, Sarah Jane; Hempstead, Sarah E; McDonald, Catherine M; Powers, Scott W; Wooldridge, Jamie; Blair, Shaina; Freedman, Steven; Harrington, Elaine; Murphy, Peter J; Palmer, Lena; Schrader, Amy E; Shiel, Kyle; Sullivan, Jillian; Wallentine, Melissa; Marshall, Bruce C; Leonard, Amanda Radmer

    2016-11-01

    Nutrition is integral to the care of individuals with cystic fibrosis (CF). Better nutritional status is associated with improved pulmonary function. In some individuals with CF, enteral tube feeding can be useful in achieving optimal nutritional status. Current nutrition guidelines do not include detailed recommendations for enteral tube feeding. The Cystic Fibrosis Foundation convened an expert panel to develop enteral tube feeding recommendations based on a systematic review of the evidence and expert opinion. These guidelines address when to consider enteral tube feeding, assessment of confounding causes of poor nutrition in CF, preparation of the patient for placement of the enteral feeding tube, management of the tube after placement and education about enteral feeding. These recommendations are intended to guide the CF care team, individuals with CF, and their families through the enteral tube feeding process.

  14. Evaluation of an intensive desensitisation, oral tolerance therapy and hunger provocation program for children who have had prolonged periods of tube feeds

    OpenAIRE

    Harding, C.; Faiman, A.; Wright, J

    2010-01-01

    Background: Some children with early feeding difficulties may require nasogastric, (NG) tube feeding or insertion of a percutaneous endoscopic gastrostomy, (PEG) from a young age. A small cohort of these children can develop severe oral aversions that can delay the re-introduction of oral feeding. Multi-disciplinary approaches that provide an intensive approach are deemed the most effective method of intervention to reduce NG and PEG dependency. Method: Two children and their parents rec...

  15. Numerical simulation of heat transfer of latent functionally thermal fluid in tubes with coaxially inserted cylindrical bars in laminar

    Institute of Scientific and Technical Information of China (English)

    JIN Jian; LIU PeiQing; LIN GuiPing

    2008-01-01

    The heat transfer of latent functionally thermal fluid in three kinds of tubes with coaxially inserted cylindrical bars is numerically researched using equivalent spe-cific heat model, and the flow fields are analyzed with field synergy field. It is found that in the tubes with coaxially inserted cylindrical bars, the heat transfer effects of functionally thermal fluid become more and more pronounced with the Ste de-creasing. This is similar to be case of functionally thermal fluid flowing in smooth straight tubes. Compared with the results receiving from smooth straight tubes, the heat transfer of functional thermal fluid in tubes with coaxially inserted cylindrical bars has been significantly enhanced. And this effect becomes more apparent as the diameter of coaxially inserted cylindrical bars increases meanwhile, however, energy consuming of the tubes shows the same trend.

  16. Numerical simulation of heat transfer of latent functionally thermal fluid in tubes with coaxially inserted cylindrical bars in laminar

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    The heat transfer of latent functionally thermal fluid in three kinds of tubes with coaxially inserted cylindrical bars is numerically researched using equivalent spe- cific heat model, and the flow fields are analyzed with field synergy field. It is found that in the tubes with coaxially inserted cylindrical bars, the heat transfer effects of functionally thermal fluid become more and more pronounced with the Ste de- creasing. This is similar to be case of functionally thermal fluid flowing in smooth straight tubes. Compared with the results receiving from smooth straight tubes, the heat transfer of functional thermal fluid in tubes with coaxially inserted cylindrical bars has been significantly enhanced. And this effect becomes more apparent as the diameter of coaxially inserted cylindrical bars increases meanwhile, however, energy consuming of the tubes shows the same trend.

  17. Comparative evaluation of intraocular pressure changes subsequent to insertion of laryngeal mask airway and endotracheal tube.

    Directory of Open Access Journals (Sweden)

    Ghai B

    2001-07-01

    Full Text Available AIMS: To evaluate the intraocular pressure and haemodynamic changes subsequent to insertion of laryngeal mask airway and endotracheal tube. SUBJECTS AND METHODS: The study was conducted in 50 adult patients. A standard general anaesthesia was administered to all the patients. After 3 minutes of induction of anaesthesia baseline measurements of heart rate, non-invasive blood pressure and intraocular pressure were taken following which patients were divided into two groups: laryngeal mask airway was inserted in group 1 and tracheal tube in group 2. These measurements were repeated at 15-30 second, every minute thereafter up to 5 minutes after airway instrumentation. RESULTS: A statistically significant rise in heart rate, systolic blood pressure, diastolic blood pressure and intraocular pressure was seen in both the groups subsequent to insertion of laryngeal mask airway or endotracheal tube. Mean maximum increase was statistically more after endotracheal intubation than after laryngeal mask airway insertion. The duration of statistically significant pressure responses was also longer after endotracheal intubation. CONCLUSION: Laryngeal mask airway is an acceptable alternative technique for ocular surgeries, offering advantages in terms of intraocular pressure and cardiovascular stability compared to tracheal intubation.

  18. Further understanding of twisted tape effects as tube insert for heat transfer enhancement

    Science.gov (United States)

    Abu-Khader, Mazen M.

    2006-12-01

    Tube inserts are used as heat transfer enhancement tool for both retrofit and new design of shell and tube heat exchangers. This paper discusses and reviews the characteristics and performance of twisted tapes. The theory and application are also addressed. Industrial case study was selected to illustrate the behaviour effect that the twisted tapes impose at various laminar, transition and turbulent flow regions. This effect was demonstrated by changing the inside tube diameter and twist ratio through evaluating selected exchanger design parameters such as: local heat transfer coefficient, friction factor and pressure drop. Testing the exponent powers for Re and Pr at both laminar and turbulent regions were carried out. General design considerations are outlined for the use of twisted tapes in shell and tube heat exchangers.

  19. Nasogastric tube insertion in anesthetized and intubated patients: a new and reliable method

    Directory of Open Access Journals (Sweden)

    Tsai Yung-Fong

    2012-08-01

    Full Text Available Abstract Background The “Rusch” intubation stylet is used to make endotracheal tube intubation easy. We designed this study to evaluate the usage of this equipment in the guidance of nasogastric tube (NGT insertion. Methods A total of 103 patients, aged 23 to 70 years, undergoing gastrointestinal or hepatic surgeries that required intraoperative NGT insertions were enrolled into our study. The patients were randomly allocated to the control group (Group C or the stylet group (Group S according to a computerized, random allocation software program. In the control group, the NGT was inserted with the patient’s head in an intubating position. In the stylet group, the NGT was inserted with the assistance of a “Rusch” intubation stylet tied together at the tips by a slipknot. The success rates of the two methods, the durations of the insertions, and the occurrences of complications were recorded. All of the failed cases in the control group were subjected to the new technique used in the stylet group, and the successful rescue rate was also evaluated. Results Successful insertions were recorded for 52/53 patients (98.1% in Group S and for 32/50 patients (64% in Group C. The mean insertion times were 39.5 ± 19.5 seconds in Group C and 40.3 ± 23.2 seconds in Group S. Successful rescues of failure cases in Group C were achieved in 17/18 patients (94.4% with the assistance of a “Rusch” intubation stylet. Conclusions The “Rusch” intubation stylet-guided method is reliable with a high success rate of NGT insertion in anesthetized and intubated patients. Trial registration Institutional Review Board of Chang Gung Memorial Hospital (IRB: 98-2669B and Australian New Zealand Clinical Trials Registry (ACTRN12611000423910

  20. A novel technique to insert nasogastric tube for the anesthetized patients during cervical esophageal reconstruction

    Institute of Scientific and Technical Information of China (English)

    Ruijie Zhang; Yu Deng; Shengling Fu; Yixin Cai; Ni Zhang; Xiangning Fu

    2014-01-01

    Objective:We are describing a novel technique to insert nasogastric tube (NGT) in the anesthetized patients dur-ing cervical esophageal reconstruction. Methods:Forty patients with mid and upper esophageal tumor enrol ed into this study were randomly al ocated into two groups (the control group, group C and the novel method group, group N). Al the patients were applied mechanical anastomosis to finish the cervical esophageal reconstruction. The procedure of NGT insertion for group C use the conventional method;wel , the group N use the novel technique. Results:Al the patients in group N had been finished the NGT insertion in the first attempt, and the total time for insertion was (5.05 ± 1.15) mins;on the contrary, for the group C, duration of insertion (min) was (24.45 ± 5.23) mins, and the successful rate of NGT insertion in the first attempt was 40%(P<0.05);no one in group N had coiling/kinking, and 6/20 (30%) in group C had it (P=0.020). The complication rate of bleeding between the two group had no significant dif erence. Conclusion:For the patient with mid and upper esophageal tumor who need cervical esophageal reconstruction, this novel method can save the NGT insertion time, and make it easier with higher successful rate.

  1. Intraocular pressure and haemodynamic responses to insertion of the i-gel, laryngeal mask airway or endotracheal tube.

    Science.gov (United States)

    Ismail, Salah A; Bisher, Neama A; Kandil, Hazem W; Mowafi, Hany A; Atawia, Hayam A

    2011-06-01

    We hypothesised that the effects of insertion of an i-gel supraglottic airway management device on intraocular pressure (IOP) and haemodynamic variables would be milder than those associated with insertion of a laryngeal mask airway (LMA) or an endotracheal tube. This study evaluated IOP and haemodynamic responses following insertion of an i-gel airway, LMA or endotracheal tube. This was a randomised controlled study in a tertiary care centre in which 60 adults scheduled for elective non-ophthalmic procedures under general anaesthesia were allocated to one of three groups. Patients with pre-existing glaucoma, cardiovascular, pulmonary or metabolic diseases or anticipated difficult intubation were excluded. Following induction of general anaesthesia, an endotracheal tube, LMA or i-gel device was inserted. IOP, SBP, DBP, heart rate (HR) and perfusion index were measured before induction of anaesthesia and before and after insertion of the airway device. Insertion of the i-gel did not increase IOP. Insertion of an endotracheal tube increased IOP from 11.6 ± 1.6 to 16.5 ± 1.7 mmHg (P intubation significantly increased HR, SBP and DBP. Insertion of the LMA significantly increased HR and SBP. These increases were significantly higher than those which followed insertion of the i-gel device. Insertion of the endotracheal tube or LMA resulted in a significant decrease in perfusion index which was maintained for 5 min following tracheal intubation and for 2 min after insertion of the LMA. Insertion of the i-gel device did not change perfusion index significantly. Insertion of the i-gel device provides better stability of IOP and the haemodynamic system compared with insertion of an endotracheal tube or LMA in patients undergoing elective non-ophthalmic surgery.

  2. Early versus on-demand nasoenteric tube feeding in acute pancreatitis

    NARCIS (Netherlands)

    Bakker, O.J.; Brunschot, S. van; Santvoort, H.C. van; Besselink, M.G.; Bollen, T.L.; Boermeester, M.A.; Dejong, C.H.; Goor, H. van; Bosscha, K.; Ali, U. Ahmed; Bouwense, S.; Grevenstein, W.M. van; Heisterkamp, J.; Houdijk, A.P.; Jansen, J.M.; Karsten, T.M.; Manusama, E.R.; Nieuwenhuijs, V.B.; Schaapherder, A.F.; Schelling, G.P. van der; Schwartz, M.P.; Spanier, B.W.; Tan, A.; Vecht, J.; Weusten, B.L.; Witteman, B.J.; Akkermans, L.M.; Bruno, M.J.; Dijkgraaf, M.G.; Ramshorst, B. van; Gooszen, H.G.; Study, G.

    2014-01-01

    BACKGROUND: Early enteral feeding through a nasoenteric feeding tube is often used in patients with severe acute pancreatitis to prevent gut-derived infections, but evidence to support this strategy is limited. We conducted a multicenter, randomized trial comparing early nasoenteric tube feeding wit

  3. Use of mobile learning module improves skills in chest tube insertion.

    Science.gov (United States)

    Davis, James S; Garcia, George D; Wyckoff, Mary M; Alsafran, Salman; Graygo, Jill M; Withum, Kelly F; Schulman, Carl I

    2012-09-01

    Just-In-Time Learning is a concept increasingly applied to medical education, and its efficacy must be evaluated. A 3-minute video on chest tube insertion was produced. Consenting participants were assigned to either the video group, which viewed the video on an Apple® iPod Touch immediately before chest tube insertion, or the control group, which received no instruction. Every participant filled out a questionnaire regarding prior chest tube experience. A trained clinician observed participants insert a chest tube on the TraumaMan® task simulator, and assessed performance using a 14-item skills checklist. Overall, 128 healthcare trainees participated, with 50% in the video group. Participants included residents (34.4%, n = 44), medical students (32.8%, n = 42), and U.S. Army Forward Surgical Team members (32.8%, n = 42). Sixty-nine percent of all participants responded that they had never placed a chest tube, but 7% had placed more than 20. Only 25% of the participants had previously used TraumaMan®. Subjects who viewed the video scored better on the skills checklist than the control group (11.09 ± 3.09 versus 7.17 ± 3.56, P < 0.001, Cohen's D = 1.16). Medical students (9.33 ± 2.65 versus 4.52 ± 3.64, P < 0.001), Forward Surgical Team members (10.07 ± 2.52 versus 8.57 ± 3.22, P < 0.001), anesthesia residents (8.25 ± 2.56 versus 5.9 ± 2.23, P = 0.017), and subjects who had placed fewer than 10 chest tubes (9.7 ± 3 versus 6.6 ± 3.9, P < 0.001) performed significantly better with the video. The procedural animation video is an effective medium for teaching procedural skills. Embedding the video on a mobile device, and allowing trainees to access it immediately before chest tube insertion, may enhance and standardize surgical education for civilians and military personnel. Copyright © 2012 Elsevier Inc. All rights reserved.

  4. Minimizing radiation dose to patient and staff during fluoroscopic, nasoenteral tube insertions

    Energy Technology Data Exchange (ETDEWEB)

    Rudin, S.; Bednarek, D.R. (New York Univ., NY (United States). School of Medicine)

    1992-02-01

    Since the fluoroscopic image during nasoenteral tube placements is used for guidance and not for diagnosis, a lower contrast image with increased quantum mottle can be easily tolerated. The three methods to reduce the radiation dose rate investigated consisted of removing camera from the image intensifier output phosphor, and setting the fluoroscopic mA to the minimum value so that the kVp could be maximized. Fluoroscopic frozen video frames of a clinical tube insertion comparing the images with and without the dose-saving techniques are presented. Measurements of the radiation dose rates using a Plexiglas phantom show that the dose for patient and staff during fluoroscopic-guided nasoenteral tube placements can be reduced by over a factor of 10 without significantly adversely affecting the actual placement procedure. (author).

  5. Feeding in Oral Cancer Patients After Massive Ablative Surgery: Percutaneous Endoscopic Gastrostomy or Nasogastric Tube.

    Science.gov (United States)

    Tabrizi, Reza; Hosseinpour, Sepanta; Taghizadeh, Fateme

    2016-06-01

    Feeding after ablative oral cancer surgery is a major concern in postoperative care phase. The aim of this study was to compare postoperative phase of healing in patients undergoing nasogastric tube insertion and percutaneous endoscopic gastrostomy. In this single randomized clinical trial, 40 patients were randomly allocated to 2 groups according to a randomized list: group one (20 patients) had nasogastric tube for 4 weeks and group two (20 patients) underwent percutaneous endoscopic gastrostomy for 4 weeks or more after the surgery. Occurrence of infection and wound dehiscence was assessed. Weight loss was defined as reduction in patients' weight at 4 weeks after the surgery compared with preoperation. Weight loss was 7.9 ± 1.91 kg in group one and 5.3 ± 1.38 kg in group two; the difference in this regard between the 2 groups was statistically significant (P = 0.001). In group one, 10 subjects had dehiscence versus 3 subjects in group two; this difference was significant (P = 0.04). Analysis of the data demonstrated a significant difference in postsurgical infection between the 2 groups (P = 0.044). It seems that gastrostomy may be an appropriate method for feeding in patients with extensive oral cancer.

  6. Immediate postpartum levonorgestrel intrauterine device insertion and breast-feeding outcomes: a noninferiority randomized controlled trial.

    Science.gov (United States)

    Turok, David K; Leeman, Lawrence; Sanders, Jessica N; Thaxton, Lauren; Eggebroten, Jennifer L; Yonke, Nicole; Bullock, Holly; Singh, Rameet; Gawron, Lori M; Espey, Eve

    2017-08-23

    Immediate postpartum levonorgestrel intrauterine device insertion is increasing in frequency in the United States, but few studies have investigated the effect of early placement on breast-feeding outcomes. This study examined the effect of immediate vs delayed postpartum levonorgestrel intrauterine device insertion on breast-feeding outcomes. We conducted this noninferiority randomized controlled trial at the University of Utah and the University of New Mexico Health Sciences Centers from February 2014 through March 2016. Eligible women were pregnant and planned to breast-feed, spoke English or Spanish, were aged 18-40 years, and desired a levonorgestrel intrauterine device. Enrolled women were randomized 1:1 to immediate postpartum insertion or delayed insertion at 4-12 weeks' postpartum. Prespecified exclusion criteria included delivery <37.0 weeks' gestational age, chorioamnionitis, postpartum hemorrhage, contraindications to levonorgestrel intrauterine device insertion, and medical complications of pregnancy that could affect breast-feeding. We conducted per-protocol analysis as the primary approach, as it is considered the standard for noninferiority studies; we also report the alternative intent-to-treat analysis. We powered the study for the primary outcome, breast-feeding continuation at 8 weeks, to detect a 15% noninferiority margin between groups, requiring 132 participants in each arm. The secondary study outcome, time to lactogenesis, used a validated measure, and was analyzed by survival analysis and log rank test. We followed up participants for ongoing data collection for 6 months. Only the data analysis team was blinded to the intervention. We met the enrollment target with 319 participants, but lost 34 prior to randomization and excluded an additional 26 for medical complications prior to delivery. The final analytic sample included 132 in the immediate group and 127 in the delayed group. Report of any breast-feeding at 8 weeks in the immediate

  7. Second look endoscopy by a laryngo-fiberscope passed via the feeding tube of the percutaneous endoscopic gastrostomy.

    Science.gov (United States)

    Lujber, László; Pytel, József

    2003-06-01

    The most commonly used techniques for percutaneous endoscopic gastrostomy (PEG) require two passes of the gastroscope. The aim of this study was to clarify whether the second per oral gastroscopy can be replaced by passing a laryngo-fiberscope through the previously inserted PEG feeding tube. Twelve patients with head and neck cancer undergoing "pull through" PEG procedures were included in this prospective study. Instead of the second per oral pass of the gastro-intestinal fiberscope, a laryngo-fiberscope was passed through the inserted feeding tube to assess the correct position of the PEG internal disc. To gain more deflection to the tip of the instrument a string was led through the instrument channel and was brought back to the hand of the examiner outside the instrument. Pulling the string provided a bigger angulation to the end of the scope and thus a good view. In all twelve patients the "trans tubal" endoscopy was successful and provided a good second look to judge the position PEG internal disc. The procedure caused no inconvenience for the patient. "Trans tubal" endoscopy is a simple, safe and painless procedure to assess the position of the PEG feeding tube without having to pass the gastro-intestinal fiberscope a second time.

  8. Impact of gastrostomy tube feeding on the quality of life of carers of children with cerebral palsy.

    Science.gov (United States)

    Sullivan, Peter B; Juszczak, Edmund; Bachlet, Allison M E; Thomas, Adrian G; Lambert, Bridget; Vernon-Roberts, Angharad; Grant, Hugh W; Eltumi, Muftah; Alder, Nicola; Jenkinson, Crispin

    2004-12-01

    The aim of this prospective cohort study was to evaluate the impact of gastrostomy tube feeding on the quality of life of carers of children with cerebral palsy (CP). Short-Form 36 version II was used to measure quality of life in carers of 57 Caucasian children with CP (28 females, 29 males; median age 4y 4mo, range 5mo to 17y 3mo) six and 12 months after insertion of a gastrostomy tube. Responses were calibrated against a normative dataset (Oxford Healthy Life Survey III). Six months after gastrostomy feeding was started, a substantial rise in mean domain scores for mental health, role limitations due to emotional problems, physical functioning, social functioning, and energy/vitality were observed. At 12 months after gastrostomy placement, carers reported significant improvements in social functioning, mental health, energy/vitality (mean increase >9.8 points;pnutritional status. This study has demonstrated a significant, measurable improvement in the quality of life of carers after insertion of a gastrostomy feeding tube.

  9. Fallopian tube insertion into the uterine cavity discovered accidentally during laparoscopic retrieval of a misplaced coil from the pelvic cavity

    OpenAIRE

    Panayotidis, Costas; Foidart, Jean-Michel; Nisolle, Michelle

    2008-01-01

    This article presents for the first time in the literature a case of fallopian tube insertion into the uterine cavity discovered accidentally during laparoscopic retrieval of a misplaced coil from the pelvic cavity. Peer reviewed

  10. Frequency characteristics of pressure transducer kits with inserted pressure-resistant extension tubes.

    Science.gov (United States)

    Fujiwara, Shigeki; Mori, Satoshi; Tachihara, Keiichi; Yamamoto, Takeshi; Yokoe, Chizuko; Imaizumi, Uno; Morimoto, Yoshinari; Miki, Yoichiro; Toyoguchi, Izumi; Yoshida, Kazu-Ichi; Yokoyama, Takeshi

    2017-04-01

    The accurate monitoring of arterial blood pressure is important for cardiovascular management. However, the frequency characteristics of pressure transducer kits are influenced by the length of the pressure-resistant tube. To date, there have been few studies addressing the frequency characteristics of pressure transducer kits with inserted pressure-resistant extension tubes (pressure-resistant extension tube (ET) circuits). In this study, we examine ET circuits from the viewpoint of the frequency characteristics of pressure transducer kits. DT4812J transducer kits (length 150 cm; Argon Medical Devices, TX, USA) were used. Three original ET circuits were prepared, with the pressure-resistant tube of the DT4812J being extended with a 30-cm length of pressure-resistant tube (180ET circuit), a 60-cm length of pressure-resistant tube (210ET circuit), and a 90-cm length of pressure-resistant tube (240ET circuit). Each of these circuits was evaluated as part of this study. The natural frequency of the original DT4812J circuit was 45.90 Hz while the damping coefficient was 0.160. For the 180 ET circuit, the natural frequency and damping coefficient were 36.4 Hz and 0.162, respectively. For the ET210 circuit, the natural frequency and damping coefficient were 30.3 Hz and 0.175, respectively. For the ET210 circuit, the natural frequency and damping coefficient were 25.3 Hz and 0.180, respectively. As a result of extending the circuit, it was found that the natural frequency decreased drastically, while the damping coefficient increased slightly. When the extension of a pressure transducer kit is required, we should pay careful attention to the major decrease in the natural frequency, which may influence the pressure monitoring.

  11. Lying behaviour and IgG-levels of newborn calves after feeding colostrum via tube and nipple bottle feeding.

    Science.gov (United States)

    Bonk, Stephanie; Nadalin, Audrey; Heuwieser, Wolfgang; Veira, Douglas

    2016-08-01

    Oesophageal tube feeding colostrum is used to ensure sufficient colostrum intake in newborn calves but the impact of tube feeding on animal behaviour is unclear. Therefore the objective of this study was to compare lying behaviour of tube-fed or bottle-fed dairy calves. Calves (n = 37) in 3 groups were offered 3·5 l colostrum 2 h after birth. Calves of the bottle group were fed with a nipple bottle. Calves of the placebo tubing group were tubed for 4 min but no colostrum was given and they were then fed with a nipple bottle. Calves of the tubing group received 3·5 l colostrum via tube feeding. Consumed amount of bottle and placebo tubing calves was recorded. If they refused some of the offered 3·5 l the rest was offered in a second feeding 2 h later. Lying behaviour was measured by data loggers fitted to right hind leg for 3 d. Blood samples were taken 24 h after birth for determination of IgG concentration. The voluntary colostrum intake differed significantly between bottle-fed and placebo tubed calves at first feeding. Considering both colostrum feedings, bottle-fed calves consumed 3·44 ± 0·14 l and placebo tubed calves consumed 3·20 ± 0·38 l colostrum. ImmunoglobulinG intake (255·6 ± 77·5 g IgG), serum IgG concentration 24 h after birth (22·8 ± 6·7 g/l) and total serum protein concentration (6·1 ± 0·6 g/dl) did not differ between groups. None of the calves had a failure of passive transfer. There was no effect of tubing on lying behaviour.

  12. Knotting of a nasogastric feeding tube in a child with head injury: A case report and review of literature.

    Science.gov (United States)

    Ismail, Nasiru J; Bot, Gyang Markus; Hassan, Ismail; Shilong, Danaan J; Obande, Joseph O; Aliu, Salamat Ahuoiza; Dung, Ezekiel D; Shehu, Bello B

    2014-01-01

    Nasogastric intubation is one of the most common routine nonoperative procedures available for the hospital care of patients. The insertion and removal of this tube is associated with many complications. The complications include trauma, nasal septal abscess and inadvertent entry into the cranial cavity and trachea, ulceration, bleeding from varices and perforation. Knotting of the nasogastric tube is one of the very rare complications of nasogastric intubation particularly in children. To the best of our knowledge there are very few reported cases in children. The technique used in the patient was the application of a steady tug which allows the lower oesophageal sphincter to open, therefore enabling the removal of the nasogastric tube. The possible predispositions to knotting of a nasogastric tube include small bore tubes, excess tube length and gastric surgery. We postulate that reduced gastric tone is another possible predisposing factor with head injury being the most likely reason in the index patient. We also challenge the fact that the small sized stomach is a risk factor for knotting of a feeding tube if the functional status and tone are normal, because of the rarity in children.

  13. Knotting of a nasogastric feeding tube in a child with head injury: A case report and review of literature

    Directory of Open Access Journals (Sweden)

    Nasiru J Ismail

    2014-01-01

    Full Text Available Nasogastric intubation is one of the most common routine nonoperative procedures available for the hospital care of patients. The insertion and removal of this tube is associated with many complications. The complications include trauma, nasal septal abscess and inadvertent entry into the cranial cavity and trachea, ulceration, bleeding from varices and perforation. Knotting of the nasogastric tube is one of the very rare complications of nasogastric intubation particularly in children. To the best of our knowledge there are very few reported cases in children. The technique used in the patient was the application of a steady tug which allows the lower oesophageal sphincter to open, therefore enabling the removal of the nasogastric tube. The possible predispositions to knotting of a nasogastric tube include small bore tubes, excess tube length and gastric surgery. We postulate that reduced gastric tone is another possible predisposing factor with head injury being the most likely reason in the index patient. We also challenge the fact that the small sized stomach is a risk factor for knotting of a feeding tube if the functional status and tone are normal, because of the rarity in children.

  14. Increasing rate of middle ear ventilation tube insertion in children in denmark

    DEFF Research Database (Denmark)

    Djurhuus, Bjarki Ditlev; Skytthe, Axel; Christensen, Kaare;

    2014-01-01

    ear ventilation tube insertion performed in Denmark in the period were identified. A possible change in incidence rate over time was examined using Poisson regression analysis, while the cumulative incidence proportion was estimated using life-tables. RESULTS: A total of 502,569 uni- or bilateral...... in incidence rate was found in 1-year-olds with an annual increase of 4.5% (95% confidence interval 4.4-4.6%). Age-specific incidence rates remained at maximum around the age of 14 months throughout the period. The cumulative incidence proportion for the 2010 birth cohort by the time they reach the age of 5...

  15. [Usefulness of endoscopically guided nasogastric-jejunal feeding tube placement in a case of aspiration pneumonia due to postgastrectomy].

    Science.gov (United States)

    Tamura, Kosei; Totsuka, Osamu; Tamura, Jun'ichi

    2015-01-01

    A 79-year-old man with a history of gastrectomy with Billroth II reconstruction 27 years previously was admitted to our hospital due to recurrent pneumonia. Because he had dysphagia and had frequently developed pneumonia over the course of a year, enteral nutrition via nasogastric tube was initiated approximately six months before admission. The clinical and computed tomography findings showed that the cause of pneumonia was aspiration of tube feeding nutrients due to gastroesophageal reflux. To prevent gastroesophageal reflux, he was continuously kept in a 30-degree or greater reclining position. However, gastroesophageal reflux was seen at an injection rate of 50 ml/h or greater. After we inserted a nasogastric-jejunal feeding tube guided by endoscopy, gastroesophageal reflux, dumping syndrome and diarrhea were not seen up to an injection rate of 300 ml/h. Endoscopically guided nasogastric-jejunal feeding tube placement is a simple method and may be useful for patients with aspiration pneumonia due to postgastrectomy. Moreover, long-term postgastrectomy patients appear to tolerate the postopyloric injection of enteral nutrition. Because the number of elderly patients who have dysphagia with postgastrectomy is increasing, these findings provide a basis for treatment in elderly medical settings.

  16. Thermal performance enhancement in tubes using helically twisted tape with alternate axis inserts

    Science.gov (United States)

    Yongsiri, K.; Thianpong, C.; Nanan, K.; Eiamsa-ard, S.

    2016-01-01

    This article presents an investigation on heat transfer enhancement in a round tube inserted with a helically twisted tape. The effects of a helically twisted tape with alternate axis (HTT-A) on heat transfer, friction factor, and thermal performance factor behaviours are reported for the turbulent regime. HTT-A geometries are tape pitch to tube diameter, P/D = 1.0, 1.5, and 2.0; alternate length to pitch length, l/P = 1.0, 1.5, and 2.0; twisted length to tape width, y/W = 3.0; and tape width to tube diameter, w/D = 0.2. The experiment has been performed by varying the volumetric air flow rate in order to adjust Reynolds number ranging from 6 000 to 20 000. The wall of the testing tube is uniformly heated as a constant heat flux while the tests are covered with thermal insulations to reduce heat loss to surroundings. Thermal performance is evaluated by comparing the present experimental results with the results of the modified HTT-A and also those obtained from previous study (conventional helically twisted tape, HTT). The thermal performance of tested tube with HTT-A is evaluated to obtain the degree of heat transfer enhancement and friction factor induced by HTT-A with respect to the plain tube under the same test conditions. Evenly, it is interesting to observe that the tube with HTT-A consistently possesses higher heat transfer and thermal performance factor than those with the HTT around 14.1% and 1.9%, respectively. The HTT-A with the smaller pitch ratio and adjacent twist length provides higher heat transfer rate and friction factor than the one with larger pitch ratio and alternate length as a result of a larger contact surface area, stronger swirl intensity and, thus, better fluid mixing near the tube wall. In the range determined, the tubes with the largest pitch ratio ( P/D = 2.0) and smallest alternate length ( l/P = 1.0) give the highest thermal performance factor at around 1.35. In addition, the empirical correlations of the Nusselt number, friction

  17. J-tube technique for double-j stent insertion during laparoscopic upper urinary tract surgical procedures.

    Science.gov (United States)

    Kim, Hyung Suk; Lee, Byung Ki; Jung, Jin-Woo; Lee, Jung Keun; Byun, Seok-Soo; Lee, Sang Eun; Jeong, Chang Wook

    2014-11-01

    Double-J stent insertion has been generally performed during laparoscopic upper urinary tract (UUT) surgical procedures to prevent transient urinary tract obstruction and postoperative flank pain from ureteral edema and blood clots. Several restrictive conditions that make this procedure difficult and time consuming, however, include the coiled distal ends of the flexible Double-J stent and the limited bending angle of the laparoscopic instruments. To overcome these limitations, we devised a Double-J stent insertion method using the new J-tube technique. Between July 2011 and May 2013, Double-J stents were inserted using the J-tube technique in 33 patients who underwent a laparoscopic UUT surgical procedure by a single surgeon. The mean stent placement time was 4.8±2.7 minutes, and there were no intraoperative complications. In conclusion, the J-tube technique is a safe and time-saving method for Double-J stent insertion during laparoscopic surgical procedures.

  18. Different method regarding stomach tube insertion effect contrastive analysis%不同方法对于胃管插入效果的对比分析

    Institute of Scientific and Technical Information of China (English)

    覃玉秋

    2011-01-01

    目的:探讨不同方法对于胃管插入效果的比较.方法:选取我院2007年9月~2010年7月收治的120例需插胃管鼻饲患者的临床资料,随机分为治疗组(60例)和对照组(60例),对照组患者采用经口腔插入胃管,治疗组患者经鼻腔插入胃管,比较两组患者插管过程中恶心、呕吐发生率,插管次数及食管损伤情况.结果:治疗组患者插管成功率高,恶心、呕吐、食管损伤发生率低,与对照组患者比较差异有统计学意义(p<0.05).结论:经鼻腔插管能有效避免不良反应的发生,降低患者的不适程度,效果满意,值得在临床推广.%Goal: Discusses the different method regarding the stomach tube insertion effect comparison. Method: Selects 120 examples which my courtyard in September, 2007 ~2010 year in July admits to insert the stomach tube nasal feeding patient's clinical material, divides into the treatment group stochastically (60 examples) and the control group (60 examples), the control group patients use after the oral cavity insertion stomach tube, the treatment group patients after the nasal cavity insertion stomach tube, inserts a tube in the process compared with two group of patients disgusting, the vomitive formation rate, the intubation number of times and the esophagus damage situation. Finally: The treatment group patients insert a tube the success ratio to be high, disgusting, the vomit, the esophagus damage formation rate are low, compares the difference with the control group patients to have statistics significance (p <0.05). Conclusion: Can avoid the untoward effect effectively after the nasal cavity intubation the occurrence, reduces patient's ill degree, the effect is satisfied, is worth in clinical promoting.

  19. The important role of positioning in nasogastric tube insertion in unconscious patients: A prospective, randomized, double-blind study.

    Science.gov (United States)

    Zhao, Wangmiao; Ge, Chunyan; Zhang, Wanzeng; Sun, Zhaosheng; Li, Xiaowei

    2017-05-25

    To investigate whether positioning the body in a lateral decubitus position will facilitate nasogastric tube insertion in unconscious patients. Inserting a nasogastric tube into unconscious patients can be challenging because these patients cannot cooperate with the operator. The piriform sinus and arytenoid cartilage are the most commonly reported impaction sites. However, we found that the first impaction site was the backward displaced tongue when inserting a nasogastric tube in unconscious patients who often exhibited glossoptosis. Performing an intubation in the lateral decubitus position could make this procedure easy. This prospective, double-blind, parallel, randomized controlled trial was conducted in Hengshui City, Hebei Province, China. 110 cases of unconscious patients were enrolled. The patients were randomly assigned to a conventional group (group C) or a lateral decubitus position group (group L). In group C, the nasogastric tube was inserted while the patients were in a supine position using the conventional technique, and in group L, the tube was inserted in a lateral decubitus position or further tilting the body to a prone decubitus position 20-30 degrees. We discussed reasonable intubation methods in unconscious patients by comparing the success rate on first insertion, the overall success rate, the intubation time and the complication rates between the two groups. Group L had a higher success rate on first insertion and overall success rate than group C (Ppassage. Nasogastric tube insertions in the lateral decubitus position are recommended in unconscious patients because of the higher success rate, reduced intubation time and lower complication rate. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  20. The Challenges of Home Enteral Tube Feeding: A Global Perspective

    Directory of Open Access Journals (Sweden)

    Omorogieva Ojo

    2015-04-01

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

  1. The challenges of home enteral tube feeding: a global perspective.

    Science.gov (United States)

    Ojo, Omorogieva

    2015-04-08

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

  2. Dose reduction during fluoroscopic placement of feeding tubes

    Energy Technology Data Exchange (ETDEWEB)

    Rudin, S.; Bednarek, D.R.; Miller, J.A. (State Univ. of New York, Buffalo (USA))

    1991-03-01

    By both increasing the optical iris of the video camera and removing the grid in fluoroscopic procedures involved in placement of a Dubbhoff feeding tube, the radiation dose to patients and staff was reduced by five to seven times. An average expected dose to a patient of about 300 mGy per procedure was reduced by two to three times when the grid was removed and by an additional three times when an iris of increased diameter was used. Because Dobbhoff procedures do not involve obtaining a diagnosis, the image degradation was acceptable and did not affect the total exposure times or ability to conduct the procedure. With the grid out, the difference between the mean exposure times of 5.1 minutes in 96 patient studies done with a normal iris opening and 4.0 minutes in 52 studies done with an enlarged iris was not statistically significant. The importance of reducing patient dose is reinforced by the finding that one-third of the patients underwent repeated procedures, accounting for almost 60% of the total.

  3. EVALUATION OF EFFECTIVENESS OF MYRINGOTOMY AND MYRINGOTOMY WITH VENTILATION TUBE INSERTION AS TREATMENT OF OTITISMEDIA WITH EFFUSION IN CHILDREN

    Directory of Open Access Journals (Sweden)

    Sujatha

    2015-04-01

    Full Text Available BACKGROUND: Considerable uncertainty and controversies exists regarding the surgical treatment options of Otitis media with effusion (OME. As untreated or improperly treated longstanding OME causes problems in social and intellectual behavior in children, it is of great public health importance. OBJECTIVES: To compare the effectiveness of myringotomy with that of myringotomy with venti lation tube (VT insertion as treatment of OME and to find out long - term sequlae of VT insertion. METHODS AND MATERIALS: Tertiary care hospital level prospective follow - up study was conducted in 50 children of 3 to 10 years of age with history of OME and a denoid hypertrophy. They were randomly divided into two groups. All children had adenoidectomy and along with that one group had myringotomy and other group underwent myringotomy and ventilation tube insertion. The patients’ characteristics were prospectively recorded during the study period of one year starting from January 2013. Results were analyzed. There is significant improvement in hearing in myringotomised children than those with ventilation tube insertion. (Student t test, p<0. 05 and t ympanic membrane appear more towards normalcy (Fisher’s exact test, p<0. 05 in those children after one year. CONCLUSION: The insertion of ventilation tube after myringotomy has not much beneficial effects on hearing in long - term. Ventilation tubes also c ause pathological changes in the tympanic membrane such as tympanosclerosis and perforation.

  4. Tube feeding in dementia: how incentives undermine health care quality and patient safety.

    Science.gov (United States)

    Finucane, Thomas E; Christmas, Colleen; Leff, Bruce A

    2007-05-01

    For nursing home residents with advanced dementia, very little evidence is available to show clinical benefit from enteral tube feeding. Although no randomized clinical trials have been done, considerable evidence from studies of weaker design strongly suggest that tube feeding does not reduce the risks of death, aspiration pneumonia, pressure ulcers, other infections, or poor functional outcome. Nationally, however, utilization is high and highly variable. System-wide incentives favor use of tube feeding, and may influence substitute decision-makers, bedside clinicians, gastroenterologists, and administrators regardless of patient preferences or putative medical indications. Underlying the widespread use of this marginally effective therapy is a basic misunderstanding about malnutrition and about aspiration pneumonia. The face value of tube feeding is strong indeed. In addition to the general faith in intervention, the impulse to "do something" when things are going poorly, financial incentives favor tube feeding for gastroenterologists, hospitals, and nursing homes. The desire to avoid regulatory sanctions, bad publicity, and liability exposure creates a further incentive for nursing homes to provide tube feeding. Rational, evidence-based use of tube feeding in advanced dementia will depend fundamentally on improved education. Reimbursement schemes require significant modification to limit the irrational use of tube feeding. Nursing home regulations based more securely on scientific evidence would likely reduce nonbeneficial tube feeding, as would evidence-based tort reform. Quality improvement initiatives could create positive incentives. Realigning incentives in these ways could, we believe, improve the quality of care, quality of life, and safety of these vulnerable individuals, likely with reduced costs of care.

  5. Use of Noninvasive Ventilation During Feeding Tube Placement.

    Science.gov (United States)

    Banfi, Paolo; Volpato, Eleonora; Valota, Chiara; D'Ascenzo, Salvatore; Alunno, Chiara Bani; Lax, Agata; Nicolini, Antonello; Ticozzi, Nicola; Silani, Vincenzo; Bach, John R

    2017-08-14

    Parenteral nutrition is indicated in amyotrophic lateral sclerosis (ALS) when dysphagia, loss of appetite, and difficulty protecting the airways cause malnutrition, severe weight loss, dehydration, and increased risk of aspiration pneumonia. The aim of this review is to compare percutaneous endoscopic gastrostomy (PEG), radiologically inserted G-tube (RIG), and percutaneous radiologic gastrostomy (PRG) in patients with ALS, performed with or without noninvasive ventilation (NIV). We searched PubMed, MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), the EBSCO Online Research Database, and Scopus up to December 2015. A priori selection included all randomized controlled trials (RCTs), quasi-randomized trials, and prospective and retrospective studies. The primary outcome was 30-d survival. We found no RCTs or quasi-RCTs. Seven studies about the implementation of the PEG/RIG procedure during the use of NIV and 5 studies without NIV were included. In another study of 59 subjects undergoing open gastrostomy, all with vital capacity < 30% of normal, 18 of whom were dependent on continuous NIV at full ventilatory support settings, there were no respiratory complications. Thus, the use of NIV during the implementation of these procedures, especially when used at full ventilatory support settings of pressure preset 18 -25 cm H2O, can support alveolar ventilation before, during, and after the procedures and prevent respiratory complications. The procedures investigated appear equivalent, but the methodological quality of the studies could be improved. Possible benefits with regard to nutrition parameters, quality of life, and psychological features need to be further investigated. Copyright © 2017 by Daedalus Enterprises.

  6. Post-pyloric versus gastric tube feeding for preventing pneumonia and improving nutritional outcomes in critically ill adults.

    Science.gov (United States)

    Alkhawaja, Sana; Martin, Claudio; Butler, Ronald J; Gwadry-Sridhar, Femida

    2015-08-04

    patient by post-pyloric feeding (mean difference (MD) 7.8%, 95% CI 1.43 to 14.18).Evidence of moderate quality revealed no differences in duration of mechanical ventilation or in mortality. Intensive care unit (ICU) length of stay was similar between the two groups. The effect on the time required to achieve the full nutrition target was uncertain (MD -1.99 hours 95% CI -10.97 to 6.99) (very low-quality evidence). We found no evidence suggesting an increase in the rate of complications during insertion or maintenance of the tube in the post-pyloric group (RR 0.51, 95% CI 0.19 to 1.364; RR1.63, 95% CI 0.93 to 2.86, respectively); evidence was assessed as being of low quality for both.Risk of bias was generally low in most studies, and review authors expressed concern regarding lack of blinding of the caregiver in most trials. We found moderate-quality evidence of a 30% lower rate of pneumonia associated with post-pyloric feeding and low-quality evidence suggesting an increase in the amount of nutrition delivered to these participants. We do not have sufficient evidence to show that other clinically important outcomes such as duration of mechanical ventilation, mortality and length of stay were affected by the site of tube feeding.Low-quality evidence suggests that insertion of a post-pyloric feeding tube appears to be safe and was not associated with increased complications when compared with gastric tube insertion. Placement of the post-pyloric tube can present challenges; the procedure is technically difficult, requiring expertise and sophisticated radiological or endoscopic assistance.We recommend that use of a post-pyloric feeding tube may be preferred for ICU patients for whom placement of the post-pyloric feeding tube is feasible. Findings of this review preclude recommendations regarding the best method for placing the post-pyloric feeding tube. The clinician is left with this decision, which should be based on the policies of institutional facilities and should be

  7. 一次性经鼻喂养管在临床上的应用%Disposable Nasal Feeding Tube in the Clinical Application

    Institute of Scientific and Technical Information of China (English)

    王艳红; 刘亚波

    2014-01-01

    Objective To explore the application of disposable nasal feeding tube in the clinic. Methods From 2012 to June to 2013 May in our department were needed indwel ing gastric tube, no nasal septum curves, no esophageal and gastric varices in 30 patients with nasal feeding tube placement of nasogastric tube disposable. Results 30 patients were successful y inserted into the nasal feeding tube. Conclusion The disposable nasal feeding tube can improve the success rate, reduce the pain of patients.%目的:探讨一次性经鼻喂养管在临床上的应用。方法对2012年6月~2013年5月我科收治需留置胃管,无鼻中隔弯曲,无食管胃底静脉曲张共30例患者改用一次性经鼻喂养管放置胃管。结果30例患者中均一次成功置入鼻胃养管。结论一次性经鼻喂养管可提高成功率,减轻患者的痛苦。

  8. A Heuristic Force Model for Haptic Simulation of Nasogastric Tube Insertion Using Fuzzy Logic.

    Science.gov (United States)

    Choi, Kup-Sze; He, Xue-Jian; Chiang, Vico C L; Deng, Zhaohong; Qin, Jing

    2016-01-01

    Nasogastric tube (NGT) placement is an essential clinical skill. The training is conventionally performed on rubber mannequins albeit practical limitations. Computer simulation with haptic feedback can potentially offer a more realistic and accessible training method. However, the complex interactions between the tube and the nasogastric passage make it difficult to model the haptic feedback during NGT placement. In this paper, a fuzzy-logic-based approach is proposed to directly transfer the experience of clinicians in NGT placement into the simulation system. Based on their perception of the varying tactile sensation and the conditions during NGT placement, the membership functions and fuzzy rules are defined to develop the force model. Forces created using the model are then combined with friction forces to drive the haptic device and render the insertion forces in real time. A prototype simulator is developed based on the proposed force model and the implementation details are presented. The usability of the prototype is also evaluated by clinical teachers. The proposed methodology has the potential for developing computerized NGT placement training methods for clinical education. It is also applicable for simulation systems involving complicated force interactions or computation-expensive models.

  9. Pneumonia Frequencies with Different Enteral Tube Feeding Access Sites.

    Science.gov (United States)

    Taylor, Henry M.

    2002-01-01

    Over a 24-month period, 25 adults with mental retardation being fed via a gastrostomy tube experienced 40 cases of pneumonia during 508 person-months of observations, whereas 5 individuals being fed via a jejunostromy tube did not experience any pneumonia during 96 person-months of observation. (Contains references.) (Author/CR)

  10. Airway management using laryngeal mask airway in insertion of the Montgomery tracheal tube for subglottic stenosis -A case report-.

    Science.gov (United States)

    Park, Jung Sun; Kwon, Young-Suk; Lee, Sangseock; Yon, Jun Heum; Kim, Dong Won

    2010-12-01

    The Montgomery tracheal tube (T-tube) is a device used as a combined tracheal stent and airway after laryngotracheoplasty for patients with tracheal stenosis. This device can present various challenges to anesthesiologists during its placement, including the potential for acute loss of the airway, inadequate administration of inhalation agents, and inadequacy of controlled mechanical ventilation. The present case of successful airway management used a laryngeal mask airway under total intravenous anesthesia with propofol and remifentanil in the insertion of a Montgomery T-tube in a tracheal resection and thyrotracheal anastomosis because of severe subglottic stenosis.

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

    Science.gov (United States)

    Hurrell, Edward; Kucerova, Eva; Loughlin, Michael; Caubilla-Barron, Juncal; Hilton, Anthony; Armstrong, Richard; Smith, Craig; Grant, Judith; Shoo, Shiu; Forsythe, Stephen

    2009-09-01

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

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

    Directory of Open Access Journals (Sweden)

    Smith Craig

    2009-09-01

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

  13. Utilization of Feeding Tubes in the Management of Feline Chronic Kidney Disease.

    Science.gov (United States)

    Ross, Sheri

    2016-11-01

    Esophagostomy feeding tubes are useful, and in many cases essential, for the comprehensive management of cats with moderate to advanced chronic kidney disease (CKD). They should be considered a lifelong therapeutic appliance to facilitate the global management of cats with CKD thus providing improved therapeutic efficacy and quality-of-life. Esophagostomy tubes facilitate the maintenance of adequate hydration and increase owner compliance by facilitating the administration of medications. Finally, feeding tubes provide a means to deliver a stage-appropriate dietary prescription for cats with CKD and maintain an adequate nutritional plane in a patient that otherwise would be subject to chronic wasting.

  14. [Reducing the Feeding-Tube Obstruction Rate in Esophageal Cancer Patients With Jejunostomy].

    Science.gov (United States)

    Chin, Ying-Chun; Hsieh, Pei-Yin; Chang, Tsyr-Huei

    2015-06-01

    Patients with esophageal cancer experience chronic dysphagia. This condition typically necessitates the use of a jejunal feeding tube to provide the patient with adequate nutrition. Obstruction of the jejunal feeding tube is common in clinical practice and results in malnutrition in most patients and mortality in the most serious cases. An analysis of the status of jejunostomy-tube use in our unit found that these tubes were obstructed in 27.6% of the cases. The causes of this obstruction were: tube bending due to tight suturing, small inner-tube diameter, the absence of adequate jejunal-feeding standards, and failure to implement relevant training strategies. These findings motivated us to attempt to reduce the incidence of jejunostomy-tube obstruction at our center. This project was designed to reduce the incidence of jejunostomy-tube obstruction in esophageal cancer patients from 27.6% to ≤ 3%. Clear strategies, including modification of the stitching method used at the implantation end of the central venous catheter-type jejunostomy tube, establishment of feeding standards, creation of educational guidelines and leaflets, classroom teaching, and technical examinations, were used to reduce the prevalence of obstruction incidents. The jejunostomy-tube obstruction rate was reduced from 27.6% to 6.7%. While the study objective was not achieved, the magnitude of the reduction was still significant at 75.7%. Cross-disciplinary collaboration, continuous education and training, and the promotion of standards of practice were used to significantly reduce the jejunostomy tube obstruction rate in esophageal cancer patients. This result substantially increased the nutrition and quality of care received by this patient population.

  15. Continuous versus bolus tube feeds: Does the modality affect glycemic variability, tube feeding volume, caloric intake, or insulin utilization?

    Science.gov (United States)

    Evans, David C; Forbes, Rachel; Jones, Christian; Cotterman, Robert; Njoku, Chinedu; Thongrong, Cattleya; Tulman, David; Bergese, Sergio D; Thomas, Sheela; Papadimos, Thomas J; Stawicki, Stanislaw P

    2016-01-01

    Introduction: Enteral nutrition (EN) is very important to optimizing outcomes in critical illness. Debate exists regarding the best strategy for enteral tube feeding (TF), with concerns that bolus TF (BTF) may increase glycemic variability (GV) but result in fewer nutritional interruptions than continuous TF (CTF). This study examines if there is a difference in GV, insulin usage, TF volume, and caloric delivery among intensive care patients receiving BTF versus CTF. We hypothesize that there are no significant differences between CTF and BTF when comparing the above parameters. Materials and Methods: Prospective, randomized pilot study of critically ill adult patients undergoing percutaneous endoscopic gastrostomy (PEG) placement for EN was performed between March 1, 2012 and May 15, 2014. Patients were randomized to BTF or CTF. Glucose values, insulin use, TF volume, and calories administered were recorded. Data were organized into 12-h epochs for statistical analyses and GV determination. In addition, time to ≥80% nutritional delivery goal, demographics, Acute Physiology and Chronic Health Evaluation II scores, and TF interruptions were examined. When performing BTF versus CTF assessments, continuous parameters were compared using Mann–Whitney U-test or repeated measures t-test, as appropriate. Categorical data were analyzed using Fisher's exact test. Results: No significant demographic or physiologic differences between the CTF (n = 24) and BTF (n = 26) groups were seen. The immediate post-PEG 12-h epoch showed significantly lower GV and median TF volume for patients in the CTF group. All subsequent epochs (up to 18 days post-PEG) showed no differences in GV, insulin use, TF volume, or caloric intake. Insulin use for both groups increased when comparing the first 24 h post-PEG values to measurements from day 8. There were no differences in TF interruptions, time to ≥80% nutritional delivery goal, or hypoglycemic episodes. Conclusions: This study

  16. Fabrication of flexible photonic crystal using alumina ball inserted Teflon tube

    Science.gov (United States)

    Watanabe, Yoshimi; Hotta, Takehiro; Sato, Hisashi

    2010-09-01

    In our previous paper, it was found that cotton yarn/TiO2-dispersed resin photonic crystals were fabricated successfully by applying textile technology. However, it is difficult to apply for practical use because these photonic crystals cannot change their shape flexibly. In this study, we fabricate the flexible photonic crystals using high-dielectric constant fibers. The high-dielectric constant fibers were made by inserting alumina balls into Teflon tubes. The crossed linear-fiber laminated fabric and multilayered woven fabric with an fcc lattice structure were structured by aligning high-dielectric constant fibers periodically. These photonic crystals consist of air and high-dielectric constant fibers. The attenuation of transmission amplitude through the photonic crystals was measured. The photonic crystal of crossed linear-fiber laminated fabric exhibits a forbidden gap in the range from 16 to 18 GHz range. On the other hand, the photonic crystal of multilayered woven fabric, which was fabricated by the same parameter with crossed linear-fiber laminated fabric, also exhibits a forbidden gap in the range from 13 to 16 GHz range. Thus, we can successfully fabricate flexible photonic crystals of woven fabric using high-dielectric constant fibers.

  17. Visualization of oscillating flow in a double-inlet pulse tube refrigerator with a diaphragm inserted in a bypass-tube

    Science.gov (United States)

    Shiraishi, Masao; Murakami, Masahide

    2012-07-01

    The double-inlet pulse tube refrigerator that has a diaphragm inserted in a bypass-tube, which enabled it to transmit a pressure oscillation whereas to obstruct a DC gas flow, was manufactured and tested. The oscillating flow behavior inside of the refrigerator was studied by using a smoke-wire flow visualization technique. It was found that if the diaphragm was optimized, the performance would be improved more than that of the refrigerator with a bypass valve due to the increase in the P-V work of the gas and the decrease in the convective heat loss caused by a secondary flow.

  18. Peristaltic pumping in an elastic tube: feeding the hungry python

    Science.gov (United States)

    Takagi, Daisuke; Balmforth, Neil

    2010-11-01

    Biological ducts convey contents like food in the digestive system by peristaltic action, propagating waves of muscular contraction and relaxation. The motion is investigated theoretically by considering a radial force of sinusoidal or Gaussian form moving steadily down a fluid-filled axisymmetric tube. Effects of the prescribed force on the resultant fluid flow and elastic deformation of the tube wall are presented. The flow can induce a rigid object suspended in the fluid to propel in different ways, as demonstrated in numerous examples.

  19. The Importance of Pharmaceutical Dosage Forms in Administration via Enteral Feeding Tubes

    Directory of Open Access Journals (Sweden)

    Kutay Demirkan

    2016-04-01

    Full Text Available SUMMARY A caloric requirement of the patients who do not have an access for feeding through an oral route is supported by enteral or parenteral nutrition. In the patients who have suitable gastrointestinal function, enteral feeding is preferred initially. Enteral feeding is also used for administration of medications in patients who cannot swallow. However, an administration of drugs via a feeding tube is complicated; appropriate techniques should be used in order to prevent obstruction of feeding tube and thereby avoid reduction of the drug effect and to minimize the risk of toxicity of given pharmaceuticals. In the patients who are not able to take medication orally, alternative routes such as intravenous, intramuscular, subcutaneous, inhaled, transdermal, rectal, and sublingual administrations are available and should be preferred at the first place. According to the American Society for Parenteral and Enteral Nutrition, an effect of a size and the position of the feeding tube, characteristics of pharmaceutical dosage form and methods of administration should be considered when applying medication via enteral tube. The risk of the drug interactions arises in patients who have nutritional support. In order to prevent drug interactions, a pharmacist, who has an extensive education and knowledge on drugs, its characteristics and mechanism of action is required for multidisciplinary team in clinical practice.

  20. Heat transfer enhancement in smooth tube with wire coil insert in laminar and transitional non-newtonian flow

    OpenAIRE

    García Pinar, Alberto; Solano Fernández, Juan Pedro; Viedma Robles, Antonio; Martínez Hernández, David Sebastián

    2010-01-01

    This work presents an experimental study on the heat transfer enhancement by means of a tube with wire-coil insert,for non-Newtonian laminar and transitional flow. The dimensionless pitch and wire diameter (based on the plain tube inner diameter) were chosen as p/D= 1 and e/D=0.09. Two pseudoplastic test fluids have been used: 1% by weight aqueous solutions of carboxymethyl cellulose (CMC) with high viscosity and medium viscosity. A wide range of flow conditions has been covered: Reynolds ...

  1. Retortable Laminate/Polymeric Food Tubes for Specialized Feeding

    Science.gov (United States)

    2012-06-01

    Advanced Food Technology School of Enviromental and Biological Sciences New Brunswick, NJ 08903 FTR 303 Defense Logistics Agency 8725 John J. Kingsman Rd...quality issues have elevated concerns over the future availability and viability of this critically important item. Quality, erosion, and availability... issues or production delays leading to loss of this tube supply source are of extreme concern to the military, as the missions which they support

  2. Efficacy of crushed lanthanum carbonate for hyperphosphatemia in hemodialysis patients undergoing tube feeding.

    Science.gov (United States)

    Kitajima, Yukie; Takahashi, Taeko; Sato, Yuzuru; Nakaya, Yutaka

    2011-08-01

    Lanthanum carbonate (LaC) is a non-calcium-based phosphate binder used to treat hyperphosphatemia in patients with chronic kidney disease. Oral administration of LaC is difficult in patients undergoing tube feeding or those who are of advanced age because it is essential to chew the LaC tablet sufficiently before swallowing it. We report two cases in whom crushed LaC was used in hemodialysis patients undergoing tube feeding. In both cases, previously crushed LaC was mixed into enteral nutrients. We found that LaC administered this way was effective for decreasing serum phosphorus levels.

  3. The chest tube inserted into the stomach after a transthoracic operation for esophageal cancer:case report

    Institute of Scientific and Technical Information of China (English)

    HAN Wei-li; ZHA Yu-xin; LI Ren-yuan; NI Yi-ming; LUO Wen-zong

    2007-01-01

    @@ Surgical complications after the transthoracic operation for esophageal cancer mainly include anastomatic fistula, thoraco-stomach fistula, stenosis of anastomosis,gastric perforation, gastric volvulus, diaphragmatic hernia,wound infection, and some other pulmonary complications. Unfortunately, there are few reports about the complications caused by position change of the chest tube until now. We presented an unusual case of a patient who underwent a transthoracic operation for esophageal cancer in our department on August 17, 2006, and a lot of intragastric material was found in his chest tube 17 days later, endoscopic examination suggested that the chest tube had inserted into the stomach. We tried to discuss the etiology and clinical management for this case as well.

  4. The effects of oral sucrose on pain due to nasogastric tube insertion in premature infants: A crossover clinical trial

    Directory of Open Access Journals (Sweden)

    Jebreili M

    2014-11-01

    Full Text Available Background and Objective: Pain in neonates may have adverse impacts. Therefore, relieving pain through harmless, simple, and applicable methods, in order to prevent its dangerous consequences, is of great importance. The aim of the present study is to determine the impact of oral sucrose on relieving nasogastric tube insertion pain in premature neonates. Materials and Method: The present study is a crossover clinical trial on 38 preterm infants (gestational age between 28-34 weeks hospitalized in Bistonoh-e-Bahman Hospital, Tabriz, Iran, in 2013. The subjects were selected by convenience sampling and divided into two groups using randomized block design. In the first group, nasogastric tube insertion was carried out in the routine way for the first time, and for the second time, by administration of oral sucrose. In the second group, the procedure was performed in the reverse order of that in the first group. In both groups the emerging pain was measured by the Premature Infant Pain Profile (PIPP tool 2 minutes before, during, and 5 minutes after the procedure. Data were analyzed using, chi-square t-test, Students' independent test, paired t-test, and repeated measures ANOVA in SPSS version 18 to examine the trend of change in pain in time. P values of less than 0.05 were considered statistically significant. Results: The results showed that oral sucrose reduces the pain response of infants. The mean pain score during the insertion of nasogastric tube and administration of oral sucrose was 5.95 ± 2.35 and during routine procedures was 9.93 ± 2.89 (P < 0.001. The mean pain score 5 minutes after insertion of nasogastric tube with administration of oral sucrose was 3.66 ± 0.57 and routine procedure was 6.38 ± 0.83 (P = 0.017. Conclusion: It was revealed that oral sucrose can relieve pain caused by nasogastric tube insertion. Therefore, its implementation as a harmless and simple method can reduce pain in preterm infants.

  5. Enteral-tube-feeding diarrhoea: manipulating the colonic microbiota with probiotics and prebiotics.

    Science.gov (United States)

    Whelan, Kevin

    2007-08-01

    Diarrhoea is a common and serious complication of enteral tube feeding. Its pathogenesis involves antibiotic prescription, enteropathogenic colonization and abnormal colonic responses, all of which involve an interaction with the colonic microbiota. Alterations in the colonic microbiota have been identified in patients receiving enteral tube feeding and these changes may be associated with the incidence of diarrhoea. Preventing negative alterations in the colonic microbiota has therefore been investigated as a method of reducing the incidence of diarrhoea. Probiotics and prebiotics may be effective because of their suppression of enteropathogenic colonization, stimulation of immune function and modulation of colonic metabolism. Randomized controlled trials of probiotics have produced contrasting results, although Saccharomyces boulardii has been shown to reduce the incidence of diarrhoea in patients in the intensive care unit receiving enteral tube feeding. Prebiotic fructo-oligosaccharides have been shown to increase the concentration of faecal bifidobacteria in healthy subjects consuming enteral formula, although this finding has not yet been confirmed in patients receiving enteral tube feeding. Furthermore, there are no clinical trials investigating the effect of a prebiotic alone on the incidence of diarrhoea. Further trials of the efficacy of probiotics and prebiotics, alone and in combination, in preventing diarrhoea in this patient group are warranted.

  6. Comparing insertion characteristics on nasogastric tube placement by using GlideScopeTM visualization vs. MacIntosh laryngoscope assistance in anaesthetized and intubated patients

    Directory of Open Access Journals (Sweden)

    Wan Hafsah Wan Ibadullah

    Full Text Available Abstract Background and objective: This was a prospective, randomized clinical study to compare the success rate of nasogastric tube insertion by using GlideScopeTM visualization versus direct MacIntosh laryngoscope assistance in anesthetized and intubated patients. Methods: Ninety-six ASA I or II patients, aged 18-70 years were recruited and randomized into two groups using either technique. The time taken from insertion of the nasogastric tube from the nostril until the calculated length of tube had been inserted was recorded. The success rate of nasogastric tube insertion was evaluated in terms of successful insertion in the first attempt. Complications associated with the insertion techniques were recorded. Results: The results showed success rates of 74.5% in the GlideScopeTM Group as compared to 58.3% in the MacIntosh Group (p = 0.10. For the failed attempts, the nasogastric tube was successfully inserted in all cases using rescue techniques. The duration taken in the first attempt for both techniques was not statistically significant; Group A was 17.2 ± 9.3 s as compared to Group B, with a duration of 18.9 ± 13.0 s (p = 0.57. A total of 33 patients developed complications during insertion of the nasogastric tube, 39.4% in Group A and 60.6% in Group B (p = 0.15. The most common complications, which occurred, were coiling, followed by bleeding and kinking. Conclusion: This study showed that using the GlideScopeTM to facilitate nasogastric tube insertion was comparable to the use of the MacIntosh laryngoscope in terms of successful rate of insertion and complications.

  7. Comparing insertion characteristics on nasogastric tube placement by using GlideScope™ visualization vs. MacIntosh laryngoscope assistance in anaesthetized and intubated patients.

    Science.gov (United States)

    Wan Ibadullah, Wan Hafsah; Yahya, Nurlia; Ghazali, Siti Salmah; Kamaruzaman, Esa; Yong, Liu Chian; Dan, Adnan; Md Zain, Jaafar

    2016-01-01

    This was a prospective, randomized clinical study to compare the success rate of nasogastric tube insertion by using GlideScope™ visualization versus direct MacIntosh laryngoscope assistance in anesthetized and intubated patients. Ninety-six ASA I or II patients, aged 18-70 years were recruited and randomized into two groups using either technique. The time taken from insertion of the nasogastric tube from the nostril until the calculated length of tube had been inserted was recorded. The success rate of nasogastric tube insertion was evaluated in terms of successful insertion in the first attempt. Complications associated with the insertion techniques were recorded. The results showed success rates of 74.5% in the GlideScope™ Group as compared to 58.3% in the MacIntosh Group (p=0.10). For the failed attempts, the nasogastric tube was successfully inserted in all cases using rescue techniques. The duration taken in the first attempt for both techniques was not statistically significant; Group A was 17.2±9.3s as compared to Group B, with a duration of 18.9±13.0s (p=0.57). A total of 33 patients developed complications during insertion of the nasogastric tube, 39.4% in Group A and 60.6% in Group B (p=0.15). The most common complications, which occurred, were coiling, followed by bleeding and kinking. This study showed that using the GlideScope™ to facilitate nasogastric tube insertion was comparable to the use of the MacIntosh laryngoscope in terms of successful rate of insertion and complications. Copyright © 2015 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

  8. App-based serious gaming for training of chest tube insertion: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Friedrich, Mirco; Bergdolt, Christian; Haubruck, Patrick; Bruckner, Thomas; Kowalewski, Karl-Friedrich; Müller-Stich, Beat Peter; Tanner, Michael C; Nickel, Felix

    2017-02-06

    Chest tube insertion is a standard intervention for management of various injuries of the thorax. Quick and accurate execution facilitates efficient therapy without further complications. Here, we propose a new training concept comprised of e-learning elements as well as continuous rating using an objective structured assessment of technical skills (OSATS) tool. The study protocol is presented for a randomized trial to evaluate e-learning with app-based serious gaming for chest drain insertion. The proposed randomized trial will be carried out at the Department of Orthopedics and Traumatology at Heidelberg University in the context of regular curricular teaching for medical students (n = 90, 3rd to 6th year). The intervention group will use e-learning with the serious gaming app Touch Surgery (TM) for chest drain insertion, whereas the control group uses serious gaming for an unrelated procedure. Primary endpoint is operative performance of chest drain insertion in a porcine cadaveric model according to OSATS. The randomized trial will help determine the value of e-learning with the serious gaming app Touch Surgery (TM) for chest drain insertion by using the OSATS score. The study will improve surgical training for trauma situations. Trial Registration Number, DRKS00009994 . Registered on 27 May 2016.

  9. Metabolic assessment and enteral tube feeding usage in children with acute neurological diseases

    Directory of Open Access Journals (Sweden)

    Heitor Pons Leite

    Full Text Available OBJECTIVE: To report on acquired experience of metabolic support for children with acute neurological diseases, emphasizing enteral tube feeding usage and metabolic assessment, and also to recommend policies aimed towards improving its implementation. DESIGN: Retrospective analysis. SETTING: Pediatric Intensive Care Unit of Hospital do Servidor Público Estadual de São Paulo. SUBJECTS: 44 patients consecutively admitted to the Pediatric ICU over a period of 3 years who were given nutrition and metabolic support for at least 72 hours. Head trauma, CNS infections and craniotomy post-operative period following tumor exeresis were the main diagnoses. MEASUREMENTS: Records of protein-energy intake, nutrient supply route, nitrogen balance and length of therapy. RESULTS: From a total of 527 days of therapy, single parenteral nutrition was utilized for 34.3% and single enteral tube feeding for 79.1% of that period. 61.4% of the children were fed exclusively via enteral tube feeding, 9.1% via parenteral and 39.5 % by both routes. The enteral tube feeding was introduced upon admission and transpyloric placement was successful in 90% of the cases. Feeding was started 48 hours after ICU admission. The caloric goal was achieved on the 7th day after admission, and thereafter parenteral nutrition was interrupted. The maximum energy supply was 104.2 ± 23.15 kcal/kg. The median length of therapy was 11 days (range 4-38. None of the patients on tube feeding developed GI tract bleeding, pneumonia or bronchoaspiration episodes and, of the 4 patients who were given exclusive TPN, 2 developed peptic ulcer. The initial urinary urea nitrogen was 7.11 g/m2 and at discharge 6.44 g/m2. The protein supply increased from 1.49 g/kg to 3.65 g/kg (p< 0.01. The nitrogen balance increased from -7.05 to 2.2 g (p< 0.01. CONCLUSIONS: Children with acute neurological diseases are hypercatabolic and have high urinary nitrogen losses. The initial negative nitrogen balance can be

  10. Negotiating mothering against the odds: gastrostomy tube feeding, stigma, governmentality and disabled children.

    Science.gov (United States)

    Craig, Gillian M; Scambler, Graham

    2006-03-01

    Using the findings of a small-scale qualitative investigation based on in-depth interviews with mothers attending a tertiary paediatric referral centre in London, this paper explores professional and parental discourses in relation to gastrostomy tube feeding and disabled children. Detailed accounts are given of women's struggles to negotiate their identities, and those of their children, within dominant discourses of mothering and child-centredness. Constructions of feeding practices as coercive conflict with normative expectations of 'good mothering' and the 'idealised autonomous' child. Although notions of 'stigmatised identities' featured in women's accounts of feeding children, both orally and by tube, stigma fails to explain why mothers are rendered culpable within expert discourses. Prevailing theories of stigma and coping are interrogated and judged to be more descriptive than explanatory. Felt stigma is posited as an aspect of governmentality.

  11. Pars plana Baerveldt tube insertion with pars plana vitrectomy for refractory glaucoma

    Directory of Open Access Journals (Sweden)

    Anton M Kolomeyer

    2012-01-01

    Conclusions: Pars plana Baerveldt tube implantation with PPV can preserve vision, reduce IOP, and decrease the number of glaucoma medications necessary to achieve target IOP in patients with recalcitrant glaucoma.

  12. Outcomes of percutaneous endoscopic gastrostomy tube insertion in respiratory impaired amyotrophic lateral sclerosis patients under noninvasive ventilation.

    Science.gov (United States)

    Czell, David; Bauer, Matthias; Binek, Janek; Schoch, Otto D; Weber, Markus

    2013-05-01

    Percutaneous endoscopic gastrostomy (PEG) tube placement in amyotrophic lateral sclerosis (ALS) patients with impaired respiratory function is associated with an increased risk of peri-procedural and post-interventional complications. It was the aim of the study to analyze peri- and post-interventional complications and survival after PEG tube placement under noninvasive ventilation (NIV) in ALS patients with various degrees of respiratory impairment. Twenty-six subjects were included in this retrospective case study. Prior to PEG tube placement, training with ventilatory support via an oronasal mask was performed with ALS subjects on the pneumology ward. PEG placement was then performed under continuous NIV. FVC, sniff nasal inspiratory pressure, and demographic data were assessed. Complication rates and 1-month and overall survival rates were analyzed. There were no deaths within 24 hours after PEG placement. One subject died within the first month. The mean survival rate after PEG was 12 ± 10 months (range 0.6-42 months). There was no difference in post-PEG survival between subjects with moderately (> 50%) and severely (< 50%) impaired FVC. In this case series, PEG tube insertion was associated with minimal peri- and post-procedural complications. The low complication rate might be due to the systematic use of procedural NIV in ALS subjects.

  13. Family Experiences With Feeding Tubes in Neurologic Impairment: A Systematic Review.

    Science.gov (United States)

    Nelson, Katherine E; Lacombe-Duncan, Ashley; Cohen, Eyal; Nicholas, David B; Rosella, Laura C; Guttmann, Astrid; Mahant, Sanjay

    2015-07-01

    Gastrostomy tubes (G-tubes) are frequently used to provide enteral nutrition for children who have neurologic impairment. Understanding the impact of G-tubes from the family's perspective will inform decision-making and improve support from health care providers. This study explored the experiences of families after G-tube placement in children with neurologic impairment. We conducted a systematic review of English-language qualitative primary research studies describing family experiences after G-tube placement. Six electronic databases were searched from inception to June 2014. Two authors independently screened and identified relevant studies, evaluated quality of reporting by using the Consolidated Criteria for Reporting Qualitative Research tool, and extracted data. Overarching concepts were developed by using thematic analysis. From 2674 screened abstracts, 84 texts were reviewed, and 13 studies met the inclusion criteria. G-tubes affect the lives of children, parents, and the family unit in many ways, both positive and negative. Improvements and challenges were described for children's health and happiness, for parental caregiving and stress, and for logistics and bonding within the family. G-tube feeding also changed relationships within the family, between the family and the medical system, and between the family and the outside world. Furthermore, experiences varied, with different families framing similar concepts as positive and negative. G-tube placement has diverse effects on daily life for children with neurologic impairment and their families. Clinicians may use the themes identified in this study to guide conversations with families about their values, experiences, and expectations before and after G-tube placement. Copyright © 2015 by the American Academy of Pediatrics.

  14. Loss of feed flow, steam generator tube rupture and steam line break thermohydraulic experiments

    Energy Technology Data Exchange (ETDEWEB)

    Mendler, O J; Takeuchi, K; Young, M Y

    1986-10-01

    The Westinghouse Model Boiler No. 2 (MB-2) steam generator test model at the Engineering Test Facility in Tampa, Florida, was reinstrumented and modified for performing a series of tests simulating steam generator accident transients. The transients simulated were: loss of feed flow, steam generator tube rupture, and steam line break events. This document presents a description of (1) the model boiler and the associated test facility, (2) the tests performed, and (3) the analyses of the test results.

  15. Experimental investigation of heat transfer and pressure drop of turbulent flow inside tube with inserted helical coils

    Science.gov (United States)

    Sharafeldeen, M. A.; Berbish, N. S.; Moawed, M. A.; Ali, R. K.

    2016-08-01

    The heat transfer and pressure drop were experimentally investigated in a coiled wire inserted tube in turbulent flow regime in the range of Reynolds number of 14,400 ≤ Re ≤ 42,900. The present work aims to extend the experimental data available on wire coil inserts to cover wire diameter ratio of 0.044 ≤ e/d ≤ 0.133 and coil pitch ratio of 1 ≤ p/d ≤ 5. Uniform heat flux was applied to the external surface of the tube and air was selected as fluid. The effects of Reynolds number and wire diameter and coil pitch ratios on the Nusselt number and friction factor were studied. The enhancement efficiency and performance criteria ranges are of (46.9-82.6 %) and (100.1-128 %) within the investigated range of the different parameters, respectively. Correlations are obtained for the average Nusselt number and friction factor utilizing the present measurements within the investigated range of geometrical parameters and Re. The maximum deviation between correlated and experimental values for Nusselt number and friction factor are ±5 and ±6 %, respectively.

  16. Resource utilization after implementing a hospital-wide standardized feeding tube placement pathway.

    Science.gov (United States)

    Richards, Morgan K; Li, Christopher I; Foti, Jeffrey L; Leu, Michael G; Wahbeh, Ghassan T; Shaw, Dennis; Libby, Arlene K; Melzer, Lilah; Goldin, Adam B

    2016-10-01

    Children requiring gastrostomy/gastrojejunostomy tubes (GT/GJ) are heterogeneous and medically complex patients with high resource utilization. We created and implemented a hospital-wide standardized pathway for feeding device placement. This study compares hospital resource utilization before and after pathway implementation. We performed a retrospective cohort study comparing outcomes through one year of follow-up for consecutive groups of children undergoing GT/GJ placement prepathway (n=298, 1/1/2010-12/31/2011) and postpathway (n=140, 6/1/2013-7/31/2014) implementation. We determined the change in the rate of hospital resource utilization events and time to first event. Prior to implementation, 145 (48.7%) devices were placed surgically, 113 (37.9%) endoscopically and 40 (13.4%) using image guidance. After implementation, 102 (72.9%) were placed surgically, 23 (16.4%) endoscopically and 15 (10.7%) using image guidance. Prior to implementation, 174/298 (58.4%) patients required additional hospital resource utilization compared to 60/143 (42.0%) corresponding to a multivariate adjusted 38% reduced risk of a subsequent feeding tube related event. Care of tube-feeding dependent patients is spread among multiple specialists leading to variability in the preoperative workup, intraoperative technique and postoperative care. Our study shows an association between implementation of a standardized pathway and a decrease in hospital resource utilization. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. [A prospective randomized study of the usefulness of weighted versus unweighted feeding tubes. A comparison of the transpyloric passage capacity, duration time and the signs of intolerance for enteral nutrition].

    Science.gov (United States)

    Jiménez, C; González-Huix, F; Auger, E; Bou, R; Pons, N; Vila, N; Figa, M; Acero, D

    1993-04-01

    Weighted feeding tubes for parenteral nutrition were designed to facilitate duodenal intubation and to reduce the risk of aspiration into the bronchi. The goal of the study was to compare the effectiveness of two types of tubes, weighted and unweighted, with regard to their ability to pass the pylorus in 24 hours' time, the time they remained, their involuntary detubation percentages, and the appearance of signs of digestive intolerance during enteral nutrition. Only patients who preserved some level of consciousness were included. Thirty-eight were fitted with weighted tubes, and 32 with unweighted tubes. Twenty-four feeding tubes reached the duodenum during the first day. The average time the tubes remained after insertion was 10.2 +/- 1.1 (range of 1-51) days. In 20 patients, the tube left the body unnoticed, and 15 displayed signs of intolerance to enteral nutrition, though it had to be suspended in the case of only 5. Weighted feeding tubes showed greater effectiveness in their duodenal intubation rate (47% versus 19%, p = 0.0058), the time they remained in the body (12.2 +/- 1.7 versus 7.9 +/- 1.1 days; p = 0.037) and their percentage of involuntary detubation (6 weighted tubes and 14 unweighted tubes, p = 0.009). There were no differences between the two tube types with regard to the appearance of signs of digestive intolerance. The weighted tubes that reached the duodenum (n = 18) were those which remained for the longest periods; 73% of them remained for over 8 days.(ABSTRACT TRUNCATED AT 250 WORDS)

  18. Bacterial contamination of blenderized whole food and commercial enteral tube feedings in the Philippines.

    Science.gov (United States)

    Sullivan, M M; Sorreda-Esguerra, P; Santos, E E; Platon, B G; Castro, C G; Idrisalman, E R; Chen, N R; Shott, S; Comer, G M

    2001-12-01

    Hospital-prepared tube feedings from four Philippine acute-care hospitals were analysed for microbial contamination. Two feedings were prepared on three separate days at each hospital. The tube feedings were either blended natural whole foods or a reconstituted commercial powdered nutritional product. Samples of each feeding were collected for coliform count and standard plate count at the time of preparation and at 1, 2 and 4 h after preparation after maintenance at room temperature (26-31 degrees C). At the time of preparation, mean coliform and standard plate counts for all samples were 10.3 most probable number per gram (MPN/g) and 7.4x10(4)colony-forming units per gram (cfu/g), respectively. Nine of 24 samples (38%) had coliform counts greater than 10 MPN/g, and 22/24 (92%) samples had standard plate counts greater than 10(3) cfu/g. There were significant increases in mean coliform and standard plate counts over 4 h (P=0.0005 and P=0.008, respectively). At 4 h after preparation, the mean coliform and standard plate counts were 18.2 MPN/g and 2.1x10(5) cfu/g, respectively. At this time, 18/24 (75%) samples had coliform counts greater than 10 MPN/g and 20/24 (83%) samples had standard plate counts greater than 10(5) cfu/g. The results of this study show that the microbial quality of the majority of the hospital-prepared enteral tube feedings analysed were not within published guidelines for safety.

  19. Maintaining Enteral Nutrition in the Severely Ill using a Newly Developed Nasojejunal Feeding Tube with Gastric Decompression Function.

    Science.gov (United States)

    Toh Yoon, Ezekiel; Nishihara, Kazuki; Murata, Hirohiko

    2016-01-01

    For nutritional support of critically ill patients, the enteral route is preferred over the parenteral route. Although nasojejunal feeding can be superior to gastric feeding when gastrointestinal symptoms occur, it does not necessarily solve the problem of large gastric residual volumes. We report the successful use of a newly developed nasojejunal feeding tube with gastric decompression function in an 84-year-old man with severe pneumonia. After gastric feeding was considered not well tolerated, the use of this tube improved the delivery of nutrition until the patient was stable enough to undergo percutaneous endoscopic gastrostomy.

  20. A descriptive study of nasogastric tube feeding among geriatric inpatients in Malaysia: utilization, complications, and caregiver opinions.

    Science.gov (United States)

    Nordin, Nordiana; Kamaruzzaman, Shahrul Bahyah; Chin, Ai-Vyrn; Poi, Philip J H; Tan, Maw Pin

    2015-01-01

    The strong emphasis on feeding in Asian cultures may influence decisions for nasogastric (NG) tube feeding in geriatric inpatients. We evaluated the utility, complications, and opinions of caregivers toward NG tube feeding in an acute geriatric ward in a teaching hospital in Kuala Lumpur. Consecutive patients aged 65 years and older receiving NG tube feeding were included. Sociodemographic, clinical, and laboratory indices were recorded. Opinion on NG tube feeding were evaluated through face-to-face interviews with caregivers, recruited through convenience sampling. Of 432 patients admitted, 96 (22%), age ± standard deviation = 80.8 ± 7.4 years, received NG tube feeding. The complication and mortality rates were 69% and 38%, respectively. Diabetes (odds ratio [95% confidence interval] = 3.34 [1.07, 10.44], aspiration pneumonia (8.15 [2.43, 27.24]), impaired consciousness (3.13 [1.05, 9.36]), and albumin ≤26 g/dl (4.43 [1.46, 13.44]) were independent predictors of mortality. Other relatives were more likely than spouses (23.5 [3.59, 154.2]) and caregivers with tertiary education more likely than those with no formal education ( 18 [1.23, 262.7]) to agree to NG feeding. Sixty-four percent of caregivers felt NG tube feeding was appropriate at the end of life, mostly due to the fear of starvation. NG tube feeding is widely used in our setting, despite high complication and mortality rates, with likely influences from cultural emphasis on feeding.

  1. Shaping oral feeding in a gastronomy tube-dependent child in natural settings.

    Science.gov (United States)

    Gutentag, S; Hammer, D

    2000-07-01

    A 3-year-old medically fragile girl who refused to eat after prolonged and frequent hospitalizations was started on a feeding program in the home and school settings. She exhibited food aversions and received all nourishment via a gastronomy tube. Preevaluation observations of her feeding behavior revealed that she refused all presented drinks and foods. Treatment was two-fold. First, food acceptance was followed by social praise and access to preferred toy play, and second, food refusal and disruptive behaviors were ignored. Gagging, vomiting, and crying occurred periodically during initial feedings. In addition, there were medical complications during the course of treatment necessitating continuous modifications of the program. Results of a multiple-phase design showed marked increases in the amount of food consumed at home, which then generalized to the school setting.

  2. Feeding Tubes

    Science.gov (United States)

    ... 25-10, Author: Beth Mays. Revised by Wendy Book, MD. Resources For Patients For Adults Strategies for Everyday Living Questions to Ask Your Doctor Pathology Reports Nutrition and Recipes The ABC’s of Food Allergies Alternate Sources of ...

  3. PROSPECTIVE COMPARATIVE STUDY OF HAEMODYNAMIC CHANGES DURING INSERTION OF LARYNGEAL MASK AIRWAY VERSUS ENDOTRACHEAL TUBE IN PAEDIATRIC PATIENTS

    Directory of Open Access Journals (Sweden)

    Roshith Thomas

    2016-06-01

    Full Text Available BACKGROUND & METHODS This study was conducted to determine and compare the pressor responses associated with insertion of a laryngeal mask airway with endotracheal tube during elective surgical procedures under general anaesthesia in paediatric patients. 64 patients of age between 2-12 years weighing between 10–40 kg, belonging to ASA grade I and II, scheduled for elective surgeries under general anaesthesia were included in the study. Patients belonging to ASA grade III and IV, those scheduled for emergency surgeries and patients with anticipated difficult airway were excluded from the study. The patients were randomised into two groups of 32 each, by computer generated software. For patients in group-L, airway was secured with laryngeal mask airway. Patients in group-E, airway was secured with endotracheal tube. Heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure and SpO2 were recorded just before induction and subsequently at 1, 3, 5 & 10 minutes. Mean heart rate increase at 1, 3 & 5 minutes was much less when compared to Group-E (p=significant. Mean systolic blood pressure of Group-L is significantly less at 1, 3, 5 & 10 minutes than that of Group-E (p=significant. Mean diastolic blood pressure of Group-L is significantly less at 1, 3 & 10 minutes compared to Group-E (p=significant. RESULTS & CONCLUSION Complications like sore throat, blood staining and coughing at the end of the procedure were seen less in Group-L than in group-E. In this study, we concluded that the pressor responses were less with LMA than with endotracheal tube. Based on our conclusion, we can say that LMA can be used as an alternative to endotracheal tube in maintaining an intact airway under general anaesthesia.

  4. Bacterial contamination of hospital-prepared enteral tube feeding formulas in Isfahan, Iran

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    Mohammad Jalali

    2009-05-01

    Full Text Available

    • BACKGROUND: Hospital-prepared tube feedings from three intensive care units of two hospitals in Isfahan, Iran were analyzed for microbial contamination.
    • METHODS: A total number of 152 samples (76 samples each at the time of preparation and 18 hours following preparation were collected. Standard plate count, coliform count and Staphylococcus aureus count for all samples were conducted. Samples were analyzed also for the presence of Salmonella spp. and Listeria spp.
    • RESULTS: At the time of food preparation, out of 76 samples, 53 samples (70% had coliform contamination and 87% of these contaminated samples had counts greater than 101 cfu/g. Also, 68  amples (90% had S. aureus contamination greater than 101 cfu/g. In standard plate count, 74 samples (97% had counts greater than 103 cfu/g, while 54 samples (71% had counts greater than 104 cfu/g. In second sampling occasion, out of 76 samples, 68 samples (90% had coliform contamination and 84% of these contaminated samples had counts greater than 101 cfu/g. Also, 72 samples (95% had S. aureus contamination, 98.6% of these contaminated samples had counts greater than 102 cfu/g. In standard plate count, 74 samples (97% had counts greater than 104 cfu/g. No Salmonella or Listeria was detected from samples.
    • CONCLUSION: The results indicated that a majority of the blenderized enteral tube feedings in those hospitals are not safe. In comparison to the standard limits, these enteral tube feedings are highly  ontaminated and posed substantial risk for developing a foodborne disease or nosocomial infection.
    • KEYWORDS: Enteral Feeding, Microbial Contamination, Nosocomial Infection, Standard Plate Count, Coliform.

  5. Chest Tube Insertion in the Delayed Esophageal Perforation Phenomenon: A Tragic or Beneficial Outcome?

    Science.gov (United States)

    Sokouti, Mohsen; Ghaffari, Mohammad Reza; Sokouti, Masoud; Rahimi-Rad, Mohammad-Hossein

    2016-01-01

    A 53-year-old woman with foreign body esophageal perforation, was first misdiagnosed as pulmonary thromboembolism. In referral hospital her chest computed tomography was reported as giant hiatal hernia or giant pulmonary abscess. She was treated for abscess, after several days, right hemithorax tube thoracostomy was performed. After that, she developed necrotizing fasciitis on the chest wall. After a 19-day delay, we found a 5-cm mid-thoracic esophageal tearing during thoracotomy and repaired it. After 2 years follow up the patient condition is good. This report describes a unique case of mid-thoracic foreign body esophageal perforation and rupture with a delay in diagnosis with a tragic course.

  6. LAMINAR CONVECTIVE HEAT TRANSFER AND FRICTION FACTOR OF AL2O3 NANOFLUID IN CIRCULAR TUBE FITTED WITH TWISTED TAPE INSERTS

    Directory of Open Access Journals (Sweden)

    L. Syam Sundar

    2011-06-01

    Full Text Available We experimentally investigated the fully developed laminar convective heat transfer and friction factor characteristics of different volume concentrations of Al2O3 nanofluid in a plain tube and fitted with different twist ratios of twisted tape inserts. Experiments were conducted with water and nanofluid in the range of particle volume concentration of , and twisted tape twist ratios of . The nanofluid heat transfer coefficient is high compared to water and further heat transfer enhancement is observed with twisted tape inserts. The pressure drop increases slightly with the inserts, but is comparatively negligible. A generalized regression equation is developed based on the experimental data for the estimation of the Nusselt number and friction factor for water and nanofluid in a plain tube and with twisted tape inserts.

  7. Does Routine Midazolam Administration Prior to Nasogastric Tube Insertion in the Emergency Department Decrease Patients' Pain? (A Pilot Study).

    Science.gov (United States)

    Manning, Chelsea Taylor; Buinewicz, Jacob Dillon; Sewatsky, Thomas Patrick; Zgonis, Evangelia; Gutierrez, Kathy; O'Keefe, Michael F; Freeman, Kalev

    2016-07-01

    Patients report pain and discomfort with nasogastric tube (NGT) intubation. We tested the hypothesis that premedication with midazolam alleviates pain during NGT placement in the emergency department (ED) by > 13 on a 100-mm visual analog scale (VAS). We performed a double-blind randomized controlled pilot study, assigning ED patients requiring NGT placement to midazolam or placebo. All patients received intranasal cophenylcaine; additionally, they received an intravenous (IV) dose of the study drug, either 2 mg of IV midazolam or saline control. Nurses placed NGTs while observed by research staff, who then interviewed subjects to determine the primary outcome of pain using a VAS. Additional data collected from patients and their nurses included discomfort during the procedure, difficulty of tube insertion, and complications. We enrolled 23 eligible patients and obtained complete data in all: 10 midazolam and 13 controls. We found a significant reduction in mean pain VAS score of -31 (95% confidence interval = -53 to -9 mm) with 2 mg of midazolam (mean ± SD = 52 ± 30 mm), compared to placebo (mean ± SD = 21 ± 18 mm), more than double the effect size considered clinically relevant. Treatment did not impact ease of placement and there were no serious adverse effects. Premedication with 2 mg of IV midazolam reduces pain of NGT insertion in ED patients without the need for full procedural sedation. © 2016 by the Society for Academic Emergency Medicine.

  8. Intravenous fluids versus gastric-tube feeding in hospitalized infants with viral bronchiolitis: a randomized, prospective pilot study.

    Science.gov (United States)

    Kugelman, Amir; Raibin, Karine; Dabbah, Husein; Chistyakov, Irina; Srugo, Isaac; Even, Lea; Bzezinsky, Nurit; Riskin, Arieh

    2013-03-01

    The American Academy of Pediatrics recommends intravenous fluids for infants with bronchiolitis who are unable to sustain oral feedings. Our randomized, prospective pilot study shows that gastric tube feeding (in 31 infants) is feasible and demonstrated comparable clinical outcomes with intravenous fluids (in 20 infants) among hospitalized infants ≤6 months of age with moderate bronchiolitis.

  9. Outcomes of upper airway reconstructive surgery for obstructive sleep apnea syndrome based on polysomnography after nasopharyngeal tube insertion

    Institute of Scientific and Technical Information of China (English)

    LI Shu-hua; WU Da-hai; BAO Ji-min; SHI Hong-jin

    2013-01-01

    Background The most common obstruction sites for obstructive sleep apnea hypopnea syndrome (OSAHS) are the oropharynx and the glossopharyx.The diagnosis of glossopharyngeal airway obstruction is difficult.The study aimed to assess the effect of upper airway reconstructive surgery for OSAHS based on polysomnography (PSG) after nasopharyngeal tube insertion (NPT-PSG),and to evaluate the clinical value of NPT-PSG in localizing the obstructive sites.Methods Seventy-nine OSAHS patients diagnosed with PSG were included in the study.PSG was repeated with a nasopharyngeal tube in place (NPT-PSG).Results of the two PSGs were compared.A NPT-PSG apnea hypopnea index (AHI) greater than 15 times per hour was used as a threshold for glossopharyngeal surgery.The cause of glossopharyngeal airway obstruction was taken into consideration in planning glossopharyngeal surgery.Assessment of efficacy was followed-up.Results After NPT-PSG,patients' AHI significantly decreased and lowest oxygen saturation (LaSO2) significantly increased.Of the 79 patients,47 were treated with uvulopalatopharyngoplasty (UPPP) alone and 32 with UPPP + glossopharyngeal surgery.Thirty-two patients were considered cured,33 markedly improved,and 14 failed.The overall surgery success rate was 82.3%.Conclusions NPT-PSG can be used as a diagnosis tool for localizing airway obstruction in OSAHS patients.Surgical treatment based on NPT-PSG results in good treatment efficacy.

  10. Surgical approaches to treatment of gastroparesis: gastric electrical stimulation, pyloroplasty, total gastrectomy and enteral feeding tubes.

    Science.gov (United States)

    Sarosiek, Irene; Davis, Brian; Eichler, Evelin; McCallum, Richard W

    2015-03-01

    Gastric electrical stimulation (GES) is neurostimulation; its mechanism of action is affecting central control of nausea and vomiting and enhancing vagal function. GES is a powerful antiemetic available for patients with refractory symptoms of nausea and vomiting from gastroparesis of idiopathic and diabetic causes. GES is not indicated as a way of reducing abdominal pain in gastroparetic patients. The need for introducing a jejunal feeding tube means intensive medical therapies are failing, and is an indication for the implantation of the GES system, which should always be accompanied by a pyloroplasty to guarantee accelerated gastric emptying.

  11. Knotting of a nasogastric feeding tube in a child with head injury: A case report and review of literature

    OpenAIRE

    Nasiru J Ismail; Gyang Markus Bot; Ismail Hassan; Danaan J Shilong; Joseph O Obande; Salamat Ahuoiza Aliu; Ezekiel D Dung; Bello B Shehu

    2014-01-01

    Nasogastric intubation is one of the most common routine nonoperative procedures available for the hospital care of patients. The insertion and removal of this tube is associated with many complications. The complications include trauma, nasal septal abscess and inadvertent entry into the cranial cavity and trachea, ulceration, bleeding from varices and perforation. Knotting of the nasogastric tube is one of the very rare complications of nasogastric intubation particularly in children. To th...

  12. The impact of child tube feeding on maternal emotional state and identity: a qualitative meta-analysis.

    Science.gov (United States)

    Wilken, Markus

    2012-06-01

    Literature on mothers' acceptance of their children's tube feeding is heterogeneous. When a child is fed via gastrostomy, parents may report higher quality of life and higher stress levels. Qualitative research suggests that tube feeding can conflict with fundamental expectations about the mothering role. In this qualitative meta-analysis, parental statements from various studies have been excerpted and theory-based analyzed. Data suggest that feeding a child orally is not only an important aspect of mothering but also a key element for the development of a motherhood identity. Nonoral feeding often results in psychological stress and a struggle to negotiate the motherhood identity successfully and may result in traumatization of the mother. Preventive psychological guidance is recommended to decrease the risk of posttraumatic stress disorder in mothers and disturbances in the mother-child relationship and to assist in maternal coping with a child's feeding disorder.

  13. Compounding rifampin suspensions with improved injectability for nasogastric enteral feeding tube administration.

    Science.gov (United States)

    de Villiers, Melgardt M; Vogel, Laura; Bogenschutz, Monica C; Fingerhut, Bonnie J; D'Silva, Joseph B; Moore, Anne

    2010-01-01

    Often medications that have to be administered to patients via a nasogastric enteral feeding tubes are only available as tablets and capsules with no suitable commercial liquid alternatives. In such situations, pharmacists and nurses have to compound the tablets and capsule contents into liquid suspension formulations for dosing. The risk of occlusion of the enteral tubes during administration is reduced by employing liquid suspensions that are composed of small and uniform particles, not subject to rapid rates of settling, resistant to caking, and easily and uniformly re-suspended upon agitation. Present techniques often employ a manual process, such as a mortar and pestle, to accomplish the particle size reduction and subsequent incorporation into a suitable liquid diluent. A new compounding device has been invented that employs an automated wet-milling process in a single-use disposable plastic container to compound the suspensions. The two processes were compared using Rifampin capsules and various liquid diluents. A prototype version of the new device was employed in the experiments. The physical characteristics of the compounded suspensions were evaluated by determining sedimentation rate, sedimentation volume, and particle size and shape using laser light scattering, optical microscopy, and scanning electron microscopy techniques. The use characteristic of the compounded suspensions was evaluated using a nasogastric tube inject ability test. The results indicated that suspensions prepared using the new device were more resistant to sedimentation and caking and were easier to re-disperse into a uniform mixture by gentle shaking. The results were a consequence of the particles generated by the new device which were found to be smaller and more uniform in shape and size. The suspensions prepared using the new device did not cause blockage of the enteral feeding tubes in comparison to those prepared using a mortar and pastle. In conclusion, the results indicate

  14. Gastrostomy tube feeding in children with cerebral palsy: a prospective, longitudinal study.

    Science.gov (United States)

    Sullivan, Peter B; Juszczak, Edmund; Bachlet, Allison M E; Lambert, Bridget; Vernon-Roberts, Angharad; Grant, Hugh W; Eltumi, Muftah; McLean, Liz; Alder, Nicola; Thomas, Adrian G

    2005-02-01

    We report a longitudinal, prospective, multicentre cohort study designed to measure the outcomes of gastrostomy tube feeding in children with cerebral palsy (CP). Fifty-seven children with CP (28 females, 29 males; median age 4y 4mo, range 5mo to 17y 3mo) were assessed before gastrostomy placement, and at 6 and 12 months afterwards. Three-quarters of the children enrolled (43 of 57) had spastic quadriplegia; other diagnoses included mixed CP (6 of 57), hemiplegia (3 of 57), undiagnosed severe neurological impairment (3 of 57), ataxia (1 of 57), and extrapyramidal disorder (1 of 57). Only 7 of 57 (12%) could sit independently, and only 3 of 57 (5%) could walk unaided. Outcome measures included growth/anthropometry, nutritional intake, general health, and complications of gastrostomy feeding. At baseline, half of the children were more than 38D below the average weight for their age and sex when compared with the standards for typically-developing children. Weight increased substantially over the study period; the median weight z score increased from -3 before gastrostomy placement to -2.2 at 6 months and -1.6 at 12 months. Almost all parents reported a significant improvement in their child's health after this intervention and a significant reduction in time spent feeding. Statistically significant and clinically important increases in weight gain and subcutaneous fat deposition were noted. Serious complications were rare, with no evidence of an increase in respiratory complications.

  15. The Fate of Fat: Pre-Exposure Fat Losses during Nasogastric Tube Feeding in Preterm Newborns.

    Science.gov (United States)

    Rayyan, Maissa; Rommel, Nathalie; Allegaert, Karel

    2015-07-29

    Deficient nutritional support and subsequent postnatal growth failure are major covariates of short- and long-term outcome in preterm neonates. Despite its relevance, extrauterine growth restriction (EUGR) is still prevalent, occurring in an important portion of extremely preterm infants. Lipids provide infants with most of their energy needs, but also cover specific supplies critical to growth, development and health. The use of human milk in preterm neonates results in practices, such as milk storage, pasteurization and administration by an infusion system. All of these pre-exposure manipulations significantly affect the final extent of lipid deposition in the intestinal track available for absorption, but the impact of tube feeding is the most significant. Strategies to shift earlier to oral feeding are available, while adaptations of the infusion systems (inversion, variable flow) have only more recently been shown to be effective in "in vitro", but not yet in "in vivo" settings. Pre-exposure-related issues for drugs and nutritional compounds show similarities. Therefore, we suggest that the available practices for "in vitro" drug evaluations should also be considered in feeding strategies to further reduce pre-exposure losses as a strategy to improve the nutritional status and outcome of preterm neonates.

  16. Nasogastric feeding tube located in the lung. SENSAR case of the trimester.

    Science.gov (United States)

    2017-01-01

    A clinical case is presented that was communicated to Spanish Notification System on Safety in Anaesthesia and Recovery (SENSAR). Using this communication and its analysis, a strategy is obtained in order to reduce the risks associated with the insertion of a nasogastric tube (NST) for enteral nutrition in adult patients in the post-surgical recovery unit. A description of the incident is presented, an analysis of its causes, and the measures that were introduced in order to avoid similar incidents in the future, as well as to promote a safety culture in the organisation. A description of associated incidents registered in SENSAR is also given. The aim of this work is to describe, analyse and introduce safety measures arising from incidents notified to SENSAR, associated with the insertion and checking of the nutrition NST in adult patients in the post-surgical recovery unit. Copyright © 2016 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

  17. Experimental and numerical investigation of the cylindrical blade tube inserts effect on the heat transfer enhancement in the horizontal pipe exchangers

    Science.gov (United States)

    Karagoz, Sendogan; Afshari, Faraz; Yildirim, Orhan; Comakli, Omer

    2017-09-01

    In this experimental and numerical study an attempt to enhance the heat transfer rate by cylindrical blade that form turbulence flow inside the exchanger pipe is carried out. The effects of the blade geometry are also examined to investigate heat transfer rate in experimented tube inserts. Experiments are performed in different blade spacing (Sy1,2,3 = 101-216-340 mm) and various blade angles (α1,2,3 = 0°-45°-90°). The water flow rate inside the tube is adjusted in three different ranges to approach intended Reynolds numbers (Re1,2,3 = 6000-11,000-17,000). Nusselt number, Reynolds number and effect of friction factor are investigated separately. For all experiments, the increase in Nu number due to used tube inserts is recorded and compared to each other and plain tube in the related profiles. It is concluded that installed tube inserts in the heat exchanger tube, led to a significant increase in Nu number and energy saving. Among different experimented cases, using mean value in various Re numbers, the highest Nusselt number was obtained at Sy1 = 101 mm which was 24% more than that of plain tube. This value was 18.7 and 8.3% for Sy2 = 216 and Sy3 = 340 mm respectively. By this way, according results for friction factor were 0.30, 0.19 and 0.14. The presented study has been simulated by ANSYS Fluent 16 software to analyze flow behavior and heat transfer characteristics.

  18. Three Dimensional Numerical Simulation of Convection-Condensation of Vapor with High Concentration Air in Tube with Inserts

    Institute of Scientific and Technical Information of China (English)

    崔永章; 田茂诚; 张林华; 李广鹏; 朱建宾

    2012-01-01

    A three-dimensional numerical model is presented for studying the convection-condensation of mixture with vapor in a tube with edgefold-twisted-tape inserts under transition flow.According to the diffusion layer theory and laminar species transport,a condensation model with user defined function is proposed and compared with heat and mass transfer analogy and experimental test.With the condensation model,the influences of gap width and op-erating parameters on thermal-hydrodynamics performance are simulated.As the gap width increases,convection and condensation heat transfer increase initially and then decrease,while convection heat transfer increases sharply and then decreases slightly.Increasing vapor fraction has a significant effect on condensation heat transfer but it has little effect on convective heat transfer.With the increase of inner wall temperature both convection and condensa-tion heat transfer all decrease and the ratio of condensation to total heat decrease dramatically.Increases inlet tem-perature mainly affects convection heat transfer.

  19. Heat transfer enhancement of laminar nanofluids flow in a circular tube fitted with parabolic-cut twisted tape inserts.

    Science.gov (United States)

    Salman, Sami D; Kadhum, Abdul Amir H; Takriff, Mohd S; Mohamad, Abu Bakar

    2014-01-01

    Numerical investigation has been carried out on heat transfer and friction factor characteristics of copper-water nanofluid flow in a constant heat-fluxed tube with the existence of new configuration of vortex generator using Computational Fluid Dynamics (CFD) simulation. Two types of swirl flow generator: Classical twisted tape (CTT) and Parabolic-cut twisted tape (PCT) with a different twist ratio (y = 2.93, 3.91 and 4.89) and different cut depth (w = 0.5, 1.0 and 1.5 cm) with 2% and 4% volume concentration of CuO nanofluid were used for simulation. The effect of different parameters such as flow Reynolds number, twist ratio, cut depth and nanofluid were considered. The results show that the enhancement of heat transfer rate and the friction factor induced by the Classical (CTT) and Parabolic-cut (PCT) inserts increases with twist ratio and cut depth decreases. The results also revealed that the heat transfer enhancement increases with an increase in the volume fraction of the CuO nanoparticle. Furthermore, the twisted tape with twist ratio (y = 2.93) and cut depth w = 0.5 cm offered 10% enhancement of the average Nusselt number with significant increases in friction factor than those of Classical twisted tape.

  20. Fibreoptic Bronchoscope for Nasogastric Tube Placement

    OpenAIRE

    Bhandari Dhiraj; Garg Deepika; Chandankhede Shweta; Sharma Vaijyanti; Premendran Benhur; Tidke Sucheta

    2015-01-01

    A patient of stage III squamous cell carcinoma of mandible with hemi-mandibulectomy, modified radical neck dissection and radiotherapy required Ryle’s Tube (RT) insertion for feeding. This case report describes use of fibreoptic bronchoscope to place an endotracheal tube in oesophagus through nasal route which was then used as a conduit to pass a RT into stomach.

  1. Fibreoptic Bronchoscope for Nasogastric Tube Placement

    Directory of Open Access Journals (Sweden)

    Bhandari Dhiraj

    2015-09-01

    Full Text Available A patient of stage III squamous cell carcinoma of mandible with hemi-mandibulectomy, modified radical neck dissection and radiotherapy required Ryle’s Tube (RT insertion for feeding. This case report describes use of fibreoptic bronchoscope to place an endotracheal tube in oesophagus through nasal route which was then used as a conduit to pass a RT into stomach.

  2. Medicamentos e sondas de nutrição Drugs and feeding tubes

    Directory of Open Access Journals (Sweden)

    Milton Luiz Gorzoni

    2010-01-01

    Full Text Available OBJETIVO: Definir a prevalência de medicamentos incompatíveis com esta via em internados em instituição de longa permanência para idosos (ILPI e em uso de sondas de nutrição. MÉTODOS: Análise de prescrições de internados em ILPI e em uso de sonda de nutrição há mais de 48 horas. Compararam-se os princípios ativos dos medicamentos prescritos, formas de apresentação e possibilidade de trituração com dados de literatura sobre viabilidade de fármacos por essa via. RESULTADOS: Observou-se sondas de nutrição em 57 pacientes (11,2% do total de leitos, idade média de 65,6 ± 16,0 anos, 32 mulheres e 25 homens. Média de fármacos por via enteral: 5,6 ± 2,2. Itens medicamentosos nas prescrições: 316 divididos em 64 fármacos, sendo 129 itens (40,8% do total e 23 fármacos (35,4% impróprios para essa via. Medicamentos impróprios mais prescritos: captopril, fenitoína, ranitidina, omeprazol e complexo B. Apresentações alternativas foram encontradas para 15 (65,2% dos 23 fármacos inadequados por essa via. CONCLUSÃO: Sondas de nutrição, como via de administração medicamentosa em ILPI, apresentam significativo risco de prescrições incompatíveis com elas.OBJECTIVE: Define the prevalence of drugs that are not compatible with this way of administration for inpatients in long term care facilities (LTCF, and their use in feeding tubes. METHODS: Analysis of prescriptions for LTCF inpatient who are using feeding tubes for more than 48 hours. The active ingredients, presentation and possibility of pulverizing drugs prescribed were compared to data in literature regarding the feasibility of enteral administration of drugs. RESULTS: Feeding tubes were observed in 57 patients (11.2% of the total of inpatients, mean age of 65.6 ± 16.0 years, 32 women and 25 men. Mean number of drugs administered enterally: 5.6 ± 2.2. Medication items in prescriptions: 316 divided into 64 drugs, with 129 items (40.8% of the total, and 23 drugs (35

  3. Ear tube insertion

    Science.gov (United States)

    Bennett JE, Dolin R, Blaser MJ. Otitis externa, otitis media, and mastoiditis. In: Klein JO, ed. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases . 8th ed. Philadelphia, PA: ...

  4. Nasogastric Tube Feeding in Predicted Severe Acute Pancreatitis. A Systematic Review of the Literature to Determine Safety and Tolerance

    Directory of Open Access Journals (Sweden)

    Maxim S Petrov

    2008-07-01

    Full Text Available Context Nasogastric tube feeding is safe and well tolerated in most critically ill patients. However, its safety and tolerance in the setting of severe acute pancreatitis is debatable. Objective We aimed to review all available studies on nasogastric feeding in patients with severe acute pancreatitis to determine the safety and tolerance of this approach. A further aim was to perform a meta-analysis of the available randomized controlled trials regarding nasogastric versus nasojejunal feeding. Methods Three electronic databases (Cochrane Central Register of Controlled Trials, EMBASE and MEDLINE and the abstracts of major gastroenterological meetings were reviewed. Meta-analysis was performed using the random effects model. Main outcome measures The summary estimates were reported as risk ratio (RR with 95% confidence interval (95% CI. Results A total of four studies on nasogastric tube feeding in 92 patients with predicted severe acute pancreatitis were identified. Documented infected pancreatic necrosis developed in 11 patients (16.9% and multiple organ failure in 10 (15.4% out of 65 patients with available data. Overall, there were 15 deaths (16.3%. An exacerbation of pain after initiation of feeding occurred in 3 (4.3% out of 69 patients with available data. Full tolerance was achieved in 73 (79.3% patients who did not require temporary reduction, stoppage or withdrawal of nasogastric feeding. The results of nasogastric feeding as compared to nasojejunal feeding, were no worse in terms of mortality (RR=0.77; 95% CI: 0.37 to 1.62; P=0.50 or intolerance of feeding (RR=1.09; 95% CI: 0.46 to 2.59; P=0.84. Conclusion Nasogastric feeding appears safe and well tolerated in patients with predicted severe acute pancreatitis. An adequately powered randomized trial on nasogastric versus nasojejunal feeding is required to support this approach as routine clinical management.

  5. Crashworthiness of Aluminium Tubes; Part 1: Hydroforming at Different Corner-Fill Radii and End Feeding Levels

    Science.gov (United States)

    D'Amours, Guillaume; Rahem, Ahmed; Williams, Bruce; Worswick, Michael; Mayer, Robert

    2007-05-01

    The automotive industry, with an increasing demand to reduce vehicle weight through the adoption of lightweight materials, requires a search of efficient methods that suit these materials. One attractive concept is to use hydroforming of aluminium tubes. By using FE simulations, the process can be optimized to reduce the risk for failure while maintaining energy absorption and component integrity under crash conditions. It is important to capture the level of residual ductility after forming to allow proper design for crashworthiness. This paper presents numerical and experimental studies that have been carried out for high pressure hydroforming operations to study the influence of the tube corner radius, end feeding, material thinning, and work hardening in 76.2 mm diameter, 3 mm wall thickness AA5754 aluminium alloy tube. End feeding was used to increase the formability of the tubes. The influence of the end feed displacement versus tube forming pressure schedule was studied to optimize the forming process operation to reduce thinning. Validation of the numerical simulations was performed by comparison of the predicted strain distributions and thinning, with measured quantities. The effect of element formulation (thin shell versus solid elements) was also considered in the models.

  6. Knowledge of Staff Members of Residential Care Facilities for Individuals with Intellectual Disability on Medication Administration via Enteral Feeding Tube

    Science.gov (United States)

    Joos, E.; Mehuys, E.; Van Bocxlaer, J.; Remon, J. P.; Van Winckel, M.; Boussery, K.

    2016-01-01

    Background: Guidelines for the safe administration of drugs through enteral feeding tube (EFT) are an important tool to minimise the risk of errors. This study aimed to investigate knowledge of these guidelines among staff of residential care facilities (RCF) for people with ID. Method: Knowledge was assessed using a 13-item self-administered…

  7. [TS-1 therapy via intestinal catheter used for tube feeding in a patient with gastric cancer after total gastrectomy].

    Science.gov (United States)

    Hagiike, Masanobu; Tsuboi, Yuka; Akamoto, Shintaro; Yachida, Shinichi; Izuishi, Kunihiko; Karasawa, Yukihiko; Goda, Fuminori; Okada, Setsuo; Usuki, Hisashi; Maeta, Hajime

    2005-07-01

    The patient was a 76-year-old man having gastric cancer with peritoneal dissemination. He underwent total gastrectomy for resection of the primary tumor and improvement of the oral intake. He developed ileus and peritonitis after the surgery, which necessitated two additional operations. An intestinal stoma was thus therefore created using a catheter for tube feeding, and tube feeding was initiated after the surgery. Nutrients, as well as TS-1 (taken out of the capsule; 80 mg/day) were administered via the catheter for tube feeding. This therapy was followed by a reduction in tumor marker levels and improvement of the patient's performance status (PS), after which the patient could be discharged. He stayed at home for about 8 months, with a much-improved quality of life during this period. We concluded that the TS-1 therapy via the catheter used for alimentation was effective for the treatment of cancer in this patient. We report our experience with this case, in which tube feeding became necessary after total gastrectomy, but administration of TS-1 via the same catheter used for alimentation improved the patient's PS and made it possible for him to receive chemotherapy at home.

  8. A Matter of Taste? Quality of Life in Day-to-Day Living with ALS and a Feeding Tube.

    Science.gov (United States)

    Pols, Jeannette; Limburg, Sarah

    2016-09-01

    Although people often refer to quality of life and there is a respectable research tradition to establish it, the meaning of the term is unclear. In this article we qualitatively study an intervention of which the quantitative effects are documented as indecisive. We do this in order to learn more about what the meaning of the term quality of life means when it is studied in daily life. With the help of these findings we reflect on the intricacies of objectifying and measuring quality of life using quantitative research designs. Our case is the feeding tube for patients suffering from ALS, a severe motor neuron disease that rapidly and progressively incapacitates patients. We studied how these patients, who lived in the Netherlands, anticipated and lived with a feeding tube in the course of their physical deterioration. Our analysis shows that the quality of life related to the feeding tube has to be understood as a process rather than as an outcome. The feeding tube becomes a different thing as patients move through the various phases of their illness, due to changes in their condition, living circumstances, and concerns and values. There are very different appreciations of the way the feeding tube changes the body's appearance and feel. Some patients refuse it because they feel it disfigures their body, whereas others are indifferent to its appearance. Our conclusion is that these differences are difficult to grasp with a quantitative study designs because 'matters of taste' and values are not distributed in a population in the same ways as physiological responses to medication. Effect studies assume physiological responses to be more or less the same for everyone, with only gradual differences. Our analysis of quality in daily life, however, shows that what a treatment comes to be and how it is valued shows shows generalities for subgroups rather than populations.

  9. Curative effects of nasal lacrimal sac anastomosis combined with tube insertion under nasal endoscope on patients with chronic dacryocystitis and nasolacrimal duct obstruction

    Directory of Open Access Journals (Sweden)

    Hao Sun

    2017-03-01

    Full Text Available AIM: To explore the effects of nasal lacrimal sac anastomosis combined with tube insertion under nasal endoscope on patients with chronic dacryocystitis and nasolacrimal duct obstruction. METHODS: Totally 70 patients(70 eyeswith chronic dacryocystitis and nasolacrimal duct obstruction in our hospital from December 2011 to December 2014 were selected, and were randomly divided into control group and study group. The control group were treated with nasal cavity lacrimal sac anastomosis under nasal endoscope, and the study group were treated with nasal lacrimal sac anastomosis combined with tube insertion under nasal endoscope. Total effective rates and fistula areas at 1, 6 and 12mo before and after operation were compared between the two groups. RESULTS: At 1mo after operation, there was no significant difference in total effective rates between the control group(97%and the study group(100%; P>0.05. At 6mo after operation, the total effective rate in the study group(97%was significantly higher than that in the control group(77%; PPP>0.05, while fistula areas in the study group were larger than those in the control group at 6 and 12mo after operation(PCONCLUSION: The effects of nasal lacrimal sac anastomosis combined with tube insertion under nasal endoscope on patients with chronic dacryocystitis and nasolacrimal duct obstruction are remarkable.

  10. Continuous nasogastric tube feeding: monitoring by combined use of refractometry and traditional gastric residual volumes.

    Science.gov (United States)

    Chang, W-K; McClave, S-A; Chao, Y-C

    2004-02-01

    Traditional use of gastric residual volumes (GRVs) is insensitive and cannot distinguish retained enteral formula from the large volume of endogenous secretions. We designed this prospective study to determine whether refractometry and Brix value (BV) measurements could be used to monitor gastric emptying and tolerance in patients receiving continuous enteral feeding. Thirty-six patients on continuous nasogastric tube feeding were divided into two groups; patients with lower GRVs (75 ml) in Group 2. Upon entry, all gastric contents were aspirated, the volume was recorded (Asp GRV), BV measurements were made by refractometry, and then the contents were reinstilled but diluted with 30 ml additional water. Finally, a small amount was reaspirated and repeat BV measurements were made. Three hours later, the entire procedure was repeated a second time. The BV ratio, calculated (Cal) GRV, and volume of formula remaining were calculated by derived equations. Mean BV ratios were significantly higher for those patients in Group 2 compared to those in Group 1. All but one of the 22 patients (95%) in Group 1 had a volume of formula remaining in the stomach estimated on both measurements to be less than the hourly infusion rate (all these patients had BV ratios 70%). Three of the Group 2 patients (21%) whose initial measurement showed evidence for retention of formula, improved on repeat follow-up measurement assuring adequate gastric emptying. The remaining five patients from Group 2 (35%) had a volume of formula remaining that was less than the hourly infusion rate on both measurements. The pattern of Asp GRVs and serial pre- and post-dilution BVs failed to differentiate these patients in Group 2 with potential emptying problems from those with sufficient gastric emptying. Refractometry and measurement of the BV may improve the clinical utilization of GRVs, by its ability to identify the component of formula within gastric contents and track changes in that component related

  11. An Unusual Complication of PEG Feeding After Pancreatico-Gastrostomy

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    Mary Phillips

    2014-05-01

    Full Text Available Context We describe a late complication of the pancreatico-gastrostomy (PG anastomosis following pancreatico-duodenectomy (PD. Case report A percutaneous endoscopic gastrostomy (PEG feeding tube was inserted many months post-operatively. In this patient activated pancreatic enzymes eroded the gastrostomy tract, resulting in pain, recurrent infection and eventual removal of the gastrostomy tube. Conclusions Where surgical insertion of a feeding jejunostomy is not viable or deemed too high risk after Whipple or PPPD, we recommend careful consideration of PEG tube insertion in patients with PG reconstruction. If a PEG is used the prophylactic use of Lanreotide is recommended.

  12. Natural Bioactive Food Components for Improving Enteral Tube Feeding Tolerance in Adult Patient Populations.

    Science.gov (United States)

    Kuchnia, Adam J; Conlon, Beth; Greenberg, Norman

    2017-08-01

    Tube feeding (TF) is the most common form of nutrition support. In recent years, TF administration has increased among patient populations within and outside hospital settings, in part due to greater insurance coverage, reduced use of parenteral nutrition, and improved formularies suitable for sole source nutrition. With increasing life expectancy and improved access to TFs, the number of adults dependent on enteral nutrition is expected to grow. However, enteral TF intolerance (ETFI) is the most common complication of TFs, typically presenting with at least 1 adverse gastrointestinal event, including nausea, diarrhea, and constipation. ETFI often leads to reductions in TF volume with associated energy and protein deficits. Potentially ensuing malnutrition is a major public health concern due its effects on increased risk of morbidity and mortality, infections, prolonged hospital length of stay, and higher healthcare costs. As such, there is a need for intervention strategies to prevent and reduce ETFI. Incorporating whole foods with bioactive properties is a promising strategy. Emerging research has elucidated bioactive properties of whole foods with specific benefits for the prevention and management of adverse gastrointestinal events commonly associated with TFs. However, lack of evidence-based recommendations and technological challenges have limited the use of such foods in commercial TF formulas. This review addresses research gaps by discussing 5 whole foods (rhubarb, banana, curcumin, peppermint oil, and ginger) with bioactive attributes identified through literature searches and clinical experience as having substantial scientific rationale to consider their application for ETFI in adult populations.

  13. [Nasogastric tube feeding in bulimia. Controlled study with follow-up at 3 months].

    Science.gov (United States)

    Rigaud, Daniel; Brayer, Véronique; Biton-Jélic, Violaine; Païs, Vanessa; Pennacchio, Hélène; Brun, Jean-Marcel

    2007-10-01

    Few effective treatments are available for severe forms of bulimia nervosa, which are accompanied by malnutrition, anxiety, and depressive mood. We previously showed in an open study that nasogastric tube feeding (TF) reduced binges and purging in patients with anorexia nervosa. This prospective randomized trial compared bulimia patients in two treatment groups: one group received TF at home, together with psychotherapy, nutritional counseling and a support group while the control group received only psychotherapy, nutritional counseling, and a support group. Patients in the first group underwent TF for 8 weeks (exclusively for 10 days and associated with meals thereafter). Assessment was based on clinical examination, laboratory results, and a variety of questionnaires (our in-house instrument for measuring binge and vomiting episodes, eating disorder inventory, Beck's depression inventory and the Hamilton rating scale for anxiety), all performed at the onset of treatment and at 8 days, 8 weeks (i.e., the end of TF), and 3 months after treatment began. Binges and vomiting disappeared faster and more frequently in TF patients than in the control group: 65% versus 29% (pbulimia nervosa, reducing the number of binge and vomiting episodes and improving nutritional status and mood.

  14. A comparison of intraocular pressure and hemodynamic responses to insertion of laryngeal mask airway or endotracheal tube using anesthesia with propofol and remifentanil in cataract surgery

    Directory of Open Access Journals (Sweden)

    Mohsen Ziyaeifard

    2012-01-01

    Full Text Available Background: The aim of this study was to evaluate intraocular pressure (IOP and hemodynamic responses following insertion of laryngeal mask airway (LMA or endotracheal tube (ETT after anesthesia induction with propofol and remifentanil in cataract surgery. Materials and Methods: In a randomized controlled study, 50 adults scheduled for elective cataract extraction procedure under general anesthesia were allocated to LMA insertion (n = 25 or ETT (n = 25 groups. IOP, systolic blood pressure (SBP, diastolic blood pressure (DBP, and heart rate (HR were measured after insertion of the airway device every minute up to 5 min. Results: There were no significant differences between LMA and ETT groups in SBP, DBP, HR, and IOP immediately after airway instrumentation up to 5 min, except in 4th min in DBP, 2nd min in HR, and 5th min in IOP (7.9 ± 2.3 mmHg in LMA and 9.4 ± 2.5 mmHg in ETT group; P = 0.030. There was good surgeon satisfaction for providing acceptable surgical field in both groups (88% in LMA and 80% in ETT group; P = 0.702. Conclusion: Propofol combined with remifentanil provides good and excellent conditions for insertion of LMA or ETT with minimal hemodynamic disturbances in cataract surgery. Considering LMA insertion is less traumatic than ETT, using LMA may be better than ETT for airway securing in these patients.

  15. Perfusion index versus non-invasive hemodynamic parameters during insertion of i-gel, classic laryngeal mask airway and endotracheal tube.

    Science.gov (United States)

    Atef, Hosam M; Fattah, Salah Abd; Gaffer, Mohammed Emad Abd; Al Rahman, Ahamed Abd

    2013-03-01

    Perfusion index (PI) is a non-invasive numerical value of peripheral perfusion obtained from a pulse oximeter. In this study, we evaluated the efficacy of PI for detecting haemodynamic stress responses to insertion of i-gel, laryngeal mask airway (LMA) and endotracheal tube and compare, its reliability with the conventional haemodynamic criteria in adults during general anaesthesia. Sixty patients scheduled for elective general surgery under general anaesthesia were randomised to three groups. (i-gel, LMA and ET groups (n=20/group). Heart rate (HR) (positive if ≥10 bpm), systolic blood pressure (SBP), diastolic blood pressure (DBP) (positive if ≥15 mm Hg) and PI (positive if ≤10%) were monitored for 5 min after insertion. SBP, DBP, HR and PI were measured before induction of anaesthesia and before and after insertion of the airway device. Insertion of airway devices produced significant increases in HR, SBP and DBP in LMA and ET groups. Moreover, PI was decreased significantly by 40%, 100% and 100% in the three groups. Using the PI criterion, the sensitivity was 100% (CI 82.4-100.0%). Regarding the SBP and DBP criterions, the sensitivity was 44.4% (CI 24.6-66.3%), 55.6% (CI 33.7-75.4%) respectively. Also, significant change in the mean PI over time (from pre-insertion value to the 1(st) min, 3(rd) min, until the 4(th) min after insertion without regard the device type), (P<0.001). PI is a reliable and easier alternative to conventional haemodynamic criteria for detection of stress response to insertion of i-gel, LMA and ET during propofol fentanyl isoflurane anaesthesia in adult patients.

  16. Perfusion index versus non-invasive hemodynamic parameters during insertion of i-gel, classic laryngeal mask airway and endotracheal tube

    Directory of Open Access Journals (Sweden)

    Hosam M Atef

    2013-01-01

    Full Text Available Background: Perfusion index (PI is a non-invasive numerical value of peripheral perfusion obtained from a pulse oximeter. In this study, we evaluated the efficacy of PI for detecting haemodynamic stress responses to insertion of i-gel, laryngeal mask airway (LMA and endotracheal tube and compare, its reliability with the conventional haemodynamic criteria in adults during general anaesthesia. Methods: Sixty patients scheduled for elective general surgery under general anaesthesia were randomised to three groups. (i-gel, LMA and ET groups ( n=20/group. Heart rate (HR (positive if ≥10 bpm, systolic blood pressure (SBP, diastolic blood pressure (DBP (positive if ≥15 mm Hg and PI (positive if ≤10% were monitored for 5 min after insertion. Main outcome measures: SBP, DBP, HR and PI were measured before induction of anaesthesia and before and after insertion of the airway device. Results: Insertion of airway devices produced significant increases in HR, SBP and DBP in LMA and ET groups. Moreover, PI was decreased significantly by 40%, 100% and 100% in the three groups. Using the PI criterion, the sensitivity was 100% (CI 82.4-100.0%. Regarding the SBP and DBP criterions, the sensitivity was 44.4% (CI 24.6-66.3%, 55.6% (CI 33.7-75.4% respectively. Also, significant change in the mean PI over time (from pre-insertion value to the 1 st min, 3 rd min, until the 4 th min after insertion without regard the device type, ( P<0.001. Conclusion: PI is a reliable and easier alternative to conventional haemodynamic criteria for detection of stress response to insertion of i-gel, LMA and ET during propofol fentanyl isoflurane anaesthesia in adult patients.

  17. 2种胃管置入术对新生儿疼痛反应的比较研究%Comparison of two different gastric tube insertion methods on neonatal pain response

    Institute of Scientific and Technical Information of China (English)

    李莉; 陈娟娟; 朱明; 夏艳; 赵武

    2011-01-01

    目的 比较2种不同方式胃管置入术对新生儿疼痛反应的影响.方法 将2010年4~7月新生儿科需要行胃管置入术的47例新生儿随机分为经鼻胃管置入组28例和经口胃管置入组19例,比较2组新生儿疼痛评分及胃管置入过程中并发症的发生率.结果 经鼻胃管置入组疼痛评分的平均秩次显著高于经口胃管置入组,经鼻胃管置入组疼痛发生率明显高于经口胃管置入组,且并发症发生率明显高于经口胃管置人组.结论 经口置入胃管对新生儿疼痛反应影响小,并发症少,值得临床推广应用.%Objective To compare two different gastric tube insertion methods on neonatal pain responae.Methods From April to July 2010,47 neonatal patients underwent gastric tube insertion in the neonatal department of our hospital were randomly classified into two groups:the nasal gastric tube insertion group(28 cases) and the oral gastric tube insertion group( 19 cases).Neonatal pain score and incidence of complications during gastric tube insertion between both groups were compared.Results The mean rank of pain scores were significantly higher in the nasal gastric tube insertion group than in the oral gastric tube insertion group.The incidence of pain and complications were higher in the nasal gastric tube insertion group than in the oral gastric tube insertion group.Conclusions The impact of oral gastric tube insertion on neonatal pain response is not significant,and few complications occur during oral gastric tube insertion,so it is worthy of clinical application.

  18. Experimental investigation on thermo-physical properties and overall performance of MWCNT-water nanofluid flow inside horizontal coiled wire inserted tubes

    Science.gov (United States)

    Akhavan-Behabadi, M. A.; Shahidi, Mohamad; Aligoodarz, M. R.; Ghazvini, Mohammad

    2017-01-01

    The present study is aimed to measure and analyze the thermo-physical properties and overall performance of MWCNT-water nanofluid in turbulent flow regimes under constant heat flux conditions inside horizontal coiled wire inserted tubes. For this purpose, stable MWCNT-water nanofluids with different particle weight fractions of 0.05, 0.1 and 0.2 % as well as deionized water were utilized as the working fluids. It was found that the existing theoretical models could not predict the thermo-physical property values accurately, especially in case of specific heat capacity. Therefore, new empirical correlations are presented based on the obtained experimental results to predict such properties for the nanofluids. In addition, the overall performance of heat transfer techniques considered in this paper was evaluated based on thermal performance factor. The results revealed that thermal performance factor for all cases are greater than unity which indicate that simultaneous usage of nanofluids and wire coil inserts enhances the heat transfer without huge penalty in pumping power. Hence, using nanofluids as the working fluid in combination with coiled wire inserted tubes can be considered for some practical applications.

  19. Enteral Feeding Tubes in Patients Undergoing Definitive Chemoradiation Therapy for Head-and-Neck Cancer: A Critical Review

    Energy Technology Data Exchange (ETDEWEB)

    Koyfman, Shlomo A., E-mail: koyfmas@ccf.org [Departments of Radiation and Solid Tumor Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio (United States); Adelstein, David J. [Departments of Radiation and Solid Tumor Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio (United States)

    2012-11-01

    Definitive chemoradiation therapy has evolved as the preferred organ preservation strategy in the treatment of locally advanced head-and-neck cancer (LA-HNC). Dry mouth and dysphagia are among the most common and most debilitating treatment-related toxicities that frequently necessitate the placement of enteral feeding tubes (FT) in these patients to help them meet their nutritional requirements. The use of either a percutaneous endoscopic gastrostomy tube or a nasogastric tube, the choice of using a prophylactic vs a reactive approach, and the effects of FTs on weight loss, hospitalization, quality of life, and long-term functional outcomes are areas of continued controversy. Considerable variations in practice patterns exist in the United States and abroad. This critical review synthesizes the current data for the use of enteral FTs in this patient population and clarifies the relative advantages of different types of FTs and the timing of their use. Recent developments in the biologic understanding and treatment approaches for LA-HNC appear to be favorably impacting the frequency and severity of treatment-related dysphagia and may reduce the need for enteral tube feeding in the future.

  20. Comparison of the performance of 'Intubating LMA' and 'Cobra PLA' as an aid to blind endotracheal tube insertion in patients scheduled for elective surgery under general anesthesia.

    Science.gov (United States)

    Darlong, Vanlal; Chandrashish, Chakravarty; Chandralekha; Mohan, Virender Kumar

    2011-03-01

    Supraglottic airways (SGA) through which blind endotracheal intubation is made possible is an area of considerable interest. Our study aimed at comparing the Cobra Perilaryngeal Airway (CPLA) with the Intubating Laryngeal Mask Airway (ILMA) with regard to the performance of the former as a conduit for facilitating blind endotracheal intubation. American Society of Anesthesiologists (ASA) I-II patients consenting to the study, with no predictors of difficult airway, scheduled for elective surgery were randomized into two groups of 30 each. Anesthesia was induced with fentanyl, propofol and vecuronium. CPLA was inserted in Group I and ILMA in Group II. Fibreoptic scoring of the laryngeal view was done through the SGA. Blind intubation through either CPLA or ILMA was then carried out with cuffed polyvinyl chloride (PVC) tube in Group I and ILMA-tracheal tube in Group II. Demographic and surgical data were comparable between the two groups. The success rate of intubation (87% through CPLA and 90% through ILMA) (p value 1), number of attempts made and the fibreoptic scores (p value 0.12) were comparable between the two groups. Insertion time was significantly longer in Group I as compared with Group II (9 s vs. 4 s; p value 0.004). Trauma and sore throat were more common in Group I (p value -0.1, 0.19 respectively). Hemodynamic monitoring showed more tachycardia during CPLA insertion as compared with ILMA (p value 0.006). We conclude that CPLA can be used as an effective conduit for blind endotracheal intubation with cuffed PVC tube and has comparable efficacy in tracheal intubation as that with ILMA. Copyright © 2011. Published by Elsevier B.V.

  1. [Use of a metal guide in the working channel of a fiberoptic scope to insert a tracheal tube in an infant with Treacher Collins syndrome and choanal atresia].

    Science.gov (United States)

    Rodríguez Conesa, A M; Etxániz Alvarez, A; Rey Calvete, A M; Pérez Gil, J; Nieto Mouronte, C M

    2010-02-01

    Neonates with Treacher Collins syndrome can present difficult airways. Ventilation through a face mask and laryngoscopy for tracheal intubation may prove impossible due to the craniofacial malformations that are characteristic of this syndrome. Furthermore, patients with this syndrome are at high risk of airway obstruction, meaning that awake fiberoptic endoscopy provides the best option for tracheal intubation. This technique is especially difficult in children, however, and material required for performing it in neonates is not always available. We report the case of a 5-day-old infant boy with Treacher Collins syndrome and bilateral choanal atresia in whom we used a flexible metal guide inserted into the working channel of a fiberoptic scope. The tracheal tube could then be inserted.

  2. Case Report: Double lumen tube insertion in a morbidly obese patient through the non-channelled blade of the King Vision (™) videolaryngoscope.

    Science.gov (United States)

    El-Tahan, Mohamed; Doyle, D John; Khidr, Alaa M; Hassieb, Ahmed G

    2014-01-01

    We describe the insertion of the double lumen endobronchial tube (DLT) using a non-channeled standard blade of the King Vision (TM) videolaryngoscope for one lung ventilation (OLV) in a morbidly obese patient with a predicted difficult airway, severe restrictive pulmonary function, asthma, and hypertension. The patient was scheduled for a video-assisted thoracoscopic lung biopsy. The stylet of the DLT was bent to fit the natural curve of the #3 non-channeled blade of the King Vision (™) videolaryngoscope. We conclude that the use of King Vision (™) videolaryngoscope could offer an effective method of DLT placement for OLV.

  3. Case Report: Double lumen tube insertion in a morbidly obese patient through the non-channelled blade of the King Vision ™ videolaryngoscope

    Science.gov (United States)

    El-Tahan, Mohamed; Doyle, D. John; Khidr, Alaa M; Hassieb, Ahmed G

    2014-01-01

    We describe the insertion of the double lumen endobronchial tube (DLT) using a non-channeled standard blade of the King Vision TM videolaryngoscope for one lung ventilation (OLV) in a morbidly obese patient with a predicted difficult airway, severe restrictive pulmonary function, asthma, and hypertension. The patient was scheduled for a video-assisted thoracoscopic lung biopsy. The stylet of the DLT was bent to fit the natural curve of the #3 non-channeled blade of the King Vision ™ videolaryngoscope. We conclude that the use of King Vision ™ videolaryngoscope could offer an effective method of DLT placement for OLV. PMID:25309730

  4. Flow topology, heat transfer characteristic and thermal performance in a circular tube heat exchanger inserted with punched delta winglet vortex generators

    Energy Technology Data Exchange (ETDEWEB)

    Boonloi, Amnart [College of Industrial Technology, Bangkok (Thailand); Jedsadaratanachai, Withada [Faculty of Engineering, Bangkok (Thailand)

    2016-01-15

    To improve the heat transfer rate and thermal performance, the punched delta winglet vortex generators, DWVGs, were inserted in the middle of the circular tube heat exchanger. The effects of the flow attack angles and the flow directions were investigated numerically for the Reynolds number Re = 100 – 2000. The finite volume method and the SIMPLE algorithm were used to study. The results are reported in terms of the flow structure, heat transfer behavior and thermal performance evaluation and also compared with the smooth tube with no vortex generators. As the numerical results, the use of the DWVGs in the tube can improve the heat transfer rate and thermal performance by creating the vortex flow through the tested section. The rise of the flow attack angle results in the increasing strength of the vortex flows. The flow attack angle of 25 .deg. performs the highest heat transfer rate and thermal performance, while the flow attack angle of 0 .deg. gives the reversed results. The computational results reveal that the optimum thermal enhancement factor is around 2.80 at Re = 2000, α = 25 .deg., with the winglet tip pointing downstream. The correlations on both the Nusselt number ratio and friction factor ratio for the DWVG in the tube heat exchanger are presented.

  5. Measurement of fluid flow by means of pressure differential devices inserted in circular cross-section conduits running full -- Part 4: Venturi tubes

    CERN Document Server

    International Organization for Standardization. Geneva

    2003-01-01

    ISO 5167-4:2003 specifies the geometry and method of use (installation and operating conditions) of Venturi tubes when they are inserted in a conduit running full to determine the flowrate of the fluid flowing in the conduit. ISO 5167-4:2003 also provides background information for calculating the flow-rate and is applicable in conjunction with the requirements given in ISO 5167-1. ISO 5167-4:2003 is applicable only to Venturi tubes in which the flow remains subsonic throughout the measuring section and where the fluid can be considered as single-phase. In addition, each of these devices can only be used within specified limits of pipe size, roughness, diameter ratio and Reynolds number. ISO 5167-4:2003 is not applicable to the measurement of pulsating flow. It does not cover the use of Venturi tubes in pipes sized less than 50 mm or more than 1 200 mm, or for where the pipe Reynolds numbers are below 20 000. ISO 5167-4:2003 deals with the three types of classical Venturi tubes: cast, machined and rough welde...

  6. Risk of bleeding in patients undergoing percutaneous endoscopic gastrotrostomy (PEG tube insertion under antiplatelet therapy: a systematic review with a meta-analysis

    Directory of Open Access Journals (Sweden)

    Alfredo J. Lucendo

    2015-03-01

    Full Text Available Background and aim: Patients undergoing percutaneous endoscopic gastrostomy (PEG tube placement often are under antiplatelet therapy with a potential thromboembolic risk if these medications are discontinued. This systematic review aims to assess if maintaining aspirin and/or clopidogrel treatment increases the risk of bleeding following PEG placement. Methods: A systematic search of the MEDLINE, EMBASE, and SCOPUS databases was developed for studies investigating the risk of bleeding in patients on antiplatelet therapy undergoing PEG tube insertion. Summary estimates, including 95 % confidence intervals (CI, were calculated. A fixed or random effects model was used depending on heterogeneity (I². Publication bias risks were assessed by means of funnel plot analysis. Results: Eleven studies with a total of 6,233 patients (among whom 3,665 were undergoing antiplatelet treatment, met the inclusion criteria and were included in the quantitative summary. Any PEG tube placement-related bleeding was found in 2.67 % (95 % CI 1.66 %, 3.91 % of the entire population and in 2.7 % (95 % CI 1.5 %, 4.1 % of patients not receiving antiplatelet therapy. Pooled relative risk (RR for bleeding in patients under aspirin, when compared to controls, was 1.43 (95 % CI 0.89, 2.29; I² = 0 %; pooled RR for clopidogrel was 1.21 (95 % CI 0.48, 3.04; I² = 0 % and for dual antiplatelet therapy, 2.13; (95 % CI 0.77, 5.91; I² = 47 %. No significant publication bias was evident for the different medications analyzed. Conclusion: Antiplatelet therapy was safe among patients undergoing PEG tube insertion. Future prospective and randomized studies with larger sample sizes are required to confirm the results of this study.

  7. Long-term management of a dog with idiopathic megaesophagus and recurrent aspiration pneumonia by use of an indwelling esophagostomy tube for suction of esophageal content and esophagogastric tube feeding

    OpenAIRE

    KANEMOTO, Yuka; FUKUSHIMA, Kenjiro; Kanemoto, Hideyuki; OHNO, Koichi; TSUJIMOTO, Hajime

    2016-01-01

    A 10-year-old neutered male Labrador Retriever dog was diagnosed with idiopathic megaesophagus. Despite receiving conventional treatments including elevated feeding, the dog showed repeated regurgitation and aspiration pneumonia, consequently developing weight loss and severe malnutrition. For the purpose of controlling regurgitation, an esophagostomy tube was placed for draining the esophageal fluid. Additionally, an esophagogastric tube was placed for nutritional support. After tube placeme...

  8. Electromagnetic-Guided Bedside Placement of Nasoenteral Feeding Tubes by Nurses Is Non-Inferior to Endoscopic Placement by Gastroenterologists: A Multicenter Randomized Controlled Trial

    NARCIS (Netherlands)

    Gerritsen, A.; Rooij, T. de; Dijkgraaf, M.G.; Busch, O.R.; Bergman, J.J.; Ubbink, D.T.; Duijvendijk, P. van; Erkelens, G.W.; Klos, M.; Kruyt, P.M.; Bac, D.J.; Rosman, C.; Tan, A.C.; Molenaar, I.Q.; Monkelbaan, J.F.; Mathus-Vliegent, E.M.; Besselink, M.G.

    2016-01-01

    OBJECTIVES: Electromagnetic (EM)-guided bedside placement of nasoenteral feeding tubes by nurses may improve efficiency and reduce patient discomfort and costs compared with endoscopic placement by gastroenterologists. However, evidence supporting this task shift from gastroenterologists to nurses i

  9. Using a nasogastric tube.

    Science.gov (United States)

    Candy, C

    1986-09-01

    This discussion of the use of a nasogastric tube covers the equipment needed, the method, rehydration and feeding, prolonged nasogastric feeding, and stopping nasogastric feeding. A nasogastric tube is useful when children are unable to drink safely and in sufficient amounts for any of the following reasons: severe dehydration; if intravenous (IV) therapy is unavailable; low birth weight infants; or the child is drowsy or vomiting. Severely malnourished children may be fed initially in this way if they are too weak or anorexic to eat or drink normally. The following equipment is needed: nasogastric tube; lubricating fluid; a syringe; blue litmus paper, if available; adhesive tape; stethoscope if available; and fluid to be given. Explain to the child's parents and the child, if old enough to understand, what will be done; lie infants flat; measure the approximate length from the child's nostril to the ear lobe and then to the top of the abdomen with the tube and mark the position; clean the nostrils to remove the mucus, and lubricate the tip of the tube and gently insert into the nostril; give the child a drink of water if he or she is conscious; continue to pass the tube down until the position marked reaches the nostril; use the syringe to suck up some fluid and test with blue litmus paper to check that the tube is in the stomach; and inject 5-10 ml of fluid (saline or oral rehydration solution, not milk formula) by syringe if satisfied the tube is in the correct position. Where possible, give a continuous drip of fluid. If this is not possible, give frequent small amounts using the syringe as a funnel. If feeding continues for more than 24 hours, clean the nostrils daily with warm water and change the tube to the other nostril every few days. Also keep the mouth very clean with a dilute solution of 8% sodium bicarbonate, if available, or citrus fruit juice. To remove the tube, remove the adhesive tape, take the tube out gently and smoothly, and offer the child a

  10. Mirtazapine treatment of diabetic gastroparesis as a novel method to reduce tube-feed residual: a case report

    Directory of Open Access Journals (Sweden)

    Gooden Janelle Y

    2013-02-01

    Full Text Available Abstract Introduction Gastroparesis is a common motility disorder that is characterized by delayed gastric emptying in the absence of mechanical obstruction. Diabetes, along with other neuromuscular and infiltrating disorders, can predispose individuals to an increased risk of developing gastroparesis. Gastroparesis can be easily diagnosed through gastric emptying studies but is usually difficult to successfully treat. Therapy usually begins with pro-kinetic and anti-emetic agents. Case presentation Our patient was an 87-year-old African-American woman who was a nursing home resident, with a history of diabetes mellitus type 2 and subarachnoid hemorrhage leading to aphasia, hemiplegia, seizures and dysphagia requiring percutaneous gastric feeds. While at the nursing home, she had recurrent aspiration pneumonia and large tube-feed residuals consistent with a diagnosis of underlying gastroparesis. Her management included metoclopramide and reduced tube-feeding rates, which improved her symptoms. However, within months the aspiration and increased residuals returned. After trials of different medication therapies without success, she started mirtazapine and her residual volume and aspirations decreased with a dose of 15mg nightly. Conclusion In patients with gastroparesis recalcitrant to first line therapies such as metoclopramide, off-label use of mirtazapine may provide adequate non-invasive management of gastroparetic symptoms.

  11. Numerical investigation of heat transfer and friction factor characteristics in a circular tube fitted with V-cut twisted tape inserts.

    Science.gov (United States)

    Salman, Sami D; Kadhum, Abdul Amir H; Takriff, Mohd S; Mohamad, Abu Bakar

    2013-01-01

    Numerical investigation of the heat transfer and friction factor characteristics of a circular fitted with V-cut twisted tape (VCT) insert with twist ratio (y = 2.93) and different cut depths (w = 0.5, 1, and 1.5 cm) were studied for laminar flow using CFD package (FLUENT-6.3.26). The data obtained from plain tube were verified with the literature correlation to ensure the validation of simulation results. Classical twisted tape (CTT) with different twist ratios (y = 2.93, 3.91, 4.89) were also studied for comparison. The results show that the enhancement of heat transfer rate induced by the classical and V-cut twisted tape inserts increases with the Reynolds number and decreases with twist ratio. The results also revealed that the V-cut twisted tape with twist ratio y = 2.93 and cut depth w = 0.5 cm offered higher heat transfer rate with significant increases in friction factor than other tapes. In addition the results of V-cut twist tape compared with experimental and simulated data of right-left helical tape inserts (RLT), it is found that the V-cut twist tape offered better thermal contact between the surface and the fluid which ultimately leads to a high heat transfer coefficient. Consequently, 107% of maximum heat transfer was obtained by using this configuration.

  12. Carnitine deficiency presenting with encephalopathy and hyperammonemia in a patient receiving chronic enteral tube feeding: a case report

    Directory of Open Access Journals (Sweden)

    Ling Peter

    2012-07-01

    Full Text Available Abstract Introduction Carnitine is an essential cofactor in mitochondrial fatty acid oxidation. Carnitine deficiency results in accumulation of non-oxidized fatty acyl-coenzyme A molecules, and this inhibits intra-mitochondrial degradation of ammonia. Hyperammonemia may lead to encephalopathy. This scenario has been previously reported. Case presentation We report the case of a 47-year-old Caucasian man who had sustained a remote motor vehicle accident injury and relied on long-term tube feeding with a commercial product that wascarnitine-free. He was also on phenytoin therapy for control of his chronic seizures. He developed significant acute psychological and behavioral changes superimposed on his chronic neurological impairment. His ammonia level was found to be elevated at 75 to 100μmol/L (normal Conclusion This case illustrates the importance of avoiding carnitine deficiency and anti-convulsant toxicity in tube-fed patients encountered in hospital wards and nursing homes. These patients should have their carnitine levels assessed regularly, and supplementation should be provided as necessary. Manufacturers of enteral feeds and formulas should consider adding carnitine to their product lines.

  13. Application of myringotomy and ventilation tube insertion in the hearing rehabilitation of children with secretory otitis media%鼓膜切开置管术在儿童分泌性中耳炎听力康复中的应用

    Institute of Scientific and Technical Information of China (English)

    苗英章; 步桂清; 张秀者; 荣宏; 张勋

    2003-01-01

    AIM: To study the role of the myringotomy and ventilation tube insertion inthe hearing rehabilitation of the children with secretory otitis media(SOM).METHODS: Myringotomy and ventilation tube insertions were performed in56 children with chronic SOM. RESULTS: The pure-tone threshold average(PTA) of six months after operation in 50 cases(91 ears) was improvedsignificantly compared with the preoperative PTA( P < 0. 01 ). The effectiverate of myringotomy and ventilation tube insertion was 92. 3%. CONCLU-SION: As a therapeutic method in the hearing rehabilitation of the childrenwith chronic SOM, the myringotomy and veptilation tube insertion should beused as primary surgical therapy.

  14. 胃镜下胃管代替鼻肠管在重症患者中应用%The application of feeding tube instead of naso-gastric tube under gastroscope in critical patients

    Institute of Scientific and Technical Information of China (English)

    焦宪法; 李伟丽; 牛杏果; 张科; 王小雯; 赵玉洁

    2012-01-01

    [ Objective ] To observe the safety and effectiveness of enteral feeding tube as nasogastric tube instead of common nasointestenal tube with the help of endoscopy in the critical patients. [Methods] 70 cases of critical patients who received enteral nutrition by postpyloric feeding tube, were divided into naso-gastric tube group and spiral naso-in-testinal tube group. Each group was consisted of 35 cases. In naso-gastric group, naso-gastric tube instead of naso-in-testinal tube, the feeding tubes were placed with endoscopy. With the guidance of endoscopy, the pincers grasped the end of the nasogastric tube, and sent it into the pylorus, as far as possible. [ Results ] The success rate of such method which placed the naso-pyloric feeding tube with the guidance of endoscopy was 100%. There were no complications during the procedure. The feeding tube displaced into the stomach in 2 cases during the enteral nutrition, reflux in 2 cases, aspiration pneumonia 2 cases, no blockage of all feeding tubes. [ Conclusion ] Naso-gastric tube instead of common naso-in-testinal tube ,which was placed beyond postpylorus as naso-postpyloric feeding tube, was safe and effective, not prone to blockage, less reflux during enteral nutrition.%目的 探讨在重症患者中胃镜辅助下以鼻胃管代替普通鼻肠管实施肠内营养的安全性和可靠性.方法 选择需要肠内营养重症患者70例,分为胃管代鼻肠管组和螺旋型鼻肠管组,每组35例.胃管代鼻肠管组在胃镜下用异物钳钳夹鼻胃管,推送胃镜和异物钳经过幽门,尽可能送胃管达幽门以远.螺旋型鼻肠管组鼻肠管远端未在小肠者,借助胃镜完成.结果 此种胃镜下胃管代鼻肠管方法营养管放置成功率为100%.放置期间均无并发症.在使用过程中有2例出现反流,胃镜检查发现1例营养管易位于胃腔,另1例位置正常.吸入性肺炎发生率为5.7%;肠内营养期间未发生堵管现象.肠内营养支持治疗后

  15. To drain or not to drain? Predictors of tube thoracostomy insertion and outcomes associated with drainage of traumatic hemothoraces.

    Science.gov (United States)

    Wells, Bryan J; Roberts, Derek J; Grondin, Sean; Navsaria, Pradeep H; Kirkpatrick, Andrew W; Dunham, Michael B; Ball, Chad G

    2015-09-01

    Historical data suggests that many traumatic hemothoraces (HTX) can be managed expectantly without tube thoracostomy (TT) drainage. The purpose of this study was to identify predictors of TT, including whether the quantity of pleural blood predicted tube placement, and to evaluate outcomes associated with TT versus expected management (EM) of traumatic HTXs. A retrospective cohort study of all trauma patients with HTXs and an Injury Severity Score (ISS) ≥12 managed at a level I trauma centre between April 1, 2005 and December 31, 2012 was completed. Mixed-effects models with a subject-specific random intercept were used to identify independent risk factors for TT. Logistic and log-linear regression were used to compute odds ratios (ORs) for mortality and empyema and percent increases in length of hospital and intensive care unit stay between patients managed with TT versus EM, respectively. A total of 635 patients with 749 HTXs were included in the study. Overall, 491 (66%) HTXs were drained while 258 (34%) were managed expectantly. Independent predictors of TT placement included concomitant ipsilateral flail chest [OR 3.03; 95% confidence interval (CI) 1.04-8.80; p=0.04] or pneumothorax (OR 6.19; 95% CI 1.79-21.5; p<0.01) and the size of the HTX (OR per 10cc increase 1.12; 95% CI 1.04-1.21; p<0.01). Although the adjusted odds of mortality were not significantly different between groups (OR 3.99; 95% CI 0.87-18.30; p=0.08), TT was associated with a 47.14% (95% CI, 25.57-69.71%; p<0.01) adjusted increase in hospital length of stay. Empyemas (n=29) only occurred among TT patients. Expectant management of traumatic HTX was associated with a shorter length of hospital stay, no empyemas, and no increase in mortality. Although EM of smaller HTXs may be safe, these findings must be confirmed by a large multi-centre cohort study and randomized controlled trials before they are used to guide practice. Copyright © 2015 Elsevier Ltd. All rights reserved.

  16. Long-term management of a dog with idiopathic megaesophagus and recurrent aspiration pneumonia by use of an indwelling esophagostomy tube for suction of esophageal content and esophagogastric tube feeding.

    Science.gov (United States)

    Kanemoto, Yuka; Fukushima, Kenjiro; Kanemoto, Hideyuki; Ohno, Koichi; Tsujimoto, Hajime

    2017-01-24

    A 10-year-old neutered male Labrador Retriever dog was diagnosed with idiopathic megaesophagus. Despite receiving conventional treatments including elevated feeding, the dog showed repeated regurgitation and aspiration pneumonia, consequently developing weight loss and severe malnutrition. For the purpose of controlling regurgitation, an esophagostomy tube was placed for draining the esophageal fluid. Additionally, an esophagogastric tube was placed for nutritional support. After tube placement, the average frequency of regurgitation was reduced from 2.4 times a day to 0.1 times a day. The nutritional state of the dog improved gradually, and the body weight increased from 18.5 to 27.9 kg. The dog died on day 951, and necropsy revealed a gastric ulcer (2.5 cm in diameter), presumably esophagostomy tube-induced injury. This case report suggests that patients with idiopathic megaesophagus and persistent regurgitation might benefit from esophageal drainage through an esophagostomy tube.

  17. 预防气管切开鼻饲患者误吸的循证护理%Prevention of aspiration among patients with an tracheostomy tube and a nasogastric feeding tube: evidence-based nursing

    Institute of Scientific and Technical Information of China (English)

    徐燕; 周丽慧; 胡静; 王菊; 胡雁

    2012-01-01

    Objective To formulate an evidence-based nursing plan to prevent aspiration among patients with an tracheostomy tube and a nasogastric feeding tube. Methods Nine patients after intracranial tumor resection were enrolled and each of them were tra-cheostomized and had a nasogastric feeding tube in place. We identified nursing problems for the nine cases, searched the best evidence on how to prevent aspiration for these cases through computer. Then we applied the best evidence to the 9 patients and evaluated its effect. Results No aspiration occurred in the 9 patients. Conclusion Evidence-based nursing approach can effectively prevent aspiration among patients with an tracheostomy tube and a nasogastric feeding tube.%目的 采用循证护理方案预防气管切开鼻饲患者发生误吸.方法 针对9例颅内肿瘤开颅切除术后患者的护理问题,计算机检索防止此类患者发生误吸的最佳实践证据,应用于该组患者并评价效果.结果 该组患者在循证护理期间未发生误吸.结论 采用循证方法提出的护理方案能有效防止气管切开并鼻饲患者发生误吸.

  18. Using sounds for making decisions: greater tube-nosed bats prefer antagonistic calls over non-communicative sounds when feeding.

    Science.gov (United States)

    Jiang, Tinglei; Long, Zhenyu; Ran, Xin; Zhao, Xue; Xu, Fei; Qiu, Fuyuan; Kanwal, Jagmeet S; Feng, Jiang

    2016-12-15

    Bats vocalize extensively within different social contexts. The type and extent of information conveyed via their vocalizations and their perceptual significance, however, remains controversial and difficult to assess. Greater tube-nosed bats, Murina leucogaster, emit calls consisting of long rectangular broadband noise burst (rBNBl) syllables during aggression between males. To experimentally test the behavioral impact of these sounds for feeding, we deployed an approach and place-preference paradigm. Two food trays were placed on opposite sides and within different acoustic microenvironments, created by sound playback, within a specially constructed tent. Specifically, we tested whether the presence of rBNBl sounds at a food source effectively deters the approach of male bats in comparison to echolocation sounds and white noise. In each case, contrary to our expectation, males preferred to feed at a location where rBNBl sounds were present. We propose that the species-specific rBNBl provides contextual information, not present within non-communicative sounds, to facilitate approach towards a food source.

  19. Body Weight and Body Mass Index in Patients with End-Stage Cystic Fibrosis Stabilize After the Start of Enteral Tube Feeding

    NARCIS (Netherlands)

    Hollander, Francis M.; Roos, de Nicole M.; Belle-Van Meerkerk, Gerdien; Teding van Berkhout, Ferdinand; Heijerman, Harry G.M.; Graaf, van de Ed A.

    2017-01-01

    Background: Enteral tube feeding (ETF) is widely used in patients with cystic fibrosis (CF) and end-stage lung disease, but previous studies have been limited to investigating whether ETF improves outcomes in patients with moderately or mildly impaired pulmonary function. Objective: This study

  20. Nasogastric tube feeding in children with cancer: The effect of two different formulas on weight, body composition, and serum protein concentrations

    NARCIS (Netherlands)

    Broeder, den E.; Lippens, L.J.J.; Hof, van 't M.A.; Tolboom, J.J.M.; Sengers, R.C.A.; Berg, van den A.M.J.; Staveren, van W.A.

    2000-01-01

    Background: Treatment of cancer cachexia partly involves the administration of adequate amounts of energy. The aim of this study was to assess the tolerance and efficacy of two equal volumes of tube feeding, one with a standard (1 kcal/mL) and one with a high energy density (1.5 kcal/mL), during the

  1. The Effect of an Intervention Aimed at Reducing Errors when Administering Medication through Enteral Feeding Tubes in an Institution for Individuals with Intellectual Disability

    Science.gov (United States)

    Idzinga, J. C.; de Jong, A. L.; van den Bemt, P. M. L. A.

    2009-01-01

    Background: Previous studies, both in hospitals and in institutions for clients with an intellectual disability (ID), have shown that medication errors at the administration stage are frequent, especially when medication has to be administered through an enteral feeding tube. In hospitals a specially designed intervention programme has proven to…

  2. Measurement of impulse peak insertion loss from two acoustic test fixtures and four hearing protector conditions with an acoustic shock tube

    Directory of Open Access Journals (Sweden)

    William J Murphy

    2015-01-01

    Full Text Available Impulse peak insertion loss (IPIL was studied with two acoustic test fixtures and four hearing protector conditions at the E-A-RCAL Laboratory. IPIL is the difference between the maximum estimated pressure for the open-ear condition and the maximum pressure measured when a hearing protector is placed on an acoustic test fixture (ATF. Two models of an ATF manufactured by the French-German Research Institute of Saint-Louis (ISL were evaluated with high-level acoustic impulses created by an acoustic shock tube at levels of 134 decibels (dB, 150 dB, and 168 dB. The fixtures were identical except that the E-A-RCAL ISL fixture had ear canals that were 3 mm longer than the National Institute for Occupational Safety and Health (NIOSH ISL fixture. Four hearing protection conditions were tested: Combat Arms earplug with the valve open, ETYPlugs ® earplug, TacticalPro headset, and a dual-protector ETYPlugs earplug with TacticalPro earmuff. The IPILs measured for the E-A-RCAL fixture were 1.4 dB greater than the National Institute for Occupational Safety and Health (NIOSH ISL ATF. For the E-A-RCAL ISL ATF, the left ear IPIL was 2.0 dB greater than the right ear IPIL. For the NIOSH ATF, the right ear IPIL was 0.3 dB greater than the left ear IPIL.

  3. Measurement of impulse peak insertion loss from two acoustic test fixtures and four hearing protector conditions with an acoustic shock tube.

    Science.gov (United States)

    Murphy, William J; Fackler, Cameron J; Berger, Elliott H; Shaw, Peter B; Stergar, Mike

    2015-01-01

    Impulse peak insertion loss (IPIL) was studied with two acoustic test fixtures and four hearing protector conditions at the E-A-RCAL Laboratory. IPIL is the difference between the maximum estimated pressure for the open-ear condition and the maximum pressure measured when a hearing protector is placed on an acoustic test fixture (ATF). Two models of an ATF manufactured by the French-German Research Institute of Saint-Louis (ISL) were evaluated with high-level acoustic impulses created by an acoustic shock tube at levels of 134 decibels (dB), 150 dB, and 168 dB. The fixtures were identical except that the E-A-RCAL ISL fixture had ear canals that were 3 mm longer than the National Institute for Occupational Safety and Health (NIOSH) ISL fixture. Four hearing protection conditions were tested: Combat Arms earplug with the valve open, ETYPlugs ® earplug, TacticalPro headset, and a dual-protector ETYPlugs earplug with TacticalPro earmuff. The IPILs measured for the E-A-RCAL fixture were 1.4 dB greater than the National Institute for Occupational Safety and Health (NIOSH) ISL ATF. For the E-A-RCAL ISL ATF, the left ear IPIL was 2.0 dB greater than the right ear IPIL. For the NIOSH ATF, the right ear IPIL was 0.3 dB greater than the left ear IPIL.

  4. Nasogastric or nasointestinal feeding in severe acute pancreatitis

    Institute of Scientific and Technical Information of China (English)

    Matteo; Piciucchi; Elettra; Merola; Massimo; Marignani; Mari-anna; Signoretti; Roberto; Valente; Lucia; Cocomello; Flavia; Baccini; Francesco; Panzuto; Gabriele; Capurso; Gianfranco; Delle; Fave

    2010-01-01

    AIM:To assess the rate of spontaneous tube migration and to compare the effects of naso-gastric and nasointestinal(NI)(beyond the ligament of Treitz) feeding in severe acute pancreatitis(SAP).METHODS:After bedside intragastric insertion,tube position was assessed,and enteral nutrition(EN) started at day 4,irrespective of tube localization.Patients were monitored daily and clinical and laboratory parameters evaluated to compare the outcome of patients with nasogastric(NG) or NI tube.RESULTS:Spontaneous tube ...

  5. Ultrasonic homogenization of expressed human milk to prevent fat loss during tube feeding.

    Science.gov (United States)

    Martinez, F E; Desai, I D; Davidson, A G; Nakai, S; Radcliffe, A

    1987-01-01

    Effective use of expressed human milk in infant feeding requires proper handling, processing, storage, and administration in order to maintain its unique nutritional properties. One of the problems with expressed human milk is the separation of fat during processing, storage, and administration to the infant. Administration by continuous nasogastric infusion, either by intermittent gravity flow or by continuous mechanical pump, resulted in significant loss of fat and variation in the constitution of the milk delivered. Homogenization by ultrasonic treatment prevented changes in fat concentration during infusion and essentially eliminated loss of this nutrient during administration. The conditions necessary to achieve fat dispersion and stabilization of fat particles in human milk by ultrasonic treatment are described.

  6. PICC Seldinger technique and traditional tube insertion.we Used to compare%Seldinger技术与传统PICC置管术应用比较

    Institute of Scientific and Technical Information of China (English)

    罗昭梅

    2016-01-01

    目的:比较超声实时引导下改良Seldinger技术与传统经外周静脉穿刺置入中心静脉导管(PICC)置管术在肿瘤患者中的应用效果。方法:将116例拟实施PICC置管化疗的肺癌患者随机分为观察组(58例)和对照组(58例),观察组是采用超声实时引导下的改良Seldinger技术穿刺置管,对照组采用传统方法置管。结果:观察组和对照组的一次性穿刺成功率、一次置管成功率、机械性静脉炎和血栓形成比较差异均有统计学意义(P<0.05),但在穿刺点渗血方面差异无统计学意义(P>0.05)。结论:超声实时引导下改良Seldinger技术行PICC置管一次成功率高,并发症少,值得在肿瘤患者化疗中进行推广。%purpose:to compare the ultrasonic guided by real-time modified Seldinger technique and traditional via peripheral venous puncture in central venous catheter (PICC) tube insertion.we application effect in cancer patients.Methods:116 cases of quasi implementation of PICC catheter chemotherapy in lung cancer patients were randomly divided into observation group (58 cases) and control group (58 cases),the observation group USES the modified Seldinger technique guided by ultrasound real-time,tube control group using traditional methods.Results:the observation group and control group of one-time success rate of puncture,a success rate of catheter,mechanical phlebitis thrombosis and comparative differences are statistically significant (P0.05).Conclusion:ultrasound guided by real-time modified Seldinger technique line of PICC catheter into a high power,fewer complications,is worth popularizing in cancer chemotherapy.

  7. Long-term nasogastric tube feeding in elderly stroke patients--an assessment of nutritional adequacy and attitudes to gastrostomy feeding in Asians.

    Science.gov (United States)

    Zaherah Mohamed Shah, F; Suraiya, H-S; Poi, P J-H; Tan, K S; Lai, P S M; Ramakrishnan, K; Mahadeva, S

    2012-08-01

    Gastrostomy feeding is superior to long-term nasogastric (NG) feeding in patients with dysphagic stroke, but this practice remains uncommon in Asia. We sought to examine the nutritional adequacy of patients on long term NG feeding and identify barriers to gastrostomy feeding in these patients. A prospective comparison of subjective global assessment (SGA), and anthropometry (mid-arm muscle circumference, MAMC; triceps skinfold thickness, TST) between elderly stroke patients on long-term NG feeding and matched controls was performed. Selected clinicians and carers of patients were interviewed to assess their knowledge and attitudes to gastrostomy feeding. 140 patients (70 NG, 70 oral) were recruited between September 2010 and February 2011. Nutritional status was poorer in the NG compared to the oral group (SGA grade C 38.6% NG vs 0% oral, pstroke on long term NG feeding have a poor nutritional status. Lack of recommendation by clinicians appears to be a major barrier to PEG feeding in these patients.

  8. The effect of an intervention aimed at reducing errors when administering medication through enteral feeding tubes in an institution for individuals with intellectual disability.

    Science.gov (United States)

    Idzinga, J C; de Jong, A L; van den Bemt, P M L A

    2009-11-01

    Previous studies, both in hospitals and in institutions for clients with an intellectual disability (ID), have shown that medication errors at the administration stage are frequent, especially when medication has to be administered through an enteral feeding tube. In hospitals a specially designed intervention programme has proven to be effective in reducing these feeding tube-related medication errors, but the effect of such a programme within an institution for clients with an ID is unknown. Therefore, a study was designed to measure the influence of such an intervention programme on the number of medication administration errors in clients with an ID who also have enteral feeding tubes. A before-after study design with disguised observation to document administration errors was used. The study was conducted from February to June 2008 within an institution for individuals with an ID in the Western part of The Netherlands. Included were clients with enteral feeding tubes. The intervention consisted of advice on medication administration through enteral feeding tubes by the pharmacist, a training programme and introduction of a 'medication through tube' box containing proper materials for crushing and suspending tablets. The outcome measure was the frequency of medication administration errors, comparing the pre-intervention period with the post-intervention period. A total of 245 medication administrations in six clients (by 23 nurse attendants) have been observed in the pre-intervention measurement period and 229 medication administrations in five clients (by 20 nurse attendants) have been observed in the post-intervention period. Before the intervention, 158 (64.5%) medication administration errors were observed, and after the intervention, this decreased to 69 (30.1%). Of all potential confounders and effect modifiers, only 'medication dispensed in automated dispensing system ("robot") packaging' contributed to the multivariate model; effect modification was

  9. Factors associated with nosocomial diarrhea in patients with enteral tube feeding Factores asociados a diarrea nosocomial en pacientes con nutrición enteral

    OpenAIRE

    J. Trabal; P. Leyes; S. Hervás; Herrera, M.; M.ª de Talló Forga

    2008-01-01

    Objectives: Diarrhea is a frequent complication associated to enteral tube feeding (ETF) and it is a frequent cause of reduction or suspension of this type of nutritional support. Our objective was to evaluate the factors associated with nosocomial diarrhea in patients receiving ETF. Results: The only significant factor associated with the appearance of diarrhea was antibiotic consumption, specially those patients receiving the combination of two or more antibiotics. We did not find any assoc...

  10. 下消化道手术废除胃肠减压并早期肠内营养治疗的临床研究%None nasogastric decompression tube and early oral feeding after lower gastrointestinal surgery

    Institute of Scientific and Technical Information of China (English)

    庞明辉; 王波; 罗斌; 张伟; 王康; 李平; 郭志义; 胡阳; 杨春; 杨洲

    2011-01-01

    Objective To investigate the safety and effectiveness with none nasogastric decompression tube and early enteral nutrition support after lower gastrointestinal surgery. Methods 226 patients undergoing lower gastrointestinal surgery were inserted nasogastric decompression tube as control group, meanwhile other 187 with none nasogastric decompression tube and early oral feeding according fast track surgery rules as the experiment group. We compared their time to flatus, mortality, and the ratio of postoperative complications including nausea, wound infection, pneumonia,anastomotic leak. and hospital stay. Results The pneumonia of study group was lower than control group(P<0. 05).And other postoperative complications were no difference between two groups. Conclusion None nasogastric decompression tube and early oral feeding after lower gastrointestinal surgery was safe and feasible.%目的 探讨下消化道手术废弃胃肠减压并术后早期进食的安全及有效性.方法 对我院胃肠外科进入快速康复的下消化道手术患者共413例,按术前是否常规安置胃肠减压分为研究组(187例)及对照组(226例).比较两组患者术后死亡率、吻合口漏发生率、肛门排气时间、呕吐、切口感染、肺部感染发生率及术后住院时间.结果 两组患者在术后死亡率、肛门排气时间、呕吐、切口感染、吻合口漏发生率及术后住院时间等指标无明显差异.研究组的术后肺部感染率要低于对照组,P<0.05.结论 下消化道手术废弃胃肠减压井术后早期进食是安全的.

  11. Evaluation of the profile of drug therapy administered through enteral feeding tube in a general hospital in Rio de Janeiro

    Directory of Open Access Journals (Sweden)

    Mario Jorge Sobreira da Silva

    2011-06-01

    Full Text Available Enteral nutrition (EN is the method of choice for patients that cannot adequately receive oral feeding despite good gastrointestinal tract condition. Enteral diets may be administered through tube or ostomy placed in the stomach, duodenum or jejunum. The administration of drugs via enteral feeding tube (EFT is a common practice in hospitals due to patient clinical status, and requires special attention from professionals involved in this process. This study entailed an analysis of the profile of drug therapy through EFT based on evaluation of medical prescriptions of the Medical Clinic of the Hospital dos Servidores do Estado (HSE of Rio de Janeiro sent to the Pharmacy Service between January and June 2007, according to standard protocols in place. Prescription of drugs via EFT outside recommended guidelines was observed, besides potential drug-nutrient incompatibilities associated with this practice. These results point to the need for improvement of enteral route access and the adoption of measures to promote safe and effective use of drugs and nutritional therapy.A nutrição enteral (NE é o método de escolha para alimentar pacientes que não podem receber alimentação por via oral de forma adequada, mas que estejam com a função gastrointestinal satisfatória para a absorção dos nutrientes. As dietas enterais podem ser administradas através de cateteres ou ostomias, posicionados no estômago, duodeno ou jejuno. A administração de medicamentos através de cateter de nutrição enteral (CNE é uma prática muito comum no ambiente hospitalar, devido ao estado clínico do paciente, necessitando atenção especial dos profissionais envolvidos neste processo. O estudo constituiu uma análise do perfil da terapia medicamentosa através de CNE por meio de uma avaliação das prescrições médicas da Clínica Médica do Hospital dos Servidores do Estado (HSE do Rio de Janeiro encaminhadas ao Serviço de Farmácia, de janeiro a junho de 2007

  12. 丁卡因在正颌术后患者胃管置入中的应用效果%Effects of tetracaine spray on insertion of stomach tubes after orthognathic surgery

    Institute of Scientific and Technical Information of China (English)

    雍琪; 魏建华; 马婕; 陈欢; 何英莲

    2013-01-01

    Objective To evaluate the effects of oropharyngeal topical anesthesia with tetracaine spray (0.1%) on the discomfort and success rate of insertion of stomach tube after orthognathic surgery.Methods Totals of 80 patients treated with bimaxillary orthognathic surgery were randomly assigned into control group (n =40) and test group (n =40).Stomach tubes were inserted into stomachs of the patients with a semirecumbent position through nasal at the day after surgery.Traditional methods of inserting stomach tubes were applied in control group,while patients in test group were given topical anesthesia with 0.1% tetracaine spray to oropharyngeal before stomach tubes inserted.The operating time and primary success rate of tube insertion were recorded.Intubation pain or discomfort was observed.Results The operating time of test group was significantly shorter than that of control group (2.7 ± 0.8 min vs 4.2 ± 1.1 min,t =2.892,P < 0.01).Primary success rate of intubation of test group was significantly higher than that of control group (97.5% vs 85%,x2 =3.914,P <0.05).There was less pain or discomfort in the intubation process in test group (Z =2.660,P < 0.01).Conclusions Stomach tube insertion with 0.1% tetracaine spray topical anesthesia can alleviate pain,improve primary success rate of stomach tube insertion.%目的 观察0.1%丁卡因表面麻醉用于正颌术后患者胃管置入过程中,对置管不适的效果和一次置管成功率的影响.方法 将80例双颌接受正颌外科手术的患者采用随机数字表法分为对照组以及干预组,每组40例.两组均于术后第1天采用半卧位经鼻留置胃管,对照组用传统方法留置胃管,干预组置管前3 min应用0.1%的丁卡因给予咽腔喷雾表面麻醉,分别测量置管时间和一次性置管成功率,并对置管不适情况进行评估.结果 干预组置管时间显著短于对照组(2.7 ±0.8 min vs 4.2±1.1 min),一次性置管率高于对照组(97.5%vs 85

  13. A virtual reality based simulator for learning nasogastric tube placement.

    Science.gov (United States)

    Choi, Kup-Sze; He, Xuejian; Chiang, Vico Chung-Lim; Deng, Zhaohong

    2015-02-01

    Nasogastric tube (NGT) placement is a common clinical procedure where a plastic tube is inserted into the stomach through the nostril for feeding or drainage. However, the placement is a blind process in which the tube may be mistakenly inserted into other locations, leading to unexpected complications or fatal incidents. The placement techniques are conventionally acquired by practising on unrealistic rubber mannequins or on humans. In this paper, a virtual reality based training simulation system is proposed to facilitate the training of NGT placement. It focuses on the simulation of tube insertion and the rendering of the feedback forces with a haptic device. A hybrid force model is developed to compute the forces analytically or numerically under different conditions, including the situations when the patient is swallowing or when the tube is buckled at the nostril. To ensure real-time interactive simulations, an offline simulation approach is adopted to obtain the relationship between the insertion depth and insertion force using a non-linear finite element method. The offline dataset is then used to generate real-time feedback forces by interpolation. The virtual training process is logged quantitatively with metrics that can be used for assessing objective performance and tracking progress. The system has been evaluated by nursing professionals. They found that the haptic feeling produced by the simulated forces is similar to their experience during real NGT insertion. The proposed system provides a new educational tool to enhance conventional training in NGT placement.

  14. Numerical Simulation of the Tube Inserted with Rotors -assembled Device for Heat Transfer Enhancement%换热管内转子强化换热的数值模拟

    Institute of Scientific and Technical Information of China (English)

    张震; 韩崇刚; 李锋样; 阎华; 杨卫民

    2011-01-01

    Principle of the rotors - assembled device for heat transfer enhancement and automatic cleaning was first introduced in the paper.Flow field, temperature field, pressure field and process of heat exchange were regarded to evaluate flow and heat transfer characteristics of the tube by building up 3 - D flow models of a plain tube and the tube inserted with several rotors.The comparison of simulation results showed that the three - dimensional flow in the tube inserted with rotors was very complex, with clear circular flow between rotors and the tube wall, while the tangential velocity and radial velocity increased to some extent, and the fluid inside the rotating radius flowed in a spiral way.In all, the tube inserted with rotors achieved stronger turbulence intensity than the plain tube, especially in the near- wall region.Therefore convective heat transfer was enhanced with heat transfer coefficient increased, which proved heat transfer enhancement and automatic cleaning functions of rotors.%本文概述了转子组合式强化传热装置的强化传热和自清洁原理.分别通过建立光管及内置多个转子换热管的三维流动模型,对换热管内流场、温度场、压力场以及换热过程进行了模拟,得到了管内流体的流动特性和传热特性.对比模拟结果表明,内置转子换热管管内的三维流动比较复杂,转子与管壁之间缝隙内的流体有着明显的环绕流动,切向速度和径向速度也增大到一定范围,转子旋转半径内的流体整体呈螺旋流动.总的来说,内置转子的换热管内较光管有较强的湍流度,尤其是近壁区域,因此强化了管内的对流换热,传热系数显著提高,从而验证了转子具有强化传热和自清洁的双重功能.

  15. Gastrostomy feeding tube - pump

    Science.gov (United States)

    ... and Practice of Nutritional Support . New York, NY: Springer; 2015:chap 10. Schattner MA, Grossman EB. Nutritional ... medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- ...

  16. Gastrostomy feeding tube - bolus

    Science.gov (United States)

    ... room temperature food, water, rubber band, clamp, and safety pin). Check that your formula or food is warm ... wrap a rubber band around the syringe and safety pin it to the top of your shirt so ...

  17. Tube Feeding Troubleshooting Guide

    Science.gov (United States)

    ... Power Failure DESCRIPTION: Unable to start pump Repeated alarms without obvious cause Excess formula left in the ... Numbness Tingling of hands or around mouth Palpitations Fatigue Taste changes Skin changes Loss of coordination IMMEDIATE ...

  18. Development of a nonintermediate-incision ventriculoperitoneal shunt procedure using a nasogastric feeding tube for infant patients with hydrocephalus: technical note.

    Science.gov (United States)

    Hamauchi, Shuji; Seki, Toshitaka; Sasamori, Toru; Houkin, Kiyohiro

    2016-05-01

    Intermediate incisions are considered necessary to pass a catheter tube from the head to the abdomen in ventriculo-peritoneal (VP) shunting via a frontal bur hole. However, an intermediate incision can sometimes become dehiscent, resulting in CSF leakage or infection of the shunt system in the early period after shunt implantation, particularly in infant patients. In this article, the authors describe a novel method of VP shunt insertion that does not require an intermediate incision. This nonintermediate-incision VP shunt procedure was performed in 3 infant patients with hydrocephalus and was not associated with any complications. This method can eliminate the intermediate incision, which is a disadvantage of VP shunt insertion via a frontal bur hole.

  19. TRAC PF1/MOD1 calculations and data comparisons for mist feed and bleed and steam generator tube rupture experiments

    Energy Technology Data Exchange (ETDEWEB)

    Siebe, D.A.; Boyack, B.E.; Steiner, J.L.

    1988-01-01

    Los Alamos National Laboratory is a participant in the Integral System Test (IST) program initiated in June 1983 for the purpose of providing integral system test data on specific issues/phenomena relevant to post-small-break loss-of-coolant accidents, loss of feedwater and other transients in Babcock and Wilcox (BandW) plant designs. The Multi-Loop Integral System Test (MIST) facility is the largest single component in the IST program. MIST is a 2 /times/ 4 (two hot legs and steam generators (SGs), four cold legs and reactor coolant pumps) representation of lowered-loop reactor system of the BandW design. It is a full-height, full-pressure facility with 1/817 power and volume scaling. Two other integral experimental facilities are included in the IST program: test loops at the University of Maryland, College Park, and at SRI International (SRI-2). The objective of the IST tests is to generate high-quality experimental data to be used for assessing thermal-hydraulic safety computer codes. Efforts are under way at Los Alamos to assess TRAC-PF1/MOD1 against data from each of the IST facilities. Calculations and data comparisons for TRAC-PF1/MOD1 assessment are presented for two transients run in the MIST facility. These are MIST Test 330302, a feed and bleed test with delayed high-pressure injection; and Test 3404AA, an SG tube-rupture test with the affected SG isolated. Only MIST assessment results are presented in this paper. The TRAC-PF1/MOD1 calculations completed to date for MIST tests are in reasonable agreement with the data from these tests. Reasonable agreement is defined as meaning that major trends are predicted correctly, although TRAC values are frequently outside the range of data uncertainty. We believe that correct conclusions will be reached if the code is used in similar applications despite minor code/model deficiencies. 7 refs., 5 figs., 2 tabs.

  20. Effect of tympanostomy tube insertion on middle ear function in children with secretory otitis media%鼓室置管对儿童分泌性中耳炎中耳功能影响的研究

    Institute of Scientific and Technical Information of China (English)

    毛承刚; 万俐佳; 周小淳; 吴燕; 鲁海涛

    2012-01-01

    目的 探讨鼓室置管治疗儿童分泌性中耳炎对中耳功能的影响.方法 选取47例(58耳)临床诊断为分泌性中耳炎的患儿,分别在鼓室置管术前及术后1个月、6个月进行纯音测听、声导抗、畸变产物耳声发射(distortion product otoacoustic emission,DPOAE)检查和耳镜检查,以评估鼓室置管手术前后中耳功能的变化及术后的并发症.结果 鼓室置管术后1个月、6个月分别行耳镜和声导抗检查,均较术前听力明显提高.术后6个月与术后1个月检查结果比较,听力改变差异无统计学意义.与鼓室置管术前比较,DPOAE引出率及部分频率幅值提高,差异具有统计学意义.鼓室置管术后的并发症主要是中耳感染、分泌性中耳炎复发、鼓膜穿孔和鼓膜内陷.结论 鼓室置管治疗儿童分泌性中耳炎,应用检测纯音测听、声导抗、DPOAE和耳镜检查,了解鼓室置管术后的并发症情况,综合评价对中耳功能的影响,具有临床指导意义.%Objective To investigate the effect of tympanostomy tube insertion on the middle ear function in children with secretory otitis media ( SOM). Methods Pure tone audiometry, acoustic impedance , distortion product otoacoustic emission ( DPOAE) examination and otoscopy were carried out in 47 children (58 ears) with SOM before tube insertion, one month and 6 months after tube insertion respectively to evaluate the changes of middle ear function and surgical complications. Results One month and 6 months after tube insertion, hearing of children with catheter patency was significantly improved. In addition, the detection rate and amplitude of DPOAE were significantly increased. The difference of hearing 1 month and 6 months after tube insertion was statistically insignificant. Surgical and postoperative complications included middle ear infection, recurrent SOM, tympanic perforation and tympanic membrane retraction. Conclusion Pure tone audiometry, acoustic impedance

  1. Numerical simulation of pressure drop characteristics in a circular tube with self-rotating twisted tape inserts%内置自旋扭带圆管内压降特性的数值模拟研究

    Institute of Scientific and Technical Information of China (English)

    冯振飞; 孙瑞娟; 林清宇

    2013-01-01

      为了直观地描述内置自旋扭带圆管内压降的特性,采用RNG k-ε湍流模型对内置静止扭带、自旋扭带圆管及空管的压降特性进行数值模拟研究,并进行了内置3种型号自旋扭带圆管压降特性的数值模拟和试验研究。研究表明:自旋扭带管的压力降约为空管的2倍,而静止扭带管的压力降差不多达到空管的3倍;在含有自旋扭带或静止扭带的管段内,压力沿轴线方向线性变化,与理论分析趋势一致;扭带压降(流体与自旋扭带的摩擦力引起的压力降)的理论计算值、数值结果均与试验结果比较一致;影响扭带压降的因素是流体轴向流速、扭带宽度及扭带节距;流体轴向流速增大,扭带压降也增大;扭带宽度增大,扭带压降也增大;扭带节距增大,扭带压降略有下降。%In order to visually describe the pressure drop characteristics in a circular tube with self-rotating twisted tape inserts , the RNG k-ε turbulent model was used to simulate the pressure drop characteristics in a circular tube with self-rotating twisted tape , static twisted tape or none inserts . The numerical simulation and experimental study of pressure drop characteristics in a circular tube with 3 types of self-rotating twisted tape inserts were presented .The results indicated that the pres-sure drop of the tube with self-rotating twisted tape is about twice of the empty tube and the pressure drop of the tube with static twisted tape is nearly three times of the empty tube .In the section of tube with self-rotating twisted tape or static twisted tape inserts , the pressure shows a linear variation along the axial direction , which is consistent with the theoretical analysis .The theoretical and nu-merical results of pressure drop caused by friction resistance between the fluid and the twisted tape are consistent with the experimental results .The flow axial velocity , the width and the half

  2. Case Report: Double lumen tube insertion in a morbidly obese patient through the non-channelled blade of the King Vision™ videolaryngoscope [v3; ref status: indexed, http://f1000r.es/41m

    Directory of Open Access Journals (Sweden)

    Mohamed El-Tahan

    2014-08-01

    Full Text Available We describe the insertion of the double lumen endobronchial tube (DLT using a non-channeled standard blade of the King VisionTM videolaryngoscope for one lung ventilation (OLV in a morbidly obese patient with a predicted difficult airway, severe restrictive pulmonary function, asthma, and hypertension. The patient was scheduled for a video-assisted thoracoscopic lung biopsy. The stylet of the DLT was bent to fit the natural curve of the #3 non-channeled blade of the King Vision™ videolaryngoscope. We conclude that the use of King Vision™ videolaryngoscope could offer an effective method of DLT placement for OLV.

  3. Case Report: Double lumen tube insertion in a morbidly obese patient through the non-channelled blade of the King Vision™ videolaryngoscope [v4; ref status: indexed, http://f1000r.es/4g3

    Directory of Open Access Journals (Sweden)

    Mohamed El-Tahan

    2014-09-01

    Full Text Available We describe the insertion of the double lumen endobronchial tube (DLT using a non-channeled standard blade of the King VisionTM videolaryngoscope for one lung ventilation (OLV in a morbidly obese patient with a predicted difficult airway, severe restrictive pulmonary function, asthma, and hypertension. The patient was scheduled for a video-assisted thoracoscopic lung biopsy. The stylet of the DLT was bent to fit the natural curve of the #3 non-channeled blade of the King Vision™ videolaryngoscope. We conclude that the use of King Vision™ videolaryngoscope could offer an effective method of DLT placement for OLV.

  4. Nutritional status and feeding-tube placement in patients with locally advanced hypopharyngeal cancer included in an induction chemotherapy-based larynx preservation program.

    Science.gov (United States)

    Bozec, Alexandre; Benezery, Karen; Chamorey, Emmanuel; Ettaiche, Marc; Vandersteen, Clair; Dassonville, Olivier; Poissonnet, Gilles; Riss, Jean-Christophe; Hannoun-Lévi, Jean-Michel; Chand, Marie-Eve; Leysalle, Axel; Saada, Esma; Sudaka, Anne; Haudebourg, Juliette; Hebert, Christophe; Falewee, Marie-Noelle; Demard, François; Santini, José; Peyrade, Frédéric

    2016-09-01

    The objective of the study is to evaluate the nutritional status and determine its impact on clinical outcomes in patients with locally advanced hypopharyngeal cancer included in an induction chemotherapy (ICT)-based larynx preservation program without prophylactic feeding-tube placement. All patients with locally advanced (T3/4, N0-3, M0) hypopharyngeal squamous cell carcinoma, technically suitable for total pharyngolaryngectomy, treated by docetaxel, cisplatin and 5-fluorouracil (TPF)-ICT for larynx preservation at our institution between 2004 and 2013, were included in this retrospective study. Patients' nutritional status was closely monitored. Enteral nutrition was used if and when a patient was unable to sustain per-oral nutrition and hydration. The impact of nutritional status on clinical outcomes was investigated in univariate and multivariate analysis. A total of 53 patients (42 men and 11 women, mean age = 58.6 ± 8.2 years) were included in this study. Six (11.3 %) patients had lost more than 10 % of their usual body weight before therapy. Compared with patients' usual weight, the mean maximum patient weight loss during therapeutic management was 8.7 ± 4.5 kg. Enteral nutrition was required in 17 patients (32 %). We found no influence of the tested nutritional status-related factors on response to ICT, toxicity of ICT, overall, cause-specific and recurrence-free survival, and on post-therapeutic swallowing outcome. Maximum weight loss was significantly associated with a higher risk of enteral tube feeding during therapy (p = 0.03) and of complications (grade ≥3, p = 0.006) during RT. Without prophylactic feeding-tube placement, approximately one-third of the patients required enteral nutrition. There was no significant impact of nutritional status on oncologic or functional outcomes.

  5. 管内插入物强化传热及除垢的研究进展%Progress in Study on Heat Transfer Enhancement for Tube Insert and Scale Removal

    Institute of Scientific and Technical Information of China (English)

    马强

    2011-01-01

    This article introduced the the field synergy theory was used to characteristics of heat transfer enhancement for tube insert, and explain the mechanism of heat transfer, especially in velocity vector field and heat flow vector field synergy between the effects of heat transfer process. In recent years, researchers have summarized the insertion of the tube with enhanced heat transfer and scale removal. Suggestions have been given for future research.%介绍了内插物强化传热技术的特点,运用了场协同理论来解释其强化传热的机理,主要是速度矢量场和热流矢量场之间的协同对传热过程的影响。总结了近年来研究者们对管内插入扭带强化传热和除垢的研究结果及进展,并对将来的研究工作提出了建议。

  6. A comparative study between ProSeal laryngeal mask airway and endotracheal tube for ease of insertion and haemodynamic changes in patients undergoing laparoscopic cholecystectomy under general anaesthesia

    Directory of Open Access Journals (Sweden)

    Veena Patodi

    2016-12-01

    Conclusions: ProSeal LMA proved to be a suitable alternative to endotracheal tube for airway management with stable haemodynamics in patients undergoing laparoscopic cholecystectomy under general anaesthesia. [Int J Res Med Sci 2016; 4(12.000: 5334-5340

  7. CATALYTIC COMBUSTION OF PROPANE IN A MEMBRANE REACTOR WITH SEPARATE FEED OF REACTANT .1. OPERATION IN ABSENCE OF TRANS-MEMBRANE PRESSURE-GRADIENTS

    NARCIS (Netherlands)

    SARACCO, G; VELDSINK, JW; VERSTEEG, GF; VANSWAAIJ, WPM

    1995-01-01

    A pilot plant study on propane catalytic combustion in a membrane reactor with separate reactant feeds is presented. The membrane consisted of a porous alumina tube activated by insertion into its pores of a Pt/gamma-Al2O3 catalyst. The role of reactants concentration and of the feed flow rates were

  8. CATALYTIC COMBUSTION OF PROPANE IN A MEMBRANE REACTOR WITH SEPARATE FEED OF REACTANT .1. OPERATION IN ABSENCE OF TRANS-MEMBRANE PRESSURE-GRADIENTS

    NARCIS (Netherlands)

    SARACCO, G; VELDSINK, JW; VERSTEEG, GF; VANSWAAIJ, WPM

    1995-01-01

    A pilot plant study on propane catalytic combustion in a membrane reactor with separate reactant feeds is presented. The membrane consisted of a porous alumina tube activated by insertion into its pores of a Pt/gamma-Al2O3 catalyst. The role of reactants concentration and of the feed flow rates were

  9. Catalytic combustion of propane in a membrane reactor with separate feed of reactants—I. Operation in absence of trans-membrane pressure gradients

    NARCIS (Netherlands)

    Saracco, Guido; Veldsink, Jan Willem; Versteeg, Geert F.; Swaaij, Wim P.M. van

    1995-01-01

    A pilot plant study on propane catalytic combustion in a membrane reactor with separate reactant feeds is presented. The membrane consisted of a porous alumina tube activated by insertion into its pores of a Pt/γ-Al2O3 catalyst. The role of reactants concentration and of the feed flow rates were

  10. A meta-analysis of the therapeutic effects of increasing insertion depth of nasogastric tube on gastrointestinal de-compression%胃管置入深度对胃肠减压疗效的Meta分析

    Institute of Scientific and Technical Information of China (English)

    郑琼娜; 王华芬; 吕敏芳; 郑晶晶

    2014-01-01

    Objective To evaluate the efficacy of increasing insertion depth of nasogastric tube in the treatment of gas-trointestinal decompression. Methods The randomized clinical trials(RCT) that compared the efficacy of increasing inser-tion depth of nasogastric tube in treatment of gastrointestinal decompression were researched from CBM,CNKI,Wangfang data,Cochrane,EMBASE,CINAHL,PubMed. After extracting data and assessing the quality of the included studies, meta-analysis was conducted using RevMan 5.2 software. Results Twenty RCTs including 3507 cases were included. Meta-analysis showed that increasing insertion depth of nasogastric tube significantly decreased occurring rate of moderate-severe abdominal distention[OR=0.28, 95%CI(0.24, 0.33)],significantly increased the 24 hours volume of drainage after nasogas-tric tube place [WMD=200.36, 95%CI (95.37, 305.35)] and significantly shortened the recovery time of bowel sounds [WMD=-23.98, 95%CI (-30.09,-17.86)]. Conclusions Increasing insertion depth of nasogastric tube can decrease oc-curring rate of moderate-severe abdominal distention, increase 24 hours volume of drainage after nasogastric tube place and shorten recovery time of bowel sounds.%目的:根据现有临床研究评价增加胃管插入深度对胃肠减压的有效性。方法检索CBM、CNKI、万方数据库、Cochrane、EMBASE、CINAHL、PubMed等数据库中的有关胃管插入深度对胃肠减压效果影响的中英文随机对照试验(RCT),提取数据并进行质量评价,数据分析采用RevMan5.2软件。结果共纳入20篇文献,共3507例患者。Meta分析结果显示:增加胃管置入深度可以降低中重度腹胀的发生率[OR=0.28,95%CI(0.24,0.33)]、增加置管后24 h引流液量[WMD=200.36,95%CI (95.37,305.35)]、缩短肠鸣音恢复时间[WMD=-23.98,95%CI (-30.09,-17.86)]。结论增加胃管的置入深度可以有效减轻腹胀、增加引流量、缩短肠鸣音的恢复时间。

  11. Numerical simulation Study on Heat Transfer Characteristics of Nanofluids in Twisted-Tape Inserts Tubes%纳米流体在内置扭带管的传热数值模拟

    Institute of Scientific and Technical Information of China (English)

    孙斌; 刘彤

    2015-01-01

    In order to take a comparative study on heat transfer enhancement of nanofluids in the twisted-tape inserts in tubes,established an enhanced heat exchanger of twisted-tape inside tubes of the tube heat exchang-er’ s physical model,carried on numerical simulation by using RNG k-ε model. Comparing with experimental results,spatial distribution of heat transfer fluid temperature field,heat transfer coefficient and flow field can be obtained. Compared nanofluids with water on influence of enhancing heat exchanger in six different twist ratio and two different materials of twisted-tape inserts. The result shows that using Cu-water nanofluids as the work-ing fluid has a significantly improvement on the heat transfer performance of the heat. The heat transfer effect of 0. 8% Cu-water nanofluids is better than that of 0. 5%. The smaller twist ratio is,the better effect of heat trans-fer can be. The enhancement of heat transfer is 0. 51 between Twisted-Tape Inserts Tubes with twist ratio is 2. 5 using 0. 5% Cu-water nanofluids and plain tube using water. Copper twisted tape inserts tube heat exchanger is better than aluminum twisted tapes.%为了对比纳米流体在内置扭带管中的强化传热效果,建立了以Cu-水纳米流体和水为传热介质的内置扭带强化换热管的管式换热器物理模型,采用RNG k-ε进行数值模拟研究,并与实验结果对比,得到了内置扭带换热管流体流动的速度、温度、湍流强度场的分布规律及特性。比较了两种质量分数的纳米流体与水在六种不同扭转比的扭带换热管中和两种不同材质的内置扭带分别对强化传热的影响。结果表明,以Cu-水纳米流体为工质的内置扭带管的换热效果明显优于纯水;质量分数为0.8%的Cu-水纳米流体换热效果优于0.5%的Cu-水纳米流体,扭转比越小,则换热效果越好,质量分数为0.5%的Cu-水纳米流体在扭转比为2.5的内置扭带管中相对于水

  12. Comparative analysis on inserting time of indwelling gastric tube and nasal tube for operation of esophageal cancer patients%食管癌手术患者留置胃管和鼻肠管置人时机的比较

    Institute of Scientific and Technical Information of China (English)

    冯志英; 冯燕芳; 黄素娟; 赖梅; 张莹

    2011-01-01

    Objective To explore the optimal timing of nasointestinal tube for operation of esophageal carcinoma patients.Methods 100 cases of esophageal cancer were randomly divided into two groups:tube after anesthesia group,anesthesia preposition pipe group.Anesthesia after tube group was in general anesthesia with tracheal intubation,after placing operation posture of indwelling stomach tube and nasal tube,anesthesia preposition pipe group placed nasal tube and indwelling gastric tube before anesthesia.Results Between the two groups,the comfort degree,nursing operation difficulty and the time,the first success rate of catheter and various complications appearing during catheter placement were significantly different (P< 0.01).Conclusion The optimal timing of indwelling gastric tube and nasal tube placement for the operation of esophageal cancer patients should be after general anesthesia with tracheal intubation and before surgical position of operation.%目的 探讨食管癌手术的患者置入胃管和鼻肠管的最佳时机.方法 100例食管癌手术患者随机分为两组:麻醉后置管组、麻醉前置管组.麻醉后置管组均在全身麻醉气管插管后、摆置手术体位前留置胃管和鼻肠管,麻醉前置管组均在麻醉前留置胃管和鼻肠管.结果 两组患者在舒适度、护理操作的难度和时间、置管首次的成功率、患者置管出现的各种并发症等方面差异有极显著性(P<0.O1).结论 食管癌手术患者留置胃管、鼻肠管置入的最佳时机在全身麻醉气管插管后、摆置手术体位前.

  13. Intercostal drainage tube or intracardiac drainage tube?

    Directory of Open Access Journals (Sweden)

    N Anitha

    2016-01-01

    Full Text Available Although insertion of chest drain tubes is a common medical practice, there are risks associated with this procedure, especially when inexperienced physicians perform it. Wrong insertion of the tube has been known to cause morbidity and occasional mortality. We report a case where the left ventricle was accidentally punctured leading to near-exsanguination. This report is to highlight the need for experienced physicians to supervise the procedure and train the younger physician in the safe performance of the procedure.

  14. 不锈钢管镶嵌件在压铸中的应用研究%Research and Application of Inserts of Stainless Steel Tube in Die Casting

    Institute of Scientific and Technical Information of China (English)

    李振生

    2013-01-01

    阐述了汽车发动机电控冷却器压铸件不锈钢油管内镶嵌件的结构、定位及工艺过程控制.其要点是,在油管接头上预先按图纸尺寸要求钻攻底孔、攻牙及铣面,同时做出与之配合的镀锌螺栓接头,装配后(将螺栓接头旋入油管接头内,成为油管总成,再放到压铸模上)通过与模具上的限位镶块精确定位,从而实现铸件压铸后油管接头位置度及接头端面的距离尺寸不变的目的.压铸结束后拆除可循环利用的螺栓接头,镀锌接头涂层防止了高温下因油污引起的生锈,满足了产品的清洁度要求.%According to the product assembly requirements, first pre-drilling thread bottom hole, tapping and milling surface in the tube union required by the drawing, and make the galvanized thread plug at the same time, the thread plug is screwed into the tube union as a tube assembly, and then put it into the casting mold . The tube dimensions of the casting would be achieved directly by the die casting process through die-casting mould precision limit insert . When the die casting is complete, remove the recyclable thread plug . The galvanized thread plug can prevent effectively metal from rust caused by the high temperature and oil of the fitting surface between the tube union and the thread plug to ensure the cleanliness requirement, and protect the tube surface against damage . The internal thread of the tube u-nion ensure the tooth shape in the thread plug force in the die casting process, so as to achieve the purpose of directly by the die-casting process. Reduce the cost under the precondition to satisfy the production requirements.

  15. ACUTE EFFECTS OF CONTINUOUS NASOGASTRIC TUBE-FEEDING ON GASTRIC FUNCTION - COMPARISON OF A POLYMERIC AND A NONPOLYMERIC FORMULA

    NARCIS (Netherlands)

    KLEIBEUKER, JH; BOERSMAVANEK, W

    1991-01-01

    The acute effects of continuous intragastric administration of 1500 ml (4200 kJ/liter) of a polymeric and of a nonpolymeric formula on gastric function were studied in 15 healthy subjects. During 450 min 1500 ml, containing 6300 kJ (1500 kcal), was given through a nasogastric tube. At regular interv

  16. 21 CFR 876.5980 - Gastrointestinal tube and accessories.

    Science.gov (United States)

    2010-04-01

    ... intubation, feeding tube, gastroenterostomy tube, Levine tube, nasogastric tube, single lumen tube with... § 876.9. (2) Class I (general controls) for the dissolvable nasogastric feed tube guide for the nasogastric tube. The class I device is exempt from the premarket notification procedures in subpart E of...

  17. Clinical Analysis of Inserting Gastric Tube to Tube Rupture in 1 Cases of Pesticide Poisoning%关于农药中毒插胃管致胃管断裂1例临床分析

    Institute of Scientific and Technical Information of China (English)

    陈霞

    2014-01-01

    目的分析抢救农药中毒患者置胃管时被患者咬断的原因。方法介绍1例女性患者因自服敌敌畏,患者洗胃时拒不配合,强行咬断胃管的前端致胃管断裂的病历进行分析。结果患者吐出断胃管,更换胃管,在口腔内置入牙垫,置入胃管完成洗胃的全过程。结论洗胃是农药中毒患者最直接有效地方法,有效地将胃管插入胃内并进行固定是确保洗胃过程顺利进行的一个关键环节,能最大限度地减少毒物的吸收,直接影响抢救有机磷农药中毒的成功率。提高洗胃的速度和清洁度,减少不良反应,提高抢救成功率,减轻护士疲劳感。%Objective Analysis for pesticide poisoning patients indwel ing gastric tube was a patient of snap. Methods A female patients because of self medication in patients with gastric lavage, dichlorvos, refuses to cooperate with, forced to bite tube rupture caused by stomach tube at the front end of the medical record analysis. Results The patient to spit out the broken tube, replace the nasogastric tube, in the mouth into the stomach with dental pad, complete the whole process of gastric lavage. Conclusion The gastric lavage is pesticide poisoning were the most direct and effective way, ef ectively the gastric tube into the stomach and fixation is the key to ensuring the gastric lavage process smoothly, can minimize the absorption of poison, directly af ect the organic phosphorus pesticide poisoning rescue success rate. To improve the speed of gastric lavage and cleanliness, reduce adverse reaction, improve the success rate, reduce the fatigue feeling.

  18. Measurement of impulse peak insertion loss from two acoustic test fixtures and four hearing protector conditions with an acoustic shock tube

    OpenAIRE

    Murphy, William J.; Cameron J Fackler; Berger, Elliott H.; Peter B Shaw; Mike Stergar

    2015-01-01

    Impulse peak insertion loss (IPIL) was studied with two acoustic test fixtures and four hearing protector conditions at the E-A-RCAL Laboratory. IPIL is the difference between the maximum estimated pressure for the open-ear condition and the maximum pressure measured when a hearing protector is placed on an acoustic test fixture (ATF). Two models of an ATF manufactured by the French-German Research Institute of Saint-Louis (ISL) were evaluated with high-level acoustic impulses created by an a...

  19. Effects of density, PVC-tubes and feeding time on growth, stress and aggression in African catfish (Clarias gariepinus)

    NARCIS (Netherlands)

    Boerrigter, J.G.J.; Bos, van den R.; Vis, van de J.W.; Spanings, T.; Flik, G.

    2016-01-01

    Successive exposure to aquaculture-related stressors may compromise the allostatic capacity of African catfish and lead to allostatic overload and poor welfare. Therefore, we tested the effect of (i) feeding during the light or dark phase, (ii) density (51 fish per 140 L versus 51 fish per 43 L) and

  20. 床边幽门后喂养管置管法用于重症患者的初步研究%A pilot study of a novel method for bedside placement of postpyloric feeding tubes in critically ill patients

    Institute of Scientific and Technical Information of China (English)

    高友山; 邝耀均; 刘宇; 徐君; 黄世芳; 刘晖

    2010-01-01

    Objective To investigate a novel method of bedside placement of postpyloric feeding tubes in critically ill patients,and to evaluate its success rate,time used,and safety of this bedside method.Methods Data of consecutive patients requiring postpyloric feeding from February 2009 to July 2009 were collected.In this new method,a nonweighted 130-cm-long nasoenteric feeding tube with a guide wire was used under 10 mg of intravenous metoclopramide.The tube was gradually advanced,and the position of the tube was confirmed by auscultation to detect bubbling sound and respiration of inflated air (the vacuum test),as well as pH measurement of aspirated fluid.An abdominal radiograph was made finally for confirmation of the position of the tube before the feeding was initiated.The time taken to insert the tube,the success rate,the time between the decision to feed and commencement of feeding,and the complications of the procedure were recorded.Results In 28 patients the postpyloric feeding tube was placed.The main indication was 18 cases with high risk of aspiration,3 with gastroparesis,and 7 with acute pancreatitis.Of the 28 tube placements performed,26 (92.9%) were successful,and in 21 (75.0% of 28) the tube was in the jejunum.The average time for successful placement was (20.36±6.41) minutes.The time between the decision for feeding and commencement of feeding was (4.15±1.68) hours.No complications occurred.Conclusion Using a conventional nasoenteric feeding tube with a guide wire,and only one medical staff needed for the placement of the tube,this method is an efficient and cost-effective method of bedside postpyloric feeding tube placement.%目的 观察床边徒手幽门后喂养管置管法对重症患者治疗的效果,并对置管成功率、操作时间及安全性进行评价.方法 2009年2月至7月对需幽门后喂养者实施幽门后喂养管置管.使用130 cm长、带导丝的普通鼻胃肠管,操作前静脉给予10 mg甲氧氯普胺.置管过程中依

  1. Instalación de "sondas digestivas ectopicas" en pacientes con patología de cabeza y cuello y otras diversas, cuando las vías naturales no son practicables o no se consideran convenientes: Una nueva metodología "Ectopic enteral tube" insertion in patients with head, neck and other pathologies when natural tracts are impracticable or inadvisable: A new method

    Directory of Open Access Journals (Sweden)

    F. Hernández-Altemir

    2008-02-01

    Full Text Available Introducción. Es frecuente que en los pacientes con patología general diversa y del territorio oral y maxilofacial tengamos que dotarles de medios extraordinarios para facilitar la alimentación y aspiración digestiva. Presentamos una nueva metodología para la instalación de lo que denominamos Sondas Digestivas Ectópicas (SDE. Material y Método. Empleamos las sondas digestivas convencionales, sólo que haciéndolas llegar al tramo digestivo por lo que denominamos vías ectópicas de instalación y entre las más habituales en nuestras manos estaría, la sonda digestiva pericraneal o submental o a través de heridas y trayectos creados o no del territorio craneofacial. Presentamos un caso clínico de un paciente con fracturas conminutadas del territorio craneomaxilofacial al que la SDE se instaló en la región temporal y supracigomática izquierda. Resultados. Conseguimos con esta nueva metodología evitar técnicas más agresivas como la gastrostomía percutánea o quirúrgica y evitar el uso de los la via nasal u oral, cuando éstos no son practicables o no están indicados manteniendo una vía fiable de aspiración y alimentación digestiva. Conclusiones. Los beneficios de esta técnica deben hacer que incorporemos la SDE en nuestro arsenal terapéutico.Introduction. Patients with a variety of general pathologies and oral and maxillofacial pathologies often require extraordinary measures for to ensure enteral feeding and aspiration. We report a new method for inserting what we call "ectopic enteral tubes" (EET. Material and Method. Conventional enteral tubes are inserted into the digestive tract using "ectopic" insertion routes. At present, the most common routes available are the pericranial or submental routes, as well as wounds and trajectories that are present or created expressly for this purpose in the craniofacial area. We report the clinical case of a patient with comminuted fractures of the temporal and left suprazygomatic

  2. 内置螺旋弹簧换热管内流动与传热三维数值模拟%3D numerical simulation of fluid flow and heat transfer in heat exchange tube with helical coil inserts

    Institute of Scientific and Technical Information of China (English)

    徐建民; 彭坤; 胡小霞; 黄伟; 余海燕

    2012-01-01

    In order to investigate single-tube heat transfer enhancement principles of heat exchange tube with helical coil inserts,the flow and heat transfer characteristics were simulated using Fluent software.The effects of spring application on flow field,pressure drop and heat transfer performance were investigated.The pitch of coil spring was set as 2 mm,4 mm,5 mm.The effects of spring pitch on the heat transfer enhancement performance were analyzed.The numerical results showed that the fluid in tube with helical coil inserts presents the helical flow,the cutting speed and the radial velocity of flow near the wall had been improved to some extent.Thus the fluid was mixed completely,boundary layer was disturbed fully and heat was exchanged thoroughly.And the temperature difference between inlet and outlet increased as well,with the maximum increase of 0.9 ℃.Under the conditions of the same Reynolds number,the Nusselt number in tube with helical coil inserts was higher than plain tube,but pressure drop and friction factor increased obviously.With the reduced spring pitch,heat transfer was enhanced and friction factor was increased.%为研究内置螺旋弹簧换热管单管强化传热原理,采用Fluent软件对内置螺旋弹簧换热管内流体流动与传热特性进行数值模拟,考察了弹簧的应用对管内流场、压降和换热性能的影响,并分别取螺旋弹簧节距p分别为2 mm、4 mm、5 mm初步研究了弹簧的节距对强化传热效果的影响。模拟结果显示:弹簧管内流体呈螺旋流动状态,管壁附近流体切向速度和径向速度有一定程度的提高,从而加剧了管内流体的混合及边界层的扰动,充分换热,弹簧管进出口温度差较光管有所增加,最高增加了0.9℃;相同雷诺数条件下,内置螺旋弹簧换热管Nu数均高于光管,而压降和阻力系数相比光管有明显增加,随着弹簧节距减小换热增强而摩擦阻力系数增加。

  3. Definition of the minimum longitude of insert in the rebuilding of Charpy test tubes for surveillance and life extension of vessels in Mexico; Definicion de la longitud minima de inserto en la reconstitucion de probetas Charpy para vigilancia y extension de vida de vasijas en Mexico

    Energy Technology Data Exchange (ETDEWEB)

    Romero C, J.; Hernandez C, R.; Rocamontes A, M., E-mail: jesus.romero@inin.gob.mx [ININ, Carretera Mexico-Toluca s/n, 52750 Ocoyoacac, Estado de Mexico (Mexico)

    2011-11-15

    In the National Institute of Nuclear Research (Mexico) a welding system for the rebuilding of Charpy test tubes has been developed, automated, qualified and used for the surveillance of the mechanical properties (mainly embrittlement) of the vessel. This system uses the halves of the rehearsed Charpy test tubes of the surveillance capsules extracted of the reactors, to obtain, of a rehearsed test tube, two reconstituted test tubes. This rebuilding process is used so much in the surveillance program like in the potential extension of the operation license of the vessel. To the halves of Charpy test tubes that have been removed the deformed part by machine are called -insert- and in a very general way the rebuilding consists in weld with the welding process -Stud Welding- two metallic implants in the ends of the insert, to obtain a reconstituted test tube. The main characteristic of this welding are the achieved small dimensions, so much of the areas welded as of the areas affected by the heat. The applicable normative settles down that the minim longitude of the insert for the welding process by Stud Welding it should be of 18 mm, however according to the same normative this longitude can diminish if is demonstrated analytic or experimentally that the central volume of 1 cm{sup 3} in the insert is not affected. In this work the measurement of the temperature profiles to different distances of the welding interface is presented, defining an equation for the maximum temperatures reached in function of the distance, on the other hand the real longitude affected in the test tube by means of metallography is determined and this way the minimum longitude of the insert for this developed rebuilding system was determined. (Author)

  4. Prophylactic PEG placement in head and neck cancer:How many feeding tubes are unused (and unnecessary)?

    Institute of Scientific and Technical Information of China (English)

    Mohammad F Madhoun; Matt M Blankenship; Derek M Blankenship; Greg A Krempl; William M Tierney

    2011-01-01

    AIM:To determine the rate of use and non-use of prophylactic percutaneous endoscopic gastrostomy (PEG) tubes among patients with head and neck cancer (HNC) patients.METHODS:All patients with HNC undergoing PEG between January 01,2004 and June 30,2006 were identified. Patients (or their next-of-kin) were surveyed by phone and all available medical records and cancer registry data were reviewed.Prophylactic PEG was defined as placement in the absence of dysphagia and prior to radiation or chemoradiation.Each patient with a prophylactic PEG was assessed for cancer diagnosis,type of therapy,PEG use,and complications related to PEG. RESULTS:One hundred and three patients had PEG tubes placed for HNC.Thirty four patients (33%) could not be contacted for follow-up.Of the 23 (22.3%) patients with prophylactic PEG tubes,11/23 (47.8%) either never used the PEG or used it for less than 2 wk. No association with PEG use vs non-use was observed for cancer diagnosis,stage,or specific cancer treatment. Non-use or limited use was observed in 3/6 (50%) treated with radiation alone vs 8/17 (47.1%) treated with chemoradiation (P = 1.0),and 3 of 10 (30%) treated with surgery vs 8 of 13 (62%) not treated with surgery (P = 0.21).Minor complications were reported in 5/23 (21.7%).One (4.3%) major complication was reported.CONCLUSION:There is a high rate of unnecessary PEG placement when done prophylactically in patients with head and neck cancer.

  5. Desain Compact Heat Exchanger Tipe Fin And Tube Sebagai Alat Pendingin Motor Pada Boiler Feed Pump. Studi Kasus Pada Sebuah Perusahaan Pembangkit Tenaga Listrik

    Directory of Open Access Journals (Sweden)

    Luki Apriliasari

    2013-09-01

    Full Text Available Motor listrik penggerak boiler feed pump harus bekerja secara kontinyu, dan hanya boleh mati pada saat dilakukan maintenance, apabila tidak diberikan pendinginan maka akan terjadi overheating dan menyebabkan kerusakan pada motor. Hal ini sering terjadi di PLTU, motor listrik hanya didinginkan dengan dialiri udara bebas. System ini memiliki keterbatasan yaitu kotoran yang terkandung di udara bisa menempel di dinding motor, justru menyebabkan panas dalam motor tidak keluar dengan maksimal. Untuk mengatasi keterbatasan tersebut, maka diusulkan suatu metode pendinginan yaitu dengan mendesain heat exchanger tipe compact (fin and tube. Data – data operasi diambil dari suatu perusahaan pembangkit tenaga listrik yang dijadikan obyek study. Perhitungan desain heat exchanger dengan metode ∆TLMTD. Setelah mendapat dimensi yang sesuai dengan panas yang akan didinginkan, maka dilakukan analisa performansi yaitu nilai effectiveness terhadap perubahan beban. Hasil yang didapatkan dari penyelesaian study kasus ini adalah dimensi compact heat exchanger yang memiliki spesifikasi sesuai surface 7.75-5/8T dari Kays and London dengan panjang fin 1 meter, lebar fin 0,3 m, dan panjang tube 1 meter. Hasil analisa performansi (effectiveness terhadap variasi beban yaitu semakin tinggi pembebanan maka nilai effectiveness juga semakin tinggi.

  6. Glytube: a conical tube and parafilm M-based method as a simplified device to artificially blood-feed the dengue vector mosquito, Aedes aegypti.

    Directory of Open Access Journals (Sweden)

    André Luis Costa-da-Silva

    Full Text Available Aedes aegypti, the main vector of dengue virus, requires a blood meal to produce eggs. Although live animals are still the main blood source for laboratory colonies, many artificial feeders are available. These feeders are also the best method for experimental oral infection of Ae. aegypti with Dengue viruses. However, most of them are expensive or laborious to construct. Based on principle of Rutledge-type feeder, a conventional conical tube, glycerol and Parafilm-M were used to develop a simple in-house feeder device. The blood feeding efficiency of this apparatus was compared to a live blood source, mice, and no significant differences (p = 0.1189 were observed between artificial-fed (51.3% of engorgement and mice-fed groups (40.6%. Thus, an easy to assemble and cost-effective artificial feeder, designated "Glytube" was developed in this report. This simple and efficient feeding device can be built with common laboratory materials for research on Ae. aegypti.

  7. Glytube: a conical tube and parafilm M-based method as a simplified device to artificially blood-feed the dengue vector mosquito, Aedes aegypti.

    Science.gov (United States)

    Costa-da-Silva, André Luis; Navarrete, Flávia Rosa; Salvador, Felipe Scassi; Karina-Costa, Maria; Ioshino, Rafaella Sayuri; Azevedo, Diego Soares; Rocha, Desirée Rafaela; Romano, Camila Malta; Capurro, Margareth Lara

    2013-01-01

    Aedes aegypti, the main vector of dengue virus, requires a blood meal to produce eggs. Although live animals are still the main blood source for laboratory colonies, many artificial feeders are available. These feeders are also the best method for experimental oral infection of Ae. aegypti with Dengue viruses. However, most of them are expensive or laborious to construct. Based on principle of Rutledge-type feeder, a conventional conical tube, glycerol and Parafilm-M were used to develop a simple in-house feeder device. The blood feeding efficiency of this apparatus was compared to a live blood source, mice, and no significant differences (p = 0.1189) were observed between artificial-fed (51.3% of engorgement) and mice-fed groups (40.6%). Thus, an easy to assemble and cost-effective artificial feeder, designated "Glytube" was developed in this report. This simple and efficient feeding device can be built with common laboratory materials for research on Ae. aegypti.

  8. Definitive airway management of patients presenting with a pre-hospital inserted King LT(S)-D laryngeal tube airway: a historical cohort study.

    Science.gov (United States)

    Subramanian, Arun; Garcia-Marcinkiewicz, Annery G; Brown, Daniel R; Brown, Michael J; Diedrich, Daniel A

    2016-03-01

    The King LT(S)-D laryngeal tube (King LT) has gained popularity as a bridge airway for pre-hospital airway management. In this study, we retrospectively reviewed the use of the King LT and its associated airway outcomes at a single Level 1 trauma centre. The data on all adult patients presenting to the Mayo Clinic in Rochester, Minnesota with a King LT in situ from July 1, 2007 to October 10, 2012 were retrospectively evaluated. Data collected and descriptively analyzed included patient demographics, comorbidities, etiology of respiratory failure, airway complications, subsequent definitive airway management technique, duration of mechanical ventilation, and status at discharge. Forty-eight adult patients met inclusion criteria. The most common etiology for respiratory failure requiring an artificial airway was cardiac arrest [28 (58%) patients] or trauma [9 (19%) patients]. Four of the nine trauma patients had facial trauma. Surgical tracheostomy was the definitive airway management technique in 14 (29%) patients. An airway exchange catheter, direct laryngoscopy, and video laryngoscopy were used in 11 (23%), ten (21%), and ten (21%) cases, respectively. Seven (78%) of the trauma patients underwent surgical tracheostomy compared with seven (18%) of the medical patients. Adverse events associated with King LT use occurred in 13 (27%) patients, with upper airway edema (i.e., tongue engorgement and glottic edema) being most common (19%). In this study of patients presenting to a hospital with a King LT, the majority of airway exchanges required an advanced airway management technique beyond direct laryngoscopy. Upper airway edema was the most common adverse observation associated with King LT use.

  9. A randomized clinical trial comparing the standard mcintosh laryngoscope and the c-mac d blade video laryngoscope™ for double lumen tube insertion for one lung ventilation in Onco surgical patients

    Directory of Open Access Journals (Sweden)

    Shagun Bhatia Shah

    2016-01-01

    Full Text Available Background and Aims: Several devices enabling double-lumen tube (DLT placement for thoracic surgeries are available, but there are no studies for D-blade video laryngoscope-guided DLT insertion. We compared the CMac D-blade videolaryngoscope™ and the Macintosh laryngoscope for DLT endobronchial intubation using parameters of time and attempts required for intubation, glottic view, incidence of complications and haemodynamic changes. Methods: Prospective, parallel group, randomised controlled clinical trial where sixty American Society of Anesthesiologists I and II patients aged 18-80 years scheduled for thoracic surgeries entailing DLT placement were randomly allocated in two groups based on the laryngoscopic device used for endobronchial intubation. Data were subjected to statistical analysis SPSS (version 17, the paired and Student′s t-test for equality of means. Nominal categorical data between the groups were compared using Chi-squared test or Fisher′s exact test as appropriate. P ˂ 0.05 was considered statistically significant. Results: Time required for intubation was comparable (37.41 ± 18.80 s in Group-M and 32.27 ± 11.13 s in Group-D. Number of attempts and incidence of complications (trauma, DLT cuff rupture, oesophageal intubation was greater in the Macintosh group, except malpositioning into the wrong bronchus (easily rectified fibre-optic bronchoscopically, which was greater with the D-blade. Greater haemodynamic changes were observed during Macintosh laryngoscopy. Conclusion: D-blade videolaryngoscope™ is a useful alternative to the standard Macintosh laryngoscope for routine DLT insertion.

  10. Effects of continuous tube feeding of dietary fat emulsions on eicosanoid production and on fatty acid composition during an acute septic shock in rats.

    Science.gov (United States)

    Utsunomiya, T; Chavali, S R; Zhong, W W; Forse, R A

    1994-10-06

    The effects of a short-term (5 days) continuous intragastric tube feeding of diets containing n - 6 polyunsaturated fatty acids (PUFA) from safflower oil (SO) or n - 3 PUFA from menhaden oil (MO) on the production of proinflammatory mediators, and on the number of animals surviving after an intravenous injection of lipopolysaccharide (LPS) were investigated in rats. The phospholipid fatty acid composition of cell membranes from several organs and of plasma were also analyzed. No marked differences in the number of animals surviving or in the production of tumor necrosis factor-alpha were observed between the 2 groups of animals. However, 90 min after LPS exposure the plasma levels of prostaglandin (PG) E2 and 6-keto-PGF1 alpha decreased significantly (40% and 60%, respectively) for the group of rats fed MO diet compared to those fed SO diet (P < 0.05). Following continuous infusion of liquid MO diet, the amount of arachidonic acid (AA) detected was significantly lower in plasma (23%), spleen (43%), lungs (41%), and liver (38%), but was unchanged in the heart tissues. The percent of eicosapentaenoic acid (EPA) incorporated into phospholipids of plasma, spleen, lungs, liver, and heart were 7.6, 4.4, 2.1, 7.2, and 1.1%, respectively. These data indicate that after continuous MO feeding, a significant decrease in the production of proinflammatory eicosanoids was associated with a marked reduction in AA content. Further, these data suggest that nutritional intervention may have a therapeutic potential to ameliorate clinical symptoms due to excessive productions of eicosanoids during acute septic complications.

  11. Insertion devices

    CERN Document Server

    Bahrdt, J

    2006-01-01

    The interaction of an insertion device with the electron beam in a storage ring is discussed. The radiation property including brightness, ux and polarization of an ideal and real planar and helical / elliptical device is described. The magnet design of planar, helical, quasiperiodic devices and of devices with a reduced on axis power density are resumed.

  12. Calorimeter insertion

    CERN Multimedia

    2006-01-01

    Calorimeter insertion between toroids in the ATLAS experiment detector Calorimeters are surrounding the inner detector. Calorimeters will absorb and measure the energies of the most charged and neutral particles after the collisions. The saved energy in the calorimeter is detected and converted to signals that are taken out with data taking electronics.

  13. Feeding the hungry river: Fluvial morphodynamics and the entrainment of artificially inserted sediment at the dammed river Isar, Eastern Alps, Germany

    Science.gov (United States)

    Heckmann, Tobias; Haas, Florian; Abel, Judith; Rimböck, Andreas; Becht, Michael

    2017-08-01

    Dams interrupt the sediment continuum in rivers by retaining the bedload; combined with flow diversion, bedload retention in tributaries and river engineering measures, this causes a bedload deficit leading to changes in river planform and morphodynamics, with potentially detrimental downstream effects. As part of the SedAlp joint project (Sediment management in Alpine basins: integrating sediment continuum, risk mitigation and hydropower), this study investigates changes within a section of the dammed river Isar between the Sylvenstein reservoir and the city of Bad Tölz. We use a multi-method approach on a range of spatial and temporal scales. First, we analysed historical maps and aerial photos to analyse river planform and landcover changes within the river corridor of the whole study area on a temporal scale of over 100 years. Results show that major changes occurred before the construction of the Sylvenstein reservoir, suggesting that present morphodynamics represent the reaction to different disturbances on different time scales. Second, changes in mean bed elevation of cross profiles regularly surveyed by the water authorities are analysed in light of artificial sediment insertion and floods; they are also used to estimate the sediment budget of river reaches between consecutive cross profiles. Results suggest stability and a slight tendency towards incision, especially near the Sylvenstein reservoir; further downstream, the sediment balance was positive. Third, we acquired multitemporal aerial photos using an unmanned aerial vehicle and generated high-resolution digital elevation models to show how sediment artificially inserted in the river corridor is entrained. Depending on the position of the artificial deposits in relation to the channel, the deposits are entrained during floods of different return periods.

  14. Evaluation of the educational technology "Caring for dependent people" by family caregivers in changes and transfers of patients and tube feeding

    Directory of Open Access Journals (Sweden)

    Maria José Lumini Landeiro

    Full Text Available ABSTRACT Objective: to assess the contributions of interactive educational technology "Caring for Dependent People" in the development of knowledge to family caregivers of dependent people in a household context and their satisfaction in its use. Method: quasi-experimental study, not randomized, of the before and after type, with a convenience sample of 65 family caregivers, from two Medicine services of a hospital in Porto, Portugal. The Control Group consisted of 33 family caregivers and the Experimental Group of 32, identified by consecutive sampling. The experimental group had access to educational technology at home. Data were collected by socio-demographic, satisfaction and evaluation of knowledge questionnaire, about how to feed by nasogastric tube, positioning and transferring the dependent person. The assessment in both groups had two moments: initial, during hospitalization and one month after discharge. Results: the experimental group had a larger increase in knowledge related to the use of the educational technology. In the control group the knowledge did not differ in the two evaluation time points. Conclusion: these results confirm the improvement of interactive educational technologies and in the training of family caregivers to care for dependents. This technology successfully met the technical quality and learning needs of caregivers, and was considered easy and stimulating.

  15. A 3-month at-home tube feeding in 118 bulimia nervosa patients: a one-year prospective survey in adult patients.

    Science.gov (United States)

    Daniel, Rigaud; Didier, Perrin; Hélène, Pennacchio

    2014-04-01

    To study the 1-yr follow-up of 118 bulimia nervosa (BN) patients after a 3-month at-home tube feeding (TF) in a prospective study. At-home TF lasted 3 months, including one month of exclusive TF (no food). All patients fulfilled 4 questionnaires (score of binge/purging episodes (BP), eating disorder inventory, anxiety, depression), before, at the 3-month TF point, and 6 and 12 months latter. The score of BP episodes dramatically decreased from 28.8 ± 15 (before TF) to 7.3 ± 5.4 at 3 months, as well as at 1 yr (15.1 ± 6.2). We also obtained a 50% decrease in Beck score (depression) and Hamilton score (anxiety). Curiously, there was no difference between the BP scores of the patients following psychotherapy and those who did not, despite lower scores for anxiety and depression. In conclusion, in bulimia nervosa patients having normal BMI and purging behavior, home-TF allow to obtain total withdrawal from bingeing/purging in at least 75% of the cases at short term (3 months) and in 25% of the patients at one year, whatever the patients have or have not psychotherapy. Copyright © 2013 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  16. Dual-Band Feed for a Microwave Reflector Antenna

    Science.gov (United States)

    Hoppe, Daniel; Reilly, Harry

    2005-01-01

    A waveguide feed has been designed to provide specified illumination patterns for a dual-reflector antenna in two wavelength bands: 8 to 9 GHz and 30 to 40 GHz. The feed (see figure) has a coaxial configuration: A wider circular tube surrounds a narrower circular tube that serves as a waveguide for the signals in the 30-to-40-GHz band. The annular space between the narrower and the wider tube serves as a coaxial waveguide for the signals in the 8-to-9-GHz band. The nominal design frequencies of the outer and inner waveguides are 8.45 and 32 GHz, respectively. Each of the two waveguides is terminated in a component that is sized and shaped to help focus the radiation in its respective frequency band into the specified illumination pattern. For the outer waveguide, the beam-shaping termination is a corrugated horn; for the inner waveguide, the beam-shaping termination is a dielectric rod insert.

  17. Gastrostomy Intraperitoneal Bumper Migration in a Three-Year-Old Child: A Rare Complication following Gastrostomy Tube Replacement.

    Science.gov (United States)

    Guanà, Riccardo; Lonati, Luca; Barletti, Claudio; Cisarò, Fabio; Casorzo, Ilaria; Carbonaro, Giulia; Lezo, Antonella; Delmonaco, Angelo Giovanni; Mussa, Alessandro; Capitanio, Martina; Cussa, Davide; Lemini, Riccardo; Schleef, Jürgen

    2014-09-01

    Feeding gastrostomy is used worldwide for adults and children with feeding impairment to obtain long-term enteral nutrition. Percutaneous endoscopic gastrostomy insertion is considered the gold standard, but after the first months requires gastrostomy tube replacement with a low-profile button. The replacement is known as an easy procedure, but several minor and major complications may occur during and after the manoeuvre. We describe intraperitoneal bumper migration in a 3-year-old boy, a rare complication following gastrostomy tube replacement, and we discuss the recent literature regarding similar cases.

  18. Gastrostomy Intraperitoneal Bumper Migration in a Three-Year-Old Child: A Rare Complication following Gastrostomy Tube Replacement

    Directory of Open Access Journals (Sweden)

    Riccardo Guanà

    2014-12-01

    Full Text Available Feeding gastrostomy is used worldwide for adults and children with feeding impairment to obtain long-term enteral nutrition. Percutaneous endoscopic gastrostomy insertion is considered the gold standard, but after the first months requires gastrostomy tube replacement with a low-profile button. The replacement is known as an easy procedure, but several minor and major complications may occur during and after the manoeuvre. We describe intraperitoneal bumper migration in a 3-year-old boy, a rare complication following gastrostomy tube replacement, and we discuss the recent literature regarding similar cases.

  19. Application of reserved jejunal feeding tube during postoperative chemotherapy of gastric cancer%保留空肠营养管在胃癌术后化疗期间的应用价值

    Institute of Scientific and Technical Information of China (English)

    马汉军; 李三荣; 金汉生; 孙坚; 舒先林; 叶亚林; 吕清泉; 魏琦

    2008-01-01

    Objective To evaluate the effects of reserved jejunal feeding tube during postoperative chemotherapy of gastric cancer. Methods Forty-two patients with gastric cancer underwent radical gastrectomy and going to adjuvant chemotherapy,conventional placed jejunal feeding tube. All of the patients weredivided into group A and group B randomly by pathological staging and tumor site, group A reserved jejunal feeding tube and received enteral nutrition through the tube during chemotherapy, and group B non-reservedjejunal feeding tube and been given daily diet,compared nutrition and immune indicators of two groups beforeand after chemotherapy ,compared the rate of vomiting,and observed complications long-term reserved jejunal feeding tube. Results In post-chemotherapy,nutrition and immune indicators of group A were betterthan those of group B, the difference was statistically significant (P<0.05) ,the rate of vomiting in group Awas significantly lower than that of in group B (X2= 9.75, P<0.01 ), no serious complieations occurred forlong-term reserved jejunal feeding tube. Conclusions Reserved jejunal feeding tube and received enteralnutrition through the tube during postoperative chemotherapy of gastric cancer can significantly improve the nutritional and immune status. It is safe and reliable, worth promoting.%目的 探讨保留空肠营养管在胃癌术后化疗期间的应用价值.方法 总结42例胃癌根治术后行辅助化疗患者的临床资料,术中常规放置空肠营养管,将所有病例按术后病理分期及肿瘤部位随机分为A、B两组,每组各21例,A组保留空肠营养管并在化疗期间经空肠营养管行肠内营养,B组不保留空肠营养管在化疗期间按日常进食,分别比较两组化疗前后营养及免疫指标,比较两组患者呕吐的发生率.观察长期保留空肠营养管的并发症.结果 化疗后A组营养及免疫指标较B组明显提高,两组比较差异有统计学意义(P<0.05).A

  20. 圆管内插入螺旋片状多孔介质的换热性能及场协同分析%Heat Transfer Performance for Tube Inserted With Helical Screw-Tape Porous Media and Its Field Synergy Analysis

    Institute of Scientific and Technical Information of China (English)

    张晓屿; 刘志春; 刘伟

    2011-01-01

    The present study introduced a tube inserted with helical screw-tape porous media which can make the fully developed laminar flow in the tube to form an equivalent thermal boundary layer, and thereby enhance the heat transfer between the fluid and the tube wall. At the same time, the increase of flow resistance in the tube is not so obvious. The overall flow and heat transfer performance for the fully developed laminar water flow in a tube inserted with helical screw-tape porous media was investigated numerically. The comparisons between helical screw-tape porous media and ring porous media and cylindrical porous media were made. And its mechanisms of enhancing heat transfer were also analyzed using the principle of field synergy. The results shows that the tube inserted with the helical screw-tape porous media can improve the flow and heat transfer performance effectively, the value of PEC varied between 3.60 and 3.95.%采用数值计算的方法,以水为流动介质,研究了圆管内插入螺旋片状多孔介质在充分发展的层流区的换热及流动综合性能,并与环状和圆柱状多孔介质插入物进行了对比,此外,利用场物理量协同原理对计算结果进行了分析。结果表明,在圆管内插入螺旋片状多孔介质可以有效提高换热与流动的综合性能,其PEC达到3.60—3.95.

  1. 旋转扭带管内传热与阻力性能的数值模拟%Numerical simulation of heat transfer and resistance performance in a rotating twisted-tape-inserted tube

    Institute of Scientific and Technical Information of China (English)

    李凯; 张林华; 崔永章; 曲云霞; 朱艳艳

    2013-01-01

    为了研究生物质锅炉换热管内插入外源驱动旋转的扭带对传热及阻力性能的影响,建立了不同扭曲比的扭带在不同转速时管内流体流动的三维物理模型.采用RNGk-ε湍流模型对传热过程进行模拟,得出了旋转扭带管内流体的换热及阻力特性.结果表明:旋转扭带提高了管内流体的轴向速度和切向速度;转速为0~10rpm时,转速越大、扭曲比越小,表面传热系数越大,阻力损失也越大;扭曲比在2.06~5.1的扭带,综合评价因子在1.13~ 1.41之间,扭曲比为3.15的扭带综合评价因子最高.%In order to study the heat transfer and resistance performance effect of rotating twisted-tapeinserted tube of the biomass boiler,a three-dimensional fluid flow model of rotating twisted tape is presented with different angular velocity and distorted ratio.The Renormalized Group (RNG) k-ε turbulence model is used to simulate the process of heat transfer for getting the heat transfer and resistance performance of rotating twisted-tape-inserted tube.The result shows that rotating twisted tape increases the axial velocity and tangential velocity of the fluid.When the rotation speed is 0-10rpm,the higher the speed is and the smaller the twist ratio is,the higher the surface heat transfer coefficient is and the more the resistance loss is.The comprehensive evaluation factor of the twisted tapes with the twist ratio of 2.06-5.1 is 1.13-1.41,while the comprehensive evaluation factor of the twisted tape with the twist ratio of 3.15 is highest.

  2. Factors associated with nosocomial diarrhea in patients with enteral tube feeding Factores asociados a diarrea nosocomial en pacientes con nutrición enteral

    Directory of Open Access Journals (Sweden)

    J. Trabal

    2008-10-01

    Full Text Available Objectives: Diarrhea is a frequent complication associated to enteral tube feeding (ETF and it is a frequent cause of reduction or suspension of this type of nutritional support. Our objective was to evaluate the factors associated with nosocomial diarrhea in patients receiving ETF. Results: The only significant factor associated with the appearance of diarrhea was antibiotic consumption, specially those patients receiving the combination of two or more antibiotics. We did not find any association between factors related to ETF, analytical parameters, nor other medications and diarrhea. Conclusions: Our observational data supports the idea that ETF should not be seen as a primary cause of diarrhea, other possible causes should be considered before reducing or discontinuing ETF administration.Objetivos: La diarrea es una complicación frecuente asociada a la nutrición enteral (NE y es causa habitual de reducción o suspensión de este tipo de soporte nutricional. Nuestro objetivo fue evaluar los factores asociados a la diarrea nosocomial en pacientes que recibían NE. Resultados: El único factor significativo asociado con la aparición de diarrea fue el consumo de antibióticos, especialmente aquellos pacientes que recibían la combinación de dos o más antibióticos. No se encontró ninguna asociación entre factores relacionados a la NE, parámetros analíticos, ni otras medicaciones y la diarrea. Conclusión: Nuestros datos observacionales respaldan la idea que la NE no debería ser vista como causa principal de diarrea, debiéndose considerar otras causas posibles antes de reducir o suspender la administración de NE.

  3. Comparison the effect of two ways of tube feeding including bolus and continuous infusion on gastric residual volume and diarrhea in patients hospitalized in Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    Shahriari M

    2015-05-01

    Full Text Available Background and Objective: Proper nutritional support is one of the important caring aspects in patients who were hospitalized in Intensive Care Unit. Although the several studies have been done concerning the selection of proper nutrition method for patients, but there is no agreement on this issue. The aim of current study was the compare the effect of two ways of tube feeding including bolus and continuous infusion on gastric residual volume and diarrhea in patients hospitalized in Intensive Care Unit.  Materials and Method: The current clinical trial was conducted on patients who were hospitalized in intensive care unit in Alzahra hospital in Isfahan, 2013. Fifty patients were selected through convenient sampling and were randomly assigned into two groups of 25 people of intervention and control. Nutrition was done through infusion pump in intervention group and by bolus in control group. Gastric residual volume and diarrhea was assessed each four hours for four days. Data were gathered through checklist and were analyzed by SPSS18 using descriptive and inferential statistics including independent T-test, Fisher's exact test and repeated measures ANOVA.  Results: The results showed that the mean of gastric residual volume in control group was more than the intervention group on the third day (p=0.04. Also, the mean of gastric residual volume did not show significant difference at different times in intervention group, but the mean of gastric residual volume was significantly increased in control group at different times (p=0.04. Fisher's exact test showed no significant difference between two groups concerning the diarrhea frequency.  Conclusion: In nutritional support with continuous infusion method, gastric residual volume was not increased and gastric emptying rate was not diminished. Therefore, this method can be used as an appropriate nutritional support in intensive care unit.

  4. Current Practices in Home Management of Nasogastric Tube Placement in Pediatric Patients: A Survey of Parents and Homecare Providers.

    Science.gov (United States)

    Northington, LaDonna; Lyman, Beth; Guenter, Peggi; Irving, Sharon Y; Duesing, Lori

    Enteral feeding tubes are used in pediatric patients to deliver nutrition, fluids or medications. The literature related to short-term feeding tube (nasogastric [NG], hereafter known as NGT, or orogastric [OGT],) use in pediatric homecare patients is sparse. This descriptive study sought to gather baseline information about these children and how their feeding tubes are managed at home. Specifically, we sought to better understand how the tubes are placed and the method(s) used for tube placement verification. Two surveys were distributed: one to parents and one to homecare providers who have direct patient contact. Responses were obtained from 144 parents and 66 homecare providers. Over half of the children were 12months of age or younger and had a 6 Fr feeding tube. Over 75% (108) had an NGT for 1year or less. Predominantly parents replaced the NGT but a few children self-inserted their tubes. Feeding tube placement was verified by auscultation (44%) or measurement of gastric pH (25%) in the parent's survey. Twenty-six percent of parents indicated they had misplaced an NGT at least once and 35 parents described symptoms of pulmonary misplacement. The homecare provider data indicated auscultation (39%) and pH measurement of gastric contents (28%) to verify NG tube placement location. Study results confirms a need for consistency of practice among health care professionals and in parent education for those children who require NGTs at home. It is troubling that auscultation is still widely used for NGT location confirmation despite practice alerts that warn against its use. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Numerical Simulation of Pressure Drop and Flow Filed in the Heat Exchanger Tube Inserted Self-rotating Straight-tooth Twisted Tape%内插自旋直齿扭带换热管压降及流场数值模拟

    Institute of Scientific and Technical Information of China (English)

    刘宜仔; 林清宇; 冯振飞; 欧向波; 刘晓林

    2014-01-01

    In order to visually describe the characteristics of pressure drop and flow filed self-ro-tating straight-tooth twisted tape inserted in heat exchanger tube,the computer model for the in-ner basin of heat exchanger tube was established,in which self-rotating straight-tooth twisted tape is inserted with water as the medium,and numerical simulation was taken to study the char-acteristics of pressure drop and flow filed in tube by using RNG k~εturbulence model.The re-sults of numerical simulation indicated that the pressure dropΔp of the tube with twisted tape in-to a parabola relationship with the flow velocity u,the faster of the flow velocity,the larger of the pressure drop,and it was greater than that of smooth tube.The fluid was a rule of three-di-mensional spiral flow in the tube with twisted tape,making the fluid form a secondary vortex flow.The twisted tape with straight serration structure enhanced the turbulence of fluid.In the region near tube wall,the flow axial velocity of the tube with twisted tape was averagely in-creased more in the range of 33.05% ~ 35.17% than that of smooth tube.%为了直观地描述内插自旋直齿扭带管内压降及流场的特性,建立了以水为介质的内插自旋直齿扭带换热管内流场的计算模型,采用RNG k~ε湍流模型对管内压降及流场的特性进行数值模拟研究。计算结果表明,扭带管的压降Δp与流体的流速u成抛物线关系,压降随着流速的增大而增大,并且大于空管的压降;扭带管的流体呈有规律的三维螺旋状流动,且存在二次流,扭带的直齿结构增强了流体的湍流程度;在近管壁区域,扭带管的流体轴向速度比空管平均提高幅度在33.05%~35.17%。

  6. Enteral feeding in head and neck cancer patients at a UK cancer centre.

    Science.gov (United States)

    Sheth, C H; Sharp, S; Walters, E R

    2013-10-01

    Patients undergoing radiotherapy or chemoradiotherapy treatment for head and neck cancer have an increased risk of malnutrition, and may require enteral feeding via nasogastric or gastrostomy tube. The aim of this audit was to examine current enteral feeding practice, mortality, morbidity and 6-month outcome data of head and neck cancer patients receiving radical (chemo)radiotherapy at a regional cancer centre and to compare the results with a regional head and neck cancer gastrostomy audit. A 2-year audit was conducted (2006-2008). Inclusion criteria were all adult patients diagnosed with squamous cell carcinoma of the head and neck, receiving radical radiotherapy or chemoradiotherapy treatment. The first-year data were collected retrospectively, and the second-year data were collected prospectively. Data were collected on all patients requiring enteral feeding with 6-month outcome data relating to route of nutrition. Approximately 14% (n = 32/223) of patients were admitted for nasogastric feeding as a result of inadequate oral alimentation. On admission, 94% were at risk of refeeding syndrome, taking a mean (SD) of 11 (4.9) days to reach full nutritional requirements. Mean (SD) length of hospital stay was 13 (5.1) days. No major complications from nasogastric tube insertion were found. The mean (SD) length of nasogastric feeding was 72 (20.1) days with 89.6% managing full nutritional requirements orally at 6 months. Patients requiring enteral feeding during treatment were fed via a nasogastric tube, rather than via a prophylactic gastrostomy tube. Compared with the regional gastrostomy audit results, our patients had a lower clinical risk/complication rate, with a greater proportion tolerating full oral intake at 6 months. Therefore, nasogastric feeding, rather than prophylactic gastrostomy tube feeding, could be a more appropriate method of enteral feeding in this patient group. © 2013 University Hospital Southampton Journal of Human Nutrition and Dietetics

  7. Ear Tubes

    Science.gov (United States)

    ... ENTCareers Marketplace Find an ENT Doctor Near You Ear Tubes Ear Tubes Patient Health Information News media ... and throat specialist) may be considered. What are ear tubes? Ear tubes are tiny cylinders placed through ...

  8. Effects of two kinds of nasal feeding tubes on dysphagia in stroke patients%两种鼻饲管在脑卒中吞咽功能障碍患者中的应用效果比较

    Institute of Scientific and Technical Information of China (English)

    贾秀萍; 张丽华; 毛立杰

    2012-01-01

    Objective To compare the one-time success rate of catheterization and comfort between the polyurethane nasal feeding tube and silicone nasal feeding tube used in stroke patients with dysphagia. Methods 80 dysphagia patients were divided into two groups randomly, 42 patients in experimental group managed with polyurethane nasal feeding tube and 38 patients in control group managed with silicone nasal feeding tube. The one-time success rate of catheterization, duration of catheterization and comfort degree were compared between the two groups. Results The one-time success rates of catheterization in the experimental group and the control group were 90.5% and 60.5%, respectively and the difference between the two groups was significant (P< 0.01). The catheterization durations of the two groups were(12.2 ± 2.3)min and (15.6 ± 2.5) min, respectively and there was significant difference between the two groups (P < 0.01). Conclusion Compared with the silicone nasal feeding tube, the polyurethane nasal feeding tube is more suitable for stroke patients with dysphagia because it has higher one-time success rate, shorter catheterization duration and better tolerance.%目的 比较聚氨酯鼻饲管与硅胶鼻饲管在脑卒中吞咽功能障碍患者鼻饲中一次置管成功率及舒适度情况.方法 将80例吞咽功能障碍患者随机分为实验组42例与对照组38例,实验组患者给予聚氨酯鼻饲管插管鼻饲,对照组患者给予硅胶鼻饲管插管鼻饲.比较两组患者一次置管成功率、置管时间及舒适度.结果 实验组患者一次置管成功率为90.5%,对照组为60.5%,两组比较,P<0.01,差异具有统计学意义;实验组患者置管所需时间为(12.2±2.3)min,对照组为(15.6±2.5)min,两组比较,P<0.01,差异具有统计学意义;实验组患者插管舒适度明显优于对照组,两组比较,P<0.01,差异具有统计学意义.结论 聚氨酯鼻饲管较硅胶鼻饲管更适用于脑卒中吞咽功能障

  9. DPEJ placement in cases of PEG insertion failure.

    Science.gov (United States)

    Del Piano, M; Ballarè, M; Carmagnola, S; Orsello, M; Garello, E; Pagliarulo, M; Sartori, M; Montino, F

    2008-02-01

    PEG placement is routinely used for enteral feeding; in some cases PEG is not feasible or indicated due to technical difficulties, such as gastric herniation, organ interposition, or presence of gastroparesis. In these cases, surgical gastrostomy or jejunostomy are possible alternatives; more recently, direct percutaneous jejunostomy (DPEJ) has been proposed to avoid surgical intervention. The aim of the study was to evaluate the necessity, technical feasibility and outcome of DPEJ in a group of patients consecutively proposed for PEG placement. In each patient proposed for PEG placement, an upper gastrointestinal endoscopy was performed, and then a pull traction removal gastrostomy tube (18-20 F) was inserted. When PEG was not feasible or contraindicated, a variable stiffness pediatric videocolonscope was used to reach the jejunum: then DPEJ was performed with the same technique and materials as PEG. In both groups enteral feeding was started 24h after the endoscopic procedure, using an enteral feeding pump and the same nutritional schedules. In a 1-year period 90 patients were proposed for PEG placement; PEG could not be performed for technical reasons in 8 (gastric herniation in 1; organ interposition in 7) and gastroparesis in 1. In one patient both PEG and DPEJ were not feasible for organ interposition. The duration of the endoscopic procedure was slightly longer in DPEJ (mean 20 min versus 15 min). No complications related to the endoscopic procedure were observed in both DPEJ and PEG patients. No nutritional complication were observed in the DPEJ group. In our experience, PEG was not feasible or contraindicated in about 10% of patients proposed for. In these patients, DPEJ was placed: the procedure resulted to be feasible and safe with the use of a pediatric videocolonscope to easily reach the jejunum. The insertion of DPEJ did not change the nutritional management of enteral feeding. However, long-term effects or complications remain to be evaluated in

  10. Compression device for feeding a waste material to a reactor

    Science.gov (United States)

    Williams, Paul M.; Faller, Kenneth M.; Bauer, Edward J.

    2001-08-21

    A compression device for feeding a waste material to a reactor includes a waste material feed assembly having a hopper, a supply tube and a compression tube. Each of the supply and compression tubes includes feed-inlet and feed-outlet ends. A feed-discharge valve assembly is located between the feed-outlet end of the compression tube and the reactor. A feed auger-screw extends axially in the supply tube between the feed-inlet and feed-outlet ends thereof. A compression auger-screw extends axially in the compression tube between the feed-inlet and feed-outlet ends thereof. The compression tube is sloped downwardly towards the reactor to drain fluid from the waste material to the reactor and is oriented at generally right angle to the supply tube such that the feed-outlet end of the supply tube is adjacent to the feed-inlet end of the compression tube. A programmable logic controller is provided for controlling the rotational speed of the feed and compression auger-screws for selectively varying the compression of the waste material and for overcoming jamming conditions within either the supply tube or the compression tube.

  11. Effects of Health Education during Follow-up Visits on Nasal Tube Feeding in Elder Patients%家庭随访指导老年患者鼻饲护理的效果评价

    Institute of Scientific and Technical Information of China (English)

    费益君; 罗建勤; 方秀莲; 李春燕; 徐碧姬; 郭佩宣; 朱艳如; 陈伟丽

    2013-01-01

    目的对家庭随访指导老年患者鼻饲护理的效果进行评价。方法对已经通过科研项目验收的“家庭随访指导提高院外老年鼻饲病人家庭管理能力”的技术进行临床推广。采用方便取样法,将2009年1月-12月金华市5家县市级医院出院的45例老年鼻饲病人设为对照组,实施常规护理指导。将2010年1月-12月金华市5家县市级医院出院的45例老年鼻饲病人设为观察组,采用电话随访、上门家访形式进行家庭随访指导。评价家庭随访指导后院外家庭老年病人鼻饲相关并发症、意外拔管发生率、吞咽功能有没有改善。结果家庭随访指导后鼻饲相关并发症明显低于对照组(P<0.01),意外拔管发生率明显低于对照组(P<0.01),吞咽功能明显改善(P<0.01)。结论家庭随访指导能明显减少鼻饲相关并发症和意外拔管的发生率,改善吞咽功能,值得临床推广。%Objective: To evaluate the effects of health education during follow-up on nasal tube feeding in elder patients. Methods: The technology generated from the scientific project"Enhancing family management on nasal tube feeding in out-of-hospital elder patients by health education during follow-up"was put into clinical practice. Convenient sampling was applied in the study for sample selection. 45 patients under nasal tube feeding discharged from 5 county-level hospitals in Jinhua City during January and December of 2009 were assigned to the control group given routing nursing care. 45 patients under nasal tube feeding discharged from 5 county-level hospitals in Jinhua City during January and December of 2010 were assigned to the observation group given health education during telephone or household follow-up visits. The complication rate, unplanned extubation rate and swallowing function were evaluated in the study. Results:After health education, the observation group had significantly lower complication

  12. Nasogastric tube syndrome induced by an indwelling long intestinal tube.

    Science.gov (United States)

    Sano, Naoki; Yamamoto, Masayoshi; Nagai, Kentaro; Yamada, Keiichi; Ohkohchi, Nobuhiro

    2016-04-21

    The nasogastric tube (NGT) has become a frequently used device to alleviate gastrointestinal symptoms. Nasogastric tube syndrome (NTS) is an uncommon but potentially life-threatening complication of an indwelling NGT. NTS is characterized by acute upper airway obstruction due to bilateral vocal cord paralysis. We report a case of a 76-year-old man with NTS, induced by an indwelling long intestinal tube. He was admitted to our hospital for treatment of sigmoid colon cancer. He underwent sigmoidectomy to release a bowel obstruction, and had a long intestinal tube inserted to decompress the intestinal tract. He presented acute dyspnea following prolonged intestinal intubation, and bronchoscopy showed bilateral vocal cord paralysis. The NGT was removed immediately, and tracheotomy was performed. The patient was finally discharged in a fully recovered state. NTS be considered in patients complaining of acute upper airway obstruction, not only with a NGT inserted but also with a long intestinal tube.

  13. Evaluation of the educational technology "Caring for dependent people" by family caregivers in changes and transfers of patients and tube feeding.

    Science.gov (United States)

    Landeiro, Maria José Lumini; Peres, Heloísa Helena Ciqueto; Martins, Teresa Vieira

    2016-08-18

    to assess the contributions of interactive educational technology "Caring for Dependent People" in the development of knowledge to family caregivers of dependent people in a household context and their satisfaction in its use. quasi-experimental study, not randomized, of the before and after type, with a convenience sample of 65 family caregivers, from two Medicine services of a hospital in Porto, Portugal. The Control Group consisted of 33 family caregivers and the Experimental Group of 32, identified by consecutive sampling. The experimental group had access to educational technology at home. Data were collected by socio-demographic, satisfaction and evaluation of knowledge questionnaire, about how to feed by nasogastric tube, positioning and transferring the dependent person. The assessment in both groups had two moments: initial, during hospitalization and one month after discharge. the experimental group had a larger increase in knowledge related to the use of the educational technology. In the control group the knowledge did not differ in the two evaluation time points. these results confirm the improvement of interactive educational technologies and in the training of family caregivers to care for dependents. This technology successfully met the technical quality and learning needs of caregivers, and was considered easy and stimulating. avaliar os contributos da tecnologia educacional interativa "Cuidar de Pessoas Dependentes" no desenvolvimento de conhecimentos aos familiares cuidadores de pessoas dependentes, no contexto domiciliário e a satisfação no seu uso. estudo quasi-experimental, não randomizado, do tipo antes e depois, com amostra de conveniência constituída por 65 familiares cuidadores, de dois Serviços de Medicina de um hospital do Porto, Portugal. O Grupo Controle foi constituído por 33 familiares cuidadores e o Grupo Experimental por 32, identificados por amostragem consecutiva. O grupo experimental teve Acesso à tecnologia educacional

  14. Nasogastric feeding in the community: safe and effective practice.

    Science.gov (United States)

    Best, Carolyn

    2013-10-01

    A small percentage of patients receiving enteral tube feeding in the community receive feed via a nasogastric tube. There are risks associated with this method if the correct procedures for monitoring tube displacement are not in place. Guidance for checking tube position has been provided by the National Patient Safety Agency (NPSA). Nurses caring for patients with nasogastric tube feeds need to be aware of how NPSA alerts impact on practice and the advice and support they may need to offer patients.

  15. Use of a Nasal Speculum for Chest-Drain Insertion

    Science.gov (United States)

    Saxena, Pankaj; Konstantinov, Igor E.; Newman, Mark A.J.

    2006-01-01

    Tube thoracostomy is a very commonly performed procedure in cardiothoracic surgery. Insertion of a chest drain requires expertise to minimize complications. We describe a simple technique of using a nasal speculum to perform this procedure. PMID:17041709

  16. Enhancement of heat transfer using varying width twisted tape inserts

    African Journals Online (AJOL)

    user

    They reported that friction factor rise due to inclusion of inserts was ... Dasmahapatra and Rao (1991) studied augmentation of heat transfer to viscous non- .... constant throughout the tube length by brazing metal pins to the edges of the tape.

  17. 21 CFR 888.4230 - Cement ventilation tube.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cement ventilation tube. 888.4230 Section 888.4230...) MEDICAL DEVICES ORTHOPEDIC DEVICES Surgical Devices § 888.4230 Cement ventilation tube. (a) Identification. A cement ventilation tube is a tube-like device usually made of plastic intended to be inserted...

  18. Pump element for a tube pump

    DEFF Research Database (Denmark)

    2011-01-01

    relative to the rod element so as to allow for a fluid flow in the tube through the first valve member, along the rod element, and through the second valve member. The tube comprises an at least partly flexible tube portion between the valve members such that a repeated deformation of the flexible tube...... portion acts to alternately close and open the valve members thereby generating a fluid flow through the tube. The invention further relates to a pump element comprising at least two non-return valve members connected by a rod element, and for insertion in an at least partly flexible tube in such tube...... pump as mentioned above, thereby acting to generate a fluid flow through the tube upon repeated deformation of the tube between the two valve members. The pump element may comprise a connecting part for coupling to another tube and may comprise a sealing part establishing a fluid tight connection...

  19. Alimentação do recém-nascido pré-termo: métodos alternativos de transição da gavagem para o peito materno The feeding of preterm newborns: alternative methods for the transition from tube-feeding to breastfeeding

    Directory of Open Access Journals (Sweden)

    Rebeca Raposo Aquino

    2008-03-01

    Full Text Available O objetivo deste trabalho foi revisar os métodos de alimentação mais utilizados na transição da gavagem para o peito materno em recém-nascidos pré-termo. A pesquisa foi realizada nas bases de dados: Lilacs, Medline, SciElo, no período de 1994 a 2007. Foram selecionados quatro artigos, considerando apenas os estudos randomizados (três dos quais também controlados. A literatura pesquisada descreve alguns desses métodos de transição da alimentação: mamadeira e copinho. Os estudos demonstram que os bebês que utilizaram copinho apresentaram melhores resultados em relação à estabilidade fisiológica (freqüência cardíaca e saturação de oxigênio e ao impacto no aleitamento materno exclusivo na alta hospitalar. Devido à escassez de estudos na literatura e aos problemas metodológicos encontrados, faz-se necessária a realização de mais estudos para comparar a utilização dos métodos de transição da alimentação em recém-nascidos pré-termo.This study investigates the methods normally used to effect the transition from tube-feeding to full breastfeeding in preterm infants. The information was gathered from papers catalogued in the Lilacs, Medline, and SciElo databases, between 1994 and 2007. Four articles were selected and only randomized studies considered (three of them, being controlled. The literature describes a number of methods used to effect the transition from tube-feeding to full breastfeeding: bottle-feeding and cup-feeding. The studies demonstrate that the babies who used cup-feeding obtained better results in relation to physiological stability (cardiac frequency and oxygen saturation and to the impact on full breastfeeding on being discharged from hospital. Given the scarcity of studies in the literature and the methodological problems found, it is clear that more studies need to be carried out to compare the alternative methods used for the preterm feeding plan.

  20. Fluoroscopy-guided percutaneous gastrostomy and nasogastric feeding tube placement: comparison of the clinical effect%X线引导下经皮胃造瘘术和鼻-胃营养管置入术的疗效比较

    Institute of Scientific and Technical Information of China (English)

    姚全军; 胡鸿涛; 黎海亮; 郭晨阳; 孟艳莉; 骆俊朋; 李亚楠

    2012-01-01

    目的 探讨X线引导下经皮胃造瘘术和鼻-胃营养管置入术的临床疗效和安全性.方法 回顾性分析67例吞咽困难患者,其中喉癌14例,食管-纵隔瘘18例,颈段食管癌35例.22例行X线引导下经皮胃造瘘术,45例行X线引导下鼻-胃营养管置入术.结果 所有患者均成功实施介入治疗,技术成功率为100%.术后8d、1个月两组患者的血清白蛋白、前白蛋白和淋巴细胞计数较术前明显升高(P<0.05).术后1、3个月两组患者的体重及生活质量较术前明显提升(P<0.05).术后1个月胃造瘘组的血清白蛋白和生活质量明显高于鼻-胃营养管置入组(P<0.05).术后两组的总并发症发生率差异无统计学意义(P>0.05).胃造瘘组的治疗费用为鼻-胃营养管置入组的2.6倍.结论 X线引导下经皮胃造瘘术和营养管置入术均可改善患者的营养状况,且安全、有效,胃造瘘术的临床疗效优于营养管置入术,但费用较昂贵.%Objective To investigate the clinical effect and safety of fluoroscopy - guided percutaneous gastrostomy and nasogastric feeding tube placement. Methods The clinical data of sixty-seven patients with dysphagia were retrospectively analyzed. The primary diseases included laryngocarcinoma (n = 14), esophagomediastinal fistul a (n = 18) and cervical esophageal carcinoma (n = 35). Twenty-two patients underwent fluoroscopy - guided percutaneous gastrostomy (group G) and forty - five patients received fluoroscopy-guided nasogastric feeding tube placement (group N). The results were analyzed and compared between the two methods. Results The interventional therapy was successfully accomplished in all patients with a technical success rate of 100%. In both groups, the levels of the serum albumin (ALB), prealbumin (PA) and total lymphocyte count (TLC) determined at 8 days and one month after the procedure were significantly higher than those determined before the therapy (P < 0.05). One and three

  1. Drug administration through feeding tubes: an integrated qualification program Administración de fármacos a través de las sondas de alimentación: un programa integrado de cualificación

    Directory of Open Access Journals (Sweden)

    M. Martins Gonzaga do Nascimento

    2012-08-01

    Full Text Available Introduction: The literature documents numerous inconveniences of drug administration through feeding tubes. Actions to improve the quality of this practice are of great importance. Objective: The objective of this study is to describe the implementation process and results of an Integrated Program to improve drug administration through feeding tubes in a Brazilian general hospital. Methods: This is a descriptive study of a clinic quality improvement program which proceeded in four steps: (1 design of a data base with technical characteristics of oral drugs; (2 application of an identification label on non-crushable tablets; (3 evaluation, through focal groups, of nursing technicians' knowledge of drug administration through feeding tubes, and formal training; (4 prescription review of patients prescribed enteral nutrition and subsequent pharmaceutical intervention. Results: A list with 131 oral drugs used within the hospital was compiled with recommendations for their administration through feeding tubes. Seven non-crushable drugs were identified with "do not crush" labels. Formal training regarding drug administration through feeding tubes was elaborated incorporating findings from the focal groups and applied to the nursing team. Over eight months, we analyzed 888 prescriptions written for 185 patients and addressed 263 pharmaceutical interventions to the medical team (which they accepted in 100% of the cases, and 105 interventions to the nursing team. Conclusions: Qualification programs with multiple strategies, as the one described here, may directly improve drug administration through feeding tubes and help to solve and prevent problems related to this practice.Introducción: En la bibliografía se documentan muchos inconvenientes de la administración de fármacos a través de las sondas de alimentación. Las acciones para mejorar la calidad de esta práctica son de gran importancia. Objetivo: El propósito de este estudio es describir el

  2. L Tube Gravity Feed Simulation Test Based on Coarse Tailings Cemented Filling%基于粗尾砂胶结充填的L管自流输送模拟试验

    Institute of Scientific and Technical Information of China (English)

    郭江龙; 白金

    2015-01-01

    Through simulation test of the gravity feed resistance of the L tube cemented filled with coarse tailings, it is proved that to add some MSP into the filling slurry can greatly improve its suspension property and liquidity, thus reducing the wear to the tube, and effectively solving the layering, separation and riffling phenomenon. So it has good popularization prospect in mine industry.%通过对某铁矿粗尾砂胶结充填的L管自流输送阻力模拟试验研究,证明了在充填料浆中添加适量的悬浮剂(简称MSP),可使其具有良好的悬浮性、流动性,减少了料浆对管道的磨损,可有效解决充填料浆在自流输送中的分层、离析、沉砂等现象,在矿山行业有较好推广前景。

  3. Efficacy of laryngeal mask airway Ⅰ-gel for airway management in patients requiring insertion of nasogastric tube before laparoscopic cholecystectomy%Ⅰ-gel喉罩用于术前置入鼻胃管的腹腔镜胆囊切除术患者气道管理的效果

    Institute of Scientific and Technical Information of China (English)

    石妤; 左明章; 杨宁; 连盟

    2014-01-01

    目的 评价Ⅰ-gel喉罩用于术前置入鼻胃管的腹腔镜胆囊切除术患者气道管理的效果.方法 择期全麻下拟行腹腔镜胆囊切除术患者60例,性别不限,ASA分级Ⅰ-Ⅲ级,年龄26 ~ 64岁,体重54 ~ 90 kg,Mallampati分级Ⅰ-Ⅲ级,采用随机数字表法,将其分为3组(n=20):Ⅰ组经Ⅰ-gel喉罩的引流管放置胃管,Ⅱ组术前经鼻放置胃管并术中保留,麻醉诱导前确定胃管位置,置入I-gel喉罩后不经引流管放置胃管,Ⅲ组术前经鼻放置胃管并术中保留,麻醉诱导前确定胃管位置,置入I-gel喉罩后经引流管放置胃管.术中监测血流动力学指标、SpO2、PETCO2和气道峰压(Ppeak).置入成功后行纤维支气管镜检查评分,并记录胃管位移的发生情况;记录喉罩置入时间、首次置入成功情况、置入刻.度、气道密封压、喉罩漏气和胃管引流情况.拔除喉罩后记录罩体内是否有血液或返流物,通过pH值试纸测定喉罩尖端及罩体的背侧和腹侧的pH值.记录术后24h内口咽部不良反应的发生情况.结果 3组术中血流动力学平稳,SpO2、Ppeak和PEr CO2均在正常范围,Ppeak低于气道密封压.3组喉罩置入时间、首次置入成功率、置入刻度、气道密封压、喉罩漏气发生率、纤维支气管镜检查评分、拔除喉罩时间、术后口咽部不良反应发生率、罩体内带血和有返流物的发生率,术后喉罩尖端及罩体背侧和腹侧的pH值比较差异无统计学意义(P>0.05),Ⅱ组和Ⅲ组经鼻胃管均未发生位移.Ⅱ组有7例患者经喉罩的引流管有黄色胃液流出,其中仅有2例患者经鼻放置的胃管有引流液.结论 对于术前置入鼻胃管的腹腔镜胆囊切除术患者,Ⅰ-gel喉罩易于置入,其气道密封性可靠,通气效果好.%Objective To evaluate the efficacy of laryngeal mask airway (LMA) Ⅰ-gel for airway management in the patients requiring insertion of nasogastric tube before laparoscopic

  4. Feasibility of supreme laryngeal mask airway in patients required insertion of nasogastric tube before laparoscopic surgery%Supreme双管喉罩用于术前置入鼻胃管的腹腔镜手术患者气道管理的可行性

    Institute of Scientific and Technical Information of China (English)

    汤洁; 张锦

    2012-01-01

    Objective To assess the feasibility of supreme laryngeal mask airway in patients required insertion of nasogastric tube before laparoscopic surgery. Methods Sixty ASA Ⅰ ~ Ⅱ patients( 24 ~62 year old,52 ~75 kg ) scheduled for elective laparoscopic surgery were randomly divided into 2 groups: group I ( n = 29 )and group Ⅱ ( n = 31 ). In group I ,the nasogastric tube was inserted through the drain tube of supreme LMA. In group Ⅱ ,the nasogastric tube was inserted before operation. The fiberoptic laryngoscopy scores were assessed. The LMA placement time,success rate of LMA placement at the first attempt, airway sealing pressure were recorded. PETCO2 and peak airway pressure ( Ppeak )were monitored during operation. The problems after removal of the LMA were observed,and the adverse reactions after operation were recorded. Results There was no significant difference in the LMA placement time, success rate of LMA placement at the first attempt, airway sealing pressure, fiberoptic laryngoscopy scores, problems after removal of the LMA and adverse reactions between the two groups ( P >0. 05 ). Conclusion Supreme LMA can be used safely and effectively for the patients required insertion of nasogastric tube before laparoscopic surgery.%目的 评价Supreme双管喉罩用于术前置入鼻胃管的腹腔镜手术患者气道管理的可行性.方法 择期全麻下拟行腹腔镜胆囊切除手术患者60例,ASA Ⅰ~Ⅱ级,年龄24~62岁,体重52~75 kg,Mallampati Ⅰ~Ⅱ级,将患者随机分为经Supreme喉罩引流管放置胃管组( I组,29例)和术前经鼻放置胃管组(Ⅱ组,31例).Ⅰ组放置胃管后经胃管引流胃内容物,Ⅱ组于术前经鼻放置胃管,麻醉诱导前充分吸引后再置入喉罩.喉罩置入成功后行纤维支气管镜检查评分.记录喉罩置入时间、首次置入成功率和气道密封压情况.记录置入喉罩后和气腹后气道峰压(Ppeak)和呼气末二氧化碳分压(PETCO2)的变化.拔除喉罩

  5. Pump element for a tube pump

    DEFF Research Database (Denmark)

    2011-01-01

    The invention relates to a tube pump comprising a tube and a pump element inserted in the tube, where the pump element comprises a rod element and a first and a second non-return valve member positioned a distance apart on the rod element. The valve members are oriented in the same direction rela...... to a part of the tube. The invention further relates to a method for creating a flow of a fluid within an at least partly flexible tube by means of a pump element as mentioned above.......The invention relates to a tube pump comprising a tube and a pump element inserted in the tube, where the pump element comprises a rod element and a first and a second non-return valve member positioned a distance apart on the rod element. The valve members are oriented in the same direction...... portion acts to alternately close and open the valve members thereby generating a fluid flow through the tube. The invention further relates to a pump element comprising at least two non-return valve members connected by a rod element, and for insertion in an at least partly flexible tube in such tube...

  6. i-gel喉罩用于术前置入鼻胃管的腹腔镜手术患者气道管理的效果%Efficacy of laryngeal mask airway i-gel in patients required insertion of nasogastric tube before laparoscopic surgery

    Institute of Scientific and Technical Information of China (English)

    杨宁; 左明章; 石妤; 宋京海

    2011-01-01

    目的 评价i-gel喉罩用于术前置入鼻胃管的腹腔镜手术患者气道管理的效果.方法 择期全麻下拟行腹腔镜手术患者55例,性别不限,ASA分级Ⅰ~Ⅲ级,年龄26~64,体重54~73 kg,Mallampati分级Ⅰ~Ⅲ级,采用随机数字表法,将患者随机分为2组:经i-gel喉罩放置胃管组(Ⅰ组,n=28)和术前经鼻放置胃管组(Ⅱ组,n=27).Ⅰ组经i-gel喉罩的引流管放置胃管,并经胃管引流胃液及气体,Ⅱ组术前经鼻放置并术中保留胃管,麻醉诱导前充分吸引后,再置入喉罩.术中监测血液动力学指标、SpO2、PETCO2和气道峰压.置入成功后行纤维支气管镜检查评分,并观察胃管位移的发生情况;记录喉罩置入时间、首次置入成功情况、气道密封压、罩体周围漏气和胃管引流情况.拔除喉罩后观察罩体内是否有血液或返流物,记录术后24 h内咽部不良反应的发生情况.结果 两组术中血液动力学平稳,SpO2、气道峰压均在正常范围,气道峰压低于喉罩密封压,组间比较差异无统计学意义(P>0.05);两组喉罩置入时间、首次置入成功率、胃管引流率、气道密封压、罩体漏气发生率、口咽部解剖结构显露评分、咽部不良反应发生率、罩体内带血和有返流物的发生率比较差异均无统计学意义(P>0.05),Ⅱ组胃管均未发生位移.结论 对于术前置入鼻胃管的腹腔镜手术患者,i-gel喉罩易于置入,气道密封性可靠,通气效果好,不影响胃管引流,可安全有效地用于该类患者的气道管理.%Objective To assess the efficacy of laryngeal mask airway (LMA) i-gel in patients required insertion of nasogastric tube before laparoscopic surgery. Methods Fifty-five ASA Ⅰ - Ⅲ patients ( Mallampati Ⅰ -Ⅲ ), aged 26-64 yr, weighing 54-73 kg, scheduled for elective laparoscopic surgery were randomly divided into 2 groups: group Ⅰ ( n= 28) and group Ⅱ ( n = 27). The size of i-gel LMA was chosen based on

  7. Enteral feeding without pancreatic stimulation

    DEFF Research Database (Denmark)

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

    2005-01-01

    OBJECTIVE: All forms of commonly practiced enteral feeding techniques stimulate pancreatic secretion, and only intravenous feeding avoids it. In this study, we explored the possibility of more distal enteral infusions of tube feeds to see whether activation of the ileal brake mechanism can result...... in enteral feeding without pancreatic stimulation, with particular reference to trypsin, because the avoidance of trypsin stimulation may optimize enteral feeding in acute pancreatitis. METHODS: The pancreatic secretory responses to feeding were studied in 36 healthy volunteers by standard double......-lumen duodenal perfusion/aspiration techniques over 6 hours. Subjects were assigned to no feeding (n = 7), duodenal feeding with a polymeric diet (n = 7) or low-fat elemental diet (n = 6), mid-distal jejunal feeding (n = 11), or intravenous feeding (n = 5). All diets provided 40 kcal/kg ideal body weight/d and 1...

  8. Complex Feeding Decisions

    Directory of Open Access Journals (Sweden)

    Anna Miles PhD

    2016-08-01

    Full Text Available Objective: Where swallowing difficulties are chronic or progressive, or a patient is palliative, tube feeding is often not deemed appropriate. Instead, patients continue to eat and drink despite the risks of pneumonia and death. There is currently little evidence to guide clinical practice in this field often termed “risk feeding.” This qualitative study investigated staff, patient, and family member perceptions of risk feeding practices in one New Zealand hospital. Method: Twenty-nine staff members and six patients and/or their family were interviewed. Results: Thematic analysis revealed four global themes: supporting practice, communication, complexity of feeding decisions, and patient and family-centered care. Staff described limited education and organizational policy around risk feeding decisions. Communication was considered a major factor in the success. Conclusion: Feeding decisions are complex in the hospital environment. The themes identified in this study provide a foundation for hospital guideline development and implementation.

  9. Toward automated cochlear implant insertion using tubular manipulators

    Science.gov (United States)

    Granna, Josephine; Rau, Thomas S.; Nguyen, Thien-Dang; Lenarz, Thomas; Majdani, Omid; Burgner-Kahrs, Jessica

    2016-03-01

    During manual cochlear implant electrode insertion the surgeon is at risk to damage the intracochlear fine-structure, as the electrode array is inserted through a small opening in the cochlea blindly with little force-feedback. This paper addresses a novel concept for cochlear electrode insertion using tubular manipulators to reduce risks of causing trauma during insertion and to automate the insertion process. We propose a tubular manipulator incorporated into the electrode array composed of an inner wire within a tube, both elastic and helically shaped. It is our vision to use this manipulator to actuate the initially straight electrode array during insertion into the cochlea by actuation of the wire and tube, i.e. translation and slight axial rotation. In this paper, we evaluate the geometry of the human cochlea in 22 patient datasets in order to derive design requirements for the manipulator. We propose an optimization algorithm to automatically determine the tube set parameters (curvature, torsion, diameter, length) for an ideal final position within the cochlea. To prove our concept, we demonstrate that insertion can be realized in a follow-the-leader fashion for 19 out of 22 cochleas. This is possible with only 4 different tube/wire sets.

  10. Tracheostomy tubes.

    Science.gov (United States)

    Hess, Dean R; Altobelli, Neila P

    2014-06-01

    Tracheostomy tubes are used to administer positive-pressure ventilation, to provide a patent airway, and to provide access to the lower respiratory tract for airway clearance. They are available in a variety of sizes and styles from several manufacturers. The dimensions of tracheostomy tubes are given by their inner diameter, outer diameter, length, and curvature. Differences in dimensions between tubes with the same inner diameter from different manufacturers are not commonly appreciated but may have important clinical implications. Tracheostomy tubes can be cuffed or uncuffed and may be fenestrated. Some tracheostomy tubes are designed with an inner cannula. It is important for clinicians caring for patients with a tracheostomy tube to appreciate the nuances of various tracheostomy tube designs and to select a tube that appropriately fits the patient. The optimal frequency of changing a chronic tracheostomy tube is controversial. Specialized teams may be useful in managing patients with a tracheostomy. Speech can be facilitated with a speaking valve in patients with a tracheostomy tube who are breathing spontaneously. In mechanically ventilated patients with a tracheostomy, a talking tracheostomy tube, a deflated cuff technique with a speaking valve, or a deflated cuff technique without a speaking valve can be used to facilitate speech. Copyright © 2014 by Daedalus Enterprises.

  11. Analysis of C60 insertion into single wall carbon nanotube by molecular dynamics simulation

    Science.gov (United States)

    Ishii, Takafumi; Esfarjani, Keivan; Hashi, Yuichi; Kawazoe, Yoshiyuki; Iijima, Sumio

    2001-10-01

    Classical molecular dynamics is used to simulate the insertion of C60 into a (10, 10) single wall nano tube (SWNT). We propose that the insertion process occurs through the open end of the tube. After insertion, the energy exchange between the C60 and the nanotube causes the kinetic energy of the former to decrease as it moves inside the tube. This kinetic energy loss is due to a "friction force" which we calculated for several insertion conditions. The binding energy of the C60 with the SWNT is due to Van der Waals interaction, and is found to be about 3.5 eV.

  12. A wandering tube.

    Science.gov (United States)

    Dubin, Ina; Gelber, Moshe; Schattner, Ami

    2016-12-05

    The predominant causes of acute mechanical small bowel obstruction in geriatric patients are adhesions and hernias, which is not much different than in other adult age groups. Unusual etiologies may be encountered, such as volvulus or gallstone ileus, but a displaced feeding gastrostomy tube is a distinctly rare cause of intestinal obstruction which needs to be considered by emergency physicians as it may be increasingly encountered.

  13. Nasogastric tube depth: the 'NEX' guideline is incorrect.

    Science.gov (United States)

    Taylor, Stephen J; Allan, Kaylee; McWilliam, Helen; Toher, Deirdre

    Misplacing 17-23% of nasogastric (NG) tubes above the stomach ( Rollins et al, 2012 ; Rayner, 2013 ) represents a serious risk in terms of aspiration, further invasive (tube) procedures, irradiation from failed X-ray confirmation, delay to feed and medication. One causal factor is that in the National Patient Safety Agency (NPSA) guidance to place a tube, length is measured from nose to ear to xiphisternum (NEX) ( NSPA, 2011 ); NEX is incorrect because it only approximates the nose to gastro-oesophageal junction (GOJ) distance and is therefore too short. To overcome this and because the xiphisternum is more difficult to locate, local policy is to measure in the opposite direction; xiphisternum to ear to nose (XEN), then add 10 cm. The authors determined whether external body measurements can be used to estimate the NG tube length to safely reach the gastric body. This involved testing the statistical association of body length, age, sex and XEN in consecutive critically ill patients against internal anatomical landmarks determined from an electromagnetic (EM) trace of the tube path. XEN averaged 50 cm in 71 critically ill patients aged 53±20 years. Tube marking and the EM trace were used to determine mean insertion distances at pre-gastro-oesophageal junction (GOJ) (48 cm), where the tube first turns left towards the stomach and becomes shallow on the trace; gastric body (62 cm), where the tube reaches the left-most part of the stomach; and gastric antrum (73 cm) at the midline on the EM trace. Using body length, age, sex and XEN in a linear regression model, only 25% of variability was predicted, showing that external measurements cannot reliably predict the length of tube required to reach the stomach. A tube length of XEN (or NEX) is too short to guarantee gastric placement and is unsafe. XEN+10 cm or more complex measurements will reach the gastric body (mid-stomach) in most patients, but because of wide variation, external measurements often fail to predict a

  14. Effect of occlusal calculus utilized as a potential "biological sealant" in special needs patients with gastric feeding tubes: a qualitative in vitro contrast to pit and fissure sealant restorations.

    Science.gov (United States)

    Owens, Barry M; Sharp, Harry K; Fourmy, Emily E; Phebus, Jeffrey G

    2016-01-01

    The aim of this case report and in vitro investigation was to evaluate the marginal microleakage of intact occlusal calculus of primary molars extracted from a special needs patient who received nutrition via a gastric feeding tube. An adolescent with a history of developmental disturbance presented for routine dental care in a hospital facility. Prophylaxis was performed, and 2 mandibular permanent molars were restored. Five primary molars were extracted due to mobility and delayed retention. Heavy deposits of intact calculus were present on the occlusal surfaces of the primary teeth. The extracted teeth were immersed in methylene blue dye solution, invested in acrylic resin, sectioned into blocks, and photographed at 20× and 40× magnification. Previously photographed calculus-free molars with pit and fissure sealants were reviewed and served as contrasting "restorations." The occlusal calculus on the primary teeth extracted from the patient absorbed the dye, while the comparison teeth containing pit and fissure sealants exhibited varying degrees of marginal dye penetration (microleakage). No marginal microleakage was noted in the calculus specimens, indicating that this substrate may serve as a "natural" occlusal surface sealant and that its removal from occlusal surfaces during routine oral prophylaxis may be unnecessary.

  15. 留置鼻胃管注食在食管癌同步放化疗中的应用及效果%Application and effect of indwelling nasogastric tube feeding in esophagus cancer concurrent radiochemotherapy

    Institute of Scientific and Technical Information of China (English)

    罗丽群; 冯洁栈

    2015-01-01

    Objective To discuss the effect of indwelling nasogastric tube feeding in esophagus cancer concurrent ra-diochemotherapy. Methods Selected 100 esophagus cancer patients,who were verified by esophagoscope and pathology and had no distant metastasis,admitted from January,2000 to July,2014. Randomly divided them into observation group(n=50) and control group(n=50). Used silica gel nasogastric feeding tube(suggest indwelling in body for less than 45 d),nasogastric tube to feed fluid in stomach on 1 d of observation group′s radiotherapy. Fed control group according to doctor′s diet instruction. Both groups′food type,amount,and frequency were decided according to patients. Observed both groups′nutritive index every 2 weeks during treatment,and the first time acute radioactive esophageal mucosa damage appeared and therapeutic continuity ,and the garde evaluation of acute radiation esophagitis. Results Compared observation group′s nutritive index with control group′s when doing chemoradiotherapy 40 Gy and 60 Gy,differences showing statistical significance(P<0.05). Patients in both groups had dif-ferent degree′s acute radioactive esophagus mucosa damage. All patients in observation group kept radiotherapy ,while 8 patients in control group broke off radiotherapy for 5-9 d when doing 40-45 Gy. Compared the number of patients who broke off radiother-apy because of acute radioactive esophagus mucosa damage in both groups,differences showing statistical significance(P<0.05). Compared the number of level 1,2 radioactive oesophagitis and level 3,4 radioactive oesophagitis,differences showing statistical significance (P<0.01). Conclusion Indwelling nasogastric tube feeding is important in esophagus cancer concurrent ra-diochemotherapy.%目的:探讨留置鼻胃管注食在食管癌同步放化疗中的效果。方法选择2000年1月至2014年7月收治的经食管镜及病理证实且无远处转移的食管癌患者100例,将其随

  16. A simple device to teach tube thoracostomy.

    Science.gov (United States)

    Ching, Jessica A; Wachtel, Thomas L

    2011-06-01

    Chest tube insertion is an important component of medical and surgical education. This article reports a cost-effective and easily reproducible method for hands-on education of tube thoracostomy placement. A wood base is constructed, and a large rack of ribs are secured to simulate the thorax. Partially inflated examination gloves and bagels are used to simulate the lung and diaphragm, respectively. A life-like, cost-efficient thoracostomy model is created allowing for proficiency training in chest tube insertion. According to Advanced Trauma Life Support criteria, 123 military personnel were satisfactory, 4 remedial, and 7 instructor potential using the described model. We have developed a simple, inexpensive training device for insertion of chest tubes and tested it on 134 military personnel.

  17. Experimental investigation of friction coefficient in tube hydroforming

    Institute of Scientific and Technical Information of China (English)

    Hyae Kyung YI; Hong Sup YIM; Gun Yeop LEE; Sung Mun LEE; Gi Suk CHUNG; Young-Hoon MOON

    2011-01-01

    The friction coefficient between tube and die in guide zone of tube hydroforming was obtained. In hydroforming, the tube is expanded by an internal pressure against the tool wall. By pushing the tube through tool, a friction force at the contact surface between the tube and the tool occurs. In guiding zone, the friction coefficients between tube and die can be estimated from the measured axial feeding forces. In expansion zone, the friction coefficients between tube and die can be evaluated from the measured geometries of expanded tubes and FE analysis.

  18. Tie rod insertion test

    CERN Multimedia

    B. LEVESY

    2002-01-01

    The superconducting coil is inserted in the outer vaccum tank and supported by a set of tie rods. These tie rods are made of titanium alloy. This test reproduce the final insertion of the tie rods inside the outer vacuum tank.

  19. PEG tubes: dealing with complications.

    Science.gov (United States)

    Malhi, Hardip; Thompson, Rosie

    A percutaneous endoscopic gastronomy tube can be used to deliver nutrition, hydration and medicines directly into the patient's stomach. Patients will require a tube if they are unable to swallow safely, putting them at risk of aspiration of food, drink and medicines into their lungs. It is vital that nurses are aware of the complications that may arise when caring for a patient with a PEG tube. It is equally important that nurses know how to deal with these complications or from where tc seek advice. This article provides a quick troubleshooting guide to help nurses deal with complications that can arise with PEG feeding.

  20. Safe and adequate placement of nasogastric tubes in the presence of a cuffed tracheostomy tube.

    Science.gov (United States)

    Parmar, A; Macleod, I; McDonald, S; Tierney, P

    2011-09-01

    This case report and review of the literature aims to highlight the importance of the use of a chest radiograph to check the placement of nasogastric tubes after insertion in an awake patient with an inflated cuffed tracheostomy tube regardless of an acidic pH test.

  1. Successful tubes treatment of esophageal fistula

    OpenAIRE

    Zhou, Ning; Chen, Wei-Xing; Li, You-ming; Xiang, Zhun; Gao, Ping; Fang, Ying

    2007-01-01

    Aim: To discuss the merits of “tubes treatment” for esophageal fistula (EF). Methods: A 66-year-old female who suffered from a bronchoesophageal and esophagothoratic fistula underwent a successful “three tubes treatment” (close chest drainage, negative pressure suction at the leak, and nasojejunal feeding tube), combination of antibiotics, antacid drugs and nutritional support. Another 55-year-old male patient developed an esophagopleural fistula (EPF) after esophageal carcinoma operation. He...

  2. [Nasogastric tubes: a lot of bother].

    Science.gov (United States)

    Tagliabue, Fabio; D'Angelo, Carlo; Zuccon, William; Giorgetta, Casimiro; Balduzzi, Valerio; Gambarini, Fabrizio; Bonandrini, Luigi

    2008-01-01

    The insertion of the nasogastric tube is one of the procedure that produces the most discomfort for the patients and practitioners. The AA, with the make use of their clinical experience and the data of the literature, report some personal reflections about the management of the nasogastric tube. The AA also analyse some variables (choice of the tube, approach to the patient, insertion of the tube, examination of the position, fixation and removal) that can influence on discomfort of the patient. The choice of the most right SNG is an important moment for the correct insertion; an effect we need to adjust the material and diameter of the tube to the prearranged use. The common practice demonstrates that the collaboration with the patient, obtained by "direct" and "indirect" strategies, gives more possibilities to immediately success of this procedure. The literature explains that it is possible to decrease the discomfort with topical anesthesia; still there are some points of view to clarify. From analyse of the different methods to check the position of SNG, the pH test of the aspirating fluid is the best solution. Once examination of right placement, we need to fix in different points (at least two). From personal experience the removal of SNG is better tolerate that the insertion because the patient is more conscious to be on the mend. The principal recommendation is to abstain from insertion of SNG if it is not closely necessary!

  3. Primary placement technique of jejunostomy using the entristar™ skin-level gastrostomy tube in patients with esophageal cancer

    Directory of Open Access Journals (Sweden)

    Wada Nobuyuki

    2011-01-01

    Full Text Available Abstract Background We developed a skin-level jejunostomy tube (SLJT procedure for patients undergoing esophagectomy using a skin-level gastrostomy tube (G-tube (Entristar™; Tyco Healthcare, Mansfield, Mass, in order to improve their nutrition status and quality of life (QOL. We describe the procedure and the adverse effects of SLJT in patients with esophageal cancer (EC. Methods Over a 24-month period (March 2008 to March 2010, there were 16 patients (mean age: 61.8 years; age range: 49-75 years; 15 men, 1 woman who had Stage II or III EC. Primary jejunostomy was performed under general anesthesia during esophagectomy. The technical success and the immediate and delayed complications of the procedure were recorded. Jejunostomy techniques SLJT placement using the G-tube (20Fr was performed 20 cm from the Treitz ligament on the side opposing the jejunal mesenterium. The internal retention bolster was exteriorized through an incision in the abdominal wall. A single purse string suture using a 4-0 absorbable suture was performed. The internal retention bolster was then inserted into the jejunal lumen via the small incision. The intestine adjacent to the tube was anchored to the peritoneum using a single stitch. Results The SLJT was successfully inserted in all 16 patients. No early complications were documented. Follow-up for a median of 107 days (range, 26-320 days revealed leakage to the skin in four patients, including superficial wound infections in two patients. There were no cases of obstruction of the tube or procedure-related death. Conclusions This SLJT placement technique using the G-tube is a safe procedure in patients with EC and allows the creation of a long-term feeding jejunostomy.

  4. Comparing Leaf and Root Insertion

    Directory of Open Access Journals (Sweden)

    Jaco Geldenhuys

    2010-07-01

    Full Text Available We consider two ways of inserting a key into a binary search tree: leaf insertion which is the standard method, and root insertion which involves additional rotations. Although the respective cost of constructing leaf and root insertion binary search trees trees, in terms of comparisons, are the same in the average case, we show that in the worst case the construction of a root insertion binary search tree needs approximately 50% of the number of comparisons required by leaf insertion.

  5. Improving the nursing intervention for feeding intolerance of patients after gastric cancer during tube feeding enteral nutrition%提高胃癌术后患者管饲肠内营养期间喂养不耐受护理效果研究

    Institute of Scientific and Technical Information of China (English)

    杨飞

    2015-01-01

    目的:探讨不耐受处理流程护理对提高胃癌术后患者肠内营养期间喂养不耐受的有效性.方法:收治肠内营养喂养不耐受的胃癌术后患者72例,随机分成对照组(n=35)及干预组(n=37).对照组接受常规护理,干预组接受不耐受处理流程护理,比较两组护理效果.结果:干预组腹胀及肺部感染发生率明显低于对照组(P<0.05);同时干预组第3天热量达标比例明显高于对照组(P<0.05).结论:不耐受处理流程护理可以有效降低胃癌术后患者肠内营养的并发症发生率,并在一定程度上改善患者的营养状况.%Objective:To explore the effect of intolerance process nursing for improving the nursing intervention for feeding intolerance of patients after gastric cancer during tube feeding enteral nutrition.Methods:72 patients with feeding intolerance after gastric cancer were selected.They were randomly divided into the control group(n=35) and the intervention group(n=37).The control group were given routine nursing,while the intervention group were given intolerance process nursing,then we compared the nursing effect of two groups.Results:In the intervention group,abdominal distension and the incidence of pulmonary infection were significantly lower than that of the control group(P<0.05),at the same time,heat standard ratio at the third day was significantly higher than that of the control group(P<0.05).Conclusion:Intolerance process nursing can effectively reduce the incidence of complications of enteral nutrition for patients after gastric cancer,and improve the nutritional status of the patients in a certain extent.

  6. Gastrostomy Tube (G-Tube)

    Science.gov (United States)

    ... the recovery room, sometimes called the "post-op" (post-operative) room or PACU (post-anesthesia care unit), and ... site; discharge that's yellow, green, or foul-smelling; fever) excessive bleeding or drainage from the tube site ...

  7. 鼻肠管在伴有胃出口梗阻的胃癌病人营养和化疗中的应用%Clinical application of nasojejunal feeding tubes in the treatment of gastric outlet obstructive patients with neoadjuvant chemotherapy

    Institute of Scientific and Technical Information of China (English)

    王金晶; 汪志明; 王震龙; 刁艳青; 李宁

    2012-01-01

    Objective: To investigate the application and effect of enteral nutrition applied in gastric outlet obstructive patients with neoadjuvant chemotherapy by the nasojejunal feeding tubes placed endoscopically. Methods: Nasojejunal feeding tubes were placed in 16 gastric cancer patients with pyloric obstruction, followed by enteral nutrition support and neoadjuvant chemotherapy. The safety and efficiency of this procedure were recorded. Results: Tubes were successfully placed in 100% of the cases with an average time of (10. 8 ±3.6) min. No complications of this procedure were observed. Enteral nutrition, neoadjuvant chemotherapy and surgery were smoothly performed. Conclusion: The nasojejunal feeding tubes were easy to place endoscopically. And enteral nutrition support can improve the nutritional status of gastric cancer patients with pyloric obstruction during the neoadjuvant chemotherapy.%目的:探讨经内镜放置鼻肠管给予肠内营养(EN)在伴有胃出口梗阻的胃癌病人新辅助化疗中的应用及疗效.方法:对16例伴有胃出口梗阻的胃癌病人经内镜放置鼻肠管并给予EN,观察该方法的安全性和有效性.结果:16例病人均成功经内镜放置鼻肠管,平均置管时间为(10.8±3.6)min,未发生消化道穿孔和出血等严重并发症.所有病人均顺利完成新辅助化疗,并在化疗结束后接受了手术.结论:经内镜放置鼻肠管行EN,能改善伴有胃出口梗阻胃癌病人的营养状况,帮助其完成新辅助化疗.

  8. Investigation of contact resistance for fin-tube heat exchanger by means of tube expansion

    Science.gov (United States)

    Hing, Yau Kar; Raghavan, Vijay R.; Meng, Chin Wai

    2012-06-01

    An experimental study on the heat transfer performance of a fin-tube heat exchanger due to mechanical expansion of the tube by bullets has been reported in this paper. The manufacture of a fin-tube heat exchanger commonly involves inserting copper tubes into a stack of aluminium fins and expanding the tubes mechanically. The mechanical expansion is achieved by inserting a steel bullet through the tube. The steel bullet has a larger diameter than the tube and the expansion provides a firm surface contact between fins and tubes. Five bullet expansion ratios (i.e. 1.045 to 1.059) have been used in the study to expand a 9.52mm diameter tubes in a fin-tube heat exchanger. The study is conducted on a water-to-water loop experiment rig under steady state conditions. In addition, the effects of fin hardness and fin pitch are investigated in the study. The results indicate that the optimum heat transfer occurred at a bullet expansion ratio ranging from 1.049 to 1.052. It is also observed that larger fin pitches require larger bullet expansion ratios, especially with lower fin hardness. As the fin pitch increases, both fin hardness (i.e. H22 and H24) exhibit increasing heat transfer rate per fin (W/fin). With the H22 hardness temper, the increase is as much as 11% while H24 increases by 1.2%.

  9. 三腔喂养管护理在胃癌患者全胃切除术中的应用%Application of the Efficacy of Three Cavity Nasal Jejunal Feeding Tube Nursing in Patients with Total Gastrectomy

    Institute of Scientific and Technical Information of China (English)

    刁秀云; 谢云亮

    2014-01-01

    Objective To explore the efficacy of three cavity nasal jejunal feeding tube nursing ( TCNJ-FTN) for the recovery of nu-trition status in patients with total gastrectomy.Methods A total of 86 patients with total gastrectomy were chosen.Among them, 43 pa-tients treated with indwelling stomach tube and routine care were selected as control group , and 43 patients treated with TCNJ -FTN were selected as observation group.The recovery status after operation , wound healing time , hospitalization time and nursing satisfaction were compared between the two groups.Results The postoperative recovery in observation group was markedly better than the control group , and there was significant difference ( P<0.05 ).The average wound healing time and hospitalization time of observation group were markedly less than those of control group , and there was significant difference ( P<0.05 ).Nursing satisfaction rate of observation group was marked-ly higher than that of control group , and there was significant difference ( P<0.05 ).Conclusion For patients with total gastrectomy , TC-NJ-FTN treatment and care can promote the rehabilitation of patients and increase nursing satisfaction .It is worthy of clinical promotion.%目的:探讨三腔喂养管护理( TCNJ-FTN)对全胃切除术患者营养的恢复情况。方法选择因胃癌实施全胃切除术的86例患者,其中将留置普通胃管并进行常规护理的43例患者作为对照组,实施TCNJ-FTN护理措施的43例患者作为观察组。对比两组术后的恢复情况、伤口愈合时间、住院时间及两组护理满意情况。结果观察组在术后的恢复情况显著优于对照组,其差异有统计学意义(P<0.05);观察组的平均伤口愈合时间、平均住院时间均显著短于对照组,其差异均有统计学意义(P<0.05);观察组的护理满意率显著高于对照组,其差异均有统计学意义( P<0.05)。结论对于

  10. The Application of Used Extracorporeal Blood Circuit Tube Governor in Nasal Feeding Nursing of Postoperative Patients with Laryngeal Cancer%体外循环血路管调速器在喉癌术后患者鼻饲饮食护理中的应用

    Institute of Scientific and Technical Information of China (English)

    郝小丹; 徐光

    2016-01-01

    Objective To discuss the application of used extracorporeal blood circuit tube governor in the nasal feeding nursing of postoperative patients with laryngeal caner. Methods 65 cases were randomly divided into 2 groups:group A (n=30) and group B (n=35);ordinary nasogastric tube was applied to cases in group A while nasogastric tube with extracorporeal blood circuit tube governor was applied to cases in group B;the time for nasal feeding nursing of the cases in the 2 groups was recorded as well as the occurrence of gastric tube damage. Results The average time of nasal feeding nursing once in group A was 8.6 minutes while that was 6.2 minutes in group B;gastric tube damage occurred in 4 cases in group A (13.3%) while no gastric tube damage occurred in group B. Conclusions It can reduce the gastric tube damage, prevent gastric distention and shorten the time of nursing to apply used extracorporeal blood circuit tube governor in the nasal feeding nursing of postoperative patients with laryngeal cancer, and it is worthy of wider application in clinic.%目的:探讨体外循环血路管调速器在喉癌术后患者鼻饲饮食护理中的应用效果。方法选择65例喉癌术后留置胃管的患者随机分为A组30例,B组35例,A组使用普通胃管进行鼻饲饮食,B组使用安装了体外循环血路管调速器的胃管进行鼻饲饮食。统计两组患者鼻饲饮食的护理时间、胃管破损发生率。结果 A组平均每次鼻饲饮食护理时间为8.6分钟,B组为6.2分钟。A组患者鼻饲过程中胃管破损而重新置入胃管4例(13.3%),B组未发生胃管破损。结论在喉癌术后患者的鼻饲饮食中使用安装了体外循环血路管调速器的胃管,可以减少胃管破损,避免胃胀气,缩短护理时间,值得临床推广。

  11. Pixel detector insertion

    CERN Multimedia

    CMS

    2015-01-01

    Insertion of the Pixel Tracker, the 66-million-channel device used to pinpoint the vertex of each colliding proton pair, located at the heart of the detector. The geometry of CMS is a cylinder lying on its side (22 meters long and 15 meters high in dia

  12. The Composite Insertion Electrode

    DEFF Research Database (Denmark)

    Atlung, Sven; Zachau-Christiansen, Birgit; West, Keld

    1984-01-01

    The specific energy obtainable by discharge of porous insertion electrodes is limited by electrolyte depletion in thepores. This can be overcome using a solid ion conductor as electrolyte. The term "composite" is used to distinguishthese electrodes from porous electrodes with liquid electrolyte...

  13. Inserting the CMS solenoid

    CERN Multimedia

    Maximilien Brice

    2005-01-01

    The huge superconducting solenoid for CMS is inserted into the cryostat barrel. CMS uses the world's largest thin solenoid, in terms of energy stored, and is 12 m long, with a diameter of 6 m and weighing 220 tonnes. When turned on the magnet will produce a field strength of 4 T using superconducting niobium-titanium material at 4.5 K.

  14. SVC obstruction and stridor relieved by nasogastric tube insertion.

    Science.gov (United States)

    Molena, Emma J; Krishnamoorthy, Ashwin; Praveen, Coimbatore

    2016-03-01

    Achalasia is an idiopathic motility disorder of the oesophagus of increasing incidence. It is characterized by aperistalsis of the lower oesophagus and failure of relaxation of the lower oesophageal sphincter. Patients classically present with chronic symptoms of dysphagia, chest pain, weight loss and regurgitation, and they commonly suffer pulmonary complications such as recurrent microaspiration of static, retained food contents of the upper oesophagus. However, it has also been described, uncommonly, to present with megaoesophagus and secondary tracheal compression. We present a case of megaoesophagus secondary to achalasia which presented with stridor and signs of acute superior vena caval obstruction.

  15. Heat Transfer Enhancement by Using Different Types of Inserts

    Directory of Open Access Journals (Sweden)

    S. Tabatabaeikia

    2014-07-01

    Full Text Available Heat transfer enhancement has been always a significantly interesting topic in order to develop high efficient, low cost, light weight, and small heat exchangers. The energy cost and environmental issue are also encouraging researchers to achieve better performance than the existing designs. Two of the most effective ways to achieve higher heat transfer rate in heat exchangers are using different kinds of inserts and modifying the heat exchanger tubes. There are different kinds of inserts employed in the heat exchanger tubes such as helical/twisted tapes, coiled wires, ribs/fins/baffles, and winglets. This paper presents an overview about the early studies on the improvement of the performance of thermal systems by using different kinds of inserts. Louvered strip insert had better function in backward flow compared to forward one. Modifying the shape of twisted tapes led to a higher efficiency in most of the cases excpet for perforated twisted tape and notched twisted tape. Combination of various inserts and tube with artificial roughness provided promising results. In case of using various propeller types, heat transfer enhancement was dependent on higher number of blades and blade angle and lower pitch ratio.

  16. Chylothorax: a rare complication of tube thoracostomy.

    Science.gov (United States)

    Limsukon, Atikun; Yick, Dennis; Kamangar, Nader

    2011-03-01

    Chylothorax resulting from chest tube injury to the thoracic duct is very rare and underreported. The purpose of this case report is to exemplify this rare but potentially significant complication of chest tube thoracostomy. An 86-year-old woman presented with sepsis and a massive right pleural effusion; she developed a chylous effusion with the pleural fluid triglyceride level of 158 mg/dL 2 days after a traumatic chest tube insertion. All investigations excluded common causes of non-traumatic chylothorax. The chylothorax improved after fasting and implementation of a medium-chain triglyceride diet. The optimal depth of insertion of the chest tube typically ranges from 5 to 15 cm, ensuring all sideports are within the chest and the proximal port is at least 2 cm beyond the rib margin. Traumatic chylothorax secondary to chest tube insertion should be included in the differential diagnosis of patients presenting with chylothorax after a thoracostomy tube. Copyright © 2011 Elsevier Inc. All rights reserved.

  17. Complications of tube thoracostomy in trauma

    Science.gov (United States)

    Bailey, R

    2000-01-01

    Objective—To assess the complication rate of tube thoracostomy in trauma. To consider whether this rate is high enough to support a selective reduction in the indications for tube thoracostomy in trauma. Methods—A retrospective case series of all trauma patients who underwent tube thoracostomy during a 12 month period at a large UK teaching hospital with an accident and emergency (A&E) department seeing in excess of 125 000 new patients/year. These patients were identified using the hospital audit department computerised retrieval system supplemented by a hand search of both the data collected for the Major Trauma Outcome Study and the A&E admission unit log book. The notes were assessed with regard to the incidence of complications, which were divided into insertional, infective, and positional. Results—Fifty seven chest drains were placed in 47 patients over the 12 month period. Seven patients who died within 48 hours of drain insertion were excluded. The commonest indications for tube thoracostomy were pneumothorax (54%) and haemothorax (20%); 90% of tubes were placed as a result of blunt trauma. The overall complication rate of the procedure was 30%. There were no insertional complications and only one (2%) major complication, which was empyema thoracis. Conclusion—This study reveals no persuasive evidence to support a selective reduction in the indications for tube thoracostomy in trauma. A larger study to confirm or refute these findings must be performed before any change in established safe practice. PMID:10718232

  18. High Speed Video Insertion

    Science.gov (United States)

    Janess, Don C.

    1984-11-01

    This paper describes a means of inserting alphanumeric characters and graphics into a high speed video signal and locking that signal to an IRIG B time code. A model V-91 IRIG processor, developed by Instrumentation Technology Systems under contract to Instrumentation Marketing Corporation has been designed to operate in conjunction with the NAC model FHS-200 High Speed Video Camera which operates at 200 fields per second. The system provides for synchronizing the vertical and horizontal drive signals such that the vertical sync precisely coincides with five millisecond transitions in the IRIG time code. Additionally, the unit allows for the insertion of an IRIG time message as well as other data and symbols.

  19. Successful tubes treatment of esophageal fistula.

    Science.gov (United States)

    Zhou, Ning; Chen, Wei-xing; Li, You-ming; Xiang, Zhun; Gao, Ping; Fang, Ying

    2007-10-01

    To discuss the merits of "tubes treatment" for esophageal fistula (EF). A 66-year-old female who suffered from a bronchoesophageal and esophagothoratic fistula underwent a successful "three tubes treatment" (close chest drainage, negative pressure suction at the leak, and nasojejunal feeding tube), combination of antibiotics, antacid drugs and nutritional support. Another 55-year-old male patient developed an esophagopleural fistula (EPF) after esophageal carcinoma operation. He too was treated conservatively with the three tubes strategy as mentioned above towards a favorable outcome. The two patients recovered with the tubes treatment, felt well and became able to eat and drink, presenting no complaint. Tubes treatment is an effective basic way for EF. It may be an alternative treatment option.

  20. Successful tubes treatment of esophageal fistula

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Aim: To discuss the merits of "tubes treatment" for esophageal fistula (EF). Methods: A 66-year-old female who suffered from a bronchoesophageal and esophagothoratic fistula underwent a successful "three tubes treatment" (close chest drainage, negative pressure suction at the leak, and nasojejunal feeding tube), combination of antibiotics, antacid drugs and nutritional support. Another 55-year-old male patient developed an esophagopleural fistula (EPF) after esophageal carcinoma operation. He too was treated conservatively with the three tubes strategy as mentioned above towards a favorable outcome. Results:The two patients recovered with the tubes treatment, felt well and became able to eat and drink, presenting no complaint. Conclusion: Tubes treatment is an effective basic way for EF. It may be an alternative treatment option.

  1. 米曲菌胰酶片在预防老年鼻饲病人留置鼻胃管并发症的疗效观察%Observation on curative effect of Oryz-Aspergillus and Pancreatin tablet in the prevention of complication of indwelling nasogastric tube for senile patients adopt nasogastric feeding

    Institute of Scientific and Technical Information of China (English)

    龚竹云; 马骁翚; 黄利虹

    2008-01-01

    目的 探讨老年长期鼻饲病人在鼻饲液中加入米曲菌胰酶片(慷彼申)的疗效.方法 将80例采用鼻饲饮食的老年病人随机分为常规方法鼻饲组和鼻饲液中加入米曲菌胰酶片实验组.观察鼻饲期间堵管、误吸、胃潴留、腹胀、腹泻的发生情况.结果 实验组堵管发生频率、胃潴留、腹胀、腹泻发生率低于对照组(P0.05).结论 对老年长期鼻饲病人进行肠内营养支持时,采用鼻饲液中加入米曲菌胰酶片(慷彼申)发生鼻胃管堵塞、胃潴留、腹胀发生率低,减轻因反复留置胃肠管和腹胀给病人造成的痛苦,值得在临床老年鼻饲病人中推广.%Objective To explore the curative effect of adding Oryz-Aspergillus and Pancreatin tablet into fluid for senile patients adopt routine nasogastric feeding. Methods Eighty senile patients adopted nasogastric feeding were randomly divided into two groups, the routine nasogastric feeding group (the control group) and the Oryz-Aspergillus and Pancreatin group (the experiment group). The incidences of jamming of gastric tube, aspiration, gastric retention, abdominal distention and diarrhea were observed. Results The incidence rates of jamming of gastric tube, gastric retention, abdominal distention and diarrhea in the experiment group were lower than those of the control group (P 0. 05). Conclusions Adding Oryz-Aspergillus and Pancreatin into fluid can reduce the incidences of nasogastric tube jamming, gastric retention, abdominal distention for senile patients with perennial nasngastric feeding, thereby lightening the suffering resulted by repeatedly indwelling nasogastric tube and abdominal distention. So it is worthy of being popularized.

  2. Intraoperative wide bore nasogastric tube knotting: A rare incidence.

    Science.gov (United States)

    Lamba, Sangeeta; Sethi, Surendra K; Khare, Arvind; Saini, Sudheendra

    2016-01-01

    Nasogastric tubes are commonly used in anesthetic practice for gastric decompression in surgical patients intraoperatively. The indications for its use are associated with a number of potential complications. Knotting of small-bore nasogastric tubes is usually common both during insertion and removal as compared to wide bore nasogastric tubes. Knotting of wide bore nasogastric tube is a rare complication and if occurs usually seen in long standing cases. We hereby report a case of incidental knotting of wide bore nasogastric tube that occurred intraoperatively.

  3. Esophageal rupture due to Sengstaken-Blakemore tube misplacement

    Institute of Scientific and Technical Information of China (English)

    Chee-Fah Chong

    2005-01-01

    The author presents three cases of esophageal rupture during the treatment of massive esophageal variceal bleeding with Sengstaken-Blakemore (SB) tube. In each case, simple auscultation was used to guide SB tube insertion, with chest radiograph obtained only after complete inflation of the gastric balloon. Two patients died of hemorrhagic shock and one died of mediastinitis.The author suggests that confirmation of SB tube placement by auscultation alone may not be adequate.Routine chest radiographs should be obtained before and after full inflation of the gastric balloon to confirm tube position and to detect tube dislocation.

  4. Bougie insertion: A common practice with underestimated dangers

    Science.gov (United States)

    Theodorou, D.; Doulami, G.; Larentzakis, A.; Almpanopoulos, K.; Stamou, K.; Zografos, G.; Menenakos, E.

    2011-01-01

    Introduction Esophageal perforation after bariatric operations is rare. We report two cases of esophageal perforation after bariatric operations indicating the dangers of a common practice – like insertion of esophageal tubes – and we describe our management of that complication. Presentation of case A 56 year old woman who underwent laparoscopic sleeve gastrectomy and a 41 year old woman who underwent laparoscopic adjustable gastric banding respectively. In both operations a bougie has been used and led to esophageal perforation. Discussion The insertion of bougie and especially of inflated bougie is a common practice. It is an invasive procedure that in most cases is performed by the anesthesiologist team. Conclusion Bougie insertion is an invasive procedure with risks and should always be attempted under direct supervision of surgical team or should be inserted by a surgeon. PMID:22288051

  5. Comparison of the Efficacies of 0.94 mm and Double Silicone Tubes for Treatment of Canalicular Obstruction

    OpenAIRE

    Choi, Seong Chan; Choi, Hye Sun; Jang, Jae Woo; Kim, Sung Joo; Lee, Jung Hye

    2017-01-01

    Purpose To compare the clinical effects of the single wide-diameter bicanalicular silicone tube and the double bicanalicular silicone tube in endonasal dacryocystorhinostomy (DCR) with canalicular trephinization for canalicular obstruction. Methods We retrospectively reviewed the records of 121 patients with monocanalicular or common canalicular obstruction who had undergone endonasal DCR with random bicanalicular insertion of either double silicone tubes (insertion of two tubes into each can...

  6. photomultiplier tube

    CERN Multimedia

    photomultiplier tubes. A device to convert light into an electric signal (the name is often abbreviated to PM). Photomultipliers are used in all detectors based on scintillating material (i.e. based on large numbers of fibres which produce scintillation light at the passage of a charged particle). A photomultiplier consists of 3 main parts: firstly, a photocathode where photons are converted into electrons by the photoelectric effect; secondly, a multiplier chain consisting of a serie of dynodes which multiply the number of electron; finally, an anode, which collects the resulting current.

  7. photomultiplier tubes

    CERN Multimedia

    photomultiplier tubes. A device to convert light into an electric signal (the name is often abbreviated to PM). Photomultipliers are used in all detectors based on scintillating material (i.e. based on large numbers of fibres which produce scintillation light at the passage of a charged particle). A photomultiplier consists of 3 main parts: firstly, a photocathode where photons are converted into electrons by the photoelectric effect; secondly, a multiplier chain consisting of a serie of dynodes which multiply the number of electron; finally, an anode, which collects the resulting current.

  8. ENDOSCOPIC GROMMET INSERTION OUR EXPERIENCE

    Directory of Open Access Journals (Sweden)

    Balasubramanian Thiagarajan

    2012-03-01

    Full Text Available Grommet insertion the commonest surgical procedure next only to circumcision is usually performed using an operating microscope 1. Authors have been using 4 mm 0 degree nasalendoscopes to perform this procedure during the last 5 years. This is a report of their experience in using endoscope inlieu of microscope in performing this surgery. This study makes a comparative analysis of Endoscopic Grommet insertion viz a viz Microscopic Grommet insertion. For this comparative analysis one year (2009 data base of Government Stanley Medical College Chennai India was used. This study reveals that Endoscopic Grommet insertion compared favorably with Microscopic Grommet insertion in all aspects with certain obvious advantages.

  9. The Multiple Silicone Tube Device, “Tubes within a Tube,” for Multiplication in Nerve Reconstruction

    Directory of Open Access Journals (Sweden)

    Fredrik Johansson

    2014-01-01

    Full Text Available Multiple nerve branches were created during the regeneration procedure after a nerve injury and such multiple branches are suggested to be used to control, for example, prosthesis with many degrees of freedom. Transected rat sciatic nerve stumps were inserted into a nine mm long silicone tube, which contained four, five mm long, smaller tubes, thus leaving a five mm gap for regenerating nerve fibers. Six weeks later, several new nerve structures were formed not only in the four smaller tubes, but also in the spaces in-between. The 7–9 new continuous nerve structures, which were isolated as individual free nerves after removal of the tubes, were delineated by a perineurium and contained both myelinated and unmyelinated nerve fibers as well as blood vessels. Stimulation of the proximal nerve elicited contractions in distal muscles. Thin metal electrodes, inserted initially into the smaller tubes in some experiments, became embedded in the new nerve structures and when stimulated contractions of the distal muscles were observed. The “tubes within a tube” technique, creating multiple new nerves from a single “mother” nerve, can be used to record multiple signals for prosthetic device control or as sources for supply of multiple denervated targets.

  10. Parent feeding interactions and practices during childhood cancer treatment. A qualitative investigation.

    Science.gov (United States)

    Fleming, Catharine A K; Cohen, Jennifer; Murphy, Alexia; Wakefield, Claire E; Cohn, Richard J; Naumann, Fiona L

    2015-06-01

    In the general population it is evident that parent feeding practices can directly shape a child's life long dietary intake. Young children undergoing childhood cancer treatment may experience feeding difficulties and limited food intake, due to the inherent side effects of their anti-cancer treatment. What is not clear is how these treatment side effects are influencing the parent-child feeding relationship during anti-cancer treatment. This retrospective qualitative study collected telephone based interview data from 38 parents of childhood cancer patients who had recently completed cancer treatment (child's mean age: 6.98 years). Parents described a range of treatment side effects that impacted on their child's ability to eat, often resulting in weight loss. Sixty-one percent of parents (n = 23) reported high levels of stress in regard to their child's eating and weight loss during treatment. Parents reported stress, feelings of helplessness, and conflict and/or tension between parent and the child during feeding/eating interactions. Parents described using both positive and negative feeding practices, such as: pressuring their child to eat, threatening the insertion of a nasogastric feeding tube, encouraging the child to eat and providing home cooked meals in hospital. Results indicated that parent stress may lead to the use of coping strategies such as positive or negative feeding practices to entice their child to eat during cancer treatment. Future research is recommended to determine the implication of parent feeding practice on the long term diet quality and food preferences of childhood cancer survivors.

  11. 肿瘤患者术后用特殊配方与标准配方肠内营养二周的效果比较%Effects of a 14-day postoperative enteral feeding in tumor patients with a metabolically adapted enteral diet versus a standard tube feeding formula

    Institute of Scientific and Technical Information of China (English)

    GuditG.Meray; 陈海东

    2001-01-01

    Malnourished cancer patients need nutritinal support,espectially at the time of surgery,when their immune system suffers further depression.The composition of the food can be fo clinical importance in the modulation of the immune response.Supportan (Fresenius Kabi) is a liquid enteral nutritriment,specially adapted to the metabolic needs of tumor patients (50% of the energy given by fat,elevated proportion of ω-3 fatty acids,plus RNA,trace elements,vitamins.)Objective The goal of the present project was to compare in a randomixed,prospective,controlled,double blind clinical study the changes in the nutritional and immunologic states of ENT cancer patients scheduled for elective laryngectomy,after 14 days of postoperative enteral feeding (continuous nasogastric pump infusion)tither with Supportan(n=20),or with an isocaloric,standard tube feeding solution (n=20).Phvsical examination,nutritional history,anthropometric+bioimpedance measurements,and laboratory analysis of evnous blood samples were performed on the admission day,the first day after operation,and at the end of the feeding program.Statistics:two-way repeated measures analysis of variance,and-ifnecessary-logarithmic transformation or Mann-Whitney U-test.Results Surgery caused significant changes in most parameters,but the majority of changes was similar in both groups.Suportan was tolerated very well.Significantintergroup differences in favor of the supportan group are the following:Conclusion As indicated also by the differences in the changes in TNFα,BW and BMI,Supportan displays pronounced advantages in the nutrition of cancer patients.A longer feeding period seems to be necessary in order to achieve clear-cut immunologic effects…….%目的 观察五官科肿瘤病人作喉切除术使用肿瘤特异性免疫营养配方肠内营养对患者营养、免疫的调理作用。 方法 本研究是一个随机、前瞻、控制、双盲的临床研究。40例手术的五官科

  12. Gastrostomy insertion: comparing the options - PEG, RIG or PIG?

    Energy Technology Data Exchange (ETDEWEB)

    Laasch, H.-U. E-mail: hul@smtr.nhs.uk; Wilbraham, L.; Bullen, K.; Marriott, A.; Lawrance, J.A.L.; Johnson, R.J.; Lee, S.H.; England, R.E.; Gamble, G.E.; Martin, D.F

    2003-05-01

    AIM: To compare percutaneous endoscopic gastrostomy (PEG) with radiologically inserted gastrostomy (RIG) and assess a hybrid gastrostomy technique (per-oral image-guided gastrostomy, PIG). MATERIALS AND METHODS: Fifty PEGs and 50 RIGs performed in three centres were prospectively compared and the endoscopic findings of 200 PEGs reviewed. A fluoroscopy-guided technique was modified to place 20 F over-the-wire PEG-tubes in 60 consecutive patients. RESULTS: Technical success was 98%, 100% and 100% for PEG, RIG and PIG, respectively. Antibiotic prophylaxis significantly reduced stoma infection for orally placed tubes (p=0.02). Ten out of 50 (20%) small-bore RIG tubes blocked. Replacement tubes were required in six out of 50 PEGs (12%), 10 out of 50 RIGs (20%), but no PIGs (p<0.001). No procedure-related complications occurred. The function of radiologically placed tubes was significantly improved with the larger PIG (p<0.001), with similar wound infection rates. PIG was successful in 24 patients where endoscopic insertion could not be performed. Significant endoscopic abnormalities were found in 42 out of 200 PEG patients (21%), all related to peptic disease. Insignificant pathology was found in 8.5%. CONCLUSION: PIG combines advantages of both traditional methods with a higher success and lower re-intervention rate. Endoscopy is unlikely to detect clinically relevant pathology other than peptic disease. PIG is a very effective gastrostomy method; it has better long-term results than RIG and is successful where conventional PEG has failed.

  13. Fatal massive hemorrhage caused by nasogastric tube misplacement in a patient with mediastinitis.

    Science.gov (United States)

    Wu, Pei-Yu; Kang, Ting-Jui; Hui, Chung-Kun; Hung, Ming-Hui; Sun, Wei-Zen; Chan, Wei-Hung

    2006-01-01

    Nasogastric tube insertion is a routine procedure in medical care. However, misplacement of the tube can cause a variety of complications, which can be life threatening in some instances. We report a case of fatal hemorrhagic shock immediately after nasogastric tube insertion in a patient undergoing debridement by video-assisted thoracoscopic surgery for mediastinitis. Emergency endoscopy showed that the bleeding came from the nasogastric tube which had perforated the esophagus and possibly tore an intrathoracic large vessel. The nasogastric tube insertion was considered to have directly produced the perforation because no esophageal perforation had been found on preoperative endoscopy. Factors contributing to the risk of esophageal perforation in this case included coexisting mediastinitis, surgical manipulation, endotracheal intubation, inability to cooperate during general anesthesia, and repetitive advancement of the nasogastric tube. Prompt clamping of the nasogastric tube or delayed insertion after failed attempts might have improved the outcome. This report illustrates the complication of massive bleeding that can occur immediately after misplaced insertion of a nasogastric tube. Extraordinary care should be taken to avoid misplacement of the nasogastric tube during insertion.

  14. Ultrasonic airborne insertion loss measurements at normal incidence (L).

    Science.gov (United States)

    Farley, Jayrin; Anderson, Brian E

    2010-12-01

    Transmission loss and insertion loss measurements of building materials at audible frequencies are commonly made using plane wave tubes or as a panel between reverberant rooms. These measurements provide information for noise isolation control in architectural acoustics and in product development. Airborne ultrasonic sound transmission through common building materials has not been fully explored. Technologies and products that utilize ultrasonic frequencies are becoming increasingly more common, hence the need to conduct such measurements. This letter presents preliminary measurements of the ultrasonic insertion loss levels for common building materials over a frequency range of 28-90 kHz using continuous-wave excitation.

  15. Vein-style air pumping tube and tire system and method of assembly

    Energy Technology Data Exchange (ETDEWEB)

    Benedict, Robert Leon; Gobinath, Thulasiram; Lin, Cheng-Hsiung; Lamgaday, Robin; Losey, Robert Allen; Griffoin, Jean-Claude Patrice Philippe

    2017-01-03

    An air pumping tube and tire system and method of assembling is provided in which a tire groove is formed to extend into a flexing region of a tire sidewall and a complementary air pumping tube inserts into the tire groove. In the green, uncured air pumping tube condition, one or more check valves are assembled into the air pumping tube through access shafts and align with an internal air passageway of the air pumping tube. Plug components of the system enclose the check valves in the air pumping tube and the check valve-containing green air pumping tube is then cured.

  16. A tube-in-tube thermophotovoltaic generator

    Energy Technology Data Exchange (ETDEWEB)

    Ashcroft, J.; Campbell, B.; Depoy, D.

    1996-12-31

    A thermophotovoltaic device includes at least one thermal radiator tube, a cooling tube concentrically disposed within each thermal radiator tube and an array of thermophotovoltaic cells disposed on the exterior surface of the cooling tube. A shell having a first end and a second end surrounds the thermal radiator tube. Inner and outer tubesheets, each having an aperture corresponding to each cooling tube, are located at each end of the shell. The thermal radiator tube extends within the shell between the inner tubesheets. The cooling tube extends within the shell through the corresponding apertures of the two inner tubesheets to the corresponding apertures of the two outer tubesheets. A plurality of the thermal radiator tubes can be arranged in a staggered or an in-line configuration within the shell.

  17. Application of venous indwelling needle single hand feeding tube method in intravenous infusion of infants and young children%静脉留置针单手送管法在婴幼儿静脉输液中的应用

    Institute of Scientific and Technical Information of China (English)

    谢雪霞

    2014-01-01

    目的:探讨静脉留置针单手送管法在小儿静脉输液中的应用。方法:将200例进行四肢静脉留置针的患儿分为对照组和试验组,各100例,用双手退针和单手退针方法送管,比较两组置管成功率。结果:试验组一次性穿刺成功率93%,对照组82%。试验组一次性成功率明显高于对照组。结论:试验组小儿静脉单手留置针送管方法有利于提高一次性穿刺成功率,值得临床推广。%Objective:To investigate the application of venous indwelling needle single hand feeding tube method in intravenous infusion of infants and young children.Methods:200 cases of limb venous indwelling needle were divided into the control group and the experimental group with 100 cases in each,feeding pipe with both hands needle and one hand needle respectively,then we compared the success rate of catheterization of two groups.Results:In the experimental group,one-time puncture success rate was 93%;that of the control group was 82%.The success rate of the experimental group was higher than that of the control group. Conclusion:In the experimental group vein single hand needle tube feeding method can helpful improve the success rate of first puncture,so it is worthy of promotion.

  18. Pneumonia in acute stroke patients fed by nasogastric tube

    OpenAIRE

    Dziewas, R. (Rainer); Ritter, M.; Schilling, M; Konrad, C.; Oelenberg, S; Nabavi, D; Stogbauer, F; Ringelstein, E; Ludemann, P

    2004-01-01

    Background: Aspiration pneumonia is the most important acute complication of stroke related dysphagia. Tube feeding is usually recommended as an effective and safe way to supply nutrition in dysphagic stroke patients.

  19. Phase-Center Extension for a Microwave Feed Horn

    Science.gov (United States)

    Hartop, R. W.; Manshadi, F.

    1987-01-01

    Corrugated cylindrical tube relocates phase center of Cassegrain antenna feed. Proposed modification increases aperture of Cassegrain antenna from 64 to 70 m. Relatively inexpensive extension moves phase center of feed without incurring cost of redesigning horn and relocating low-noise equipment. Extension does not affect polarization characteristics of feed.

  20. Facility target insert shielding assessment

    Energy Technology Data Exchange (ETDEWEB)

    Mocko, Michal [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2015-10-06

    Main objective of this report is to assess the basic shielding requirements for the vertical target insert and retrieval port. We used the baseline design for the vertical target insert in our calculations. The insert sits in the 12”-diameter cylindrical shaft extending from the service alley in the top floor of the facility all the way down to the target location. The target retrieval mechanism is a long rod with the target assembly attached and running the entire length of the vertical shaft. The insert also houses the helium cooling supply and return lines each with 2” diameter. In the present study we focused on calculating the neutron and photon dose rate fields on top of the target insert/retrieval mechanism in the service alley. Additionally, we studied a few prototypical configurations of the shielding layers in the vertical insert as well as on the top.

  1. A preliminary investigation of the neoprene tube finger extension splint.

    Science.gov (United States)

    Clark, E N

    1997-01-01

    Neoprene tube finger extension splints were analyzed to determine the production, amounts, and directions of force magnitude on the proximal interphalangeal joint during the flexing of the tube up to angles of 80 degrees. The tubes were examined in their empty form, with a human digit inserted into the tube, and with portions of the tube on the volar and dorsal surfaces removed. Upward forces ranged from less than 100 g to 225 g in the empty tubes. Upon insertion of a human digit into the tubes, forces increased from 125 g at 10 degrees to 650 g at 80 degrees flexion. Removal of a 2-cm square portion on the dorsal surface over the PIP joint did not significantly affect the tube's ability to lift upward demonstrating little or no downward pressure in the device. The tube had little or no upward force following removal of a 2-cm square encompassing the angle of the device on the volar surface. Positive effectiveness of the tubes were examined in case reports.

  2. Stroke: ineffective tube securement reduces nutrition and drug treatment.

    Science.gov (United States)

    Brazier, Sophie; Taylor, Stephen J; Allan, Kaylee; Clemente, Rowan; Toher, Deirdre

    2017-06-22

    Stroke patients with dysphagia often depend on nutrition, hydration and medication via nasogastric (NG) feeding tubes. Securing tubes using tape is associated with repeated tube loss. In this study, the authors determined cause and effect by auditing tube placement methods, delays incurred, duration and costs. Of 202 NG tube placements in 75 patients, 67 placements occurred in 17 patients over a full course of enteral nutrition (EN) and 40 of these placements were tracked. Tubes were secured by tape in 100%, mittens 31% and special observation 5.4%. However, over an EN course, inadvertent tube loss occurred in 82% of patients and was associated with age (p=0.049) and mitten use (pnutrition, hydration and drug treatments; this may impair recovery. Reducing tube loss is likely to reduce patient distress, treatment cost and enhance recovery.

  3. Impedance calculation for ferrite inserts

    Energy Technology Data Exchange (ETDEWEB)

    Breitzmann, S.C.; Lee, S.Y.; /Indiana U.; Ng, K.Y.; /Fermilab

    2005-01-01

    Passive ferrite inserts were used to compensate the space charge impedance in high intensity space charge dominated accelerators. They study the narrowband longitudinal impedance of these ferrite inserts. they find that the shunt impedance and the quality factor for ferrite inserts are inversely proportional to the imaginary part of the permeability of ferrite materials. They also provide a recipe for attaining a truly passive space charge impedance compensation and avoiding narrowband microwave instabilities.

  4. Insertion device and method for accurate and repeatable target insertion

    Energy Technology Data Exchange (ETDEWEB)

    Gubeli, III, Joseph F.; Shinn, Michelle D.; Bevins, Michael E.; Dillon-Townes, Lawrence; Neil, George R.

    2017-07-04

    The present invention discloses a device and a method for inserting and positioning a target within a free electron laser, particle accelerator, or other such device that generates or utilizes a beam of energy or particles. The system includes a three-point registration mechanism that insures angular and translational accuracy and repeatability of positioning upon multiple insertions within the same structure.

  5. Tube-shape verifier

    Science.gov (United States)

    Anderson, A. N.; Christ, C. R.

    1980-01-01

    Inexpensive apparatus checks accuracy of bent tubes. Assortment of slotted angles and clamps is bolted down to flat aluminum plate outlining shape of standard tube bent to desired configuration. Newly bent tubes are then checked against this outline. Because parts are bolted down, tubes can be checked very rapidly without disturbing outline. One verifier per tube-bending machine can really speed up production in tube-bending shop.

  6. 重症医学科对空肠营养管堵管、脱管原因分析及护理对策%Critical Care Medicine Division of the Jejunal Feeding Tube Plugging, Detached Reason and Nursing

    Institute of Scientific and Technical Information of China (English)

    蒋春

    2016-01-01

    To analyse the reasons for the phenomenon of plugging and removal of the nasal jejunum nutrition infusion was analyzed. To explore the nursing strategies of using the method of nutrition support and the use of tube and tube in the process of the use of nasal jejunum nutrition tube. There are some new understanding about the choice of pipeline, the selection of nutrient solution, the proper fixation, the way of infusion, the communication and so on, and learning activities carried out new technology, developed a routine nursing for nursing staff to carry out the work, more conducive to the patient’s recovery.%分析鼻空肠营养输注后,发生堵管、脱管现象的原因。探讨鼻空肠营养管营养支持使用方法及使用过程中遇到堵管、脱管现象的护理对策。重症医学科在管道选择、营养液的选择、妥善固定、输注方式、沟通等方面有了新的认识,并开展了新技术的学习活动,制订了护理常规,便于护理人员开展工作,更有利于病人病情的恢复。

  7. OUTCOME OF EARLY ORAL FEEDING AFTER ELECTIVE COLONIC ANASTOMOSIS

    Directory of Open Access Journals (Sweden)

    Sushant

    2015-08-01

    Full Text Available OBJECTIVE: Outcome of early oral feeding after elective colonic anastomosis . STUDY DESI G N: Descriptive case series . PLACE & DURATION OF STUDY : Department of Surgery Mata Gujari Medical C ollege, Kishanganj, Bihar, India. From June 2012 - March 2014. METHODOLOGY: De tailed preoperative ev aluation of the selected patients was done. Patients with malignancies, heart disease, poor general conditions, distal loop obstructions were excluded from the series. In selected patient’s proper history, physical examination and base line investigations were done. Limited bowel preparation was done in all the patients. Postope ratively 15 - 50 ml of sips was allowed 2 hourly after recovery form anesthesia . Free oral fluid intake was allowed on postoperative day - 1 , semisolids on day - 2 and day - 3 as tolerated and full oral diet allowed on day - 4. In case of two episodes of vomiting and absence of bowel sounds , patients were kept nil by mouth and nasogastric tube was inserted . RESULTS : Total 68 pat ients were selected, out of which 46(67.64% were males and 22(32.36% females (M.F2.09 : 1 . The age range was from 28 year to 76 year wi th mean age of 47.5 +2.4 year . Passage of first flatus was observed between 2 to 6 days (mean 2.8 days , and the time of first passage of stool was 3 - 8 days (mean 4.6 days. Twelve (17.64% patients did not tolerate feeding . Intolerance to feed results into vomiting and abdominal distension. Postoperative complications included wound infection (10.29% , electrolyte imbalance (4.41%, respiratory tract infections (2.94%, anastigmatic leaks (1.47% and wound dehiscence (1.47% . The hospital stay was 3 - 8 day ( M ean 5.4 day . CONCLUSION : Early oral feeding after elective colonic surgery was safe and well tolerated by majority of the patients.

  8. Fistuloclysis can successfully replace parenteral feeding in the nutritional support of patients with enterocutaneous fistula.

    Science.gov (United States)

    Teubner, A; Morrison, K; Ravishankar, H R; Anderson, I D; Scott, N A; Carlson, G L

    2004-05-01

    Use of total parenteral nutrition (TPN) in patients with acute intestinal failure due to enteric fistulation might be avoided if a simpler means of nutritional support was available. The aim of this study was to determine whether feeding via an intestinal fistula (fistuloclysis) would obviate the need for TPN. Fistuloclysis was attempted in 12 patients with jejunocutaneous or ileocutaneous fistulas with mucocutaneous continuity. Feeding was achieved by inserting a gastrostomy feeding tube into the intestine distal to the fistula. Infusion of enteral feed was increased in a stepwise manner, without reinfusion of chyme, until predicted nutritional requirements could be met by a combination of fistuloclysis and regular diet, following which TPN was withdrawn. Energy requirements and nutritional status were assessed before starting fistuloclysis and at the time of reconstructive surgery. Fistuloclysis replaced TPN entirely in 11 of 12 patients. Nutritional status was maintained for a median of 155 (range 19-422) days until reconstructive surgery could be safely undertaken in nine patients. Two patients who did not undergo surgery remained nutritionally stable over at least 9 months. TPN had to be recommenced in one patient. There were no complications associated with fistuloclysis. Fistuloclysis appears to provide effective nutritional support in selected patients with enterocutaneous fistula. Copyright 2004 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

  9. Efficacy of 48-hour post-operative antibiotics prophylaxis for patients undergoing percutaneous endoscopic gastrostomy tube in preventing site infection.

    Science.gov (United States)

    Agha, Adnan; Alsaudi, Dib; Furnari, Manuele; Abdulhadi Ali, Mamdouh M; Al-Majadah, Saeed Salim Abdullah; Savarino, Vincenzo; Inferrera, Simona; Giannini, Edoardo G

    2011-06-01

    Percutaneous Endoscopic Gastrostomy (PEG) is an endoscopic procedure for placing a feeding tube into the stomach through the skin, primarily to avoid malnutrition. Malnutrition can increase the risk of wound infection, whose incidence can be decreased by using antibiotic prophylaxis. The purpose of our study was to evaluate the efficacy of a new antibiotic regimen in preventing acute post-PEG procedure complications. Ninety-seven consecutive patients were put on combined antibiotic therapy of clindamycin 600 mg and cefotaxime 1,000 mg every eight hours, starting with the insertion of the PEG tube and maintained for 48 hours. Pain/tenderness, leakage/drainage, bleeding fever, maximum white blood cells (WBC) count, pus/discharge, and PEG tube function were evaluated within 48 hours and 1 week from PEG insertion. Infection at the site of PEG insertion occurred in 3 cases (3.1%) within 48 hours and in 1 case (1.0%) within 7 days. Within 48 hours from the procedure, incidence of fever and increased WBC count was 10.3% and 9.3%, respectively, though at 7 days all were resolved. Pain, leak, and bleeding at the site of PEG placement were prevalently mild within 48 hours (74.2%, 12.4%,13.4% of patients, respectively) and subsided within 7 days (2.1%, 0%, 0%). One case (1.0%) of minor antibiotic side effect occurred. Two patients died due to complications not related to the procedure. The combined use of short-term cefotaxime and clindamycin seems to be effective in reducing incidence of acute complications due to PEG placement without increasing side-effects.

  10. Lithium insertion in nanostructured titanates

    NARCIS (Netherlands)

    Borghols, W.J.H.

    2010-01-01

    Upon nano-sizing of insertion compounds several significant changes in Li-insertion behavior have been observed for sizes below approximately 50 nm. Although the origins of the phenomena are interrelated, the changes can be divided in three main observations. (1) The formation of new phases, leading

  11. Optimizing the Thermoacoustic Pulse Tube Refrigerator Performances

    Directory of Open Access Journals (Sweden)

    E. V. Blagin

    2014-01-01

    Full Text Available The article deals with research and optimization of the thermoacoustic pulse tube refrigerator to reach a cryogenic temperature level. The refrigerator is considered as a thermoacoustic converter based on the modified Stirling cycle with helium working fluid. A sound pressure generator runs as a compressor. Plant model comprises an inner heat exchanger, a regenerative heat exchanger, a pulse tube, hot and cold heat exchangers at its ends, an inertial tube with the throttle, and a reservoir. A model to calculate the pulse tube thermoacoustic refrigerator using the DeltaEC software package has been developed to be a basis for calculation techniques of the pulse tube refrigerator. Momentum, continuity, and energy equations for helium refrigerant are solved according to calculation algorithm taking into account the porosity of regenerator and heat exchangers. Optimization of the main geometric parameters resulted in decreasing temperature of cold heat exchanger by 41,7 K. After optimization this value became equal to 115,01 K. The following parameters have been optimized: diameters of the feeding and pulse tube and heat exchangers, regenerator, lengths of the regenerator and pulse and inertial tubes, as well as initial pressure. Besides, global minimum of temperatures has been searched at a point of local minima corresponding to the optimal values of abovementioned parameters. A global-local minima difference is 0,1%. Optimized geometric and working parameters of the thermoacoustic pulse tube refrigerator are presented.

  12. Root cause of incomplete control rod insertions at Westinghouse reactors

    Energy Technology Data Exchange (ETDEWEB)

    Ray, S. [Westinghouse, Monroeville, PA (United States)

    1997-01-01

    Within the past year, incomplete RCCA insertions have been observed on high burnup fuel assemblies at two Westinghouse PWRs. Initial tests at the Wolf Creek site indicated that the direct cause of the incomplete insertions observed at Wolf Creek was excessive fuel assembly thimble tube distortion. Westinghouse committed to the NRC to perform a root cause analysis by the end of August, 1996. The root cause analysis process used by Westinghouse included testing at ten sites to obtain drag, growth and other characteristics of high burnup fuel assemblies. It also included testing at the Westinghouse hot cell of two of the Wolf Creek incomplete insertion assemblies. A mechanical model was developed to calculate the response of fuel assemblies when subjected to compressive loads. Detailed manufacturing reviews were conducted to determine if this was a manufacturing related issue. In addition, a review of available worldwide experience was performed. Based on the above, it was concluded that the thimble tube distortion observed on the Wolf Creek incomplete insertion assemblies was caused by unusual fuel assembly growth over and above what would typically be expected as a result of irradiation exposure. It was determined that the unusual growth component is a combination of growth due to oxide accumulation and accelerated growth, and would only be expected in high temperature plants on fuel assemblies that see long residence times and high power duties.

  13. Tube Thoracostomy: Complications and Its Management

    Science.gov (United States)

    Kesieme, Emeka B.; Dongo, Andrew; Ezemba, Ndubueze; Irekpita, Eshiobo; Jebbin, Nze; Kesieme, Chinenye

    2012-01-01

    Background. Tube thoracostomy is widely used throughout the medical, surgical, and critical care specialities. It is generally used to drain pleural collections either as elective or emergency. Complications resulting from tube thoracostomy can occasionally be life threatening. Aim. To present an update on the complications and management of complications of tube thoracostomy. Methods. A review of the publications obtained from Medline search, medical libraries, and Google on tube thoracostomy and its complications was done. Results. Tube thoracostomy is a common surgical procedure which can be performed by either the blunt dissection technique or the trocar technique. Complication rates are increased by the trocar technique. These complications have been broadly classified as either technical or infective. Technical causes include tube malposition, blocked drain, chest drain dislodgement, reexpansion pulmonary edema, subcutaneous emphysema, nerve injuries, cardiac and vascular injuries, oesophageal injuries, residual/postextubation pneumothorax, fistulae, tumor recurrence at insertion site, herniation through the site of thoracostomy, chylothorax, and cardiac dysrhythmias. Infective complications include empyema and surgical site infection. Conclusion. Tube thoracostomy, though commonly performed is not without risk. Blunt dissection technique has lower risk of complications and is hence recommended. PMID:22028963

  14. Placement of jejunal feeding tubes via a gastrostomy stoma in elderly patients with upper gastrointestinal perforation:An analysis of 13 cases%经胃造瘘管放置空肠营养管治疗老年上消化道穿孔13例

    Institute of Scientific and Technical Information of China (English)

    范学圣; 张舰; 刘兵

    2013-01-01

    目的:探讨经胃造瘘管放置空肠营养管治疗上消化道穿孔老年患者的可行性及治疗价值.方法:将我院普外科2008-02/2012-07收治的38例消化道穿孔患者,根据其肠内营养方式分为2组,A组患者术后采用鼻饲管进行肠内营养,B组患者采用经胃造瘘放置空肠营养管术后予肠内营养.分析比较两组患者术后出现呼吸道、消化道及其他各类不适的比例.结果:B组患者术后排斥引流管心理、鼻咽部不适、异物感、置管营养期间恶心、呕吐、早起(<3d)下床活动及置管后严重咳嗽、咳痰、合并肺炎等发生率与A组患者比较有明显统计学意义(P=0.036);营养改善方面,两组手术后第9天与第1天比较白蛋白,前白蛋白等指标均明显升高(P=0.024; 0.044),但二者第9天之间比较无明显差异(P>0.05).结论:采用经胃造瘘管置空肠营养管,术后早期行肠内营养,患者耐受性好,并发症低,尤其适合老年上消化道穿孔患者.%AIM: To assess the feasibility and therapeutic value of placement of jejunal feeding tubes via a gastrostomy stoma in elderly patients with upper gastrointestinal perforation. METHODS: Thirty-eight elderly patients with upper gastrointestinal perforation treated at our hospital from February 2008 to July 2012 were divided into two groups, those with a nasogastric tube or nasointestinal tube (group A) and those with a jejunal feeding tube placed via a gastrostomy stoma (group B). The percentages of patients with discomfort in the respiratory tract or gastrointestinal tract and other parameters were compared between the two groups. RESULTS: Group B was significantly different from Group A in the percentages of patients with a fear of intubation or complaints of na-sopharyngeal discomfort, serious cough and expectoration, and the incidence of nausea and vomiting during the period of enteral nutrition (all P 0.05). CONCLUSION: Placement of jejunal feeding tubes via a

  15. Differential outcome of fissure-positioned tube in closed thoracostomy for primary spontaneous pneumothorax.

    Science.gov (United States)

    Kim, Yong Won; Byun, Chun Sung; Cha, Yong Sung; Kim, Oh Hyun; Lee, Kang Hyun; Park, Il Hwan

    2015-05-01

    Closed tube thoracostomy is often used to evacuate a primary spontaneous pneumothorax (PSP). Occasionally, this procedure is complicated by placement of the chest tube location in the fissural area instead of pleural space. There is a paucity of studies on outcomes according to chest tube placement. As such, we investigated outcomes of chest tube placement in fissural versus pleural area in closed thoracostomy for PSP. Patients between 14 and 65 years of age who had been treated with chest tube insertion to evacuate PSP were selected based on retrospective review of medical records. Patients selected for this study received chest tube placement at either the fissural or pleural spaces. Those with pre-existing lung disease or those transferred into our hospital after closed thoracostomy were excluded. Of the 255 patients with PSP treated with chest tube insertion, 172 patients were enrolled in this study. Twenty-nine (16.9%) had fissural tube placement and 143 (83.1%) had pleural tube placement. A higher proportion of patients in the fissural versus pleural group required additional chest tube insertion (20.7% vs 4.9%, P = 0.010, respectively). There was no significant difference in body mass index, smoker status, symptom duration, number of episodes, post-thoracostomy complications, need for subsequent management, and duration of hospitalization in either group. In closed thoracostomy for PSP, there is a higher chance of tube dysfunction when the chest tube is positioned at fissural area as compared with the pleural space.

  16. 人工鼻饲护理模式在脑卒中意识障碍留置胃管患者中的应用%Application of artificial nasal feeding mode in the consciousness obstacle of stroke patients with nasogastric tube

    Institute of Scientific and Technical Information of China (English)

    张雅静; 李茜茜; 季衍丽

    2012-01-01

    Objective To explore the effect of artificial nasal feeding mode on the consciousness obstacle of stroke patients with nasogastric tube.Methods From November 2010 to July 2012,50 patients with consciousness disorder and nasogastric tube in the ward of neurology department were enrolled in the study.The routine and artificial nasal feeding methods were performed on odd days and even days respectively.Then,bowel sound frequency,the incidence of reflux were observed and analyzed.Results The incidence of gastroesophageal reflux in the artificial nasal feeding mode group was significantly lower than that in the routine artificial feeding method group (14.7% vs 33.8% ; x2 =20.718,P < 0.01).And patients had significantly different incidence of reflux with different bowel sound frequency (x2 =51.824,P < 0.01).Conclusions The incidence of reflux is negatively correlated with the bowel sound frequency.And application of the artificial nasal feeding mode on consciousness obstacle of stroke patients with nasogastric tube can reduce the incidence of gastro-esophageal reflux.%目的 探讨人工鼻饲护理模式在脑卒中意识障碍留置胃管的患者中的应用效果.方法 选择2010年11月至2012年7月在解放军总医院神经内科住院50例意识障碍留置胃管实施人工喂养的患者作为研究对象,期间单日采用常规鼻饲方法,双日采用人工鼻饲护理模式方法.分析不同肠鸣音次数患者食管反流发生率情况,并比较两种方法食管反流发生率.结果 不同肠鸣音次数患者食管反流发生率不同,差异有统计学意义(x2 =51.824,P<0.01);采用人工鼻饲护理模式患者食管反流发生率为14.7%,明显低于常规鼻饲方法患者(33.8%),差异有统计学意义(x2=20.718,P <0.01).结论 肠鸣音次数越多患者食管反流发生率越低;人工鼻饲护理模式能够有效预防和降低胃食管反流的发生.

  17. Comparison of two percutaneous radiological gastrostomy tubes in the nutritional management of ALS patients.

    Science.gov (United States)

    Rio, Alan; Ampong, Mary Ann; Turner, Martin R; Shaw, Ashley S; Al-Chalabi, Ammar; Shaw, Chris E; Leigh, P Nigel; Sidhu, Paul S

    2005-09-01

    Patient care and minimizing complications post gastrostomy have to date received little attention in ALS patients. We compare the complications associated with pigtail and mushroom type percutaneous radiological gastrostomy tubes in this patient group. Patients requiring PRG received either Wills-Oglesby or the skin level Entristar. Retrospective review of the clinical notes was performed capturing demographic data, peristomal infection, tube displacement, tube failure, nutritional status, site of disease onset, and survival. Thirty-five patients (Group 1) had the Wills-Oglesby tube of which 14 (40%) tubes required replacement. The Entristar tube was inserted in 29 patients (Group 2) where 8 (28%) required replacement (NS). The incidence of infection was significantly lower with the Entristar tube, (psyndrome'. We conclude that the Entristar skin level gastrostomy tube is associated with a reduction in peristomal infection, tube failure and blockage compared with the Wills-Oglesby tube.

  18. Comparison of cuffed and uncuffed preformed oral pediatric tracheal tubes.

    Science.gov (United States)

    Weiss, Markus; Bernet, Vera; Stutz, Katharina; Dullenkopf, Alexander; Maino, Paolo

    2006-07-01

    In preformed cuffed tracheal tubes the position of the cuff within the airway is given by its distance to the tube bend placed at the lower teeth. The aim of this study was to compare the design of cuffed and uncuffed preformed pediatric oral tracheal tubes with regard to anatomical landmarks. Complete series of cuffed and uncuffed preformed oral pediatric tracheal tubes sized from internal diameter 3.0-7.0 mm if available were ordered from five different manufacturers. The distance from the bend to the distal tube tip and to the upper border of the cuff were measured and compared with anatomical airway landmarks in the developing child. Between cuffed and uncuffed tracheal preformed tubes up to 37 mm differences in the bend-to-tracheal tube tip distances were found for given age groups. Thus uncuffed preformed tracheal tubes were more at risk for inadvertent endobronchial intubation than cuffed preformed tracheal tubes. Comparison of bend-to-upper border of the cuff distances with teeth-to-vocal cord distances calculated from anatomical data revealed that several of the tracheal tube cuffs become positioned within the subglottic larynx or even within the vocal cords when inserted according to the bend. There is a need for improvement in cuffed preformed pediatric tracheal tubes, namely a standard bend-to-tracheal tube tip distance to allow a safe insertion depth, a short cuff placed on the tube shaft as distally as possible and an intubation depth mark to verify a proper position of the cuff in the trachea.

  19. Outcome of percutaneous endoscopic gastrostomy feeding in patients on peritoneal dialysis.

    Science.gov (United States)

    Fein, P A; Madane, S J; Jorden, A; Babu, K; Mushnick, R; Avram, M M; Grosman, I

    2001-01-01

    Protein malnutrition is now well established as an important contributory factor to the high mortality in peritoneal dialysis (PD) patients. Low dietary protein calorie intake is one of the factors leading to protein malnutrition. If PD patients develop difficulty eating, percutaneous endoscopic gastrostomy (PEG) feeding may prove beneficial in providing adequate nutrition. Studies on the effectiveness of PEG feeding in PD patients are limited to pediatric patients. The objective of the present study was to assess the outcome of PEG feeding in adult patients with end-stage renal disease (ESRD) on PD. We retrospectively reviewed charts from May 1992 to February 2000 of 10 consecutive patients in our center who had had feeding tubes inserted. The patients' ages ranged from 37 to 81 years, with mean age of 65. Of the 10 patients, 7 were male, 5 were diabetic, and 1 was infected with the human immunodeficiency virus. Two patients had cerebrovascular accident (CVA) with dysphagia, 3 had multi-infarct dementia, 2 had anoxic encephalopathy, 2 had dementia, and 1 had calciphylaxis with anorexia. Of the 10 patients, 9 failed to eat because of neurologic disorders. Two patients who had functioning PEG feedings before starting PD had no complications. Only 2 of 8 patients already on PD continued with long-term PD after a PEG was inserted. Both patients whose PD was not interrupted at the time of PEG placement immediately developed peritonitis. Of the 6 patients who were maintained on hemodialysis (HD), 2 developed peritonitis within one week of starting PEG feedings. The other 4 had no complications from PEG feedings while being maintained on HD, but 1 developed peritonitis when PD was resumed. Of the 5 patients who developed peritonitis, 3 experienced fungal peritonitis. In PD patients, PEG feeding is associated with frequent complications. However, PEG placement prior to PD initiation appears to be safe. Maintaining patients on HD for at least 6 weeks appears to decrease

  20. Sonographic confirmation of the correct placement of a nasoenteral tube in a woman with hyperemesis gravidarum: case report.

    Science.gov (United States)

    Swartzlander, Ty K; Carlan, S J; Locksmith, Greg; Elms, Luke

    2013-01-01

    Hyperemesis gravidarum is a serious systemic disorder of pregnant women characterized by intractable vomiting resulting in metabolic, biochemical, and hematologic changes. Enteral nutrition has been used successfully and has a lower complication rate than parenteral nutrition. Tube feeding requires location of the feeding tube tip before the infusion of nutritional substance is started. We report a case of assisted feeding tube tip location using real time sonography in a pregnant women treated for hyperemesis gravidarum. Sonographic examination may be used as an alternative to x-ray for the confirmation of feeding tube location in pregnant women and thus eliminate exposure of the fetus to ionizing radiation.

  1. [Intubation with a tube exchanger on an intubation trainer. Influence of tube tip position on successful intubation].

    Science.gov (United States)

    Kemper, M; Haas, T; Imach, S; Weiss, M

    2014-07-01

    participants showed no successful intubation attempts at all and 38 out of 160 intubation attempts (23.8 %) were successful. Intubation success with the tracheal tube tip placed ventrally (0°) was 60 % followed by the left (270°) and right (90°) tracheal tube tip positions with 27.5 % and 7.5 % intubation success, respectively. With the tube tip placed dorsally (180°) none of the 40 intubation attempts were successful. Intubation attempts with the Rüsch tube were more successful (28.8 %) than those with the Covidien tube (18.8 %). Placing the tracheal tube tip ventrally, the Rüsch tube was twice as successful as the Covidien tube with 16 (80 %) versus 8 attempts (40 %, p = 0.011). There was no correlation between professional experience and intubation success (p = 0.362). Tube insertion via an airway exchange catheter or a fiberoptic bronchoscope is a basic technique in anesthesia. Knowledge about the difficulties and their prevention are essential for every anesthetist. The gap between the airway exchange catheter, the fiber bronchoscope and the tube diameters is one of the major reasons for tube tip impingement. This investigation showed that intubation success via a tube exchange catheter, as investigated in an intubation mannequin, is considerably influenced by the tracheal tube tip position. A 90° anticlockwise rotation, placing the tracheal tube tip ventrally, considerably increased intubation success. This is of particular importance if an anesthesia department has no appropriately sized tube exchange catheters or fiber bronchoscope for every age group of patients.

  2. Newly Emerging Feeding Difficulties in a 33-Year-Old Adult With CHARGE Syndrome

    OpenAIRE

    Hudson, Alexandra; Blake, Kim

    2015-01-01

    Feeding and swallowing difficulties are common among individuals with CHARGE syndrome. Many children require gastrostomy tube feeding in their early years and often undergo a delay in feeding and oral-motor skill development. There is little information available on adults with CHARGE syndrome, and the feeding difficulties they face. The present case describes newly emerging mouth over-stuffing feeding behaviors and feeding difficulties in a 33-year-old adult with CHARGE syndrome who had not ...

  3. Application of enteral nutrition by nasal jejunal double-lumen feeding tube to the critically ill patients in the department of neurosurgery%经鼻空肠双腔管营养在神经外科重症患者中的应用

    Institute of Scientific and Technical Information of China (English)

    陈永汉; 李宗豪; 张磊; 邓占城; 姚俊朝; 王毅

    2013-01-01

    目的:探讨经鼻空肠双腔管营养在神经外科重症患者中的应用效果.方法:将 80例神经外科重症患者随机分为实验组和对照组各40例,实验组采用经鼻空肠双腔管进行肠内营养,对照组采用经鼻胃管进行肠内营养.记录两组置管前及置管后第 7天、第 14 天的营养指标,并发症发生情况,评定两组患者预后情况.结果:置管后第14天鼻空肠双腔管营养组白蛋白、前白蛋白、血红蛋白、外周血淋巴细胞计数均高于经鼻胃管营养组;鼻空肠双腔管营养组的反流、误吸、吸入性肺炎发生率低于鼻胃管营养组,两组格拉斯哥预后评分显示鼻空肠双腔管营养组预后优于鼻胃管营养组(P<0.05).结论:在神经外科重症患者中应用鼻空肠双腔管营养效果更好,更有利于患者预后.%Objective:To investigate the application effect of enteral nutrition by nasal jejunal double -lumen feeding tube to the critically ill patients in the department of neurosurgery. Methods: 80 severe patients in the department of neurosurgery were randomly divided into the experimental group and the control group ( 40 cases in each group ). The patients in the experimental group were given enteral nutrition by nasal jejunal double - lumen feeding tube and enteral nutrition by nasogastric tube was given to the patients in the control group. The nutritional index and incidence of complications were recorded in the two groups before enteral nutrition and on the 7th, 14th clay after enteral nutrition,the prognosis of patients was evaluated in both groups. Results:The level of albumin,prealbumin,hemoglobin and lymphocyte count in peripheral blood were higher in the experimental group than the control group on the 14th day after enteral nutrition; the incidence of reflux, aspiration and aspiration pneumonia was lower in the experimental group than the control group; Glasgow outcome scale displayed that the prognosis of patients was better in

  4. Nasogastric Tube Placement in Newborns Before Discharge.

    Science.gov (United States)

    Alnemri, Abdulrahman M; Saeed, Anjum; Assiri, Asaad M

    2016-04-01

    The aim of this study was to assess the knowledge of medical staff (physicians) at different levels about insertion or placement of nasogastric tube (NGT) in a normal newborn before discharge. It was a survey-based, observational study conducted at King Khalid University Hospital. Atotal of 103 doctors were sent text message; among those 81 (78.6%) responded. Among the respondents, 27, 16, 11 and 27 were neonatologists, general physicians, obstetricians/ ENT/pediatric surgeons, and senior registrars neonatology (SRN), respectively. Majority of physicians, 57 (70.3%) rejected the idea of insertion of NGTin a normal newborn but in 24 (29.6%), answer was to insert NGTin all the newborns before discharge to check the patency of nasal cavities. Regarding the position, region of doctors and their response, majority from Center said ‘No’(not in favour of insertion) but from South, 17/18 (94.4%) said ‘Yes’(in favour of insertion). Regarding other specialties, majority of them showed rejection of this idea. In conclusion, most of the healthcare professionals, directly involved with neonatal care, rejected the idea of routine insertion of NGTin normal newborn examination before discharge; rather, some non-invasive technique could be opted.

  5. 不留置胃肠减压管并早期进食在上消化道穿孔修补术中的应用%Application of early feeding and no nasogastric tube decompression in upper gastrointestinal tract perforation repair

    Institute of Scientific and Technical Information of China (English)

    马静; 刘士会; 李季

    2011-01-01

    目的:探讨上消化道穿孔修补术时不常规留置胃肠减压管并早期进食的安全性及有效性.方法:随机选取2008年2月至2010年9月上消化道穿孔行修补术患者28例作为观察组,术后不留置胃管并早期进食;2003年5月到2008年1月上消化道穿孔行修补术患者31例作为对照组,常规留置胃管,并于肝门排气后拔管、进食.比较2组患者术后肠鸣音恢复时间、肛门恢复排气时间及恶心、呕吐、腹胀等并发症发生率.结果:观察组较对照组的肠鸣音恢复时间及肛门排气时间均显著提前,恶心显著减少(P0.05).结论:在上消化道穿孔行修补术中不留置胃肠减压管并早期恢复进食是安全可行的,有利于患者的快速康复.%Objective: To investigate the safety and effect of early feeding and no nasogastric tube decompression in upper gastrointestinal tract perforation repair. Methods: Thirty-one cases of routine nasogastric decompression were selected randomly as control group,and 28 cases of early feeding and no nasogasthc tube decompression selected as trial grpup. The recovery time of bowel sounds, rectal discharge, complication rates of nausea, vomiting, and distention were compared between the two groups. Results:The recovery time of bowel sounds and rectal discharge in trial group was much earlier than that in control group ( P < 0.01 ). Cases of vomiting and distention showed no statisticus difference in two groups ( P > 0.05 ). Conclusions: It is safe and benefictial for the patient's quick recovery to apply early feeding without routine nasogastric decompression for upper gastrointestinal perforation repare.

  6. 老年脑卒中吞咽障碍患者间歇管饲对吞咽功能改善的应用效果%The Application Effect of Interval Tube Feed to Improve the Swallowing Function in Patients With Dysphagia After Stroke

    Institute of Scientific and Technical Information of China (English)

    曹高凡

    2016-01-01

    目的:探讨间歇管饲对老年脑卒中吞咽障碍患者吞咽功能改善应用效果。方法选取老年脑卒中吞咽障碍患者57例,分为观察组32例与对照组25例,对照组给予常规饮食护理,观察组在此基础上给予间歇管饲法饮食护理干预。采用洼田饮水试验对两组患者进行吞咽功能评估。结果观察组患者吞咽功能提高幅度明显高于对照组,护士插管成功率也显著提高,差异有统计学意义(P<0.05)。结论间歇管饲能改善老年脑卒中患者的吞咽功能,有效促进吞咽功能的恢复。%Objective To investigate the effect of intermittent tube feeding on swallowing function in elderly patients with dysphagia after stroke. Methods The elderly stroke patients with dysphagia were divided into observation group (32 cases) and control group (25 cases), the control group was given routine diet nursing, and the observation group was given the intermittent tube feeding method of diet nursing intervention on the basis of the control group. The swallowing function evaluation of two groups of patients were performed using the drinking water test in the ifeld.Results Observation group of patients swallowing function increased higher than the control group, the success rate of nurses intubation was improved, difference had statistically significant (P<0.05).Conclusion Intermittent feeding can signiifcant improve the swallowing function of elderly patients with stroke, and effectively promote the recovery of swallowing function.

  7. Non-insertional Achilles tendinopathy

    Science.gov (United States)

    Pearce, Christopher J.; Tan, Audrey

    2016-01-01

    Non-insertional Achilles tendinopathy is a degenerative condition characterised by pain on activity. Eccentric stretching is the most effective treatment. Surgical treatment is reserved for recalcitrant cases. Minimally-invasive and tendinoscopic treatments are showing promising results. Cite this article: Pearce CJ, Tan A. Non-insertional Achilles tendinopathy. EFORT Open Rev 2016;1:383-390. DOI: 10.1302/2058-5241.1.160024. PMID:28461917

  8. 鼻空肠管营养加鼻胃管减压在重型颅脑损伤并胃瘫中的应用效果%Efficacy of nasojejunal feeding and nasogastric tube decompression in severe traumatic brain injury complicated with gastrop-aresis

    Institute of Scientific and Technical Information of China (English)

    巩麦林; 鲍洪; 丁轩

    2015-01-01

    Objective To evaluate the response of nasojejunal feeding and nasogastric tube decompression applied in severe traumatic brain injury complicated with gastroparesis.Methods One hundred and twenty patients were divided into two group randomly with 60 cases in either group.Patients in the control group were treated with nasojejunal feeding,and those in the observation group were treated with nasojejunal feeding plus nasogastric tube decompression.General clinical outcomes,prognosis and complications of the two groups were compared.Results Compared with the control group,hemoglobin,serum albumin,pre albumin and body mass of patients in the observation group were higher(P <0.01 ),and the rates of pulmonary infection,abdominal distension,vomiting,diarrhea,intes-tinal infection and gastric contents reflux incidence were lower(P <0.05 or P <0.01 ).The effective rate of the observation group was higher than that of the control group(P <0.05 ).Conclusion Nasojejunal feeding plus nasogastric tube decompression applied in patients with severe traumatic brain injury complicated with gastroparesis can improve nutritional status,reduce susceptibility to infec-tion,complications and improve prognosis.%目的:探讨鼻空肠管营养加鼻胃管减压在重型颅脑损伤并胃瘫中的应用效果。方法将120例重型颅脑损伤并胃瘫患者随机分为两组,各60例。对照组给予鼻空肠管营养方式治疗,观察组给予鼻空肠管营养加鼻胃管减压方式治疗。比较两组一般临床指标、预后及并发症情况。结果治疗后,观察组血红蛋白、血清白蛋白、前白蛋白和体重均高于对照组(P<0.01),腹胀、肺部感染、呕吐、肠源性感染、腹泻及胃内容物反流发生率均低于对照组(P <0.05或 P <0.01);观察组治疗有效率高于对照组(P <0.05)。结论对重型颅脑损伤并胃瘫患者采用鼻空肠管营养加鼻胃管减压方式治疗,可有效改善患者营养

  9. Feeding method and health outcomes of children with cerebral palsy.

    Science.gov (United States)

    Rogers, Brian

    2004-08-01

    Disorders of feeding and swallowing are common in children with cerebral palsy. Feeding and swallowing disorders have significant implications for development, growth and nutrition, respiratory health, gastrointestinal function, parent-child interaction, and overall family life. Assessments need to be comprehensive in scope and centered around the medical home. Oral feeding interventions for children with cerebral palsy may be effective in promoting oral motor function, but have not been shown to be effective in promoting feeding efficiency or weight gain. Feeding gastrostomy tubes are a reasonable alternative for children with severe feeding and swallowing problems who have had poor weight gain.

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

    African Journals Online (AJOL)

    Malawi Medical Journal; 26 (3): 55-59 September 2014. Nurses' Competency and .... Regarding nurses' awareness of guidelines for tube feeding existing in the unit; ... confirmation is not practical, and poses a radiation hazard. Patient's Head ...

  11. Gas turbine vane cooling air insert

    Energy Technology Data Exchange (ETDEWEB)

    North, W.E.; Hultgren, K.G.; Dishman, C.D.; Van Heusden, G.S.

    1992-09-08

    This patent describes a gas turbine. It comprises turbine vanes, each of the vanes supplied with cooling air and having: an airfoil portion forming a first cavity having an insert disposed therein for directing the flow of the cooling air, the insert having first and second insert ends; a shroud portion from which the airfoil portion extends, the insert attached to the shroud portion at the first insert end; an insert extension extending through a portion of the insert and extending beyond the first insert end, the insert extension and the insert forming an annular gap therebetween separating the insert from the insert extension; a plate covering at least a portion of the shroud, the plate having a first hole formed therein through which the insert extension extends; and at least a first seal extending between the insert extension and the insert, and sealing the annular gap therebetween. This patent also describes a method of making a gas turbine. It comprises welding a first tubular insert adjacent its first end to a vane outer shroud; partially inserting a second tubular insert into the first tubular member and attaching the second tubular insert thereto; placing a plate having a hole formed therein on the outer shroud so that the hole surrounds the second tubular insert; and attaching the second tubular insert to the plate by placing a first seal between the first and second tubular inserts and attaching the first seal to each of the first and second tubular inserts, and placing a second seal between the second tubular insert and the plate and welding the second seal to the second tubular insert and the plate.

  12. Urethral catheter insertion forces: a comparison of experience and training

    Directory of Open Access Journals (Sweden)

    Benjamin K. Canales

    2009-02-01

    Full Text Available Purpose: This study was undertaken to evaluate the insertion forces utilized during simulated placement of a urethral catheter by healthcare individuals with a variety of catheter experience. Materials and Methods: A 21F urethral catheter was mounted to a metal spring. Participants were asked to press the tubing spring against a force gauge and stop when they met a level of resistance that would typically make them terminate a catheter placement. Simulated catheter insertion was repeated fives times, and peak compression forces were recorded. Healthcare professionals were divided into six groups according to their title: urology staff, non-urology staff, urology resident/ fellow, non-urology resident/ fellow, medical student, and registered nurse. Results: A total of fifty-seven healthcare professionals participated in the study. Urology staff (n = 6 had the lowest average insertion force for any group at 6.8 ± 2.0 Newtons (N. Medical students (n = 10 had the least amount of experience (1 ± 0 years and the highest average insertion force range of 10.1 ± 3.7 N. Health care workers with greater than 25 years experience used significantly less force during catheter insertions (4.9 ± 1.8 N compared to all groups (p < 0.01. Conclusions: We propose the maximum force that should be utilized during urethral catheter insertion is 5 Newtons. This force deserves validation in a larger population and should be considered when designing urethral catheters or creating catheter simulators. Understanding urethral catheter insertion forces may also aid in establishing competency parameters for health care professionals in training.

  13. 气管切开患者留置鼻饲管长度与相关并发症的研究%Tracheotomy patients with indwelling nasogastric feeding length and related complications

    Institute of Scientific and Technical Information of China (English)

    陈健敏; 林笑哈; 邓春涛

    2014-01-01

    目的:探讨气管切开患者留置鼻饲管长度不同对所发生并发症的影响。方法:将患者随机分为对照组和观察组,对照组鼻饲管置入长度为45~55cm,观察组为60~70cm。结果:观察组患者并发症的发生率明显低于对照组。结论:延长鼻饲管插入长度后,保证胃管末端达到胃幽门部,减少并发症的发生。%To investigate the effect of different length of nasogastric tube tracheostomy complication in patients with indwell -ing.Methods:The patients were randomly divided into control group and observation group ,the control group feeding tube insertion length is 45-55cm,the observation group was 60-70cm.Results:The incidence of complications in patients with observation group was obvious-ly lower than the control group .Conclusion:Extended the insertion length of nasogastric tube and ensure the gastric tube reach the gastric helicobacter could reduce gastrointestinal reaction and complications.

  14. Small tube thoracostomy (20-22 Fr) in emergent management of chest trauma.

    Science.gov (United States)

    Tanizaki, Shinsuke; Maeda, Shigenobu; Sera, Makoto; Nagai, Hideya; Hayashi, Minoru; Azuma, Hiroyuki; Kano, Ken-Ichi; Watanabe, Hiroki; Ishida, Hiroshi

    2017-09-01

    The optimal tube size for an emergent thoracostomy for traumatic pneumothorax or hemothorax is unknown. Both small catheter tube thoracostomy and large-bore chest tube thoracostomy have been shown to work for the nonemergent management of patients with traumatic pneumothorax or hemothorax. This study was conducted to compare the efficacy of a small chest tube with that of a large tube in emergent thoracostomy due to chest trauma. Our hypothesis was that there would be no difference in clinical outcomes including tube-related complications, the need for additional tube placement, and thoracotomy, with the replacement of large tubes with small tubes. A retrospective review of all patients with chest trauma requiring tube thoracostomy within the first 2h from arrival at our emergency department over a 7-year period was conducted. Charts were reviewed for demographic data and outcomes including complications and initial drainage output. Small chest tubes (20-22 Fr) were compared with a large tube (28 Fr). Our primary outcome was tube-related complications. Secondary outcomes included additional invasive procedures, such as additional tube insertion and thoracotomy. There were 124 tube thoracostomies (small: 68, large: 56) performed in 116 patients. There were no significant differences between the small- and large-tube groups with regard to age, gender, injury mechanism, systolic blood pressure, heart rate, and injury severity score. Both groups were similar in the posterior direction of tube insertion, initial drainage output, and the duration of tube insertion. There was no significant difference in the primary outcomes of tube-related complications, including empyema (small: 1/68 vs. large: 1/56; p=1.000) or retained hemothorax (small: 2/68 vs. large: 2/56; p=1.000). Secondary outcomes, including the need for additional tube placement (small: 2/68 vs. large: 4/56; p=0.408) or thoracotomy (small: 2/68 vs. large: 1/56; p=1.000), were also similar. For patients with

  15. 插入双面有三角形翅片的金属带对热交换管中流动和传热特性的影响%Influence of Double-sided Delta-wing Tape Insert with Alternate-axes on Flow and Heat Transfer Characteristics in a Heat Exchanger Tube

    Institute of Scientific and Technical Information of China (English)

    Smith Eiamsa-ard; Pongjet Promvonge

    2011-01-01

    The convective heat transfer and friction behaviors of turbulent tube flow through a straight tape with double-sided delta wings (T-W) have been studied experimentally. In the current work, the T-W formed on the tape was used as vortex generators for enhancing the heat transfer coefficient by breakdown of thermal boundary layer and by mixing of fluid flow in tubes. The T-W characteristics are (1) T-W with forward/backward-wing arrangement, (2) T-W with alternate axis (T-WA), (3) three wing-width ratios and (4) wing-pitch ratios. The experimental result reveals that for using the T-W, the increases in the mean Nusselt number (Nu) and friction factor are, respectively, up to 165% and 14.8 times of the plain tube and the maximum thermal performance factor is 1.19. It is also obvious that the T-W with forward-wing gives higher heat transfer rate than one with backward-wing around 7%.The present investigation also shows that the heat transfer rate and friction factor obtained from the T-WA is higher than that from the T-W. In addition, the flow pattern and temperature fields in the T-W tube with both backward and forward wings were also examined numerically.

  16. 高龄卧床患者鼻饲自制匀浆膳食鼻饲量及其间隔时间%The elderly bedridden patients with nasogastric tube feeding and home-made blenderized diet time interval

    Institute of Scientific and Technical Information of China (English)

    甄丽辉; 黄鑫

    2015-01-01

    objective:to explore-bed nasogastric homemade homogenate diet in patients with nasal feeding amount and time interval. Methods:choose from June 2013 to June 2015 treated 80 cases of senile patients in bed, is divided into two groups, using different number of nasogastric, nasal feeding amount, contrast and the incidence of adverse reactions observed two groups of patients as well as the body quality and so on. Results:the incidence of complications (15%) of patients with observation group was obviously lower than the control group (45%), significant differences (P<0.05). Conclusion:the impact of different nasogastric scheme for the patient.%目的:探析高龄卧床患者鼻饲自制匀浆膳食鼻饲量及其间隔时间。方法:选我院2013年6月至2015年6月收治的80例高龄卧床患者,分成两组,采用不同的鼻饲次数、鼻饲量,对比与观察两组患者的不良反应发生率以及体质量等。结果:观察组患者并发症发生率(15%)明显低于对照组(45%),差异性显著(P<0.05)。结论:不同的鼻饲方案对患者产生的影响不同。

  17. Modified gastric tube fixation in laryngeal cancer patients with total resection of nasal feeding treatment%改良胃管固定方式在喉癌全切患者鼻饲营养治疗中的效果观察

    Institute of Scientific and Technical Information of China (English)

    肖红英

    2015-01-01

    Objective In order to improve the comfort of patient and reduce unscheduled decannulation rate, guarantee the effect of postoperative laryngeal cancer patients nutrition support,we investigated the laryngeal cancer with all postoperative nasal feeding patients with gastric tube fixed way.Methods The 80 patients with laryngeal cancer after fulllaryngeal resection indwelling gastric tube were randomly divided into control group and observation group, 40 cases for eachgroup.We used the traditional method as well as the improved method of fixed gastric tube, respectively.we compared two groups of patients with the rate of unscheduled decannulation and the comfort in the effect of nutritional support.Results The rate of observation group of unscheduled decannulation is lower than that of the control group, and the comfort is significantly higher than the control group,as well as the clinical effect of nutritional support. the comparative difference was statistically significant (P< 0.01).Conclusion The Modified gastric tube fixation method can fix gastric tube properly, improve the comfort and decrease the rate of unplanned extubation.The effect of nutritional support for patients is better than the traditional method of stomach tube fixed, is worth using for reference.%目的:探讨喉癌全切术后鼻饲患者胃管固定方式,提高患者的舒适度,降低非计划性拔管率,保证喉癌患者术后营养支持效果。方法将80例喉癌全切术后留置胃管患者随机分为对照组和观察组各40例,分别采用传统方法、改良法固定胃管,比较两组患者非计划性拔管率和舒适度及营养支持效果的差异。结果观察组非计划性拔管率低于对照组,而舒适度明显高于对照组,临床营养支持效果更佳。经比较差异有统计学意义(P<0.01)。结论改良胃管固定方法既能妥善固定胃管,又能提高患者的舒适度,降低非计划拔管率,对患者的营养支持效果

  18. Heat Transfer Enhancement of Shell and Tube Heat Exchanger Using Conical Tapes.

    Directory of Open Access Journals (Sweden)

    Dhanraj S.Pimple

    2014-12-01

    Full Text Available This paper provides heat transfer and friction factor data for single -phase flow in a shell and tube heat exchanger fitted with a helical tape insert. In the double concentric tube heat exchanger, hot air was passed through the inner tube while the cold water was flowed through the annulus. The influences of the helical insert on heat transfer rate and friction factor were studied for counter flow, and Nusselt numbers and friction factor obtained were compared with previous data (Dittus 1930, Petukhov 1970, Moody 1944 for axial flows in the plain tube. The flow considered is in a low Reynolds number range between 2300 and 8800. A maximum percentage gain of 165% in heat transfer rate is obtained for using the helical insert in comparison with the plain tube.

  19. Further studies in filmwise condensation of steam on horizontal finned tubes

    OpenAIRE

    Swensen, Keith Andrew

    1992-01-01

    Approved for public release; distribution is unlimited Over the years, there has been significant variation in the filmwise steam condensation data at NOS on horizontal low0integral finned tubes. With a view to increasing the accuracy of the data, inserts were used inside the tubes to reduce inside thermal resistance; however, significant discrepancies then occurred in the calculated outside coefficient when compared to data taken without an insert. These discrepancies arose due to the d...

  20. Neural Tube Defects

    Science.gov (United States)

    Neural tube defects are birth defects of the brain, spine, or spinal cord. They happen in the ... that she is pregnant. The two most common neural tube defects are spina bifida and anencephaly. In ...

  1. Visual beam tube inspection at the TRIGA reactor Vienna

    Energy Technology Data Exchange (ETDEWEB)

    Boeck, H.; Musilek, A.; Villa, M. [Vienna University of Technology, Atominstitut of the Austrian Universities, Vienna (Austria)], E-mail: boeck@ati.ac.at

    2006-07-01

    Of the four TRIGA beam tubes two have been visually inspected in 1985. Prior to the inspection the reactor was shut down for 3 weeks. The fuel elements around the beam tubes were removed. Stainless steel dummy elements were inserted in the fuel positions to shield the core radiation. The active part of the Fast Rabbit Tube was removed into the beam tube loading device and transferred to an interim storage: Front dose rate was {approx} 50 mSv/h. Generally the beam tube was very clean, after the last inspection about 30 years ago. A1 cm cut was observed at the beam tube front end. A rigid endoscope was used to check the beam tube's inner surface using a 90 degree deflection objective and photo- and video equipment. The direct dose rate in front of the beam tube was about 30 mSv/h. The beam tube was vacuum cleaned. A corroded shielding tank containing boric acid has leaked. A wooden collimator partially disintegrating due to extreme temperature was removed from beam tube D. Documentation of the inspection for visible defects is produced for later comparison.

  2. Post-CTS Delay Insertion

    Directory of Open Access Journals (Sweden)

    Jianchao Lu

    2010-01-01

    clock skew operation is performed only at the clock sinks in order to preserve the structure and the optimizations implemented in the clock tree synthesis stage. The methodology is implemented as a linear programming model amenable to two design objectives: fixing timing violations or optimizing the clock period. Experimental results show that the clock networks of the largest ISCAS'89 circuits can be corrected post-CTS to resolve the timing conflicts in approximately 90% of the circuits with minimal delay insertion (0.159  ×  clock period per clock path on average. It is also shown that the majority of the clock period improvement achievable through unrestricted clock skew scheduling are obtained through very limited insertion (≈43% average improvement through 10% of max insertion.

  3. Gene Insertion Patterns and Sites

    Science.gov (United States)

    Vain, Philippe; Thole, Vera

    During the past 25 years, the molecular analysis of transgene insertion patterns and sites in plants has greatly contributed to our understanding of the mechanisms underlying transgene integration, expression, and stability in the nuclear genome. Molecular characterization is also an essential step in the safety assessment of genetically modified crops. This chapter describes the standard experimental procedures used to analyze transgene insertion patterns and loci in cereals and grasses transformed using Agrobacterium tumefaciens or direct transfer of DNA. Methods and protocols enabling the determination of the number and configuration of transgenic loci via a combination of inheritance studies, polymerase chain reaction, and Southern analyses are presented. The complete characterization of transgenic inserts in plants is, however, a holistic process relying on a wide variety of experimental approaches. In this chapter, these additional approaches are not detailed but references to relevant bibliographic records are provided.

  4. Representações sociais sobre a alimentação por sonda obtidas de pacientes adultos hospitalizados Representaciones sociales asociadas con la nutrición por sondas en pacientes hospitalizados Social representations associated with tube feeding among adult hospitalized patients

    Directory of Open Access Journals (Sweden)

    Jaqueline Almeida Guimarães Barbosa

    2005-04-01

    tratamiento.This study aimed to identify and understand adult patients' representations on tube feeding. Data were collected through interviews with sixteen patients who were using feeding tubes, which were analyzed through discourse analysis and Social Representation Theory. We identified a sequence in which representations are reorganized and redefined through experience, in order to turn this treatment tolerable. This sequence begins when patients face the need of a feeding tube, followed by the experience of its use and finally, when deciding about continuing its use or not, when going home. Some representations contribute to treatment adherence and others to its rejection. Getting to know positive and negative ideas about this treatment makes it possible to approach these patients in a more direct way, with a view to better adherence and satisfaction.

  5. 品管圈管理在预防神经内科鼻饲管非计划性拔管中的作用%Effect of Quality Control Circle Management in Predicting Unplanned Extu-bation of Nasogastric Feeding Tube in Department of Neurology

    Institute of Scientific and Technical Information of China (English)

    赵爱学

    2016-01-01

    Objective To research the application effect of quality control circle management in predicting unplanned extu-bation of nasogastric feeding tube in department of neurology. Methods 88 cases of patients with nasogastric feeding tube in department of neurology treated in our hospital from November 2012 to December 2015 were selected and divided into two groups according to the application time of quality control circle management, 44 cases of patients without application of quality control circle management from November 2012 to November 2013 were selected as the control group, and 44 cases of patients with application of quality control circle management from December 2013 to December 2015 were selected as the research group, and the incidence rate of unplanned extubation and eight quality and ability scores were compared be-tween the two groups. Results The incidence rate of unplanned extubation in the research group was lower than that in the control group, the eight quality and ability scores such as harmonious degree, quality control technique, enthusiasm, cohe-sive force, sense of joy, communication and coordination, sense of responsibility and problem-solving ability in the research group were higher than those in the control group, and the differences had statistical significance(P<0.05). Conclusion The application of quality control circle management in predicting unplanned extubation of nasogastric feeding tube in depart-ment of neurology is effective, which can improve the comprehensive ability of nursing staff, and it is suitable for promotion and application.%目的:研究在神经内科鼻饲管非计划性拔管预防中品管圈管理的应用效果。方法对2012年11月-2015年12月间在该院接受治疗的神经内科鼻饲患者88例进行研究,以品管圈管理的应用时间作为分界点进行分组,即以2012年11月-2013年11月间44例未应用品管圈管理的患者为对照组,以2013年12月-2015年12月间44例应用品

  6. An insertion algorithm for catabolizability

    CERN Document Server

    Blasiak, Jonah

    2009-01-01

    Motivated by our recent work relating canonical bases to combinatorics of Garsia-Procesi modules \\cite{B}, we give an insertion algorithm that computes the catabolizability of the insertion tableau of a standard word. This allows us to characterize catabolizability as the statistic on words invariant under Knuth transformations, certain (co)rotations, and a new operation called a catabolism transformation. We also prove a Greene's Theorem-like characterization of catabolizability, and a result about how cocyclage changes catabolizability, strengthening a similar result in \\cite{SW}.

  7. Dielectric rod feed for compact range reflector

    CERN Document Server

    Balabukha, Nikolay P; Shapkina, Natalia E

    2014-01-01

    A dielectric rod feed with a special radiation pattern of a tabletop form used for the compact range reflector is developed and analyzed. Application of this feed increases the size of the compact range quiet zone generated by the reflector. The feed consists of the dielectric rod made of polystyren, the rod is inserted into the circular waveguide with a corrugated flange. The waveguide is excited by the H11-mode. The rod is covered by the textolite biconical bushing and has a fluoroplastic insert in the vicinity of the bushing. Mathematical modeling was used to obtain the parameters of the feed for the optimal tabletop form of the radiation pattern. The problem of the electromagnetic radiation was solved for metal-dielectric bodies of rotation by method of integral equations with further solving of the problem of the synthesis for feed parameters. The dielectric rod feed was fabricated for the X-frequency range. Feed amplitude and phase patterns were measured in the frequency range 8.2-12.5 GHz. Presented re...

  8. 不同匀浆膳制剂对老年糖尿病管饲患者生化水平及血红蛋白的影响%Effect of different homogenated diets on blood biochemistry and hemoglobin in elderly type 2 diabetic patients with tube feeding

    Institute of Scientific and Technical Information of China (English)

    张新胜; 刘英华; 于晓明; 徐庆; 刘钊; 贺源; 薛长勇

    2011-01-01

    To observe the effect of different homogenated diets on blood biochemistry and hemoglobin in elderly type 2 diabetic patients with tube feeding. Methods Fifty-six type 2 diabetic patients were divided into home-made homogenated diet group, Sanjiu homogenated diet group and TPF-D group. Parameters of body height, body weight, waist circumference and hip circumference, as well as findings of biochemical testing including hemoglobin (Hb) of the patients were analyzed. Results The serum levels of uric acid (sUA), iron (Fe), calcium(Ca) and Hb were significantly higher in those after feeding the diets than in those before feeding the diets (P<0.05). The blood sodium (Na) level was higher while the blood potassium (K) level was lower in home-made homogenated diet group than in the other two groups (P<0.05). The sUA level was significantly higher in TPF-D group than in the other groups (P<0.05). The ApoAl level was significantly higher in Sanjiu homogenated diet group than in the other groups (P<0.05). The blood Na level was higher and the blood K level was lower in home-made homogenated diet group than in the other groups (P<0.05). No significant difference was found in other parameters among the 3 groups. Conclusion The three homogenated diets can meet the nutrition requirements of elderly diabetic patients with tube feeding. Rational addition of nutrients according to the different conditions of such patients should be stressed if these diets are used for a long time due to their different advantages and disadvantages.%目的 观察不同匀浆膳制剂对老年精尿病管饲患者生化水平及血红蛋白的影响.方法 56例2型老年糖尿病管饲患者,按照匀浆膳种类分为自制匀浆膳组、三九匀浆膳组和肠内营养乳剂(TPF-D)组,收集患者人体测量指标(身高、体重、腰围、臀围)、生化检测结果及血红蛋白(检验指标均累计>4次,取平均值).结果 三组患者血清尿酸、铁、钙及血红蛋白

  9. Transpyloric feeding in 49 infants undergoing intensive care.

    Science.gov (United States)

    Dryburgh, E

    1980-11-01

    The use of transpyloric feeding in 46 very ill newborn infants requiring assisted ventilation was evaluated. It was found to be a simple and well-tolerated technique. A possible complication of significance was necrotising enterocolitis in 4 infants. Transpyloric tube feeding in 3 infants with treated upper small-bowel atresia is also described.

  10. Contrast-free endoscopic stent insertion in malignant biliary obstruction

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    AIM: To present a case series of MRCP-guided endoscopic biliary stent placement, performed entirely without contrast injection.METHODS: Contrast-free endoscopic biliary drainage was attempted in 20 patients with malignant obstruction,unsuitable for resection on the basis of tumor extent or medical illness. MRCP images were used to confirm the diagnosis of tumor, to exclude other biliary diseases and to demonstrate the stenoses as well as dilation of proximal liver segments. The procedure was carried out under conscious sedation. Patients were placed in the left lateral decubitus position. The endoscope was inserted, the papilla identified and cannulated by a papillotome. A guide wire was inserted and guided deeply into the biliary tree, above the stenosis, by fluoroscopy. A papillotomy approximately 1 cm. long was performed and the papillotome was exchanged with a guiding-catheter. A 10 Fr, Amsterdam-type plastic stent,7 to 15 cm long, was finally inserted over the guide wire/guiding catheter by a pusher tube system.RESULTS: Successful stent insertion was achieved in all patients. There were no major complications. Successful drainage, with substantial reduction in bilirubin levels,was achieved in all patients.CONCLUSION: This new method of contrast-free endoscopic stenting in malignant biliary obstruction is a safe and effective method of palliation. However, a larger, randomized study comparing this new approach with the standard procedure is needed to confirm the findings of the present study.

  11. Spectral analysis of hearing protector impulsive insertion loss.

    Science.gov (United States)

    Fackler, Cameron J; Berger, Elliott H; Murphy, William J; Stergar, Michael E

    2017-01-01

    To characterise the performance of hearing protection devices (HPDs) in impulsive-noise conditions and to compare various protection metrics between impulsive and steady-state noise sources with different characteristics. HPDs were measured per the impulsive test methods of ANSI/ASA S12.42- 2010 . Protectors were measured with impulses generated by both an acoustic shock tube and an AR-15 rifle. The measured data were analysed for impulse peak insertion loss (IPIL) and impulsive spectral insertion loss (ISIL). These impulsive measurements were compared to insertion loss measured with steady-state noise and with real-ear attenuation at threshold (REAT). Tested HPDs included a foam earplug, a level-dependent earplug and an electronic sound-restoration earmuff. IPIL for a given protector varied between measurements with the two impulse noise sources, but ISIL agreed between the two sources. The level-dependent earplug demonstrated level-dependent effects both in IPIL and ISIL. Steady-state insertion loss and REAT measurements tended to provide a conservative estimate of the impulsively-measured attenuation. Measurements of IPIL depend strongly on the source used to measure them, especially for HPDs with less attenuation at low frequencies. ISIL provides an alternative measurement of impulse protection and appears to be a more complete description of an HPD's performance.

  12. Biliary peritonitis due to fistulous tract rupture following a T-tube removal.

    Science.gov (United States)

    Sakorafas, George H; Stafyla, Vania; Tsiotos, Gregory G

    2005-06-24

    We present a patient with biliary peritonitis following a T-tube removal. The patient underwent laparotomy; a rupture of the fistulous tract around the T-tube was found. A Nelaton catheter was inserted through this opening and advanced toward the biliary tree and secured in place by a suture ligature. Postoperative course was uneventful.

  13. Non-operative management of tube thoracostomy induced pulmonary artery injury.

    Science.gov (United States)

    Sundaramurthy, Senthilkumar R; Moshinsky, Randall A; Smith, Julian A

    2009-10-01

    Tube thoracostomy insertion is a common procedure in the management of air and fluid collections in the pleural space. Pulmonary artery injury is a rare but serious complication following intercostal catheterisation. This complication is usually managed surgically. We report a case of successful non-operative management of a pulmonary artery injury after tube thoracostomy.

  14. Concepts for stereoselective acrylate insertion

    KAUST Repository

    Neuwald, Boris

    2013-01-23

    Various phosphinesulfonato ligands and the corresponding palladium complexes [{((PaO)PdMeCl)-μ-M}n] ([{( X1-Cl)-μ-M}n], (PaO) = κ2- P,O-Ar2PC6H4SO2O) with symmetric (Ar = 2-MeOC6H4, 2-CF3C6H4, 2,6-(MeO)2C6H3, 2,6-(iPrO)2C 6H3, 2-(2′,6′-(MeO)2C 6H3)C6H4) and asymmetric substituted phosphorus atoms (Ar1 = 2,6-(MeO)2C6H 3, Ar2 = 2′-(2,6-(MeO)2C 6H3)C6H4; Ar1 = 2,6-(MeO)2C6H3, Ar2 = 2-cHexOC 6H4) were synthesized. Analyses of molecular motions and dynamics by variable temperature NMR studies and line shape analysis were performed for the free ligands and the complexes. The highest barriers of ΔGa = 44-64 kJ/mol were assigned to an aryl rotation process, and the flexibility of the ligand framework was found to be a key obstacle to a more effective stereocontrol. An increase of steric bulk at the aryl substituents raises the motional barriers but diminishes insertion rates and regioselectivity. The stereoselectivity of the first and the second methyl acrylate (MA) insertion into the Pd-Me bond of in situ generated complexes X1 was investigated by NMR and DFT methods. The substitution pattern of the ligand clearly affects the first MA insertion, resulting in a stereoselectivity of up to 6:1 for complexes with an asymmetric substituted phosphorus. In the consecutive insertion, the stereoselectivity is diminished in all cases. DFT analysis of the corresponding insertion transition states revealed that a selectivity for the first insertion with asymmetric (P aO) complexes is diminished in the consecutive insertions due to uncooperatively working enantiomorphic and chain end stereocontrol. From these observations, further concepts are developed. © 2012 American Chemical Society.

  15. Feeding Your Newborn

    Science.gov (United States)

    ... Old Feeding Your 1- to 2-Year-Old Feeding Your Newborn KidsHealth > For Parents > Feeding Your Newborn ... giving up the breast. previous continue About Formula Feeding Commercially prepared infant formula is a nutritious alternative ...

  16. Pulse Tube Refrigerator

    Science.gov (United States)

    Matsubara, Yoichi

    The pulse tube refrigerator is one of the regenerative cycle refrigerators such as Stirling cycle or Gifford-McMahon cycle which gives the cooling temperature below 150 K down to liquid helium temperature. In 1963, W. E. Gifford invented a simple refrigeration cycle which is composed of compressor, regenerator and simple tube named as pulse tube which gives a similar function of the expander in Stirling or Gifford-McMahon cycle. The thermodynamically performance of this pulse tube refrigerator is inferior to that of other regenerative cycles. In 1984, however, Mikulin and coworkers made a significant advance in pulse tube configuration called as orifice pulse tube. After this, several modifications of the pulse tube hot end configuration have been developed. With those modifications, the thermodynamic performance of the pulse tube refrigerator became the same order to that of Stirling and Gifford-McMahon refrigerator. This article reviews the brief history of the pulse tube refrigerator development in the view point of its thermodynamically efficiency. Simplified theories of the energy flow in the pulse tube have also been described.

  17. 脑卒中患者胃管留置长度的循证护理实践与效果评价%Evidence based nursing practice and effect evaluation of gastric tube insertion length for stroke patients with cerebral

    Institute of Scientific and Technical Information of China (English)

    陈鸿梅; 邓丽媛; 王艳红; 兰鸿

    2014-01-01

    Objective To study and evaluate the effect of nasogastric tube's indwelling length for stroke patients with cerebral .Method 116 patients with enteral nutrition by nasogastric tube were randomly assigned and divided in‐to control group and observe group .The indwelling length of nasogastric tube was 55~65 cm from eyebrows to na‐vel in the control group ,and 45~55 cm in the observe group .Result The remain volume of gastric juice in the ob‐serve group was more than that of the control group(P<0 .05) .Conclusion Selecting a suitable indwelling length of nasogastric tube among stroke patients by the evidence‐based nursing may reflect the gastric residual volume accu‐rately ,reduce reflux ,choking and aspiration rates .Its a feasibility method for clinical using .%目的:应用循证护理探讨脑卒中患者胃管置入长度并评价其效果。方法将我院116例经鼻胃管肠内营养的脑卒中患者随机分为对照组(n=52)和观察组(n=64),观察组根据循证步骤选取最佳的证据,改进胃管留置长度为患者眉心至脐的体表距离(约55~65 cm );对照组按《基础护理学》教材,胃管留置长度为患者前额发际至剑突的体表距离(约45~55 cm ),比较两组患者返流、呛咳及误吸的发生率和胃内残留量监测情况。结果观察组返流、呛咳及误吸发生率均低于对照组(P<0.05);观察组胃内残留量大于对照组(P<0.05)。结论采取循证护理的方法制订科学、个性化的胃管留置长度,可准确反映胃内残留量,减少返流、呛咳及误吸发生率,值得在临床实践工作中推荐。

  18. A heating tube

    Energy Technology Data Exchange (ETDEWEB)

    Burmistrov, V.M.; Rachev, L.A.

    1980-09-23

    Hollow needles made of an electrically conducting material are attached by hinges in the openings of the perforated end of an insert in order to intensify heat and mass transfer. The free sections of the needles are placed outside the insert, and a wick is placed on the wall of the frame in the condensation area. The wick overlaps the inlet openings of the insert.

  19. Percutaneous Endoscopic Gastrostomy in the Enteral Feeding of the Elderly

    Directory of Open Access Journals (Sweden)

    Huan-Lin Chen

    2011-09-01

    Full Text Available Today we are faced with an aging society that may develop malnutrition because of dysphagia related to dementia, stroke, and malignancy seen often in the elderly. The preferred form of nutritional supplementation for this group is enteral nutrition, and the most appropriate long-term method is by use of a gastrostomy. Percutaneous endoscopic gastrostomy (PEG was first introduced in 1980 as an alternative to the traditional operative procedure and rapidly became the preferred procedure. In geriatric patients, the principal indications are neurological dysphagia and malnutrition, related to an underlying disease or anorexia-cachexia in very elderly. PEG is contraindicated in the presence of respiratory distress, previous gastric resection, total esophageal obstruction, coagulation disorders and sepsis in the elderly. Common complications include wound infection, leakage, hemorrhage, and fistula in the general population, but aspiration pneumonia is the major case of death in this group. Risks and complications of PEG must be discussed with patients and their families; and the decision for percutaneous endoscopic gastrostomy insertion should only be made after careful consideration and discussion between managing physicians, allied health professionals, and the patient and/or family. Four ethical principles may help make feeding decisions: beneficence, non-maleficence, autonomy and justice. Attentive long-term care after tube replacement is mandatory. Acceptance of percutaneous endoscopic gastrostomy placement by patients and their families tends to increase once favorable outcomes are offered.

  20. Cervical pharyngostomy: an alternative approach to enteral feeding.

    Science.gov (United States)

    Patil, Pavan M; Warad, Neelkant M; Patil, Rajshekhar N; Kotrashetti, S M

    2006-12-01

    Surgical patients may be unable or unwilling to feed normally, owing to mechanical obstruction to ingestion because of nausea or anorexia or secondary to neurologic abnormality. Such patients may be in a malnourished state that compromises their chances of successful recovery. The Nasogastric tube (NGT) has been the standard method of postoperative alimentation in head and neck cancer patients. However, prolonged use of an NGT has been associated with many problems. Percutaneous endoscopic gastrotomy (PEG) tubes are generally easier to manage and more esthetically pleasing than NGTs. However, they are associated with their own set of shortcomings. Problems and complications with traditional NGT led us to evaluate feeding tubes placed through a cervical pharyngostomy. We present our experience with this technique in 15 patients in whom it was used for postoperative feeding after oropharyngeal cancer resection and reconstruction. The cervical pharyngostomy technique has proven to be a safe, reliable, cost-effective and convenient method for postoperative feeding.

  1. Insertion device calculations with mathematica

    Energy Technology Data Exchange (ETDEWEB)

    Carr, R. [Stanford Synchrotron Radiation Lab., CA (United States); Lidia, S. [Univ. of California, Davis, CA (United States)

    1995-02-01

    The design of accelerator insertion devices such as wigglers and undulators has usually been aided by numerical modeling on digital computers, using code in high level languages like Fortran. In the present era, there are higher level programming environments like IDL{reg_sign}, MatLab{reg_sign}, and Mathematica{reg_sign} in which these calculations may be performed by writing much less code, and in which standard mathematical techniques are very easily used. The authors present a suite of standard insertion device modeling routines in Mathematica to illustrate the new techniques. These routines include a simple way to generate magnetic fields using blocks of CSEM materials, trajectory solutions from the Lorentz force equations for given magnetic fields, Bessel function calculations of radiation for wigglers and undulators and general radiation calculations for undulators.

  2. The first LHC insertion quadrupole

    CERN Multimedia

    2004-01-01

    An important milestone was reached in December 2003 at the CERN Magnet Assembly Facility. The team from the Accelerator Technology - Magnet and Electrical Systems group, AT-MEL, completed the first special superconducting quadrupole for the LHC insertions which house the experiments and major collider systems. The magnet is 8 metres long and contains two matching quadrupole magnets and an orbit corrector, a dipole magnet, used to correct errors in quadrupole alignment. All were tested in liquid helium and reached the ultimate performance criteria required for the LHC. After insertion in the cryostat, the superconducting magnet will be installed as the Q9 quadrupole in sector 7-8, the first sector of the LHC to be put in place in 2004. Members of the quadrupole team, from the AT-MEL group, gathered around the Q9 quadrupole at its inauguration on 12 December 2003 in building 181.

  3. Inserting Agility in System Development

    Science.gov (United States)

    2012-07-01

    Agile IT Acquisition, IT Box, Scrum Inserting Agility in System Development Matthew R. Kennedy and Lt Col Dan Ward, USAF With the fast-paced nature...1,700 individuals and 71 countries, found Scrum and eXtreme Programming to be the most widely followed method- ologies (VersionOne, 2007). Other...University http://www.dau.mil 259 Defense ARJ, July 2012, Vol. 19 No. 3 : 249–264 Scrum Scrum is a framework used for project management, which is

  4. HTS Insert Magnet Design Study

    CERN Document Server

    Devaux, M; Fleiter, J; Fazilleau, P; Lécrevisse, T; Pes, C; Rey, J-M; Rifflet, J-M; Sorbi, M; Stenvall, A; Tixador, P; Volpini, G

    2011-01-01

    Future accelerator magnets will need to reach higher field in the range of 20 T. This field level is very difficult to reach using only Low Temperature Superconductor materials whereas High Temperature Superconductors (HTS) provide interesting opportunities. High current densities and stress levels are needed to design such magnets. YBCO superconductor indeed carries large current densities under high magnetic field and provides good mechanical properties especially when produced using the IBAD approach. The HFM EUCARD program studies the design and the realization of an HTS insert of 6 T inside a Nb3Sn dipole of 13T at 4.2 K. In the2HTS insert, engineering current densities higher than 250 MA/m under 19 T are required to fulfill the specifications. The stress level is also very severe. YBCO IBAD tapes theoretically meet these challenges from presented measurements. The insert protection is also a critical because HTS materials show low quench propagation velocities and the coupling with the Nb3Sn magnet make...

  5. Myringotomy versus ventilation tubes in secretory otitis media: eardrum pathology, hearing, and eustachian tube function 25 years after treatment

    DEFF Research Database (Denmark)

    Caye-Thomasen, P.; Stangerup, S.E.; Jorgensen, G.

    2008-01-01

    , myringosclerosis and late atrophy. The temporary hearing improvement may reduce the risk of detrimental effects on speech and language development. The prevalence and extension of the various subtypes of pathology change over the years after treatment, which implies the existence of intrinsic repair mechanisms......OBJECTIVE: This report documents the dynamics of eardrum pathology, hearing acuity, and eustachian tube function during 25 years after treatment of bilateral secretory otitis media. The included children were treated by myringotomy on the left ear and ventilation tube insertion on the right ear....... MATERIALS AND METHODS: Two hundred twenty-four children with bilateral secretory otitis media were treated by bilateral myringotomy and insertion of a ventilation tube on the right side only. The children were reexamined by otomicroscopy, tympanometry, and pure tone audiometry after 3, 7, and 25 years...

  6. Comparison of guided insertion of the LMA ProSeal vs the i-gel.

    Science.gov (United States)

    Gasteiger, L; Brimacombe, J; Perkhofer, D; Kaufmann, M; Keller, C

    2010-09-01

    In a randomised, non-crossover study, we tested the hypothesis that the ease of insertion using a duodenal tube guided insertion technique and the oropharyngeal leak pressure differ between the LMA ProSeal and the i-gel in non-paralysed, anesthetised female subjects. One hundred and fifty-two females aged 19-70 years were studied. Insertion success rate, insertion time and oropharyngeal leak pressure were measured. First attempt and overall insertion success were similar (LMA ProSeal, 75/76 (99%) and 76/76 (100%); i-gel 73/75 (97%) and 75 (100%), respectively). Mean (SD) insertion times were similar (LMA ProSeal, 40 (16) s; i-gel 43 (21) s). Mean oropharyngeal leak pressure was 7 cmH(2) O higher with the LMA ProSeal (p LMA ProSeal and i-gel is similarly easy using a duodenal tube guided technique, but the LMA ProSeal forms a more effective seal for ventilation.

  7. Heated Tube Facility

    Data.gov (United States)

    Federal Laboratory Consortium — The Heated Tube Facility at NASA GRC investigates cooling issues by simulating conditions characteristic of rocket engine thrust chambers and high speed airbreathing...

  8. Fuel nozzle tube retention

    Energy Technology Data Exchange (ETDEWEB)

    Cihlar, David William; Melton, Patrick Benedict

    2017-02-28

    A system for retaining a fuel nozzle premix tube includes a retention plate and a premix tube which extends downstream from an outlet of a premix passage defined along an aft side of a fuel plenum body. The premix tube includes an inlet end and a spring support feature which is disposed proximate to the inlet end. The premix tube extends through the retention plate. The spring retention feature is disposed between an aft side of the fuel plenum and the retention plate. The system further includes a spring which extends between the spring retention feature and the retention plate.

  9. Laryngeal tube use in out-of-hospital cardiac arrest by paramedics in Norway

    Directory of Open Access Journals (Sweden)

    Sunde Geir A

    2012-12-01

    Full Text Available Abstract Background Although there are numerous supraglottic airway alternatives to endotracheal intubation, it remains unclear which airway technique is optimal for use in prehospital cardiac arrests. We evaluated the use of the laryngeal tube (LT as an airway management tool among adult out-of-hospital cardiac arrest (OHCA patients treated by our ambulance services in the Haukeland and Innlandet hospital districts. Methods Post-resuscitation forms and data concerning airway management in 347 adult OHCA victims were retrospectively assessed with regard to LT insertion success rates, ease and speed of insertion and insertion-related problems. Results A total of 402 insertions were performed on 347 OHCA patients. Overall, LT insertion was successful in 85.3% of the patients, with a 74.4% first-attempt success rate. In the minority of patients (n = 46, 13.3%, the LT insertion time exceeded 30 seconds. Insertion-related problems were recorded in 52.7% of the patients. Lack of respiratory sounds on auscultation (n = 100, 28.8%, problematic initial tube positioning (n = 85, 24.5%, air leakage (n = 61, 17.6%, vomitus/aspiration (n = 44, 12.7%, and tube dislocation (n = 17, 4.9% were the most common problems reported. Insertion difficulty was graded and documented for 95.4% of the patients, with the majority of insertions assessed as being “Easy” (62.5% or “Intermediate” (24.8%. Only 8.1% of the insertions were considered to be “Difficult”. Conclusions We found a high number of insertion related problems, indicating that supraglottic airway devices offering promising results in manikin studies may be less reliable in real-life resuscitations. Still, we consider the laryngeal tube to be an important alternative for airway management in prehospital cardiac arrest victims.

  10. Pleural controversy: optimal chest tube size for drainage.

    Science.gov (United States)

    Light, Richard W

    2011-02-01

    In recent years, a higher and higher percentage of patients with pleural effusions or pneumothorax are being treated with small-bore (10-14 F) chest tubes rather than large-bore (>20 F). However, there are very few randomized controlled studies comparing the efficacy and complication rates with the small- and large-bore catheters. Moreover, the randomized trials that are available have flaws in their design. The advantages of the small-bore catheters are that they are easier to insert and there is less pain with their insertion while they are in place. The placement of the small-bore catheters is probably more optimal when placement is done with ultrasound guidance. Small-bore chest tubes are recommended when pleurodesis is performed. The success of the small-bore indwelling tunnelled catheters that are left in place for weeks documents that the small-bore tubes do not commonly become obstructed with fibrin. Patients with complicated parapneumonic effusions are probably best managed with small-bore catheters even when the pleural fluid is purulent. Patients with haemothorax are best managed with large-bore catheters because of blood clots and the high volume of pleural fluid. Most patients with pneumothorax can be managed with aspiration or small-bore chest tubes. If these fail, a large-bore chest tube may be necessary. Patients on mechanical ventilation with barotrauma induced pneumothoraces are best managed with large-bore chest tubes.

  11. Continuous feedings of fortified human milk lead to nutrient losses of fat, calcium, and phosphorous

    Science.gov (United States)

    Substantial losses of nutrients may occur during tube (gavage) feeding of fortified human milk. Our objective was to compare the losses of key macronutrients and minerals based on method of fortification, and gavage feeding method. We used clinically available gavage feeding systems and measured pre...

  12. Leucine pulses enhance skeletal muscle protein synthesis during continuous feeding in neonatal pigs

    Science.gov (United States)

    Infants unable to maintain oral feeding can be nourished by orogastric tube. We have shown that orogastric continuous feeding restricts muscle protein synthesis compared with intermittent bolus feeding in neonatal pigs. To determine whether leucine leu infusion can be used to enhance protein synthes...

  13. Steam generator tube failures

    Energy Technology Data Exchange (ETDEWEB)

    MacDonald, P.E.; Shah, V.N.; Ward, L.W.; Ellison, P.G.

    1996-04-01

    A review and summary of the available information on steam generator tubing failures and the impact of these failures on plant safety is presented. The following topics are covered: pressurized water reactor (PWR), Canadian deuterium uranium (CANDU) reactor, and Russian water moderated, water cooled energy reactor (VVER) steam generator degradation, PWR steam generator tube ruptures, the thermal-hydraulic response of a PWR plant with a faulted steam generator, the risk significance of steam generator tube rupture accidents, tubing inspection requirements and fitness-for-service criteria in various countries, and defect detection reliability and sizing accuracy. A significant number of steam generator tubes are defective and are removed from service or repaired each year. This wide spread damage has been caused by many diverse degradation mechanisms, some of which are difficult to detect and predict. In addition, spontaneous tube ruptures have occurred at the rate of about one every 2 years over the last 20 years, and incipient tube ruptures (tube failures usually identified with leak detection monitors just before rupture) have been occurring at the rate of about one per year. These ruptures have caused complex plant transients which have not always been easy for the reactor operators to control. Our analysis shows that if more than 15 tubes rupture during a main steam line break, the system response could lead to core melting. Although spontaneous and induced steam generator tube ruptures are small contributors to the total core damage frequency calculated in probabilistic risk assessments, they are risk significant because the radionuclides are likely to bypass the reactor containment building. The frequency of steam generator tube ruptures can be significantly reduced through appropriate and timely inspections and repairs or removal from service.

  14. Vascular anatomy of the stomach related to gastric tube construction.

    Science.gov (United States)

    Buunen, M; Rooijens, P P G M; Smaal, H J; Kleinrensink, G J; van der Harst, E; Tilanus, H W; Lange, J F

    2008-01-01

    In view of constructing a gastric tube after esophagus resection, the vascular anatomy of the greater curvature of the stomach, especially the connection between the left and right gastro-epiploic arteries, was investigated. The vascular anatomy was studied in 20 embalmed human specimens. After dissection a gastric tube of 4 cm wide was constructed, using the greater gastric curvature. Various lengths of the arterial arcades were measured. In 70% an anastomosis between the right and left gastro-epiploic arteries was present. With the construction of an isoperistaltic gastric tube, in which the left gastro-epiploic artery is left in situ (ligating it at the splenic hilus), there is an 18.7% increase of length of arterial arcade along the gastric tube. Leaving the left gastro-epiploic artery in situ increases the feeding arterial arcaded-length along the gastric tube with 5.0 cm (19%).

  15. Field errors in hybrid insertion devices

    Energy Technology Data Exchange (ETDEWEB)

    Schlueter, R.D. [Lawrence Berkeley Lab., CA (United States)

    1995-02-01

    Hybrid magnet theory as applied to the error analyses used in the design of Advanced Light Source (ALS) insertion devices is reviewed. Sources of field errors in hybrid insertion devices are discussed.

  16. Hologram recording tubes

    Science.gov (United States)

    Rajchman, J. H.

    1973-01-01

    Optical memories allow extremely large numbers of bits to be stored and recalled in a matter of microseconds. Two recording tubes, similar to conventional image-converting tubes, but having a soft-glass surface on which hologram is recorded, do not degrade under repeated hologram read/write cycles.

  17. Abdominal Plain Film Before Gastrostomy Tube Placement to Predict Success of Percutaneous Endoscopic Procedure

    NARCIS (Netherlands)

    Pruijsen, J. M.; de Bruin, A.; Sekema, G.; Koetse, H. A.; van Rheenen, P. F.

    2013-01-01

    Objectives: Percutaneous endoscopic gastrostomy (PEG) tube feeding is a convenient method for children requiring long-term enteral nutrition. Preoperative fitness of the majority of pediatric PEG candidates is graded as American Society of Anesthesiologists physical status >= III, indicating increas

  18. 107-120, 2015 107 Thermal analysis of shell and tube heat ...

    African Journals Online (AJOL)

    Keywords: Shell and tube heat exchanger, feed forward, artificial neural network ... regression, simulated annealing, genetic algorithms and neural networks are ... in most engineering situation. ..... Selection, Rating, and Thermal Design, CRC.

  19. Molybdenum Tube Characterization report

    Energy Technology Data Exchange (ETDEWEB)

    Beaux II, Miles Frank [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Usov, Igor Olegovich [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2017-02-07

    Chemical vapor deposition (CVD) techniques have been utilized to produce free-standing molybdenum tubes with the end goal of nuclear fuel clad applications. In order to produce tubes with properties desirable for this application, deposition rates were lowered requiring long deposition durations on the order of 50 hours. Standard CVD methods as well as fluidized-bed CVD (FBCVD) methods were applied towards these objectives. Characterization of the tubes produced in this manner revealed material suitable for fuel clad applications, but lacking necessary uniformity across the length of the tubes. The production of freestanding Mo tubes that possess the desired properties across their entire length represents an engineering challenge that can be overcome in a next iteration of the deposition system.

  20. Categorising YouTube

    DEFF Research Database (Denmark)

    Simonsen, Thomas Mosebo

    2011-01-01

    This article provides a genre analytical approach to creating a typology of the User Generated Content (UGC) of YouTube. The article investigates the construction of navigation processes on the YouTube website. It suggests a pragmatic genre approach that is expanded through a focus on YouTube’s...... technological affordances. Through an analysis of the different pragmatic contexts of YouTube, it is argued that a taxonomic understanding of YouTube must be analysed in regards to the vacillation of a user-driven bottom-up folksonomy and a hierarchical browsing system that emphasises a culture of competition...... and which favours the already popular content of YouTube. With this taxonomic approach, the UGC videos are registered and analysed in terms of empirically based observations. The article identifies various UGC categories and their principal characteristics. Furthermore, general tendencies of the UGC within...

  1. Wavy tube heat pumping

    Energy Technology Data Exchange (ETDEWEB)

    Haldeman, C. W.

    1985-12-03

    A PVC conduit about 4'' in diameter and a little more than 40 feet long is adapted for being seated in a hole in the earth and surrounds a coaxial copper tube along its length that carries Freon between a heat pump and a distributor at the bottom. A number of wavy conducting tubes located between the central conducting tube and the wall of the conduit interconnect the distributor with a Freon distributor at the top arranged for connection to the heat pump. The wavy conducting tubing is made by passing straight soft copper tubing between a pair of like opposed meshing gears each having four convex points in space quadrature separated by four convex recesses with the radius of curvature of each point slightly less than that of each concave recess.

  2. Comparison of bougie-guided insertion of Proseal tm laryngeal mask airway with digital technique in adults

    Directory of Open Access Journals (Sweden)

    Anand Kuppusamy

    2010-01-01

    Full Text Available The Proseal TM laryngeal mask airway (PLMA TM , Laryngeal Mask Company, UK was designed to improve ventilatory characteristics and offer protection against regurgitation and gastric insufflation. The PLMA is a modified laryngeal mask airway with large ventral cuff, dorsal cuff and a drain tube. These modifications improve seal around glottis and enable better ventilatory characteristics. The drain tube prevents gastric distension and offers protection against aspiration. There were occasional problems, like failed insertion and inadequate ventilation, in placing PLMA TM using the classical digital technique. To overcome these problems, newer placement techniques like thumb insertion technique, introducer tool placement and gum elastic bougie (GEB-aided placement were devised. We compared classical digital placement of PLMA TM with gum elastic bougie-aided technique in 60 anaesthetised adult patients (with 30 patients in each group with respect to number of attempts to successful placement, effective airway time, airway trauma during insertion, postoperative airway morbidity and haemodynamic response to insertion. The number of attempts to successful placement, airway trauma during insertion and haemodynamic response to insertion were comparable among the two groups, while effective airway time and oropharyngeal leak pressure were significantly higher in bougie- guided insertion of PLMA. Postoperatively, sore throat was more frequent with digital technique while dysphagia was more frequent with bougie-guided technique. Hence gum elastic bougie guided, laryngoscope aided insertion of PLMA is an excellent alternate to classical digital technique.

  3. JT/LJT connector insert material evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Baca, J.R.F.

    1991-10-01

    Different insert (insulator) materials are undergoing evaluation to replace the Fiberite E-3938 BE96 material currently used. Also being evaluated is the reconfiguration of the insert and metal shell-edge geometries for the purpose of reducing the alleged interference principally responsible for insert damage.

  4. A styletted tracheal tube with a posterior-facing bevel reduces epistaxis during nasal intubation: a randomized trial.

    Science.gov (United States)

    Sugiyama, Kazuna; Manabe, Yozo; Kohjitani, Atsushi

    2014-05-01

    Epistaxis is a common complication of nasal intubation. Ease of insertion of the tracheal tube may be influenced by bevel orientation and tip bending. We examined ease of insertion and epistaxis with two tubes with different orientations and with or without a stylet to modify tip bending. Two hundred patients scheduled to undergo oral or maxillofacial surgery were randomized into four groups according to method of nasal intubation used after induction of anesthesia. In one group, a Portex(®) tracheal tube was inserted with bevel facing left (Portex Group). In the second group, a Parker Flex-Tip(®) tube (Parker Group) was inserted with the bevel facing posteriorly, and in the last two groups, a stylet bent at 60° anteriorly was used with the Portex tube (Stylet-Portex Group) or Parker tube (Stylet-Parker Group). When the tube advanced without resistance, insertion was defined as "smooth", and when resistance was encountered, insertion was defined as "impinged". Severity of epistaxis was evaluated as none, mild, moderate, or severe. Smooth insertion was observed in 60% of patients in the Portex Group; 80% in the Parker Group; 100% in the Stylet-Portex Group; and 100% in the Stylet-Parker Group. Epistaxis was found in 50%, 24%, 20%, and 4% of patients, respectively. The styletted tip (difference: 30%; 95% confidence interval [CI]: 20.3 to 38.5; P tube with a posterior-facing bevel improves ease of insertion through the nasopharynx and decreases the severity of epistaxis during nasal intubation. UMIN Clinical Trials Registry (UMIN-CTR), UMIN000011327.

  5. A Shocking Complication of a Pneumothorax: Chest Tube-Induced Arrhythmias and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Shaun Cardozo

    2014-01-01

    Full Text Available We describe a patient with a recent chest tube insertion leading to atrial fibrillation with rapid ventricular rate that led to multiple inappropriate internal cardiac defibrillator (ICD shocks. This is the first reported case of this occurring in a patient with an ICD leading to inappropriate shocks. Our elderly patient with emphysema presented with a spontaneous pneumothorax and developed rapid atrial fibrillation following emergency tube thoracostomy. The patient had a single lead ICD and received multiple inappropriate shocks for the rapid ventricular rate in the therapy zone. Although medical treatment helped stabilize the patient, resolution of the atrial fibrillation occurred only after the chest tube was removed. In a patient with a chest tube or other intrathoracic catheters, maintaining a high index of suspicion that chest tube insertions can cause secondary life threatening cardiovascular complications needs to be considered. In such patients, removal of the device proves to be the most prudent treatment action.

  6. What Are Neural Tube Defects?

    Science.gov (United States)

    ... NICHD Research Information Clinical Trials Resources and Publications Neural Tube Defects (NTDs): Condition Information Skip sharing on social media links Share this: Page Content What are neural tube defects? Neural (pronounced NOOR-uhl ) tube defects are ...

  7. [Nasogastric tube syndrome suspected at the end of anesthesia].

    Science.gov (United States)

    Ohshima, Misako; Hori, Etsuyo; Suzuki, Akira; Katoh, Hiromi; Itagaki, Taiga; Adachi, Yushi; Doi, Matsuyuki; Sato, Shigehito

    2010-04-01

    The case of a patient who might have developed nasogastric tube syndrome at the end of anesthesia is presented. A 62-year-old woman was scheduled for a general anesthesia with fiberscopic oro-tracheal intubation because of a predicted difficult airway. After the smooth and gentle intubation without any trauma and injury, a nasogastric tube was inserted blindly. At the end of surgery, the anesthesiologists observed the pharyngeal tissue and found significant edema on the epiglottis and arytenoids. Extubation was cancelled and the patient was moved to an intensive care unit for respiratory management. On the next day, fiberscopic observation revealed a complete recovery and the endotracheal tube was removed without any difficulty. We strongly suspected the pharyngeal injury as acute nasogastric tube syndrome and an attention to this rare complication is required by anesthesiologists.

  8. A Note regarding Problems with Interaction and Varying Block Sizes in a Comparison of Endotracheal Tubes

    Directory of Open Access Journals (Sweden)

    Richard L. Einsporn

    2014-01-01

    Full Text Available A randomized clinical experiment to compare two types of endotracheal tubes utilized a block design where each of the six participating anesthesiologists performed tube insertions for an equal number of patients for each type of tube. Five anesthesiologists intubated at least three patients with each tube type, but one anesthesiologist intubated only one patient per tube type. Overall, one type of tube outperformed the other on all three effectiveness measures. However, analysis of the data using an interaction model gave conflicting and misleading results, making the tube with the better performance appear to perform worse. This surprising result was caused by the undue influence of the data for the anesthesiologist who intubated only two patients. We therefore urge caution in interpreting results from interaction models with designs containing small blocks.

  9. Superconducting Quadrupole for the ISR high luminosity insertion assembly in its cryostat

    CERN Multimedia

    1979-01-01

    The picture shows the insertion of the quadrupole magnet active part with its thermal shield into the cryostat. Above the cylindrical part of the cryostat one sees the funnel containing the current leads and the helium feed and exhaust lines. Standing onthe left side is Pierre Pugin. See also 7704022, 7906592X, 7812211,7904252,7702690X.

  10. 蒸发器内置毛细管开孔系统强化换热的试验研究%Experimental Study on Heat Transfer Enhancement by Holes Opened in the Capillary Inserted in the Tube of the Evaporator

    Institute of Scientific and Technical Information of China (English)

    李鹏; 刘斌; 王清伟; 段爱鹏

    2016-01-01

    Based on the field synergy principle and enhancement of heat transfer characteristics of jet impingement,a new type heat ex-changer was designed.In this device,the capillary with opening holes was placed into the evaporation tube,making the refrigerant directly spray to the inner surface of the evaporation and absorb heat by evaporating,in which the heat transferring effi-ciency was extremely high because of the best coordination between velocity field and temperature gradient field.Theoretical anal-ysis of the capillary tube was taken to learn the coordination between velocity field and temperature gradient field with inlet veloci-ty (2m/s and 0.5m/s)and aperture (1mm and 0.5mm).Meanwhile experiments of the new type heat ex-changer were carried out under the evaporation pressure of 0 MPa,and compared with conventional capillary throttle system.The results shows the temperature field on the surface of the evaporation tube was more stable in the opening experiments,while there was a big fluctua-tion in contrast capillary experiment due to its poor ability of flow adjustment.With the same conditions of evaporation pressure and heat transfer area,the exhaust pressure in conventional capillary experiment was 13.6%higher than that of opening experi-ment,so the coefficient of performance and refrigerant charge amount are better than those of conventional capillary experiment. Meanwhile compressor power consumption in conventional capillary experiment was 9.1% higher than that of opening experiment, which verified the higher refrigerating efficiency of opening experiment.Due to the jet impingement of refrigerant and the best co-ordination between the flow field and temperature gradient field,the performance of heat ex-changer was dramatically improved, which made the temperature field on the surface of the evaporating tubes more uniform.%基于场协同强化理论,结合射流冲击的换热特点对常规毛细节流制冷系统进行优化,设计出一种新型的换

  11. Isolated Fallopian Tube Torsion

    Directory of Open Access Journals (Sweden)

    S. Kardakis

    2013-01-01

    Full Text Available Isolated torsion of the Fallopian tube is a rare gynecological cause of acute lower abdominal pain, and diagnosis is difficult. There are no pathognomonic symptoms; clinical, imaging, or laboratory findings. A preoperative ultrasound showing tubular adnexal masses of heterogeneous echogenicity with cystic component is often present. Diagnosis can rarely be made before operation, and laparoscopy is necessary to establish the diagnosis. Unfortunately, surgery often is performed too late for tube conservation. Isolated Fallopian tube torsion should be suspected in case of acute pelvic pain, and prompt intervention is necessary.

  12. Breastfeeding vs. Formula Feeding

    Science.gov (United States)

    ... 1- to 2-Year-Old Breastfeeding vs. Formula Feeding KidsHealth > For Parents > Breastfeeding vs. Formula Feeding Print ... a lactation specialist. previous continue All About Formula Feeding Commercially prepared infant formulas are a nutritious alternative ...

  13. Animal Feeding Operations

    Science.gov (United States)

    ... What's this? Submit Button Healthy Water Home Animal Feeding Operations Recommend on Facebook Tweet Share Compartir On ... Concentrated Animal Feeding Operations (CAFOs) What are Animal Feeding Operations (AFOs)? According to the United States Environmental ...

  14. Breastfeeding vs. Formula Feeding

    Science.gov (United States)

    ... A What's in this article? All About Breastfeeding Breastfeeding Challenges All About Formula Feeding Formula Feeding Challenges Making a Choice en español Lactancia materna versus lactancia artificial Choosing whether to breastfeed or formula feed their ...

  15. [Rare problem with the insertion of a Supreme™ laryngeal mask airway device. Case of the trimester].

    Science.gov (United States)

    2014-03-01

    A breast tumor was resected under general anesthesia. After induction, the airway was managed with a Supreme™ laryngeal mask airway device. The insertion of the laryngeal mask airway device, the insertion of the orogastric tube through the drain tube, as well as the mechanical ventilation, were very difficult from the beginning. On removing the laryngeal mask airway device to solve the problem, it was observed that the drain tube was broken, and the orogastric tube had passed into the anterior, laryngeal part of the device through the split. It was later found out that the laryngeal mask airway device, as well as the whole manufacturing batch, had suffered a design modification: the cuff was constructed with a softer material without reinforcement in the tip, and the drain tube had a heat-sealing defect that facilitated the break. The incident was reported to the local supplier and the manufacturer, and the defective batch of laryngeal mask airway devices was recalled. The incident was also reported to other hospitals via SENSAR, to warn other users of the potential dangers of the design modification in the Supreme™ laryngeal mask airway. Copyright © 2013 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Published by Elsevier España. All rights reserved.

  16. Assessing and predicting successful tube placement outcomes in ALS patients.

    Science.gov (United States)

    Beggs, Kathleen; Choi, Marcia; Travlos, Andrew

    2010-01-01

    This study reviews feeding tube placement outcomes in 69 ALS outpatients seen at an outpatient interdisciplinary ALS clinic in British Columbia, Canada. The objective was to determine at which point the risks outweigh the benefits of tube placement by reviewing outcomes against parameters of respiratory function, nutritional status and speech and swallowing deterioration. The study was a retrospective review of tube placements between January 2000 and 2005, analysing data on respiratory function (forced vital capacity and respiratory status), weight change from usual body weight (UBW) and speech/swallowing deterioration using ALS Severity Score ratings (Hillel et al., 1989) at time of tube placement. Results show a statistically significant association between nutritional status and successful tube placement outcomes (p=0.003), and none between respiratory status, speech/swallowing variables, or number of deteriorated variables in each patient. Study findings were impacted by lack of available respiratory data. The only study variable that predicted successful tube placement outcome was a body weight greater than or equal to 74% UBW at time of tube placement. In the absence of access to respiratory testing, the relatively simple assessment of weight may assist patients and caregivers in appropriate decisions around tube placement.

  17. Tube-Forming Assays.

    Science.gov (United States)

    Brown, Ryan M; Meah, Christopher J; Heath, Victoria L; Styles, Iain B; Bicknell, Roy

    2016-01-01

    Angiogenesis involves the generation of new blood vessels from the existing vasculature and is dependent on many growth factors and signaling events. In vivo angiogenesis is dynamic and complex, meaning assays are commonly utilized to explore specific targets for research into this area. Tube-forming assays offer an excellent overview of the molecular processes in angiogenesis. The Matrigel tube forming assay is a simple-to-implement but powerful tool for identifying biomolecules involved in angiogenesis. A detailed experimental protocol on the implementation of the assay is described in conjunction with an in-depth review of methods that can be applied to the analysis of the tube formation. In addition, an ImageJ plug-in is presented which allows automatic quantification of tube images reducing analysis times while removing user bias and subjectivity.

  18. Snorkeling and Jones tubes

    OpenAIRE

    Lam, Lewis Y. W.; Weatherhead, Robert G.

    2015-01-01

    We report a case of tympanic membrane rupture during snorkeling in a 17-year-old young man who had previously undergone bilateral Jones tubes placed for epiphora. To our knowledge, this phenomenon has not been previously reported.

  19. Snorkeling and Jones tubes.

    Science.gov (United States)

    Lam, Lewis Y W; Weatherhead, Robert G

    2015-01-01

    We report a case of tympanic membrane rupture during snorkeling in a 17-year-old young man who had previously undergone bilateral Jones tubes placed for epiphora. To our knowledge, this phenomenon has not been previously reported.

  20. Kinking of medical tubes.

    Science.gov (United States)

    Ingles, David

    2004-05-01

    The phenomenon of kinking in medical tubing remains a problem for some applications, particularly critical ones such as transporting gasses or fluids. Design features are described to prevent its occurrence.

  1. Magnesium tube hydroforming

    Energy Technology Data Exchange (ETDEWEB)

    Liewald, M.; Pop, R. [Institute for Metal Forming Technology (IFU), Stuttgart (Germany)

    2008-04-15

    Magnesium alloys reveal a good strength-to-weight ratio in the family of lightweight metals and gains potential to provide up to 30% mass savings compared to aluminium and up to 75 % compared to steel. The use of sheet magnesium alloys for auto body applications is however limited due to the relatively low formability at room temperature. Within the scope of this paper, extruded magnesium tubes, which are suitable for hydroforming applications, have been investigated. Results obtained at room temperature using magnesium AZ31 tubes show that circumferential strains are limited to a maximal value of 4%. In order to examine the influence of the forming temperature on tube formability, investigations have been carried out with a new die set for hot internal high pressure (IHP) forming at temperatures up to 400 C. Earlier investigations with magnesium AZ31 tubes have shown that fractures occur along the welding line at tubes extruded over a spider die, whereby a non-uniform expansion at bursting with an elongation value of 24% can be observed. A maximum circumferential strain of approx. 60% could be attained when seamless, mechanically pre-expanded and annealed tubes of the same alloy have been used. The effect of annealing time on materials forming properties shows a fine grained structure for sufficient annealing times as well as deterioration with a large increase at same time. Hence, seamless ZM21 tubes have been used in the current investigations. With these tubes, an increased tensile fracture strain of 116% at 350 C is observed as against 19% at 20 C, obtained by tensile testing of milled specimens from the extruded tubes. This behaviour is also seen under the condition of tool contact during the IHP forming process. To determine the maximum circumferential strain at different forming temperatures and strain rates, the tubes are initially bulged in a die with square cross-section under plane stress conditions. Thereafter, the tubes are calibrated by using an

  2. Treatment of Snoring with a Nasopharyngeal Airway Tube

    Science.gov (United States)

    Chang, Edward T.; Fernandez-Salvador, Camilo; Capasso, Robson

    2016-01-01

    Objective. To study the feasibility of a standard nasopharyngeal airway tube (NPAT) as treatment for snoring. Methods. An obese 35-year-old man, who is a chronic, heroic snorer, used NPATs while (1) the patient's bedpartner scored the snoring and (2) the patient recorded himself with the smartphone snoring app “Quit Snoring.” Baseline snoring was 8–10/10 (10 = snoring that could be heard through a closed door and interrupted the bedpartner's sleep to the point where they would sometimes have to sleep separately) and 60–200 snores/hr. Several standard NPATs were tested, consisting of soft polyvinyl chloride material raging between 24- and 36-French (Fr) tubes. Results. The 24 Fr tube did not abate snoring. The 26 Fr tube was able to abate the snoring sound most of the night (smartphone app: 11.4 snores/hr, bedpartner VAS = 2/10). The 28 and 30 Fr tubes abated the snoring sound the entire time worn (smartphone app: 0 snores, bedpartner VAS 0/10) but could not be tolerated more than 2.5 hours. The tube of 36 Fr size could not be inserted, despite several attempts bilaterally. Conclusion. Appropriately sized nasopharyngeal airway tubes may abate the snoring sound; however, as in this patient, they may be too painful and intolerable for daily use. PMID:27795710

  3. Treatment of Snoring with a Nasopharyngeal Airway Tube

    Directory of Open Access Journals (Sweden)

    Macario Camacho

    2016-01-01

    Full Text Available Objective. To study the feasibility of a standard nasopharyngeal airway tube (NPAT as treatment for snoring. Methods. An obese 35-year-old man, who is a chronic, heroic snorer, used NPATs while (1 the patient’s bedpartner scored the snoring and (2 the patient recorded himself with the smartphone snoring app “Quit Snoring.” Baseline snoring was 8–10/10 (10 = snoring that could be heard through a closed door and interrupted the bedpartner’s sleep to the point where they would sometimes have to sleep separately and 60–200 snores/hr. Several standard NPATs were tested, consisting of soft polyvinyl chloride material raging between 24- and 36-French (Fr tubes. Results. The 24 Fr tube did not abate snoring. The 26 Fr tube was able to abate the snoring sound most of the night (smartphone app: 11.4 snores/hr, bedpartner VAS = 2/10. The 28 and 30 Fr tubes abated the snoring sound the entire time worn (smartphone app: 0 snores, bedpartner VAS 0/10 but could not be tolerated more than 2.5 hours. The tube of 36 Fr size could not be inserted, despite several attempts bilaterally. Conclusion. Appropriately sized nasopharyngeal airway tubes may abate the snoring sound; however, as in this patient, they may be too painful and intolerable for daily use.

  4. Power vacuum tubes handbook

    CERN Document Server

    Whitaker, Jerry

    2012-01-01

    Providing examples of applications, Power Vacuum Tubes Handbook, Third Edition examines the underlying technology of each type of power vacuum tube device in common use today. The author presents basic principles, reports on new development efforts, and discusses implementation and maintenance considerations. Supporting mathematical equations and extensive technical illustrations and schematic diagrams help readers understand the material. Translate Principles into Specific Applications This one-stop reference is a hands-on guide for engineering personnel involved in the design, specification,

  5. Characterization of Friction Stir Welded Tubes by Means of Tube Bulge Test

    Science.gov (United States)

    D'Urso, G.; Longo, M.; Giardini, C.

    2011-05-01

    Mechanical properties of friction stir welded joints are generally evaluated by means of conventional tensile test. This testing method might provide insufficient information because maximum strain obtained in tensile test before necking is small; moreover, the application of tensile test is limited when the joint path is not linear or even when the welds are executed on curved surfaces. Therefore, in some cases, it would be preferable to obtain the joints properties from other testing methods. Tube bulge test can be a valid solution for testing circumferential or longitudinal welds executed on tubular workpieces. The present work investigates the mechanical properties and the formability of friction stir welded tubes by means of tube bulge tests. The experimental campaign was performed on tubular specimens having a thickness of 3 mm and an external diameter of 40 mm, obtained starting from two semi-tubes longitudinally friction stir welded. The first step, regarding the fabrication of tubes, was performed combining a conventional forming process and friction stir welding. Sheets in Al-Mg-Si-Cu alloy AA6060 T6 were adopted for this purpose. Plates having a dimension of 225×60 mm were bent (with a bending axis parallel to the main dimension) in order to obtain semi-tubes. A particular care was devoted to the fabrication of forming devices (punch and die) in order to minimize the springback effects. Semi-tubes were then friction stir welded by means of a CNC machine tool. Some preliminary tests were carried out by varying the welding parameters, namely feed rate and rotational speed. A very simple tool having flat shoulder and cylindrical pin was used. The second step of the research was based on testing the welded tubes by means of tube bulge test. A specific equipment having axial actuators with a conical shape was adopted for this study. Some analyses were carried out on the tubes bulged up to a certain pressure level. In particular, the burst pressure and the

  6. Note: An improved solenoid driver valve for miniature shock tubes.

    Science.gov (United States)

    Lynch, P T

    2016-05-01

    A solenoid driver valve has been built to improve the operating performance of diaphragmless shock tubes, which are used for high pressure, high temperature chemical kinetics, and fluid mechanics studies. For shock tube driver application, the most important characteristics are those of sealing, strength, and quality of the generated shock waves and repeatability of opening characteristics and therefore subsequent post-shock conditions. The main features of the new driver valve are a face o-ring sealing design of the valve, the large internal volume, and through inserts near the solenoid core: adjustable opening characteristics of the valve.

  7. Aeronautical tubes and pipes

    Science.gov (United States)

    Beauclair, N.

    1984-12-01

    The main and subcomponent French suppliers of aircraft tubes and pipes are discussed, and the state of the industry is analyzed. Quality control is essential for tubes with regard to their i.d. and metallurgical compositions. French regulations do not allow welded seam tubes in hydraulic circuits unless no other form is available, and then rustproofed steel must be installed. The actual low level of orders for any run of tubes dictates that the product is only one of several among the manufacturers' line. Automation, both in NDT and quality control, assures that the tubes meet specifications. A total of 10 French companies participate in the industry, serving both civil and military needs, with some companies specializing only in titanium, steel, or aluminum materials. Concerns wishing to enter the market must upgrade their equipment to meet the higher aeronautical specifications and be prepared to furnish tubes and pipes that serve both functional and structural purposes simultaneously. Additionally, pipe-bending machines must also perform to tight specifications. Pipes can range from 0.2 mm exterior diameter to 40 mm, with wall thicknesses from 0.02 mm to 3 mm. A chart containing a list of manufacturers and their respective specifications and characteristics is presented, and a downtrend in production with reduction of personnel is noted.

  8. A gas laser tube

    Energy Technology Data Exchange (ETDEWEB)

    Tetsuo, F.; Tokhikhide, N.

    1984-04-19

    A gas laser tube is described in which contamination of the laser gas mixture by the coolant is avoided, resulting in a longer service life of the mirrors. The holder contains two tubes, one inside the other. The laser gas mixture flows through the internal tube. An electrode is fastened to the holder. The coolant is pumped through the slot between the two tubes, for which a hole is cut into the holder. The external tube has a ring which serves to seal the cavity containing the coolant from the atmosphere. The internal tube has two rings, one to seal the laser gas mixture and the other to seal the coolant. A slot is located between these two rings, which leads to the atmosphere (the atmosphere layer). With this configuration, the degradation of the sealing properties of the internal ring caused by interaction with the atmospheric layer is not reflected in the purity of the laser gas mixture. Moreover, pollution of the mirrors caused by the penetration of the coolant into the cavity is eliminated.

  9. An improved automatic computer aided tube detection and labeling system on chest radiographs

    Science.gov (United States)

    Ramakrishna, Bharath; Brown, Matthew; Goldin, Jonathan; Cagnon, Christopher; Enzmann, Dieter

    2012-03-01

    Tubes like Endotracheal (ET) tube used to maintain patient's airway and the Nasogastric (NG) tube used to feed the patient and drain contents of the stomach are very commonly used in Intensive Care Units (ICU). The placement of these tubes is critical for their proper functioning and improper tube placement can even be fatal. Bedside chest radiographs are considered the quickest and safest method to check the placement of these tubes. Tertiary ICU's typically generate over 250 chest radiographs per day to confirm tube placement. This paper develops a new fully automatic prototype computer-aided detection (CAD) system for tube detection on bedside chest radiographs. The core of the CAD system is the randomized algorithm which selects tubes based on their average repeatability from seed points. The CAD algorithm is designed as a 5 stage process: Preprocessing (removing borders, histogram equalization, anisotropic filtering), Anatomy Segmentation (to identify neck, esophagus, abdomen ROI's), Seed Generation, Region Growing and Tube Selection. The preliminary evaluation was carried out on 64 cases. The prototype CAD system was able to detect ET tubes with a True Positive Rate of 0.93 and False Positive Rate of 0.02/image and NG tubes with a True Positive Rate of 0.84 and False Positive Rate of 0.02/image respectively. The results from the prototype system show that it is feasible to automatically detect both tubes on chest radiographs, with the potential to significantly speed the delivery of imaging services while maintaining high accuracy.

  10. Dynamic tube/support interaction in heat exchanger tubes

    Energy Technology Data Exchange (ETDEWEB)

    Chen, S.S.

    1991-01-01

    The supports for heat exchanger tubes are usually plates with drilled holes; other types of supports also have been used. To facilitate manufacture and to allow for thermal expansion of the tubes, small clearances are used between tubes and tube supports. The dynamics of tube/support interaction in heat exchangers is fairly complicated. Understanding tube dynamics and its effects is important for heat exchangers. This paper summarizes the current state of the art on this subject and to identify future research needs. Specifically, the following topics are discussed: dynamics of loosely supported tubes, tube/support gap dynamics, tube response in flow, tube damage and wear, design considerations, and future research needs. 55 refs., 1 fig.

  11. NEI You Tube Videos: Amblyopia

    Medline Plus

    Full Text Available ... search for current job openings visit HHS USAJobs Home > NEI YouTube Videos > NEI YouTube Videos: Amblyopia NEI YouTube Videos YouTube Videos Home Age-Related Macular Degeneration Amblyopia Animations Blindness Cataract ...

  12. Sequential cooling insert for turbine stator vane

    Energy Technology Data Exchange (ETDEWEB)

    Jones, Russel B

    2017-04-04

    A sequential flow cooling insert for a turbine stator vane of a small gas turbine engine, where the impingement cooling insert is formed as a single piece from a metal additive manufacturing process such as 3D metal printing, and where the insert includes a plurality of rows of radial extending impingement cooling air holes alternating with rows of radial extending return air holes on a pressure side wall, and where the insert includes a plurality of rows of chordwise extending second impingement cooling air holes on a suction side wall. The insert includes alternating rows of radial extending cooling air supply channels and return air channels that form a series of impingement cooling on the pressure side followed by the suction side of the insert.

  13. Impact of enteral nutrition through jejunal feeding tube during chemotherapy on the nutritional status and immunologic function of patients after total gastrectomy%胃癌术后辅助化疗期间肠内营养对患者免疫及营养状况的影响

    Institute of Scientific and Technical Information of China (English)

    孙元水; 钱振渊; 许晓东; 胡俊峰; 叶再元

    2012-01-01

    目的 观察胃癌全胃根治性切除术后辅助化疗期间肠内营养支持对患者免疫及营养状况的影响.方法 将2009年1月至2010年6月行全胃根治性切除加空肠造口术后给予辅助静脉化疗的86例胃癌患者按住院号尾号单双数分成肠内营养支持组(EN组)和对照组,每组各43例.EN组延期留置空肠造口管至6个化疗疗程结束,每个疗程经空肠造口管给予肠内营养支持7d.对照组于化疗前拔除空肠造口管,每个化疗疗程自由饮食,不予营养支持.检测两组第1次化疗前1d和第6次化疗结束后1d的营养及免疫指标.结果 EN组3例因导管堵塞或导管脱落、对照组2例因化疗副反应或经济原因未能完成研究,81例进入统计分析.第6次化疗结束后两组体重均有所下降,EN组体重下降百分比显著低于对照组(6.9%±0.95%比11.2%±1.32%,P=0.0000).与第1次化疗前比较,第6次化疗结束后两组预后营养指数(PNI)均下降,但EN组化疗前后差异无统计学意义(P=0.1534),对照组化疗后PNI显著低于化疗前(P=0.0000),且EN组化疗后PNI显著高于对照组(P =0.0040).第6次化疗结束后,EN组IgG、自然杀伤细胞、CD4+和CD4+/CD8+水平显著高于对照组(P=0.0083、P=0.0143、P=0.0000、P=0.0000).结论 术后辅助化疗期间给予肠内营养支持可改善全胃根治性切除胃癌患者的营养及免疫状况.由于病例数少,两组入量控制存在不可控制因素,需要更严格的进一步研究.%Objective To investigate the impact of enteral nutrition (EN) through jejunal feeding tube on the nutritional status and immunologic function of patients during chemotherapy after total gastrectomy.Methods Totally 86 patients with gastric cancer who had undergone total gastrectomy with radical resection and jejunostomy received adjuvant venous chemotherapy in our department from January 2009 to June 2010.They were divided into EN group ( n =43 ) and control group ( n =43

  14. Teleoperated master-slave needle insertion.

    Science.gov (United States)

    Abolhassani, Niki; Patel, Rajni V

    2009-12-01

    Accuracy of needle tip placement and needle tracking in soft tissue are of particular importance in many medical procedures. In recent years, developing autonomous and teleoperated systems for needle insertion has become an active area of research. In this study, needle insertion was performed using a master-slave set-up with multi-degrees of freedom. The effect of force feedback on the accuracy of needle insertion was investigated. In addition, this study compared autonomous, teleoperated and semi-autonomous needle insertion. The results of this study show that incorporation of force feedback can improve teleoperated needle insertion. However, autonomous and semi-autonomous needle insertions, which use feedback from a deflection model, provide significantly better performance. Development of a haptic master-slave needle insertion system, which is capable of performing some autonomous tasks based on feedback from tissue deformation and needle deflection models, can improve the performance of autonomous robotics-based insertions as well as non-autonomous teleoperated manual insertions. Copyright (c) 2009 John Wiley & Sons, Ltd.

  15. A HTS dipole insert coil constructed

    CERN Document Server

    Ballarino, A; Rey, J M; Stenvall, A; Sorbi, M; Tixador, P

    2013-01-01

    This report is the deliverable report 7.4.1 “A HTS dipole insert coil constructed“. The report has three parts: “Design report for the HTS dipole insert”, “One insert pancake prototype coil constructed with the setup for a high field test”, and “All insert components ordered”. The three report parts show that, although the insert construction will be only completed by end 2013, all elements are present for a successful completion and that, given the important investments done by the participants, there is a full commitment of all of them to finish the project

  16. Metallographic study of reconstitution welding in inserts of 1 cm{sup 3}; Estudio metalografico de soldaduras de reconstitucion en insertos de 1 cm{sup 3}

    Energy Technology Data Exchange (ETDEWEB)

    Romero C, J.; Garcia R, R.; Fernandez T, F.; Perez R, N.; Rocamontes A, M. [ININ, 52750 La Marquesa, Estado de Mexico (Mexico)

    2007-07-01

    In this article, the welding metallographic study carried out in Charpy test tubes reconstituted with notch in 'V', used in the surveillance programs of the vessel in nucleo electric plants is described. Inserts of 1 cm{sup 3} are used, where the inserts are usually rectangular of minimum 18 millimeters of length. The importance of using inserts of 1 cm{sup 3} is that the mechanical properties can be measured in another direction of the vessel steel, when changing the direction or sense of the notch in 'V' or the face where this notch is made in the insert. (Author)

  17. Review on Tube Hydroforming Process with Considerable Parametric Effect

    Directory of Open Access Journals (Sweden)

    Vijay. R. Parekh

    2012-06-01

    Full Text Available In this paper, an overall review of the different parameter affecting on tube hydroforming process is presented so that other researchers can concentrate on same to further critical investigations in this area. Tube hydro forming is one of the most acceptable unconventional metal forming processes which is widely used to form various tubular components. In this process, tubes are formed into different shapes using internal pressure and axial compressive loads simultaneously to force a tubular blank to conform the shape of a given die cavity. The main process parameters in hydroforming are the inner pressure and the material feeding, where a correct combination of these parameters is crucial for the success of the process. Finite Element simulations are powerful tools for estimating the process parameters in an automated procedure. Hyper works is software which is having applicability to simulate the appropriate section of the tube profile for in depth parametric analysis.

  18. Acute pancreatitis and cholangitis: A complication caused by a migrated gastrostomy tube

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Percutaneous endoscopic gastrostomy (PEG) is generally considered safe with a low rate of serious complications. However, dislocation of the PEG-tube into the duodenum can lead to serious complications.An 86-year old Japanese woman with PEG-tube feeding sometimes vomited after her family doctor replaced the PEG-tube without radiologic confirmation. At her hospitalization, she complained of severe tenderness at the epigastric region and the PEG-tube was drawn into the stomach. Imaging studies showed that the tip of PEG-tube with the inflated balloon was migrated into the second portion of the duodenum, suggesting that it might have obstructed the bile and pancreatic ducts,inducing cholangitis and pancreatitis. After the PEG-tube was replaced at the appropriate position, vomiting and abdominal tenderness improved dramatically and laboratory studies became normal immediately. Our case suggests that it is important to secure PEG-tube at the level of skin, especially after replacement.

  19. 三腔鼻空肠喂养管护理对全胃切除术患者营养恢复的影响%Observation on the Efficacy of Three Cavity Nasal Jejunal Feeding Tube Nursing for the Recov-ery of Nutrition Status in Patients with Total Gastrectomy

    Institute of Scientific and Technical Information of China (English)

    王小斌

    2014-01-01

    【目的】探讨三腔鼻空肠喂养管护理(TCNJ-FTN)对全胃切除术患者营养的恢复情况。【方法】选择因胃癌实施全胃切除术患者86例,其中留置普通胃管并进行常规护理的患者43例作为对照组,实施T C-NJ-FTN护理措施的患者43例作为观察组。对比两组术后的恢复情况、伤口愈合时间、住院时间及两组护理满意情况。【结果】观察组在术后的恢复情况显著优于对照组,其差异有统计学意义( P <0.05);观察组的平均伤口愈合时间、平均住院时间均显著少于对照组,其差异均有统计学意义( P <0.05);观察组的护理满意率显著高于对照组,其差异均有统计学意义( P <0.05)。【结论】对于全胃切除术的患者实施 TCNJ-FTN治疗及护理,能促进患者康复,并增加护理满意度,值得临床推广。%[Objective]To explore the efficacy of three cavity nasal jejunal feeding tube nursing (TCNJ-FTN) for the recovery of nutrition status in patients with total gastrectomy .[Methods]A total of 86 patients with total gastrectomy were chosen .Among them ,43 patients treated with indwelling stomach tube and rou-tine care were selected as control group ,and 43 patients treated with TCNJ-FTN were selected as observation group .The recovery status after operation ,wound healing time ,hospitalization time and nursing satisfaction were compared between two groups .[Results] The postoperative recovery in observation group was markedly better than the control group ,and there was significant difference ( P < 0 .05) .The average wound healing time and hospitalization time of observation group were markedly less than those of control group ,and there was significant difference( P<0 .05) .Nursing satisfaction rate of observation group was markedly higher than that of control group ,and there was significant difference( P <0 .05) .[Conclusion] For patients with total gastrectomy ,TCNJ

  20. Effect of tube size on electromagnetic tube bulging

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    The commercial finite code ANSYS was employed for the simulation of the electromagnetic tube bulging process. The finite element model and boundary conditions were thoroughly discussed. ANSYS/EMAG was used to model the time varying electromagnetic field in order to obtain the radial and axial magnetic pressure acting on the tube. The magnetic pressure was then used as boundary conditions to model the high velocity deformation of various length tube with ANSYS/LSDYNA. The time space distribution of magnetic pressure on various length tubes was presented. Effect of tube size on the distribution of radial magnetic pressure and axial magnetic pressure and high velocity deformation were discussed. According to the radial magnetic pressure ratio of tube end to tube center and corresponding dimensionless length ratio of tube to coil, the free electromagnetic tube bulging was studied in classification. The calculated results show good agreements with practice.

  1. Categorising YouTube

    Directory of Open Access Journals (Sweden)

    Thomas Mosebo Simonsen

    2011-09-01

    Full Text Available This article provides a genre analytical approach to creating a typology of the User Generated Content (UGC of YouTube. The article investigates the construction of navigationprocesses on the YouTube website. It suggests a pragmatic genre approach that is expanded through a focus on YouTube’s technological affordances. Through an analysis of the different pragmatic contexts of YouTube, it is argued that a taxonomic understanding of YouTube must be analysed in regards to the vacillation of a user-driven bottom-up folksonomy and a hierarchical browsing system that emphasises a culture of competition and which favours the already popular content of YouTube. With this taxonomic approach, the UGC videos are registered and analysed in terms of empirically based observations. The article identifies various UGC categories and their principal characteristics. Furthermore, general tendencies of the UGC within the interacting relationship of new and old genres are discussed. It is argued that the utility of a conventional categorical system is primarily of analytical and theoretical interest rather than as a practical instrument.

  2. The impact of a chest tube management protocol on the outcome of trauma patients with tube thoracostomy.

    Science.gov (United States)

    de Abreu, Emanuelle Maria Sávio; Machado, Carla Jorge; Pastore Neto, Mario; de Rezende Neto, João Baptista; Sanches, Marcelo Dias

    2015-01-01

    to investigate the effect of standardized interventions in the management of tube thoracostomy patients and to assess the independent effect of each intervention. A chest tube management protocol was assessed in a retrospective cohort study. The tube thoracostomy protocol (TTP) was implemented in August 2012, and consisted of: antimicrobial prophylaxis, chest tube insertion in the operating room (OR), admission post chest tube thoracostomy (CTT) in a hospital floor separate from the emergency department (ED), and daily respiratory therapy (RT) sessions post-CTT. The inclusion criteria were, hemodynamic stability, patients between the ages of 15 and 59 years, and injury severity score (ISS) < 17. All patients had isolated injuries to the chest wall, lung, and pleura. During the study period 92 patients were managed according to the standardized protocol. The outcomes of those patients were compared to 99 patients treated before the TTP. Multivariate logistic regression analysis was performed to assess the independent effect of each variable of the protocol on selected outcomes. Demographics, injury severity, and trauma mechanisms were similar among the groups. As expected, protocol compliance increased after the implementation of the TTP. There was a significant reduction (p<0.05) in the incidence of retained hemothoraces, empyemas, pneumonias, surgical site infections, post-procedural complications, hospital length of stay, and number of chest tube days. Respiratory therapy was independently linked to significant reduction (p<0.05) in the incidence of seven out of eight undesired outcomes after CTT. Antimicrobial prophylaxis was linked to a significant decrease (p<0.05) in retained hemothoraces, despite no significant (p<0.10) reductions in empyema and surgical site infections. Conversely, OR chest tube insertion was associated with significant (p<0.05) reduction of both complications, and also significantly decreased the incidence of pneumonias. Implementation of

  3. [A case of subglottic stenosis with bridging granuloma after intubation with double-lumen endotracheal tube].

    Science.gov (United States)

    Ito, Yosuke; Nakata, Yoko; Nakamura, Sakiko; Nagaya, Kei

    2013-08-01

    We present a case of subglottic stenosis with rare bridging granuloma after intubation with double-lumen endotracheal tube. An 81-year-old woman was diagnosed with the lung tumor and scheduled for the thoracoscopic surgery. We induced anesthesia with propofol, remifentanil and rocuronium. A 35 Fr double-lumen intratracheal tube was inserted to the trachea with some resistance, when the tube passed through the glottis. A few days later, she suffered from respiratory discomfort. An otolaryngologist examined her larynx and subglottis. Laryngoscopic examination revealed bridging granuloma leading to tracheal stenosis. Tracheostomy and resection of granuloma were performed, and her symptom improved. If we feel resistance in intubating a double-lumen endotracheal tube in a patient with a history of intubation with a tracheal tube, we should operate gently adjusting the size of the tracheal tube.

  4. Complications of tube thoracostomy using Advanced Trauma Life Support technique in chest trauma.

    Science.gov (United States)

    Iribhogbe, P E; Uwuigbe, O

    2011-01-01

    Tube thoracostomy (TT) is central in the management of chest trauma sufficing in over 80% of cases. As a result the procedure is commonly performed in most emergency departments. The aim of this study was to assess the efficacy and complications of TT using Advanced Trauma Life Support (ATLS) technique in chest trauma. This prospective study was done at the Trauma Unit of the University of Benin Teaching Hospital in Nigeria. All patients with chest trauma who needed tube thoracostomy between February 2006 and February 2009 were studied. Data recorded for each patient included injury, mechanism of injury, Glasgow Coma score, revised trauma score, and indications for tube thoracostomy. Chest radiographs were obtained preinsertion, post insertion and post extubation for all the cases. Patients were monitored for tube thoracostomy complications. Of 9415 trauma patients seen during the period 105 patients had tube thoracostomy but only 70 (56 male, 14 female) had adequate data for analysis. Seventy-four tubes were passed in the 70 patients with unilateral tubes in 66 (94.3%) and bilateral tubes in 4 (5.7%). Blunt chest trauma occurred in 32 (45.7%) and penetrating chest trauma in 38 (54.3%) of the patients. Simple haemothorax and haemopneumothorax were the commonest indications for tube thoracostomy. Complications recorded include four cases of kinked tubes, four of superficial wound infection and 10 cases of residual haemothorax. Tube thoracostomy in the emergency department using advanced trauma life support principles is effective in chest trauma and associated with few complications.

  5. Gastrostomía Endoscópica Percutánea: 7 años de experiencia en nutrición enteral a largo plazo. Seguimiento clínico Percutaneous endoscopic gastrostomy: A 7 years experience long-term tube feeding. Follow-up

    Directory of Open Access Journals (Sweden)

    P. Rodríguez Ortega

    2011-04-01

    Full Text Available La Gastrostomía Endoscópica Percutánea (PEG es el método de elección para la alimentación enteral a largo plazo, cuando el tubo digestivo está indemne, y la supervivencia de los pacientes es superior a 2 meses. Son cada vez más, las series comunicadas e indicaciones, a pesar de ser una técnica segura, debemos tener en cuenta una adecuada selección de los pacientes. El propósito de este trabajo es analizar el seguimiento de los pacientes sometidos a Gastrostomía Endoscópica Percutánea (PEG, en un Hospital de gran nivel asistencial y uno de los referentes de Trasplante de órganos en nuestra comunidad, con las peculiaridades que esto tiene en nuestra serie. Analizamos una cohorte de 73 pacientes sometidos a PEG, durante los años 2000 a 2007 en el Hospital Reina Sofía de Córdoba. Las Enfermedades Neurológicas y Neoplásicas de la esfera ORL y Digestiva alta son las causas más frecuentes, con resultados similares a los publicados en otras series. Destacamos, el número de paciente jóvenes con Fibrosis Quística (FQ, en nuestra serie, con soporte nutricional a través de PEG complementaria a la alimentación oral y nocturna, lo cual, ha supuesto una mejora de los parámetros nutricionales de cara al trasplante pulmonar. En consecuencia, analizamos las características de los pacientes, las implicaciones éticas y morales de algunos de ellos, como son los enfermos neurológicos, sus complicaciones y mortalidad. Destacamos con interés, la indicación transitoria y bien tolerada en un subgrupo de pacientes con FQ, que en nuestra serie merece especial mención.Percutaneous endoscopic gastrostomy (PEG is the first choice method for long-term enteral feeding when the digestive tube is undamaged and the patients' survival is longer than 2 months. There are increasing series and indications reported and although it is a safe technique we should take into account an appropriate patient selection. The aim of this work was to analyze the

  6. Tracheostomy tubes and related appliances.

    Science.gov (United States)

    Hess, Dean R

    2005-04-01

    Tracheostomy tubes are used to administer positive-pressure ventilation, to provide a patent airway, to provide protection from aspiration, and to provide access to the lower respiratory tract for airway clearance. They are available in a variety of sizes and styles, from several manufacturers. The dimensions of tracheostomy tubes are given by their inner diameter, outer diameter, length, and curvature. Differences in length between tubes of the same inner diameter, but from different manufacturers, are not commonly appreciated but may have important clinical implications. Tracheostomy tubes can be angled or curved, a feature that can be used to improve the fit of the tube in the trachea. Extra proximal length tubes facilitate placement in patients with large necks, and extra distal length tubes facilitate placement in patients with tracheal anomalies. Several tube designs have a spiral wire reinforced flexible design and have an adjustable flange design to allow bedside adjustments to meet extra-length tracheostomy tube needs. Tracheostomy tubes can be cuffed or uncuffed. Cuffs on tracheostomy tubes include high-volume low-pressure cuffs, tight-to-shaft cuffs, and foam cuffs. The fenestrated tracheostomy tube has an opening in the posterior portion of the tube, above the cuff, which allows the patient to breathe through the upper airway when the inner cannula is removed. Tracheostomy tubes with an inner cannula are called dual-cannula tracheostomy tubes. Several tracheostomy tubes are designed specifically for use with the percutaneous tracheostomy procedure. Others are designed with a port above the cuff that allows for subglottic aspiration of secretions. The tracheostomy button is used for stoma maintenance. It is important for clinicians caring for patients with a tracheostomy tube to understand the nuances of various tracheostomy tube designs and to select a tube that appropriately fits the patient.

  7. Multipurpose Transposon-Insertion Libraries in Yeast.

    Science.gov (United States)

    Kumar, Anuj

    2016-06-01

    Libraries of transposon-insertion alleles constitute powerful and versatile tools for large-scale analysis of yeast gene function. Transposon-insertion libraries are constructed most simply through mutagenesis of a plasmid-based genomic DNA library; modification of the mutagenizing transposon by incorporation of yeast selectable markers, recombination sites, and an epitope tag enables the application of insertion alleles for phenotypic screening and protein localization. In particular, yeast genomic DNA libraries have been mutagenized with modified bacterial transposons carrying the URA3 marker, lox recombination sites, and sequence encoding multiple copies of the hemagglutinin (HA) epitope. Mutagenesis with these transposons has yielded a large resource of insertion alleles affecting nearly 4000 yeast genes in total. Through well-established protocols, these insertion libraries can be introduced into the desired strain backgrounds and the resulting insertional mutants can be screened or systematically analyzed. Relative to alternative methods of UV irradiation or chemical mutagenesis, transposon-insertion alleles can be easily identified by PCR-based approaches or high-throughput sequencing. Transposon-insertion libraries also provide a cost-effective alternative to targeted deletion approaches, although, in contrast to start-codon to stop-codon deletions, insertion alleles might not represent true null-mutants. For protein-localization studies, transposon-insertion alleles can provide encoded epitope tags in-frame with internal codons; in many cases, these transposon-encoded epitope tags can provide a more accurate localization for proteins in which terminal sequences are crucial for intracellular targeting. Thus, overall, transposon-insertion libraries can be used quickly and economically and have a particular utility in screening for desired phenotypes and localization patterns in nonstandard genetic backgrounds.

  8. Performance of cryogenically treated CBN inserts on difficult to cut materials during turning

    Directory of Open Access Journals (Sweden)

    S. Thamizhmanii

    2012-12-01

    Full Text Available Machining of materials is recognized as removing unwanted materials by using different cutting inserts. In this research, cutting inserts used are CBN inserts and treated cryogenically at -196°C in liquid nitrogen chamber. The inserts are subjected to 30 hours of treatment in controlled atmosphere. The materials used are Titanium and AISI 440 C hard Martensitic Stainless steel. The cutting parameters are cutting velocity 30, 40 and 50 m/min with feed rate of 0.05, 0.10 and 0.15 mm/rev and depth of cut of 0.05, 0.75 and 1.00 mm. The performance evaluated was tool wear, surface roughness. Cryogenically treated CBN inserts produced less tool wear on titanium than AISI 440 C Martensitic stainless steel. The roughness produced was low at high cutting speed with low feed rate. Flank wear was not progressive and varied. In turning AISI 440 C stainless steel, built up edge formed in all cutting speed which is a common phenomena and lead to crater wear formation. The chips produced were saw tooth chips by both materials.

  9. 不同鼻饲方法对机械通气长期肠内营养老年患者误吸的影响%Effects of four different nasal feeding methods on aspiration in elderly patients receiving long-term enteral nutrition with mechanical ventilation

    Institute of Scientific and Technical Information of China (English)

    吴小梅; 王微; 奚艳; 王璐璐

    2012-01-01

    Objective To investigate the effects of four different nasal feeding methods on aspiration in elderly patients receiving long-term enteral nutrition with mechanical ventilation. Methods Twenty five elderly patients receiving mechanical ventilation were fed for long-term enteral nutrition with 4 nasogastric feeding methods as follows: 1) The patient took semi-recumbent position, with the nasogastric tube inserted at the distance from the earlobe, across the tip of nose and to ensiform cartilage plus 10cm and the feeding speed of 15 mlVmin; 2) The patient took supine position, with the nasogastric tube inserted at the same length and the same feeding speed as in the first method; 3) The patients took decumbent position, with the nasogastric tube inserted at the same length and the same feeding speed as in the first method; 4) The patients took the decumbent position, with the nasogastric tube inserted at the same length as in the first method but with the feeding speed of 25 Ml/min. Results The differences in aspiration rates among the four methods were statistically significant (P < 0.01). The aspiration rate in the first group was the lowest (P < 0.01) compared with other three methods. Conclusions The method of feeding the elderly patients at semi-recumbent position with feeding speed of 10 ~ 15 Ml/min may be meaningful for preventing aspiration in mechanically ventilated elderly patients receiving long-term enteral nutrition.%目的 探讨采用4种鼻饲方法对机械通气长期肠内营养老年患者误吸的影响.方法 对25例机械通气长期肠内营养老年患者分别采用4种鼻饲方法:①方法1:半坐卧位,置管长度从耳垂→鼻尖→剑突的距离延长10 cm,推注速度为15 mL/min;②方法2:仰卧位,置管长度和推注速度同方法1;③方法3:置管长度从耳垂→鼻尖→剑突的距离,卧位和推注速度同方法1;④方法4:卧位和置管长度同方法1,推注速度为25 mL/min.观察采用4种方法患

  10. Replacement Gastrostomy Tube Causing Acute Pancreatitis: Case Series with Review of Literature

    Directory of Open Access Journals (Sweden)

    Anish M Shah

    2012-01-01

    Full Text Available Context Percutaneous endoscopic gastrostomy (PEG feedings are generally considered safe with few serious complications. Acute pancreatitis is a rare complication associated with replacement percutaneous endoscopic gastrostomy tubes. Case report We report two cases of acute pancreatitis induced by migrated replacement percutaneous endoscopic gastrostomy tubes. Conclusions Migration of a balloon into the duodenum can result in external manipulation of the ampulla of Vater thereby disturbing the flow of pancreatic secretions leading to acute pancreatitis. Recognition of this complication is important and should be included as potential etiology of acute pancreatitis in patients receiving percutaneous endoscopic gastrostomy feedings. Periodic examination and documentation of the distance of the balloon from the skin should be performed to document the position of the tubes or any inadvertent migration of the tubes. The use of Foley catheters as permanent replacement tubes should be considered medically inappropriate.

  11. HOW TO REDUCE NEEDLE INSERTION INDUCED PAIN

    Institute of Scientific and Technical Information of China (English)

    王斌; 董莉

    2001-01-01

    Acupuncture needle insertion always results in pain in the local area due to stimulating the free nerve endings—algesireceptors of the skin. In spite of mildness, this pain may induce many patients' fright, and thus, hinders more extensive application of acupuncture. In the present paper, the author introduces some methods for reducing needle insertion induced pain.

  12. Marginal adaptation of ceramic inserts after cementation

    NARCIS (Netherlands)

    Ozcan, M; Pfeiffer, P; Nergiz, [No Value

    2002-01-01

    The advantage of using ceramic inserts is to prevent major drawbacks of composite resins such as polymerization shrinkage, wear and microleakage. This in vitro study evaluated the marginal adaptation of two approximal ceramic insert systems after cementation to the cavities opened with ultrasonic ti

  13. An Elementary Account of Needle Insertion

    Institute of Scientific and Technical Information of China (English)

    张文兵; 霍则军

    2004-01-01

    @@ Based on the authors' clinical and personal experiences, several pain-inducing factors easily to be ignored by the operators when quick needle insertion is applied, and the authors' first invented slow painless needle insertion method are introduced in the article.

  14. Polymerization shrinkage and contraction force of composite resin restorative inserted with "Megafiller".

    Science.gov (United States)

    Tani, Y; Nambu, T; Ishikawa, A; Katsuyama, S

    1993-12-01

    This study quantified the contraction force and polymerization shrinkage of composite resins with/without beta-Quartz Glass Ceramic Inserts (BQCI) as "Megafiller". The materials used for the determination included a chemically cured composite and five light-cured composites. The system for measuring contraction force consisted of a transparent teflon tube for preparing the specimen, a small load cell, a dynamic strain gauge and a pen-recorder. After the composite was packed into the teflon mold, a BQCI (Type R3) was inserted through the opening and the specimen was cured. Linear polymerization shrinkage of the composites was measured every 10 seconds from the start of mixing or irradiation to 90 minutes by the mercury bath method. Three pieces each of BQCI (Type T3) were inserted in each specimen. The results suggested that BQCI was markedly effective in reducing polymerization shrinkage, but was not always effective in reducing the contraction force during polymerization.

  15. Methods for batch fabrication of cold cathode vacuum switch tubes

    Energy Technology Data Exchange (ETDEWEB)

    Walker, Charles A. (Albuquerque, NM); Trowbridge, Frank R. (Albuquerque, NM)

    2011-05-10

    Methods are disclosed for batch fabrication of vacuum switch tubes that reduce manufacturing costs and improve tube to tube uniformity. The disclosed methods comprise creating a stacked assembly of layers containing a plurality of adjacently spaced switch tube sub-assemblies aligned and registered through common layers. The layers include trigger electrode layer, cathode layer including a metallic support/contact with graphite cathode inserts, trigger probe sub-assembly layer, ceramic (e.g. tube body) insulator layer, and metallic anode sub-assembly layer. Braze alloy layers are incorporated into the stacked assembly of layers, and can include active metal braze alloys or direct braze alloys, to eliminate costs associated with traditional metallization of the ceramic insulator layers. The entire stacked assembly is then heated to braze/join/bond the stack-up into a cohesive body, after which individual switch tubes are singulated by methods such as sawing. The inventive methods provide for simultaneously fabricating a plurality of devices as opposed to traditional methods that rely on skilled craftsman to essentially hand build individual devices.

  16. Enhancement of acoustical performance of hollow tube sound absorber

    Science.gov (United States)

    Putra, Azma; Khair, Fazlin Abd; Nor, Mohd Jailani Mohd

    2016-03-01

    This paper presents acoustical performance of hollow structures utilizing the recycled lollipop sticks as acoustic absorbers. The hollow cross section of the structures is arranged facing the sound incidence. The effects of different length of the sticks and air gap on the acoustical performance are studied. The absorption coefficient was measured using impedance tube method. Here it is found that improvement on the sound absorption performance is achieved by introducing natural kapok fiber inserted into the void between the hollow structures. Results reveal that by inserting the kapok fibers, both the absorption bandwidth and the absorption coefficient increase. For test sample backed by a rigid surface, best performance of sound absorption is obtained for fibers inserted at the front and back sides of the absorber. And for the case of test sample with air gap, this is achieved for fibers introduced only at the back side of the absorber.

  17. Enhancement of acoustical performance of hollow tube sound absorber

    Energy Technology Data Exchange (ETDEWEB)

    Putra, Azma, E-mail: azma.putra@utem.edu.my; Khair, Fazlin Abd, E-mail: fazlinabdkhair@student.utem.edu.my; Nor, Mohd Jailani Mohd, E-mail: jai@utem.edu.my [Centre for Advanced Research on Energy, Universiti Teknikal Malaysia Melaka, Hang Tuah Jaya, Durian Tunggal Melaka 76100 Malaysia (Malaysia)

    2016-03-29

    This paper presents acoustical performance of hollow structures utilizing the recycled lollipop sticks as acoustic absorbers. The hollow cross section of the structures is arranged facing the sound incidence. The effects of different length of the sticks and air gap on the acoustical performance are studied. The absorption coefficient was measured using impedance tube method. Here it is found that improvement on the sound absorption performance is achieved by introducing natural kapok fiber inserted into the void between the hollow structures. Results reveal that by inserting the kapok fibers, both the absorption bandwidth and the absorption coefficient increase. For test sample backed by a rigid surface, best performance of sound absorption is obtained for fibers inserted at the front and back sides of the absorber. And for the case of test sample with air gap, this is achieved for fibers introduced only at the back side of the absorber.

  18. Heat transfer augmentation in a circular tube with winglet vortex generators☆

    Institute of Scientific and Technical Information of China (English)

    Suriya Chokphoemphun; Monsak Pimsarn; Chinaruk Thianpong; Pongjet Promvonge

    2015-01-01

    The article presents the influence of winglet vortex generators (WVGs) placed in the core flow area on ther-mal performance enhancement of a tube heat exchanger. The experiment was carried out in a uniform wall heat-fluxed tube by varying turbulent alrflow for Reynolds number ranging from 5300 to 24000. In the pres-ent work, the WVGs with an attack angle of 30° were inserted into the test tube at four different winglet pitch ratios (RP=P/D) and three winglet-width or blockage ratios (RB=e/D). The experimental results at various RP and RB values were evaluated and compared with those for smooth tube and tubes with twist-ed tape or wire coil. The measurement reveals that the WVGs enhance considerably the heat transfer and friction loss above the plaln tube, wire coil and twisted tape. The Nusselt number and friction factor increase with the increment of RB and Re but with the decreasing RP. The average Nusselt numbers for the WVGs with various RB are in the range of 2.03–2.34 times above the plaln tube. The thermal performance for the WVGs is found to be much higher than that for the wire coil and twisted tape and is in a range of 1.35–1.59. Also, a numerical investigation is conducted to study the flow structure and heat transfer enhancement mecha-nisms in the winglet-inserted tube.

  19. Intradermal normal saline solution, self-selected music, and insertion difficulty effects on intravenous insertion pain.

    Science.gov (United States)

    Jacobson, A F

    1999-01-01

    To examine the effect of listening to self-selected music versus an intradermal injection of normal saline solution on the intensity and distress of intravenous (IV) catheter insertion pain. Prospective, randomized, controlled study. Inpatient and outpatient units in 2 university-affiliated southwestern medical centers. One hundred ten adult inpatients and outpatients undergoing IV therapy. Pain intensity, pain distress, and IV insertion difficulty visual analog scales. Patients were randomly assigned to receive an intradermal injection of normal saline solution, listen with headphones to self-selected music, or be in a control group for IV insertion. A MANOVA revealed no statistically significant multivariate or univariate differences in pain by treatment group, but significantly higher pain distress scores with failed IV insertions. The pain intensity and distress scores were significantly higher in the saline solution group when compared with the music and control groups combined. Insertion difficulty was significantly positively correlated with pain intensity and distress for the entire sample, with weak, nonsignificant correlations in the music group. Intradermal unpreserved saline solution contributes to greater pain intensity and distress, greater insertion difficulty, and a higher failure rate than the use of music or routine IV insertion. Listening to preferred music attenuates the effect of insertion difficulty on IV insertion pain. Intravenous insertion attempts were unsuccessful in more than one third of the subjects, resulting in higher pain distress scores. Further research is needed on interventions to reduce IV insertion pain and on factors contributing to IV insertion failure.

  20. Long-distance effects of insertional mutagenesis.

    Directory of Open Access Journals (Sweden)

    Ruchi Singhal

    Full Text Available BACKGROUND: Most common systems of genetic engineering of mammalian cells are associated with insertional mutagenesis of the modified cells. Insertional mutagenesis is also a popular approach to generate random alterations for gene discovery projects. A better understanding of the interaction of the structural elements within an insertional mutagen and the ability of such elements to influence host genes at various distances away from the insertion site is a matter of considerable practical importance. METHODOLOGY/PRINCIPAL FINDINGS: We observed that, in the context of a lentiviral construct, a transcript, which is initiated at an internal CMV promoter/enhancer region and incorporates a splice donor site, is able to extend past a collinear viral LTR and trap exons of host genes, while the polyadenylation signal, which is naturally present in the LTR, is spliced out. Unexpectedly, when a vector, which utilizes this phenomenon, was used to produce mutants with elevated activity of NF-κB, we found mutants, which owed their phenotype to the effect of the insert on a gene located tens or even hundreds of kilobases away from the insertion site. This effect did not result from a CMV-driven transcript, but was sensitive to functional suppression of the insert. Interestingly, despite the long-distance effect, expression of loci most closely positioned to the insert appeared unaffected. CONCLUSIONS/SIGNIFICANCE: We concluded that a polyadenylation signal in a retroviral LTR, when occurring within an intron, is an inefficient barrier against the formation of a hybrid transcript, and that a vector containing a strong enhancer may selectively affect the function of genes far away from its insertion site. These phenomena have to be considered when experimental or therapeutic transduction is performed. In particular, the long-distance effects of insertional mutagenesis bring into question the relevance of the lists of disease-associated retroviral integration

  1. Conservative management of migrated percutaneous endoscopic colostomy tube

    Science.gov (United States)

    Chase, Thomas J.G.; Luck, Joshua; Harris, Lauren S.; Bashir, Gareth

    2017-01-01

    A 68-year-old male nursing home resident presented following dislodgement of a percutaneous endoscopic colostomy (PEC) tube originally sited to prevent recurrent sigmoid volvulus. Computed tomography demonstrated tube migration into the lumen of the recto-sigmoid junction, where it remained for 12 days before passing spontaneously. During this period, the patient remained asymptomatic; the residual colocutaneous fistula functioned as a decompressive valve. Originally, the patient was due to be discharged with early flexible sigmoidoscopy follow-up. However, complex social issues delayed discharge. During his admission, a second PEC tube was successfully inserted next to the previous colostomy site without complication. This is an unusual case and no similar episodes of asymptomatic PEC migration have been reported. We demonstrate that such cases may be offered an appropriate trial of conservative management. Here, we describe our experience and critically appraise the literature. PMID:28064245

  2. Thoracostomy tubes: A comprehensive review of complications and related topics

    Science.gov (United States)

    Kwiatt, Michael; Tarbox, Abigail; Seamon, Mark J.; Swaroop, Mamta; Cipolla, James; Allen, Charles; Hallenbeck, Stacinoel; Davido, H. Tracy; Lindsey, David E.; Doraiswamy, Vijay A.; Galwankar, Sagar; Tulman, David; Latchana, Nicholas; Papadimos, Thomas J.; Cook, Charles H.; Stawicki, Stanislaw P.

    2014-01-01

    Tube thoracostomy (TT) placement belongs among the most commonly performed procedures. Despite many benefits of TT drainage, potential for significant morbidity and mortality exists. Abdominal or thoracic injury, fistula formation and vascular trauma are among the most serious, but more common complications such as recurrent pneumothorax, insertion site infection and nonfunctioning or malpositioned TT also represent a significant source of morbidity and treatment cost. Awareness of potential complications and familiarity with associated preventive, diagnostic and treatment strategies are fundamental to satisfactory patient outcomes. This review focuses on chest tube complications and related topics, with emphasis on prevention and problem-oriented approaches to diagnosis and treatment. The authors hope that this manuscript will serve as a valuable foundation for those who wish to become adept at the management of chest tubes. PMID:25024942

  3. Heat-shrink plastic tubing seals joints in glass tubing

    Science.gov (United States)

    Del Duca, B.; Downey, A.

    1968-01-01

    Small units of standard glass apparatus held together by short lengths of transparent heat-shrinkable polyolefin tubing. The tubing is shrunk over glass O-ring type connectors having O-rings but no lubricant.

  4. Central Solenoid Insert Technical Specification

    Energy Technology Data Exchange (ETDEWEB)

    Martovetsky, Nicolai N [ORNL; Smirnov, Alexandre [ORNL

    2011-09-01

    The US ITER Project Office (USIPO) is responsible for the ITER central solenoid (CS) contribution to the ITER project. The Central Solenoid Insert (CSI) project will allow ITER validation the appropriate lengths of the conductors to be used in the full-scale CS coils under relevant conditions. The ITER Program plans to build and test a CSI to verify the performance of the CS conductor. The CSI is a one-layer solenoid with an inner diameter of 1.48 m and a height of 4.45 m between electric terminal ends. The coil weight with the terminals is approximately 820 kg without insulation. The major goal of the CSI is to measure the temperature margin of the CS under the ITER direct current (DC) operating conditions, including determining sensitivity to load cycles. Performance of the joints, ramp rate sensitivity, and stability against thermal or electromagnetic disturbances, electrical insulation, losses, and instrumentation are addressed separately and therefore are not major goals in this project. However, losses and joint performance will be tested during the CSI testing campaign. The USIPO will build the CSI that will be tested at the Central Solenoid Model Coil (CSMC) Test Facility at the Japan Atomic Energy Agency (JAEA), Naka, Japan. The industrial vendors (the Suppliers) will report to the USIPO (the Company). All approvals to proceed will be issued by the Company, which in some cases, as specified in this document, will also require the approval of the ITER Organization. Responsibilities and obligations will be covered by respective contracts between the USIPO, called Company interchangeably, and the industrial Prime Contractors, called Suppliers. Different stages of work may be performed by more than one Prime Contractor, as described in this specification. Technical requirements of the contract between the Company and the Prime Contractor will be covered by the Fabrication Specifications developed by the Prime Contractor based on this document and approved by

  5. Downhole pulse tube refrigerators

    Energy Technology Data Exchange (ETDEWEB)

    Swift, G.; Gardner, D. [Los Alamos National Lab., NM (United States). Condensed Matter and Thermal Physics Group

    1997-12-01

    This report summarizes a preliminary design study to explore the plausibility of using pulse tube refrigeration to cool instruments in a hot down-hole environment. The original motivation was to maintain Dave Reagor`s high-temperature superconducting electronics at 75 K, but the study has evolved to include three target design criteria: cooling at 30 C in a 300 C environment, cooling at 75 K in a 50 C environment, cooling at both 75 K and 30 C in a 250 C environment. These specific temperatures were chosen arbitrarily, as representative of what is possible. The primary goals are low cost, reliability, and small package diameter. Pulse-tube refrigeration is a rapidly growing sub-field of cryogenic refrigeration. The pulse tube refrigerator has recently become the simplest, cheapest, most rugged and reliable low-power cryocooler. The authors expect this technology will be applicable downhole because of the ratio of hot to cold temperatures (in absolute units, such as Kelvin) of interest in deep drilling is comparable to the ratios routinely achieved with cryogenic pulse-tube refrigerators.

  6. The thermal tube

    Energy Technology Data Exchange (ETDEWEB)

    Semena, M.G.

    1980-08-30

    A thermal tube is proposed which contains a layer of dielectric, capillary porous material located on the internal surface of the body. To increase the heat transmitting capability, the layer of capillary porous material is made in the form of a felting, formed by hollow fibers from a non-alkaline, borosilicate glass.

  7. Prawns in Bamboo Tube

    Institute of Scientific and Technical Information of China (English)

    1998-01-01

    Ingredients: 400 grams Jiwei prawns, 25 grams pork shreds, 5 grams sliced garlic. Condiments: 5 grams cooking oil, minced ginger root and scallions, cooking wine, salt, pepper and MSG (optional) Method: 1. Place the Shelled prawns into a bowl and mix with all the condiments. 2. Stuff the prawns into a fresh bamboo tube,

  8. Cladding tube manufacturing technology

    Energy Technology Data Exchange (ETDEWEB)

    Hahn, R. [Kraftwerk Union AG, Mulheim (Germany); Jeong, Y.H.; Baek, B.J.; Kim, K.H.; Kim, S.J.; Choi, B.K.; Kim, J.M. [Korea Atomic Energy Research Institute, Taejon (Korea, Republic of)

    1999-04-01

    This report gives an overview of the manufacturing routine of PWR cladding tubes. The routine essentially consists of a series of deformation and annealing processes which are necessary to transform the ingot geometry to tube dimensions. By changing shape, microstructure and structure-related properties are altered simultaneously. First, a short overview of the basics of that part of deformation geometry is given which is related to tube reducing operations. Then those processes of the manufacturing routine which change the microstructure are depicted, and the influence of certain process parameters on microstructure and material properties are shown. The influence of the resulting microstructure on material properties is not discussed in detail, since it is described in my previous report 'Alloy Development for High Burnup Cladding.' Because of their paramount importance still up to now, and because manufacturing data and their influence on properties for other alloys are not so well established or published, the descriptions are mostly related to Zry4 tube manufacturing, and are only in short for other alloys. (author). 9 refs., 46 figs.

  9. Misdirected Minitracheostomy Tube

    Science.gov (United States)

    Singh, Ajmer; Nanda, Chinmaya; Mehta, Yatin

    2017-01-01

    We report a patient who after an uneventful coronary artery bypass graft surgery and left ventricular aneurysmorrhaphy developed intracerebral hemorrhage and subsequently required minitracheostomy. Chest X-ray showed misdirected minitracheostomy tube facing upward toward the laryngeal opening which was repositioned using bronchoscope. PMID:28074805

  10. Misdirected minitracheostomy tube

    Directory of Open Access Journals (Sweden)

    Ajmer Singh

    2017-01-01

    Full Text Available We report a patient who after an uneventful coronary artery bypass graft surgery and left ventricular aneurysmorrhaphy developed intracerebral hemorrhage and subsequently required minitracheostomy. Chest X-ray showed misdirected minitracheostomy tube facing upward toward the laryngeal opening which was repositioned using bronchoscope.

  11. Optimizing feed force for turned parts through the Taguchi technique

    Indian Academy of Sciences (India)

    Hari Singh; Pradeep Kumar

    2006-12-01

    The objective of the paper is to obtain an optimal setting of turning process parameters (cutting speed, feed rate and depth of cut) resulting in an optimal value of the feed force when machining EN24 steel with TiC-coated tungsten-carbide inserts. The effects of the selected turning process parameters on feed force and the subsequent optimal settings of the parameters have been accomplished using Taguchi’s parameter design approach. The results indicate that the selected process parameters significantly affect the selected machining characteristics. The results are confirmed by further experiments.

  12. Simplified feeding appliance for an infant with cleft palate

    Directory of Open Access Journals (Sweden)

    Shaila Masih

    2014-01-01

    Full Text Available A child born with cleft palate may experience difficulties while feeding. Early surgical treatment may need to be postponed until certain age and weight gain of the infant. The case presented here is of a 1-month-old neonate born with cleft palate, assisted with a new feeding appliance made with ethylene vinyl acetate using pressure molding technique to aid in proper feeding. The patient′s weight and health significantly improved after the insertion of obturator. The advantages of this material included being lightweight, moldability, good palatal fit and decreased soft tissue injury.

  13. Fluid flow of incompressible viscous fluid through a non-linear elastic tube

    Energy Technology Data Exchange (ETDEWEB)

    Lazopoulos, A.; Tsangaris, S. [National Technical University of Athens, Fluids Section, School of Mechanical Engineering, Zografou, Athens (Greece)

    2008-11-15

    The study of viscous flow in tubes with deformable walls is of specific interest in industry and biomedical technology and in understanding various phenomena in medicine and biology (atherosclerosis, artery replacement by a graft, etc) as well. The present work describes numerically the behavior of a viscous incompressible fluid through a tube with a non-linear elastic membrane insertion. The membrane insertion in the solid tube is composed by non-linear elastic material, following Fung's (Biomechanics: mechanical properties of living tissue, 2nd edn. Springer, New York, 1993) type strain-energy density function. The fluid is described through a Navier-Stokes code coupled with a system of non linear equations, governing the interaction with the membrane deformation. The objective of this work is the study of the deformation of a non-linear elastic membrane insertion interacting with the fluid flow. The case of the linear elastic material of the membrane is also considered. These two cases are compared and the results are evaluated. The advantages of considering membrane nonlinear elastic material are well established. Finally, the case of an axisymmetric elastic tube with variable stiffness along the tube and membrane sections is studied, trying to substitute the solid tube with a membrane of high stiffness, exhibiting more realistic response. (orig.)

  14. Restore condition of Incore thimble tubes in guide tubes

    Energy Technology Data Exchange (ETDEWEB)

    Solanas, A.; Izquierdo, J.

    2014-07-01

    Aging of Nuclear Power Plant and succession of outages lead to wear and twist of the thimbles tubes but also to the fooling of Incore guide tubes. These can create friction and a high strength must be used for thimble tubes withdrawal. (Author)

  15. Esophageal Perforation with Unilateral Fluidothorax Caused by Nasogastric Tube

    Directory of Open Access Journals (Sweden)

    Lukas P. Mileder

    2016-01-01

    Full Text Available Preterm infants are highly susceptible to injuries following necessary and often life-saving medical interventions. Esophageal perforation is a rare, yet serious complication that can be caused by aerodigestive tract suction, endotracheal intubation, or nasogastric tube placement. We present the case of a neonate born at 23 weeks plus three days of gestation with chest radiography showing malposition of the nasogastric feeding tube and massive right-sided effusion of Iopamidol in the pleural cavity due to esophageal perforation. In addition, the article summarizes common signs and symptoms associated with esophageal perforation in infants and discusses diagnostic approaches.

  16. Prevalence and severity of feeding and nutritional problems in children with neurological impairment: Oxford Feeding Study.

    Science.gov (United States)

    Sullivan, P B; Lambert, B; Rose, M; Ford-Adams, M; Johnson, A; Griffiths, P

    2000-10-01

    The aim of this study was to estimate the prevalence and severity of feeding and nutritional problems in children with neurological impairment within a defined geographical area. In a cross-sectional study, a validated questionnaire was sent to 377 parents of children (aged 4 to 13 years) on the Oxford Register of Early Childhood Impairments with oromotor dysfunction. The return rate was 72%. Of these, 93% had cerebral palsy; 47% were unable to walk; 78% had speech difficulty; and 28% continuous drooling of saliva. Gastrointestinal problems were commonly encountered: 59% were constipated; 22% had significant problems with vomiting, and 31% had suffered at least one chest infection in the previous 6 months. Feeding problems were prevalent: 89% needed help with feeding and 56% choked with food; 20% of parents described feeding as stressful and unenjoyable. Prolonged feeding times (3h/day) were reported by 28%. Only 8% of participants received caloric supplements and 8% were fed via gastrostomy tube. Even though 38% of respondents considered their child to be underweight, 64% of children had never had their feeding and nutrition assessed. The results highlight that feeding problems in children with neurological impairment are common and severe, causing parental concern. Many of these children would benefit from nutritional assessment and management as part of their overall care.

  17. Foley Catheters as Temporary Gastrostomy Tubes: Experience of a Nurse-Led Service.

    Science.gov (United States)

    Metussin, Adli; Sia, Rusanah; Bakar, Suriawati; Chong, Vui Heng

    2016-01-01

    Percutaneous endoscopic gastrostomy tube is the modality of choice for long-term enteral nutrition. In the event that replacement tubes are not available, urinary catheters can be used to maintain patency of the gastrostomy tract. This study reports our experience in a nurse-led service using Foley catheters as temporary gastrostomy tubes and the associated complications. Patients who had used Foley catheter as gastrostomy tube over a 2-year period (Jan 2011 to December 2012) were studied. Twenty-one patients had used Foley catheters as a temporary gastrostomy tube, and 12 (57.4%) did not experience any complications, including three patients who were still using Foley catheters at a median of 15 months (range 3-18). Two patients preferred the Foley catheter as feeding tubes. Six patients had replacements with formal balloon replacement tubes, and two patients did not require replacement. Complications occurred in nine (42.6%) patients: repeated burst Foley catheter balloon with peristomal leakage (n = 4), lumen blockage (n = 1), and catheter migration resulting in small bowel obstruction (n = 4). All complications were successfully managed with tube replacements. We showed that in a nurse-led service, using a Foley catheter as a temporary feeding gastrostomy tube is safe, but requires monitoring for complications.

  18. Hot Machining of Hardened Steels with Coated Carbide Inserts

    Directory of Open Access Journals (Sweden)

    M. A. Lajis

    2009-01-01

    Full Text Available Problem statement: The benefits of easier manufacture of hardened steel components can be substantial in terms of reduced machining costs and lead times compared to the traditional route involving machining of the annealed state followed by heat treatment, grinding/EDM and manual finishing. But machinability of hard material through conventional machining is hindered due to excessive wear of the cutting tools and differently in achieving desired quality of the machined surface. In end milling the cutting tool is not in constant operation and so undergoes a heat cycle during the intermittent cutting. This alternate heating and cooling of the inserts lead to the thermal cracks and subsequently failure of the tool. Approach: This study was conducted to investigate the effect of preheating through inductive heating mechanism in end milling (vertical milling center of AISI D2 hardened steel (56-62 HRC by using coated carbide tool inserts. Apart from preheating, two other machining parameters such as cutting speed and feed were varied while the depth of cut was kept constant. Results: Tool wear phenomenon and machined surface finish were found to be significantly affected by preheating temperature and other two variables. Preheating temperature of 335°C coupled with cutting speed of 40 m min-1, depth of cut of 1.0 mm and feed of 0.02 mm/tooth resulted in a noticeable reduction in tool wear rate leading to a maximum tool life 188.55 min. In addition, cutting speed of 56.57 m min-1 together with feed of 0.044 mm/tooth and depth of cut 1.0 mm at which maximum VMR (9500 mm3 was secured provides a better surface finish with minimum surface roughness 0.25µm leaving a possibility of skipping the grinding and polishing operations for certain applications. Conclusion/Recommendation: Through the end milling of preheated AISI D2 hardened steel by using TiAlN coated carbide cutting tool it can be concluded that an overall enhanced machinability is achievable by

  19. Feeding Your Baby

    Medline Plus

    Full Text Available ... Baby Feeding your baby Other Baby topics ') document.write(' Caring for your baby ') document.write('') } ') document.write(' Feeding your baby ') document.write('') } ') document. ...

  20. Feeding Your Newborn

    Science.gov (United States)

    ... for your child. These guidelines on breastfeeding and bottle feeding can help you make the decision that's right ... formula is a nutritious alternative to breast milk. Bottle feeding can offer more freedom and flexibility for moms, ...