Sample records for haemodynamics coagulation acid-base

  1. Blood Coagulation and Acid-Base Balance at Craniocerebral Hypothermia in Patients with Severe Traumatic Brain Injury

    Directory of Open Access Journals (Sweden)

    V. E. Avakov


    Full Text Available Systemic therapeutic hypothermia has gained a negative reputation in treating multiple trauma patients and is regarded as one of the factors in the lethal triad of shock, acidosis, and hypothermia. This fact owes to no relationship between acidosis and hypothermia; the effects of the latter on coagulation are evident and complexly reversible in the presence of acidosis.Objective: to determine the impact of noninvasive local brain cooling on the metabolic and blood coagulation indicators of a patient with acute cerebral ischemia.Subjects and methods. The subjects of the study were 113 patients with severe brain injury, including that complicated by the involvement of stem structures, who underwent brain cooling in different modifications. In so doing, the val ues of acidbase balance and coagulation system in arterial and venous blood were investigated.Results. Local brain hypother mia was not found to affect coagulation while the baseline negative values of excess buffer bases showed positive values (a right shift by the end of cooling. Recommendations were given to prevent metabolic shifts.Conclusion. Patients at very high risk for bleeding may be safely cooled to a brain temperature of 32—34°C even in the presence of moderatetosevere acidosis. This is a great advantage of local hypothermia over systemic one.

  2. Haemodynamic effects of eating

    DEFF Research Database (Denmark)

    Høost, U; Kelbaek, H; Rasmusen, H


    1. The purpose of this study was to investigate the effect of fractional meal stimulation on postprandial haemodynamic changes, the possible correlation between these changes and the potential mediating role of circulating catecholamines and insulin. 2. Healthy young subjects were studied before ...

  3. Ultrasonography for haemodynamic monitoring. (United States)

    Poth, Jens M; Beck, Daniel R; Bartels, Karsten


    Echocardiography has become an indispensable tool in the evaluation of medical and surgical patients. As ultrasound (US) machines have become more widely available and significantly more compact, there has been an exponential growth in the use of transthoracic echocardiography (TTE), transoesophageal echocardiography (TOE) and other devices in the perioperative setting. Here, we review recent findings relevant to the use of perioperative US, with a special focus on the haemodynamic management of the surgical patient. Published by Elsevier Ltd.

  4. The haemodynamic effect of carotid endarterectomy

    DEFF Research Database (Denmark)

    Nielsen, Ming-Yuan; Sillesen, H H; Jørgensen, Lisbeth


    to assess the haemodynamic effect of carotid artery surgery, and to relate postoperative changes to the state of cerebral circulation before assess the haemodynamic effect of carotid artery surgery, and to relate postoperative changes to the state of cerebral circulation before revascularisation....

  5. Haemodynamics and fluid retention in liver disease

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik Sahl; Møller, Søren


    Patients with cirrhosis and portal hypertension exhibit characteristic haemodynamic changes with a hyperkinetic systemic circulation, an abnormal distribution of the blood volume and neurohumoral dysregulation. Their plasma and noncentral blood volumes are increased, but the central and arterial ...

  6. Monitoring of cerebral haemodynamics in newborn infants

    DEFF Research Database (Denmark)

    Liem, K Djien; Greisen, Gorm


    The most important cerebrovascular injuries in newborn infants, particularly in preterm infants, are cerebral haemorrhage and ischemic injury. The typical cerebral vascular anatomy and the disturbance of cerebral haemodynamics play important roles in the pathophysiology. The term 'cerebral...

  7. Coagulation management. (United States)

    Grottke, Oliver


    Trauma-induced coagulopathy is a frequent complication in severely injured patients. To correct coagulopathy and restore haemostasis, these patients have traditionally been treated with fresh frozen plasma, but in the last decade, there has been a shift from empirical therapy to targeted therapy with coagulation factor concentrates and other haemostatic agents. This review highlights emerging therapeutic options and controversial topics. Early administration of the antifibrinolytic medication tranexamic acid was shown in the multicentre CRASH-2 trial to be an effective and inexpensive means of decreasing blood loss. Numerous retrospective and experimental studies have shown that the use of coagulation factor concentrates decreases blood loss and may be useful in reducing the need for transfusion of allogeneic blood products. In particular, early use of fibrinogen concentrate and thrombin generators has a positive impact on haemostasis. However, the use of prothrombin complex concentrate to correct trauma-induced coagulopathy has also been associated with a potential risk of serious adverse events. Current evidence in trauma resuscitation indicates a potential role for coagulation factor concentrates and other haemostatic agents in correcting trauma-induced coagulopathy. Despite a shift towards such transfusion strategy, there remains a shortage of data to support this approach.

  8. Inflammation and coagulation

    NARCIS (Netherlands)

    Levi, Marcel; van der Poll, Tom


    In the pathogenesis of sepsis, inflammation and coagulation play a pivotal role. Increasing evidence points to an extensive cross-talk between these two systems, whereby inflammation leads to activation of coagulation, and coagulation also considerably affects inflammatory activity. Molecular

  9. Haemodynamics and fluid retention in liver disease

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik; Møller, Søren


    Patients with cirrhosis and portal hypertension exhibit characteristic haemodynamic changes with a hyperkinetic systemic circulation, an abnormal distribution of the blood volume and neurohumoral dysregulation. Their plasma and noncentral blood volumes are increased, but the central and arterial...... blood volume and systemic vascular resistance are decreased. A systemic and splanchnic vasodilatation is of pathogenic importance to the low systemic vascular resistance and abnormal volume distribution. These are important elements in the development of the low arterial blood pressure and hyperkinetic......, and elevated circulation vasopressin, endothelin-1 may also be implicated in the haemodynamic counter-regulation in cirrhosis. Recent research has focused on the assertion that the haemodynamic and neurohumoral abnormalities in cirrhosis are part of a general circulatory dysfunction, influencing the course...

  10. Spatial coagulation with bounded coagulation rate


    Bailleul, Ismael


    We prove that the spatial coagulation equation with bounded coagulation rate is well-posed for all times in a given class of kernels if the convection term of the underlying particle dynamics has divergence bounded below by a positive constant. Multiple coagulations, fragmentation and scattering are also considered.

  11. Haemodynamics and fluid retention in liver disease

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik; Møller, Søren


    blood volume and systemic vascular resistance are decreased. A systemic and splanchnic vasodilatation is of pathogenic importance to the low systemic vascular resistance and abnormal volume distribution. These are important elements in the development of the low arterial blood pressure and hyperkinetic......, and elevated circulation vasopressin, endothelin-1 may also be implicated in the haemodynamic counter-regulation in cirrhosis. Recent research has focused on the assertion that the haemodynamic and neurohumoral abnormalities in cirrhosis are part of a general circulatory dysfunction, influencing the course...... of the disease with reduction of kidney function and sodium-water retention as the outcome....

  12. Haemodynamic and anaesthetic advantages of dexmedetomidine ...

    African Journals Online (AJOL)

    Supplementation with end-tidal sevoflurane 1-2% was considered when heart rate (HR) and mean arterial pressure exceeded 20% of baseline values. On completion of surgery, the time taken to discontinue dexmedetomidine infusion and the extubation time were recorded. Outcome measures: Changes in haemodynamic ...

  13. Disseminated intravascular coagulation (DIC) (United States)

    ... Disseminated intravascular coagulation (DIC) To use the sharing features on this page, please enable JavaScript. Disseminated intravascular coagulation is a serious disorder in which the proteins ...

  14. Insect acid-base physiology. (United States)

    Harrison, J F


    Acid-base status influences many aspects of insect biology, including insect distributions in aquatic systems, insect-plant and insect-pathogen interactions, membrane transport phenomena, and the mode of action of pesticides. Acid-base status in the hemolymph and gut lumen of insects is generally well regulated but varies somewhat within individuals owing to effects of temperature, activity, discontinuous ventilation, and diet. The pH of the midgut lumen varies with the phylogeny and feeding ecology. Insect fluids have buffer values similar to those of vertebrates. The respiratory system participates in acid-base homeostasis primarily by regulating the internal carbon dioxide (partial) pressure via changes in spiracular opening and convective ventilation. The epithelia of the renal system and gut participate in hemolymph acid-base regulation by varying acid-base transport in response to organismal acid-base status. Evidence to date suggests that the dominant mechanisms for control of renal acid-base excretion involve hormonal regulation of H+-V-ATPase activity.


    Directory of Open Access Journals (Sweden)



    Full Text Available Acid-base, electrolyte, and metabolic disturbances are common in the intensive care unit. Almost all critically ill patients often suffer from compound acid-base and electrolyte disorders. Successful evaluation and management of such patients requires recognition of common patterns (e.g., metabolic acidosis and the ability to dissect one disorder from another. The intensivists needs to identify and correct these condition with the easiest available tools as they are the associated with multiorgan failure. Understanding the elements of normal physiology in these areas is very important so as to diagnose the pathological condition and take adequate measures as early as possible. Arterial blood gas analysis is one such tool for early detection of acid base disorder. Physiology of acid base is complex and here is the attempt to simplify it in our day to day application for the benefit of critically ill patients.

  16. Haemodynamic consequences of mild therapeutic hypothermia after cardiac arrest.

    NARCIS (Netherlands)

    Bergman, R.; Braber, A.; Adriaanse, M.A.; Vugt, R. van; Tjan, D.H.; Zanten, A.R. van


    BACKGROUND AND OBJECTIVE: Mild therapeutic hypothermia (MTH) is used after out-of-hospital cardiac arrest (OHCA) to minimize cerebral damage. Induced hypothermia may further interfere with cardiac function and influence haemodynamics after OHCA. METHODS: This was a prospective study of haemodynamic

  17. Haemodynamic response to laryngoscopy with and without tracheal ...

    African Journals Online (AJOL)

    Haemodynamic response to laryngoscopy with and without tracheal intubation. P Smith, F.J Smith, P.J Becker. Abstract. Introduction Tracheal intubation is accompanied by an increased blood pressure and heart rate. The aim of this study was to find the most important source of this haemodynamic response, namely ...

  18. Cerebral haemodynamics during experimental intracranial hypertension. (United States)

    Donnelly, Joseph; Czosnyka, Marek; Harland, Spencer; Varsos, Georgios V; Cardim, Danilo; Robba, Chiara; Liu, Xiuyun; Ainslie, Philip N; Smielewski, Peter


    Intracranial hypertension is a common final pathway in many acute neurological conditions. However, the cerebral haemodynamic response to acute intracranial hypertension is poorly understood. We assessed cerebral haemodynamics (arterial blood pressure, intracranial pressure, laser Doppler flowmetry, basilar artery Doppler flow velocity, and vascular wall tension) in 27 basilar artery-dependent rabbits during experimental (artificial CSF infusion) intracranial hypertension. From baseline (∼9 mmHg; SE 1.5) to moderate intracranial pressure (∼41 mmHg; SE 2.2), mean flow velocity remained unchanged (47 to 45 cm/s; p = 0.38), arterial blood pressure increased (88.8 to 94.2 mmHg; p intracranial pressure (∼75 mmHg; SE 3.7), both mean flow velocity and laser Doppler flowmetry decreased (45 to 31.3 cm/s p intracranial hypertension demonstrated two intracranial pressure-dependent cerebroprotective mechanisms: with moderate increases in intracranial pressure, wall tension decreased, and arterial blood pressure increased, while with severe increases in intracranial pressure, an arterial blood pressure increase predominated. Clinical monitoring of such phenomena could help individualise the management of neurocritical patients.

  19. Coagulation disorders in intensive care

    NARCIS (Netherlands)

    Levi, Marcel


    Coagulation disorders are common in intensive care patients and may range from isolated thrombocytopenia or prolonged clotting times to disseminated intravascular coagulation. There are many causes of disturbed coagulation in critically ill patients and each may require specific treatment

  20. Disseminated intravascular coagulation in sepsis

    NARCIS (Netherlands)

    Zeerleder, Sacha; Hack, C. Erik; Wuillemin, Walter A.


    Disseminated intravascular coagulation is a frequent complication of sepsis. Coagulation activation, inhibition of fibrinolysis, and consumption of coagulation inhibitors lead to a procoagulant state resulting in inadequate fibrin removal and fibrin deposition in the microvasculature. As a

  1. Aptamer-based modulation of blood coagulation. (United States)

    Mayer, G; Rohrbach, F; Pötzsch, B; Müller, J


    Nucleic acid based aptamers are single-stranded oligonucleotide ligands isolated from random libraries by an in-vitro selection procedure. Through the formation of unique three-dimensional structures, aptamers are able to selectively interact with a variety of target molecules and are therefore also promising candidates for the development of anticoagulant drugs. While thrombin represents the most prominent enzymatic target in this field, also aptamers directed against other coagulation proteins and proteases have been identified with some currently being tested in clinical trials. In this review, we summarize recent developments in the design and evaluation of aptamers for anticoagulant therapy and research.

  2. Comparison of the Success Rates and Haemodynamic Changes of ...

    African Journals Online (AJOL)

    Comparison of the Success Rates and Haemodynamic Changes of Caudal Block .and Dorsal Penile Nerve Block in Paediatric Day-Case Circumcision. Panda U. Shehu, Abubakar S. Adamu, Samboy Tanimu, Mohammed Tela, Samuelwabada Saniadamu ...

  3. Correlation between liver morphology and haemodynamics in alcoholic liver disease

    DEFF Research Database (Denmark)

    Krogsgaard, K; Gluud, C; Henriksen, Jens Henrik Sahl


    was found with haemodynamic variables. The present data substantiate the concept that established portal hypertension in alcoholic liver disease is mainly accomplished by a derangement in hepatic architecture, whereas parenchymal changes, including hepatocyte size, are of less importance....

  4. Haemodynamic Profile of Patients with End-Stage Liver Disease

    DEFF Research Database (Denmark)

    Møller, Søren; Henriksen, Jens Henrik Sahl


    Patients with cirrhosis and portal hypertension exhibit characteristic haemodynamic changes. A vasodilatatory state and a hyperdynamic circulation affect various functions, resulting in multi-organ failure. Thus, the circulation of the lungs, kidneys, brain, gastrointestinal tract and periphery i...

  5. Lamotrigine - Induced Intravascular Coagulation


    J Gordon Millichap


    Two children, ages 3 and 11, who developed multiorgan dysfunction and disseminated intravascular coagulation (DIC) 9 days after the addition of lamotrigine to valproic acid anticonvulsant therapy are reported from the Hospital for Sick Children, Toronto, Canada.

  6. Coagulation: consultative hemostasis

    NARCIS (Netherlands)

    Hambleton, Julie; Leung, Lawrence L.; Levi, Marcel


    Clinical hematologists are frequently consulted for the care of hospitalized patients with complicated coagulopathies. This chapter provides an update on the scientific and clinical advances noted in disseminated intravascular coagulation (DIC) and discusses the challenges in hemostasis

  7. Disseminated intravascular coagulation

    NARCIS (Netherlands)

    Levi, Marcel


    OBJECTIVE:: To review the current knowledge on the clinical manifestation, pathogenesis, diagnosis, and management of disseminated intravascular coagulation (DIC). DATA SOURCE:: Selected articles from the MEDLINE database. DATA SYNTHESIS:: DIC may complicate a variety of disorders and can cause

  8. Coagulation properties of milk


    Hallén, Elin


    Concentrations of the different proteins in milk are important for the outcome of the coagulation processes which yield our dairy products, whereas total milk protein content is a poor indicator of coagulation properties of milk. In order to design the milk protein composition to meet dairy processing requirements, selection for genetic variants of milk proteins have been proposed. This work aimed to study genetic milk protein polymorphism and its association with the detailed milk protein co...

  9. Coagulation and Mental Disorders

    Directory of Open Access Journals (Sweden)

    Silvia Hoirisch-Clapauch


    Full Text Available The neurovascular unit is a key player in brain development, homeostasis, and pathology. Mental stress affects coagulation, while severe mental illnesses, such as recurrent depression and schizophrenia, are associated with an increased thrombotic risk and cardiovascular morbidity. Evidence indicates that the hemostatic system is involved to some extent in the pathogenesis, morbidity, and prognosis of a wide variety of psychiatric disorders. The current review focuses on emerging data linking coagulation and some psychiatric disorders.

  10. [Acquired coagulant factor inhibitors]. (United States)

    Nogami, Keiji


    Acquired coagulation factor inhibitors are an autoimmune disease causing bleeding symptoms due to decreases in the corresponding factor (s) which result from the appearance of autoantibodies against coagulation factors (inhibitor). This disease is quite different from congenital coagulation factor deficiencies based on genetic abnormalities. In recent years, cases with this disease have been increasing, and most have anti-factor VIII autoantibodies. The breakdown of the immune control mechanism is speculated to cause this disease since it is common in the elderly, but the pathology and pathogenesis are presently unclear. We herein describe the pathology and pathogenesis of factor VIII and factor V inhibitors. Characterization of these inhibitors leads to further analysis of the coagulation process and the activation mechanisms of clotting factors. In the future, with the development of new clotting examination method (s), we anticipate that further novel findings will be obtained in this field through inhibitor analysis. In addition, detailed elucidation of the coagulation inhibitory mechanism possibly leading to hemostatic treatment strategies for acquired coagulation factor disorders will be developed.

  11. The haemodynamic effect of carotid endarterectomy. (United States)

    Nielsen, M-Y; Sillesen, H H; Jørgensen, L G; Schroeder, T V


    to assess the haemodynamic effect of carotid artery surgery, and to relate postoperative changes to the state of cerebral circulation before revascularisation. using transcranial Doppler we studied bilateral middle cerebral artery (MCA) flow velocities before and on 1st day, 2nd or 3rd day and 4th or 5th day and 3 months after carotid surgery in 61 patients. In addition, ipsilateral MCA flow velocity was monitored continuously during surgery. Data were related to the internal carotid artery (ICA) perfusion pressure (cerebral perfusion pressure index, CPPI), measured directly before ICA clamping. postoperatively, MCA flow velocities increased significantly overall (pCPPICPPI, whereas MCA flow velocities remained increased in the group of patients with low CPPI. At 3 months flow velocities in both groups were normalised. New neurological symptoms occurred in four patients, who all had low CPPI preoperatively (22% (4/18) vs 0%; Fisher's exact test: p=0.006). some degree of hyperperfusion was seen in most patients, but the changes were significantly more pronounced in patients with preoperative hypoperfusion, who also suffered significantly more neurological complications.

  12. Modelling of acid-base equilibria. (United States)

    Jabor, A; Kazda, A


    A quantitative evaluation of metabolic acid-base component is described. The model is based on Stewart's analysis of acid-base chemistry. The metabolic component of acid-base disturbances is divided into four partial metabolic disorders; they can result from abnormal concentrations of chloride, albumin and phosphate disturbances, or from appearance of abnormal unidentified strong anions. The efficiency of the model is sufficient, quantitative partial results are given in the same units as base excess. In complex acid-base disturbances, such as are seen in critically ill patients, a detailed analysis of the specific components of the metabolic acid-base status allows one to plan specific therapeutic interventions.

  13. Coagulation concepts update. (United States)

    O'Connor, Stacy D; Taylor, Andrew J; Williams, Eliot C; Winter, Thomas C


    Since the previous comprehensive radiology review on coagulation concepts that was done in 1990, many studies have been published in the medical and surgical literature that can guide the approach of a radiology practice. The purpose of this article is to provide an analysis of these works, updating the radiologist on proper use and interpretation of coagulation assessment tools, medications that modify the hemostatic system, and the use of transfusions prior to interventions. The basic tools for coagulation assessment have not changed; however, results from subspecialty research have suggested ways in which the use of these tools can be modified and streamlined to safely reduce time and expense for the patient and the health care system.

  14. Coagulation complications following trauma. (United States)

    Martini, Wenjun Z


    Traumatic injury is one of the leading causes of death, with uncontrolled hemorrhage from coagulation dysfunction as one of the main potentially preventable causes of the mortality. Hypothermia, acidosis, and resuscitative hemodilution have been considered as the significant contributors to coagulation manifestations following trauma, known as the lethal triad. Over the past decade, clinical observations showed that coagulopathy may be present as early as hospital admission in some severely injured trauma patients. The hemostatic dysfunction is associated with higher blood transfusion requirements, longer hospital stay, and higher mortality. The recognition of this early coagulopathy has initiated tremendous interest and effort in the trauma community to expand our understanding of the underlying pathophysiology and improve clinical treatments. This review discusses the current knowledge of coagulation complications following trauma.

  15. Haemodynamic and respiratory effects of an abdominal compression binder

    DEFF Research Database (Denmark)

    Toft, M.H.; Bulow, J.; Simonsen, L.


    In order to elucidate the circulatory and respiratory effects of a newly developed abdominal compression binder 25 healthy, normal weight subjects were studied. In supine position the central haemodynamics were measured and estimated with a Finapress device. Lower extremity venous haemodynamics...... with or without the abdominal compression binder. The results show that the compression binder significantly increases the venous volume in the lower extremities as showed by a reduction in the venous capacitance in the lower extremities and a reduction in the stroke volume and cardiac output, while it does...... not influence the pulmonary volumes. It is concluded that the applied abdominal binder significantly affects peripheral and central haemodynamics. It should therefore be used with caution when in the supine position for longer periods, as the pooling of blood it induces in the lower extremities may have...

  16. Coagulation for the clinician

    African Journals Online (AJOL)

    The blood coagulation cascade is usually initiated when sub- endothelial tissue factor is exposed/expressed ... take longer.19 The reactions occur on the platelet surface, but only on those platelets that are activated ..... after appropriate dilution of the blood sample with ADVIA 120. RBC/PLT reagent. The red blood cells are ...

  17. Models of blood coagulation

    NARCIS (Netherlands)

    Butenas, S.; van 't Veer, C.; Cawthern, K.; Brummel, K. E.; Mann, K. G.


    We have used three models to study the process of tissue factor-initiated blood coagulation. These are: synthetic 'plasma' mixtures prepared with the proteins and membranes involved in the reaction and its regulation; mathematical models based on the reaction kinetics, binding constants and

  18. Coagulation abnormalities in sepsis. (United States)

    Tsao, Cheng-Ming; Ho, Shung-Tai; Wu, Chin-Chen


    Although the pathophysiology of sepsis has been elucidated with the passage of time, sepsis may be regarded as an uncontrolled inflammatory and procoagulant response to infection. The hemostatic changes in sepsis range from subclinical activation of blood coagulation to acute disseminated intravascular coagulation (DIC). DIC is characterized by widespread microvascular thrombosis, which contributes to multiple organ dysfunction/failure, and subsequent consumption of platelets and coagulation factors, eventually causing bleeding manifestations. The diagnosis of DIC can be made using routinely available laboratory tests, scoring algorithms, and thromboelastography. In this cascade of events, the inhibition of coagulation activation and platelet function is conjectured as a useful tool for attenuating inflammatory response and improving outcomes in sepsis. A number of clinical trials of anticoagulants were performed, but none of them have been recognized as a standard therapy because recombinant activated protein C was withdrawn from the market owing to its insufficient efficacy in a randomized controlled trial. However, these subgroup analyses of activated protein C, antithrombin, and thrombomodulin trials show that overt coagulation activation is strongly associated with the best therapeutic effect of the inhibitor. In addition, antiplatelet drugs, including acetylsalicylic acid, P2Y12 inhibitors, and glycoprotein IIb/IIIa antagonists, may reduce organ failure and mortality in the experimental model of sepsis without a concomitant increased bleeding risk, which should be supported by solid clinical data. For a state-of-the-art treatment of sepsis, the efficacy of anticoagulant and antiplatelet agents needs to be proved in further large-scale prospective, interventional, randomized validation trials. Copyright © 2014. Published by Elsevier B.V.

  19. Acid-base disorders in liver disease. (United States)

    Scheiner, Bernhard; Lindner, Gregor; Reiberger, Thomas; Schneeweiss, Bruno; Trauner, Michael; Zauner, Christian; Funk, Georg-Christian


    Alongside the kidneys and lungs, the liver has been recognised as an important regulator of acid-base homeostasis. While respiratory alkalosis is the most common acid-base disorder in chronic liver disease, various complex metabolic acid-base disorders may occur with liver dysfunction. While the standard variables of acid-base equilibrium, such as pH and overall base excess, often fail to unmask the underlying cause of acid-base disorders, the physical-chemical acid-base model provides a more in-depth pathophysiological assessment for clinical judgement of acid-base disorders, in patients with liver diseases. Patients with stable chronic liver disease have several offsetting acidifying and alkalinising metabolic acid-base disorders. Hypoalbuminaemic alkalosis is counteracted by hyperchloraemic and dilutional acidosis, resulting in a normal overall base excess. When patients with liver cirrhosis become critically ill (e.g., because of sepsis or bleeding), this fragile equilibrium often tilts towards metabolic acidosis, which is attributed to lactic acidosis and acidosis due to a rise in unmeasured anions. Interestingly, even though patients with acute liver failure show significantly elevated lactate levels, often, no overt acid-base disorder can be found because of the offsetting hypoalbuminaemic alkalosis. In conclusion, patients with liver diseases may have multiple co-existing metabolic acid-base abnormalities. Thus, knowledge of the pathophysiological and diagnostic concepts of acid-base disturbances in patients with liver disease is critical for therapeutic decision making. Copyright © 2017 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

  20. Circulating noradrenaline and central haemodynamics in patients with cirrhosis

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik Sahl; Ring-Larsen, H; Christensen, N J


    Cardiovascular haemodynamics and circulating catecholamines were studied in 22 patients with cirrhosis. Arterial plasma noradrenaline (NA) was significantly increased (median, 0.48 ng/ml, versus controls, 0.24 ng/ml; n = 17; P less than 0.001), indicating enhanced sympathetic nervous activity...

  1. Haemodynamics in acute arthritis of the knee in puppies

    DEFF Research Database (Denmark)

    Bünger, C; Hjermind, J; Harving, S


    In order to study the haemodynamic changes of the juvenile knee in acute arthritis, an experimental model was developed in puppies by unilateral intra-articular injections of Carragheenin solution into the knee. Tissue blood flow was studied by the tracer microsphere technique in eight dogs and s...

  2. Attenuation of the haemodynamic response to placement of the ...

    African Journals Online (AJOL)

    Introduction: Application of the Mayfield clamp causes a significant haemodynamic response. Different methods have been used to attenuate this response. We compared two of these methods, namely alfentanil bolus (Group A) and nerve block of the scalp (Group B). METHOD: Twenty-two patients entered the study.

  3. A comparative study of the haemodynamic effects of atropine and ...

    African Journals Online (AJOL)

    Background:Bradycardia following administration of halothane and suxamethonium in children leads to reduced cardiac output, which can be prevented with prophylactic anticholinergics. Anticholinergics may result in tachycardia and arrhythmias. This study was designed to compare haemodynamic changes and incidence ...

  4. Splanchnic haemodynamics after intravenous terlipressin in anaesthetised healthy pigs

    DEFF Research Database (Denmark)

    Hansen, EF; Strandberg, C; Højgaard, L


    BACKGROUND/AIMS: Terlipressin is used for the treatment of bleeding oesophageal varices. We evaluated the effects of terlipressin on hepatic haemodynamics, with special focus on the interactions between portal venous flow and hepatic arterial flow over time. Secondly, we evaluated the estimated h...

  5. A randomized controlled trial comparing haemodynamic stability in ...

    African Journals Online (AJOL)

    A randomized controlled trial comparing haemodynamic stability in elderly patients undergoing spinal anaesthesia at L5, S1 versus spinal anaesthesia at L3, 4 at a ... Conventionally, spinal anaesthesia is performed at the level of L3,4 interspace; with a reported incidence of hypotension in the elderly ranging between 65% ...

  6. The Kidney and Acid-Base Regulation (United States)

    Koeppen, Bruce M.


    Since the topic of the role of the kidneys in the regulation of acid base balance was last reviewed from a teaching perspective (Koeppen BM. Renal regulation of acid-base balance. Adv Physiol Educ 20: 132-141, 1998), our understanding of the specific membrane transporters involved in H+, HCO , and NH transport, and especially how these…

  7. Identifying acid-base and electrolyte imbalances. (United States)

    Gooch, Michael D


    Acid-base and electrolyte imbalances often complicate patient management in acute care settings. Correctly identifying the imbalance and its cause is vital. This article will review the physiology of acid-base and electrolyte balance, their common disturbances, associated causes, clinical manifestations, and management implications for nurse practitioners.

  8. Overview of the coagulation system

    Directory of Open Access Journals (Sweden)

    Sanjeev Palta


    Full Text Available Coagulation is a dynamic process and the understanding of the blood coagulation system has evolved over the recent years in anaesthetic practice. Although the traditional classification of the coagulation system into extrinsic and intrinsic pathway is still valid, the newer insights into coagulation provide more authentic description of the same. Normal coagulation pathway represents a balance between the pro coagulant pathway that is responsible for clot formation and the mechanisms that inhibit the same beyond the injury site. Imbalance of the coagulation system may occur in the perioperative period or during critical illness, which may be secondary to numerous factors leading to a tendency of either thrombosis or bleeding. A systematic search of literature on PubMed with MeSH terms ′coagulation system, haemostasis and anaesthesia revealed twenty eight related clinical trials and review articles in last 10 years. Since the balance of the coagulation system may tilt towards bleeding and thrombosis in many situations, it is mandatory for the clinicians to understand physiologic basis of haemostasis in order to diagnose and manage the abnormalities of the coagulation process and to interpret the diagnostic tests done for the same.


    Directory of Open Access Journals (Sweden)

    Dr. Sheikh Sajjadieh Mohammad Reza


    Full Text Available Patients with advanced hepatic failure may present with the entire spectrum of coagulation factor deficiencies. This study was designed to determine laboratory abnormalities in coagulation in chronic liver disease and the association of these abnormalities with the extent of chronic hepatitis and cirrhosis. Coagulation markers were assayed in 60 participants: 20 patients with chronic hepatitis, 20 patients with cirrhosis, and 20 healthy individuals (control. Plasma levels of anti-thrombin III were determined by a chromogenic substrate method, and plasma concentrations of fibrinogen were analyzed by the Rutberg method. Commercially available assays were used for laboratory coagulation tests. The levels of coagualation activity markers in patients with chronic liver disease were significantly different in comparison to those in healthy participants. These results indicate the utility of measuring markers for coagulation activity in determining which cirrhosis patients are more susceptible to disseminated intravascular coagulation.

  10. In vivo measurement of blood flow in a micro-scale stenosis model generated by laser photothermal blood coagulation. (United States)

    Lee, Sang Joon; Ha, Ho Jin


    Blood flow in a stenosed vessel is one of the most important issues, because it is closely related to the outbreak of circulatory diseases. To overcome the technological limitations encountered in the haemodynamic studies using in vitro stenosis models, the authors induced a stenosed flow model in the extraembryonic vessels of a chicken embryo. Blood was coagulated by laser irradiation to artificially form a stenosis on the designated spot in a straight blood vessel. Owing to photothermal coagulation of red blood cells (RBCs), the blood is denatured and a stable blood coagulum is induced in the vessel. The blood coagulum adheres firmly and stably on the vessel wall without any size variation. It disturbs the on-coming blood flow significantly. To investigate the haemodynamic characteristics of the blood flow in the stenosed vessel, a micro particle image velocimetry technique was employed using RBCs as tracers to measure the spatial distributions of velocity vectors, streamlines and shear rate. The present simple modelling of in vivo stenosis would be useful for investigating the basic haemodynamic mechanisms underlying circulatory vascular diseases.

  11. Impedance cardiography: A valuable method of evaluating haemodynamic parameters. (United States)

    Sodolski, Tomasz; Kutarski, Andrzej


    This year marks 40 years since the technique was designed of measuring and monitoring the basic haemodynamic parameters in humans by means of impedance cardiography (ICG), also known as "impedance plethysmography of the chest", "electrical bioimpedance of the chest" or "reocardiography". The method makes it possible to denote stroke volume and cardiac output. It also enables the factors to be assessed that influence the following: preload (measurement of thoracic fluid content), afterload (measurement of systemic vascular resistance), the systemic vascular resistance index, contractibility (measurement of the acceleration index), the velocity index, the pre-ejection period, left ventricular ejection time, systolic time ratio and heart rate. Advances in hardware and software, including digital signal tooling and new algorithms, have certainly improved the quality of the results obtained. The accuracy and repeatability of the results have been confirmed in comparative studies with results obtained through invasive methods and echocardiography. Not only are haemodynamic changes monitored by means of ICG in intensive care units, in operating theatres and at haemodialysis stations, but repeated measurements also provide haemodynamic information during the treatment of patients with hypertension and heart failure and pregnant women with cardiological problems and gestosis. A single ICG investigation makes a great contribution to the basic information available about the circulatory system, which is helpful in the initial evaluation of patients in a severe general condition (for example in the admission room), and also makes it possible to make a swift diagnosis of the cause of complaints such as dyspnoea and hypotonia. A particular application of ICG is the assessment of haemodynamic parameters during the programming of atrioventricular and CRT pacemakers. Besides these uses, ICG is a valuable investigative tool. It is defect-free and does not have pulmonary artery

  12. Haemodynamic changes in insulin-induced hypoglycaemia in normal man

    DEFF Research Database (Denmark)

    Hilsted, J; Bonde-Petersen, F; Nørgaard, M B


    Haemodynamic variables (plasma volume, heart rate, blood pressure, cardiac output, stroke volume, pulmonary tissue volume, total peripheral vascular resistance, hepato-splanchnic vascular resistance, lower extremity vascular resistance and plasma catecholamines) were measured before and after......-adrenal activity. Total peripheral vascular resistance as well as lower extremity vascular resistance decreased, whereas hepato-splanchnic vascular resistance was unaffected. Thus insulin-induced hypoglycaemia has marked transient effects on the circulation....

  13. Cardiac and systemic haemodynamic complications of liver cirrhosis

    DEFF Research Database (Denmark)

    Henriksen, Jens H; Møller, Søren


    by physical and pharmacological strain. Cardiac failure is an important cause of mortality after liver transplantation and stressful procedures as insertions of transjugular intrahepatic portal systemic shunt (TIPS), peritoneal venous shunting, and other types of surgery. Improvement of liver function has......Cardiovascular complications of liver cirrhosis include cardiac dysfunction and abnormalities in the central-, splanchnic,- and peripheral circulation. Vasodilatation prevails, but vascular beds with various degrees of reduced and increased haemodynamic resistance are the results of massive...

  14. The coagulant response in sepsis and inflammation

    NARCIS (Netherlands)

    Levi, M. [=Marcel M.


    Critically ill patients often have systemic activation of both inflammation and coagulation. Increasing evidence points to an extensive cross-talk between these two systems, whereby inflammation not only leads to activation of coagulation, but coagulation also considerably affects inflammatory

  15. Haemodynamic and electrophysiological markers of pragmatic language comprehension in schizophrenia. (United States)

    Schneider, Sabrina; Wagels, Lisa; Haeussinger, Florian B; Fallgatter, Andreas J; Ehlis, Ann-Christine; Rapp, Alexander M


    The present study aimed at investigating neurophysiological markers of language perception in schizophrenia using simultaneous near-infrared spectroscopy (NIRS) and event-related potentials (ERPs), which have been proven to be useful for studying language processing abilities in psychiatric patients. The study shall help to integrate previous findings from ERP and fMRI studies on figurative language comprehension in schizophrenia and elucidate how electrophysiological and haemodynamic markers of language processing are related. Twenty-two healthy subjects and 22 schizophrenia patients judged 120 sentences regarding their meaningfulness. Phrases were literal, metaphoric, or meaningless. EEG-fNIRS signals were recorded throughout the entire experiment. Schizophrenia patients showed deficient and delayed sentence comprehension. Both the early N400 and left-hemispheric activation during language comprehension were altered in patients. Correlation analyses showed that metaphor-related ERPs were strongly linked to haemodynamic cortical activity in healthy subjects, but not in patients. Our results indicate group differences in cortical electrophysiological and haemodynamic activation that represent rather general impairments in the processing of complex language. Simultaneous EEG/NIRS applications are useful to depict these neural markers and to investigate their relationship. Future studies are needed to clarify the nature of respective anomalies and their potential as putative neural markers in schizophrenia research.

  16. Haemodynamic changes during lung recruitment. A systematic review

    Directory of Open Access Journals (Sweden)

    Z. Molnar


    Full Text Available The fundamental role of the cardio-respiratory system is to supply the tissues with adequate amount of oxygen to cover their metabolic need. Acute lung injury and acute respiratory distress syndrome are characterized by atelectasis of the alveoli, causing inadequate gas exchange in the lung and lack of oxygen supply to the body. Under these circumstances by increasing the FiO2 only may not be enough to improve oxygenation. One of the possible alternatives is the lung recruitment manoeuvre, during which the alveoli are opened up with high inflation pressure and to keep them open by maintaining appropriate positive end expiratory pressure. However, high intrathoracic pressures may cause haemodynamic instability by affecting the work of the heart and compressing the mediastinal veins. It is uncertain, how haemodynamics are best monitored during lung recruitment. Is continuous monitoring of the mean arterial pressure and the central venous pressure enough, or do we need to measure invasive haemodynamic parameters such as cardiac output and intrathoracic blood volume during such an aggressive intervention?. The aim of this article is to give a review of the possible answers for these questions based on the results of physiological and recently published clinical and experimental research. Key words: lung recruitment, acute respiratory distress syndrome, positive end expiratory pressure, extravascular lung water, oxygenation, hemodynamic monitoring.

  17. [Kidney, Fluid, and Acid-Base Balance]. (United States)

    Shioji, Naohiro; Hayashi, Masao; Morimatsu, Hiroshi


    Kidneys play an important role to maintain human homeostasis. They contribute to maintain body fluid, electrolytes, and acid-base balance. Especially in fluid control, we, physicians can intervene body fluid balance using fluid resuscitation and diuretics. In recent years, one type of fluid resuscitation, hydroxyl ethyl starch has been extensively studied in the field of intensive care. Although their effects on fluid resuscitation are reasonable, serious complications such as kidney injury requiring renal replacement therapy occur frequently. Now we have to pay more attention to this important complication. Another topic of fluid management is tolvaptan, a selective vasopressin-2 receptor antagonist Recent randomized trial suggested that tolvaptan has a similar supportive effect for fluid control and more cost effective compared to carperitide. In recent years, Stewart approach is recognized as one important tool to assess acid-base balance in critically ill patients. This approach has great value, especially to understand metabolic components in acid-base balance. Even for assessing the effects of kidneys on acid-base balance, this approach gives us interesting insight. We should appropriately use this new approach to treat acid-base abnormality in critically ill patients.

  18. Trauma and Coagulation

    Directory of Open Access Journals (Sweden)

    Murat Yılmaz


    Full Text Available Bleeding and coagulation disorders related to trauma are pathological processes which are frequently seen and increase mortality. For the purpose, trauma patients should be protected from hypoperfusion, hypothermia, acidosis and hemodilution which may aggravate the increase in physiological responses to trauma as anticoagulation and fibrinolysis. Performing damage control surgery and resuscitation and transfusion of adequate blood and blood products in terms of amount and content as stated in protocols may increase the rate of survival. Medical treatments augmenting fibrin formation (fibrinogen, desmopressin, factor VIIa or preventing fibrin degradation (tranexamic acid have been proposed in selected cases but the efficacy of these agents in trauma patients are not proven. (Journal of the Turkish Society Intensive Care 2011; 9:71-6

  19. Hypokalemic paralysis and acid-base balance

    Directory of Open Access Journals (Sweden)

    Ivo Casagranda


    Full Text Available Three cases of hypokalemic paralysis are reported, presenting to the Emergency Department. The first is a patient with a hypokalemic periodic paralysis with a normal acid-base status, the second is a case of hypokalemic flaccid paralysis of all extremities with a normal anion gap metabolic acidosis, the last is a patient with a hypokalemic distal paralysis of right upper arm with metabolic alkalosis. Afterwards some pathophysiologic principles and the clinical aspects of hypokalemia are discussed and an appropriate approach to do in Emergency Department, to identify the hypokalemic paralysis etiologies in the Emergency Department, is presented, beginning from the evaluation of acid-base status.

  20. Coagulation efficiency of Dicerocaryum eriocarpum (DE) plant ...

    African Journals Online (AJOL)

    A coagulation efficiency of 99% using modified mucilage coagulant was achieved. The modified mucilage of potassium crude extract and sodium crude extract displayed higher coagulation efficiencies than unmodified mucilage of deionized water crude extract. An increase in coagulant dosage and initial turbidity influenced ...

  1. Blood coagulation factors as inflammatory mediators

    NARCIS (Netherlands)

    Schoenmakers, Saskia H. H. F.; Reitsma, Pieter H.; Spek, C. Arnold


    After the first observations about blood coagulation by Hippocrates, it took until the early 1900s before the classic theory of blood coagulation was presented. As more and more other coagulation factors were discovered, the four-factor coagulation scheme became more complex, but better understood,

  2. 21 CFR 864.5400 - Coagulation instrument. (United States)


    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Coagulation instrument. 864.5400 Section 864.5400....5400 Coagulation instrument. (a) Identification. A coagulation instrument is an automated or semiautomated device used to determine the onset of clot formation for in vitro coagulation studies. (b...

  3. Cardiac contractility, central haemodynamics and blood pressure regulation during semistarvation

    DEFF Research Database (Denmark)

    Stokholm, K H; Breum, L; Astrup, A


    Eight obese patients were studied before and after 2 weeks of treatment by a very-low-calorie diet (VLCD). Cardiac output and central blood volume (pulmonary blood volume and left atrial volume) were determined by indicator dilution (125I-albumin) and radionuclide angiocardiography (first pass...... increased capacitance of the venous bed was the main operator of a reduced venous return. Thus, the haemodynamic alterations in obese patients during short-term semistarvation may be caused by the fall in oxygen uptake and produced mainly by changes in the sympathetic tone....

  4. Haemodynamic changes following treatment of subclinical and overt hyperthyroidism

    DEFF Research Database (Denmark)

    Faber, J; Wiinberg, N; Schifter, S


    Hyperthyroidism has profound effects on the cardiovascular system, including reduced systemic vascular resistance (SVR) due to relaxation of vascular smooth muscle cells, enhanced heart rate (HR) and cardiac output (CO) due to an increase in cardiac diastolic relaxation, contractility and heart...... rate. Subclinical hyperthyroidism is characterised by reduced serum TSH levels despite free thyroxine (T4) and tri-iodothyronine (T3) estimates within the reference range, in subjects with no obvious symptoms of hyperthyroidism. We measured haemodynamic changes (using impedance cardiography......) in subjects with endogenous subclinical hyperthyroidism in order to elucidate whether these patients had signs of excess thyroid hormone at the tissue level....

  5. Glycine/Glycolic acid based copolymers

    NARCIS (Netherlands)

    in 't Veld, P.J.A.; in 't Veld, Peter J.A.; Shen, Zheng-Rong; Shen, Z.; Takens, Gijsbert A.J.; Takens, G.A.J.; Dijkstra, Pieter J.; Feijen, Jan


    Glycine/glycolic acid based biodegradable copolymers have been prepared by ring-opening homopolymerization of morpholine-2,5-dione, and ring-opening copolymerization of morpholine-2,5-dione and glycolide. The homopolymerization of morpholine-2,5-dione was carried out in the melt at 200°C for 3 min

  6. Jigsaw Cooperative Learning: Acid-Base Theories (United States)

    Tarhan, Leman; Sesen, Burcin Acar


    This study focused on investigating the effectiveness of jigsaw cooperative learning instruction on first-year undergraduates' understanding of acid-base theories. Undergraduates' opinions about jigsaw cooperative learning instruction were also investigated. The participants of this study were 38 first-year undergraduates in chemistry education…

  7. Separation of Acids, Bases, and Neutral Compounds (United States)

    Fujita, Megumi; Mah, Helen M.; Sgarbi, Paulo W. M.; Lall, Manjinder S.; Ly, Tai Wei; Browne, Lois M.


    Separation of Acids, Bases, and Neutral Compounds requires the following software, which is available for free download from the Internet: Netscape Navigator, version 4.75 or higher, or Microsoft Internet Explorer, version 5.0 or higher; Chime plug-in, version compatible with your OS and browser (available from MDL); and Flash player, version 5 or higher (available from Macromedia).

  8. Robotic automation of coagulation analysis. (United States)

    Graves, S; Holman, B; Rossetti, M; Estey, C; Felder, R


    Laboratory automation systems (LAS) have been installed in over 22 sites across North America providing automation of many preanalytical and analytical tasks in clinical laboratories. Only a few laboratories have automated the analysis of citrated whole blood for the diagnosis of hemostasis disorders. The analysis of coagulation factors in citrated blood requires a large amount of labor in order to provide rapid turnaround; thus automation of this analytical process is attractive. Therefore, we have created an automated coagulation workstation using a systematic approach to automation design and engineering. First, we used discrete event simulation to calculate potential throughput and to identify possible bottlenecks for the proposed coagulation workcell. We then created a three-dimensional animated computer model of the workstation to simplify workstation design. Finally, we constructed a prototype workcell using a mobile robot, an articulated robotic arm, and a coagulation analytical system.

  9. Disorders of coagulation in pregnancy. (United States)

    Katz, D; Beilin, Y


    The process of haemostasis is complex and is further complicated in the parturient because of the physiological changes of pregnancy. Understanding these changes and the impact that they have on the safety profile of the anaesthetic options for labour and delivery is crucial to any anaesthetist caring for the parturient. This article analyses current theories on coagulation and reviews the physiological changes to coagulation that occur during pregnancy and the best methods with which to evaluate coagulation. Finally, we examine some of the more common disorders of coagulation that occur during pregnancy, including von Willebrand disease, common factor deficiencies, platelet disorders, the parturient on anticoagulants, and the more rare acute fatty liver of pregnancy, with a focus on their implications for neuraxial anaesthesia. © The Author 2015. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email:

  10. The Coagulant Response in Sepsis

    NARCIS (Netherlands)

    Levi, Marcel


    Sepsis is often associated with systemic intravascular activation of coagulation, potentially leading to widespread microvascular deposits of fibrin, and thereby contributing to multiple organ dysfunction. A complex interaction exists between activation of inflammatory systems and the initiating and

  11. Monitoring cardiac output during hyperbaric oxygen treatment of haemodynamically unstable patients

    DEFF Research Database (Denmark)

    Hansen, Marco Bo; Treschow, Frederik; Skielboe, Martin


    Patients suffering from necrotizing fasciitis (NF) are often haemodynamically unstable and require extended monitoring of cardiovascular parameters; yet this is limited during hyperbaric oxygen treatment (HBOT). We aimed to evaluate the use and safety of transoesophageal Doppler (TED) monitoring ...... of cardiac output (CO) under hyperbaric conditions in haemodynamically unstable patients diagnosed with NF and sepsis or septic shock....

  12. Coagulant Recovery from Waterworks Sludge


    Keeley, James


    Coagulation is a ubiquitous process in the treatment of raw surface water for eventual potable use. Despite its capabilities, the sheer scale of its use is manifested in the volumes of chemicals it demands and waste sludge it produces. Recovering and reusing the chemical activity of the coagulant sludge in water treatment is a logical solution but this practice has been restricted by the presence of contaminants within the sludge. This thesis has investigated methods that ca...

  13. Effects of treatment with β-blocker and aldosterone antagonist on central and peripheral haemodynamics and oxygenation in cirrhosis

    DEFF Research Database (Denmark)

    Winkler, Christine; Hobolth, Lise; Krag, Aleksander


    Patients with cirrhosis often exhibit abnormalities in cardiovascular regulation and oxygenation. Many of these patients are treated with β-blockers and aldosterone antagonists that may influence the regulation of systemic haemodynamics, but the specific effects on systemic haemodynamics and oxyg......Patients with cirrhosis often exhibit abnormalities in cardiovascular regulation and oxygenation. Many of these patients are treated with β-blockers and aldosterone antagonists that may influence the regulation of systemic haemodynamics, but the specific effects on systemic haemodynamics...

  14. Comparison of coagulation performance and floc properties of a novel zirconium-glycine complex coagulant with traditional coagulants. (United States)

    Zhang, Zhilin; Wu, Chunde; Wu, Yue; Hu, Caixia


    A new inorganic-organic hybrid material zirconium-glycine complex (ZGC) was firstly used as a coagulant in a coagulation process to treat Pearl River raw water. Its coagulation performance was compared with commonly used aluminum (Al) coagulants such as aluminum sulfate (Al2(SO4)3) and polyaluminum chloride (PAC), in terms of water quality parameters and floc properties. ZGC coagulation achieved higher removal of turbidity (93.8%) than other traditional coagulants. Charge neutralization was proven to act as a dominant mechanism during ZGC coagulation. The aggregated flocs with ZGC showed the fastest growth rate and good recovery ability compared with the other coagulants and achieved the largest floc size within 5 min. The ZGC coagulant can decrease the hydraulic retention time and increase removal efficiency.

  15. Haemodynamic response to ACTH administration in essential hypertension. (United States)

    Whitworth, J A; Saines, D; Andrews, J; Sloman, J G; Scoggins, B A


    1. The haemodynamic and volume response to ACTH administration was investigated in six patients with mild, untreated essential hypertension and two patients with Addison's disease on maintenance steroids. Blood pressure, heart rate and weight were recorded daily. Plasma volume (125I-HSA) and cardiac output (thermo-dilution) were measured during the control period and on the 5th day of ACTH treatment. 2. In the hypertensive subjects, mean arterial pressure rose from 94.3 +/- 2.2 to 105.7 +/- 2.8 mmHg on the 5th day of ACTH administration (P less than 0.02). Plasma volume rose from 29.8 +/- 2.2 to 34 +/- 2.2 ml/kg. Cardiac index increased from 2.85 +/- 0.21 to 3.32 +/- 0.14 l/min per m2 (P less than 0.05). Cardiac output rose from 5.81 +/- 0.69 to 6.72 +/- 0.59 l/min. Calculated total peripheral resistance, heart rate and body weight were unchanged. No such changes were seen in patients with Addison's disease. 3. The haemodynamic characteristics of ACTH in patients with mild untreated essential hypertension are similar to those in the experimental model of ACTH induced hypertension in sheep.

  16. Effect of manual hyperinflation on haemodynamics in an animal model. (United States)

    Anning, Luke; Paratz, Jennifer; Wong, Wai Pong; Wilson, Kathleen


    Manual hyperinflation is a physiotherapy technique that improves static compliance and mobilizes secretions, but has the potential to alter haemodynamic function. The aim of the present study was to investigate the effects of manual hyperinflation on haemodynamic function in a healthy animal model, without the usual confounding effects inherent in an heterogeneous intensive care population. The study used a within-subjects design, in an animal research theatre. Nine healthy sheep (eight Border Leicester, one Merino, mean weight 39.5 kg, standard deviation (SD) 1.6 kg) completed the study. The sheep were induced (thiopentane 15-20 ml), intubated, ventilated and surgically instrumented for an arterial line and pulmonary artery catheter. Anaesthesia was maintained by 1.5% halothane/oxygen. Manual hyperinflation was delivered for two minutes with a Mapleson C circuit, using a peak inspiratory pressure of 35 cmH2O and an inspiratory:expiratory ratio of 2:1. Mean tidal volume during manual hyperinflation was 294% (SD 22%) of the ventilator tidal volume. A paired Student's t-test demonstrated that cardiac output (thermodilution method) decreased significantly (p manual hyperinflation. A repeated-measures analysis of variance (ANOVA) and a least-significant difference pairwise comparison revealed that mean arterial pressure and pulse pressure decreased significantly during (p manual hyperinflation (p respiratory function.

  17. Coagulation-Flocculation Process in Landfill Leachate Treatment: Focus on Coagulants and Coagulants Aid (United States)

    Kamaruddin, M. A.; Abdullah, M. M. A.; Yusoff, M. S.; Alrozi, R.; Neculai, O.


    In physico-chemical treatment, the separation of suspended particles from the liquid phase is usually accomplished by coagulation, flocculation and sedimentation. Coagulation-flocculation processes have been widely used as alternative treatment to remove leachate pollutants such as BOD, COD, TSS, heavy metals, colour, and nitrogen compounds prior to other treatment methods. It is often coupled with treatment methods like biological process, chemical oxidation, adsorption or filtration to achieve desirable effluent quality. In spite of being economical, the dewatering and disposal of the precipitated sludge could be laborious and time-consuming. In this manuscript, brief discussions on coagulant and coagulants aid in landfill leachate treatment is discussed with respect to their mechanism.

  18. Acid-base balance in lake water

    Energy Technology Data Exchange (ETDEWEB)

    Brosset, C.


    As expected, the acid-base content of lake water is composed of strong base or acid, weak acids (mainly fulvic acid) and carbonic acid. All of these may be determined by using a simple titration method. The concentration of undissociated carbonic acid sometimes appears not to be in equilibrium with the CO/sub 2/-concentration in air. Observed supersaturation seems to be connected to the concentration of fulvic acid.

  19. The impact of phosphate-balanced crystalloid infusion on acid-base homeostasis (PALANCE study): study protocol for a randomized controlled trial. (United States)

    Pagel, Judith-Irina; Hulde, Nikolai; Kammerer, Tobias; Schwarz, Michaela; Chappell, Daniel; Burges, Alexander; Hofmann-Kiefer, Klaus; Rehm, Markus


    This study aims to investigate the effects of a modified, balanced crystalloid including phosphate in a perioperative setting in order to maintain a stable electrolyte and acid-base homeostasis in the patient. This is a single-centre, open-label, randomized controlled trial involving two parallel groups of female patients comparing a perioperative infusion regime with sodium glycerophosphate and Jonosteril® (treatment group) or Jonosteril® (comparator) alone. The primary endpoint is to maintain a stable concentration of weak acids [A(-)] according to the Stewart approach of acid-base balance. Secondary endpoints are measurement of serum phosphate levels, other acid-base parameters such as the strong ion difference (SID), the onset and severity of postoperative nausea and vomiting (PONV), electrolyte levels and their excretion in the urine, monitoring of renal function and glycocalyx components, haemodynamics, amounts of catecholamines and other vasopressors used and the safety of the infusion regime. Perioperative fluid replacement with the use of currently available crystalloid preparations still fail to maintain a stable acid-base balance and experts agree that common balanced solutions are still not ideal. This study aims to investigate the effectivity and safety of a new crystalloid solution by adding sodium glycerophosphate to a standardized crystalloid preparation in order to maintain a balanced perioperative acid-base homeostasis. EudraCT number 201002422520 . Registered on 30 November 2010.

  20. Hydrolysis of polyaluminum chloride prior to coagulation: Effects on coagulation behavior and implications for improving coagulation performance. (United States)

    Zhang, Zhongguo; Wang, Jun; Liu, Dan; Li, Jiuyi; Wang, Xiaolin; Song, Boyu; Yue, Bing; Zhao, Kehui; Song, Yun


    The effects of polyaluminum chloride (PACl) hydrolysis prior to coagulation on both the coagulation zone and coagulation performance of a kaolin suspension were investigated by a novel jar test named the "reversed coagulation test". The tests showed that PACl hydrolysis prior to coagulation decreased the performance of charge neutralization coagulation in the case of short-time slow mixing (10min; G=15sec(-1)) and increased the optimal dosage for charge neutralization and sweep coagulation. Moreover, the hydrolysis time had insignificant effects on the size and zeta potential of PACl precipitates and the residual turbidity of the raw water. However, PACl hydrolysis prior to coagulation and the size of PACl precipitates had a negligible effect on the performance of sweep coagulation. The results imply that, in practice, preparing a PACl solution with deionized water, rather than tap water or the outlet water from a wastewater treatment unit, can significantly save PACl consumption and improve the performance of charge neutralization coagulation, while preparing the PACl solution with tap or outlet water would not affect the performance of sweep coagulation. In addition, the optimal rapid mixing intensity appears to be determined by a balance between the degree of coagulant hydrolysis before contacting the primary particles and the average size of flocs in the rapid mixing period. These results provide new insights into the role of PACl hydrolysis and will be useful for improving coagulation efficiency. Copyright © 2016. Published by Elsevier B.V.

  1. Bitter tastants alter gastric-phase postprandial haemodynamics. (United States)

    McMullen, Michael K; Whitehouse, Julie M; Whitton, Peter A; Towell, Anthony


    Since Greco-Roman times bitter tastants have been used in Europe to treat digestive disorders, yet no pharmacological mechanism has been identified which can account for this practice. This study investigates whether the bitter tastants, gentian root (Gentian lutea L.) and wormwood herb (Artemisia absinthium L.), stimulate cephalic and/or gut receptors to alter postprandial haemodynamics during the gastric-phase of digestion. Normal participants ingested (1) 100 mL water plus capsules containing either cellulose (placebo-control) or 1000 mg of each tastant (n=14); or (2) 100mL of water flavoured with 500 or 1500 mg of each tastant (a) gentian (n=12) and (b) wormwood (n=12). A single beat-to-beat cardiovascular recording was obtained for the entire session. Pre/post-ingestion contrasts with the control were analysed for (1) the encapsulated tastants, in the "10 to 15" minute post-ingestion period, and (2) the flavoured water in the "5 to 10" minute post-ingestion period. Water, the placebo-control, increased cardiac contraction force and blood pressure notwithstanding heart rate decreases. Encapsulated tastants did not further alter postprandial haemodynamics. In contrast gentian (500 and 1500 mg) and wormwood (1500 mg) flavoured water elicited increased peripheral vascular resistance and decreased cardiac output, primarily by reducing stroke volume rather than heart rate. Drinking 100mL water elicits a pressor effect during the gastric-phase of digestion due to increased cardiac contraction force. The addition of bitter tastants to water elicits an additional and parallel pressor effect due to increased peripheral vascular resistance; yet the extent of the post-prandial blood pressure increases are unchanged, presumably due to baroreflex buffering. The vascular response elicited by bitter tastants can be categorised as a sympathetically-mediated cephalic-phase response. A possible mechanism by which bitter tastants could positively influence digestion is altering

  2. Correlation between liver morphology and haemodynamics in alcoholic liver disease

    DEFF Research Database (Denmark)

    Krogsgaard, K; Gluud, C; Henriksen, J H


    was found with haemodynamic variables. The present data substantiate the concept that established portal hypertension in alcoholic liver disease is mainly accomplished by a derangement in hepatic architecture, whereas parenchymal changes, including hepatocyte size, are of less importance.......In 32 alcoholic patients the degree of hepatic architectural destruction was graded (preserved architecture, nodules alternating with preserved architecture, totally destroyed architecture) and related to portal pressure. A significant positive correlation was found between degree of architectural...... destruction and wedged-to-free hepatic vein pressure (W-FHVP) (p less than 0.001). The degree of necrosis, fatty change and inflammation showed no correlation with portal pressure, whereas a significant positive correlation was found between the occurrence of Mallory bodies and W-FHVP (p less than 0...

  3. Central haemodynamics in patients with severe postural hypotension

    DEFF Research Database (Denmark)

    Mehlsen, J; Haedersdal, C; Trap-Jensen, J


    Central haemodynamics in the supine and head-up tilted positions were studied in 24 patients with severe postural hypotension with and without supine hypertension. Results were compared with those obtained in eight normotensive and eight untreated hypertensive controls. In the supine position...... the patients had higher vascular resistances, lower stroke volumes and longer left ventricular ejection time indexes compared to controls, whereas left ventricular ejection fractions did not differ significantly. The patients with supine hypertension had significantly higher vascular resistance compared...... to those with supine normotension. The highest supine blood pressure levels were found in patients with multiple system atrophy. During tilt, vascular resistance and heart rates were increased and stroke volumes and left ventricular ejection time indexes were decreased in the controls. The patients were...

  4. The diagnosis of disseminated intravascular coagulation

    NARCIS (Netherlands)

    Levi, Marcel; de Jonge, Evert; Meijers, Joost


    Disseminated intravascular coagulation (DIC) is a syndrome characterized by systemic intravascular activation of coagulation, leading to widespread deposition of fibrin in the circulation. In recent years, the pathogenetic pathways leading to DIC have been largely identified, which could result in

  5. Coagulants modulate the hypocholesterolemic effect of tofu ...

    African Journals Online (AJOL)



    Feb 2, 2006 ... The recent increase in soymilk and tofu (coagulated soymilk) consumption especially in western countries is due to the recognition of the health benefits of soy foods. The amount and the type of coagulated biomolecules (such as isoflavones) vary with the type of coagulant, and this will inevitable alter their ...

  6. Coagulants modulate the hypocholesterolemic effect of tofu ...

    African Journals Online (AJOL)

    The recent increase in soymilk and tofu (coagulated soymilk) consumption especially in western countries is due to the recognition of the health benefits of soy foods. The amount and the type of coagulated biomolecules (such as isoflavones) vary with the type of coagulant, and this will inevitable alter their biological activity.

  7. Advances of Coagulation Factor XIII

    Directory of Open Access Journals (Sweden)

    Da-Yu Shi


    Conclusions: FXIII has many more biologic functions besides being known as coagulation factor. The TG activity of FXIII contributes to several processes, including wound healing, bone extracellular matrix stabilization, and the interaction between embryo and decidua of uterus. Further research is needed to elucidate the link between FXIII and leukemia and solid tumors.

  8. Investigating Students' Reasoning about Acid-Base Reactions (United States)

    Cooper, Melanie M.; Kouyoumdjian, Hovig; Underwood, Sonia M.


    Acid-base chemistry is central to a wide range of reactions. If students are able to understand how and why acid-base reactions occur, it should provide a basis for reasoning about a host of other reactions. Here, we report the development of a method to characterize student reasoning about acid-base reactions based on their description of…

  9. Assessing College Students' Understanding of Acid Base Chemistry Concepts (United States)

    Wan, Yanjun Jean


    Typically most college curricula include three acid base models: Arrhenius', Bronsted-Lowry's, and Lewis'. Although Lewis' acid base model is generally thought to be the most sophisticated among these three models, and can be further applied in reaction mechanisms, most general chemistry curricula either do not include Lewis' acid base model, or…

  10. Using Willie's Acid-Base Box for Blood Gas Analysis (United States)

    Dietz, John R.


    In this article, the author describes a method developed by Dr. William T. Lipscomb for teaching blood gas analysis of acid-base status and provides three examples using Willie's acid-base box. Willie's acid-base box is constructed using three of the parameters of standard arterial blood gas analysis: (1) pH; (2) bicarbonate; and (3) CO[subscript…

  11. Teaching Acid/Base Physiology in the Laboratory (United States)

    Friis, Ulla G.; Plovsing, Ronni; Hansen, Klaus; Laursen, Bent G.; Wallstedt, Birgitta


    Acid/base homeostasis is one of the most difficult subdisciplines of physiology for medical students to master. A different approach, where theory and practice are linked, might help students develop a deeper understanding of acid/base homeostasis. We therefore set out to develop a laboratory exercise in acid/base physiology that would provide…

  12. Haemodynamical stress in mouse aortic arch with atherosclerotic plaques: Preliminary study of plaque progression


    Assemat, P.; Siu, K.K.; Armitage, J.A.; Hokke, S.N.; Dart, A; Chin-Dusting, J; Hourigan, K.


    Atherosclerotic plaques develop at particular sites in the arterial tree, and this regional localisation depends largely on haemodynamic parameters (such as wall shear stress; WSS) as described in the literature. Plaque rupture can result in heart attack or stroke and hence understanding the development and vulnerability of atherosclerotic plaques is critically important. The purpose of this study is to characterise the haemodynamics of blood flow in the mouse aortic arch using numerical mode...

  13. Haemodynamic simulation of aneurysm coiling in an anatomically accurate computational fluid dynamics model: technical note

    Energy Technology Data Exchange (ETDEWEB)

    Mitsos, Aristotelis P. [University of Oxford, Department of Neuroradiology, John Radcliffe Hospital, Oxford (United Kingdom); University of Oxford, Wolfson College, Oxford (United Kingdom); Kakalis, Nikolaos M.P.; Ventikos, Yiannis P. [University of Oxford, Department of Engineering Science, Oxford (United Kingdom); Byrne, James V. [University of Oxford, Department of Neuroradiology, John Radcliffe Hospital, Oxford (United Kingdom)


    Computational fluid dynamics (CFD) is a numerical technique that is used for studying haemodynamic parameters in cerebral aneurysms. As it is now possible to represent an anatomically accurate intracranial aneurysm in a computational model, we have attempted to simulate its endosaccular occlusion with coils and demonstrate the haemodynamic changes induced. This is the first attempt to use this particular porous medium-based method for coiling simulation in a CFD model, to our knowledge. Datasets from a rotational 3-D digital subtraction angiogram of a recently ruptured anterior communicating aneurysm were converted into a 3-D geometric model and the discretized data were processed using the computational technique developed. Coiling embolisation simulation was achieved by impediment of flow through a porous medium with characteristics following a series of embolisation coils. Haemodynamic parameters studied were: pressure distribution on the vessel wall, blood velocity and blood flow patterns. Significant haemodynamic changes were detected after deployment of the first coil. Similar, but less dramatic changes occurred during subsequent stages of coiling. The blood flow patterns became less vortical in the aneurysm sac as velocity decreased to stagnation and the wall pressure at the fundus was gradually reduced. Furthermore, the haemodynamic characteristics developed at the area of the neck remnant could form the basis for assessing the likelihood of delayed coil compaction and aneurysm regrowth. Appropriate computational techniques show great promise in simulating the haemodynamic behaviour of the various stages in coil embolisation and may be a potentially valuable tool in interventional planning and procedural decision-making. (orig.)

  14. Bedside Analysis of Acid-Base Balance

    Directory of Open Access Journals (Sweden)

    Yu. S. Podlesskikh


    Full Text Available Laboratory service is one of the most hang-the-expense items in the cost of treatment of patients in an intensive care unit. Isolated acid-base balance (ABB impairments are rare in clinical practice. These impairments are generally combined and they frequently cause a drastic change in the pH value of blood. Early detection of their origin and its elimination are of profound importance in these situations. Miniaturization of analyzers has made it possible to conduct some investigations and particularly to determine ABB just in the intensive care unit or operating suite. The attached software permits creation of a database and transmission of information to the laboratory network. One year’s experience has indicated that the quality of reagents and reference substances allows real-time determination of the values of ABB with a high degree of accuracy and reproducibility at a patient’s bed. 

  15. Electrical properties of nucleic acid bases (United States)

    Basch, Harold; Garmer, D. R.; Jasien, P. G.; Krauss, M.; Stevens, W. J.


    The dipole polarizabilities for the five nucleic acid bases, uracil, cytosine, thymine, guanine, and adenine have been determined by the coupled perturbed Hartree-Fock (CPHF) method using a polarized double-zeta basis set. Electronic correlation corrections from second-order Møller-Plesset (MP2) perturbation theory are given. The treatment required to obtain accurate polarizabilities of these π systems was estimated from calculations on imidazole, benzene, and pyridine, giving results that are in good agreement with experiment. Similarly, optimal basis sets for static electrical properties were determined and applied to calculations of the dipole moments of the bases. With correlation corrections, these agree with experiment within 5% for all molecules except adenine.

  16. Spatial distributions of red blood cells significantly alter local haemodynamics.

    Directory of Open Access Journals (Sweden)

    Joseph M Sherwood

    Full Text Available Although bulk changes in red blood cell concentration between vessels have been well characterised, local distributions are generally overlooked. Red blood cells aggregate, deform and migrate within vessels, forming heterogeneous distributions which have considerable effect on local haemodynamics. The present study reports data on the local distribution of human red blood cells in a sequentially bifurcating microchannel, representing the branching geometry of the microvasculature. Imaging methodologies with simple extrapolations are used to infer three dimensional, time-averaged velocity and haematocrit distributions under a range of flow conditions. Strong correlation between the bluntness of the velocity and haematocrit profiles in the parent branch of the geometry is observed and red blood cell aggregation has a notable effect on the observed trends. The two branches of the first bifurcation show similar characteristics in terms of the shapes of the profiles and the extent of plasma skimming, despite the difference in geometric configuration. In the second bifurcation, considerable asymmetry between the branches in the plasma skimming relationship is observed, and elucidated by considering individual haematocrit profiles. The results of the study highlight the importance of considering local haematocrit distributions in the analysis of blood flow and could lead to more accurate computational models of blood flow in microvascular networks. The experimental approaches developed in this work provide a foundation for further examining the characteristics of microhaemodynamics.

  17. Management and monitoring of haemodynamic complications in acute heart failure. (United States)

    Aspromonte, Nadia; Cruz, Dinna N; Valle, Roberto; Ronco, Claudio


    The pathophysiology of acute heart failure syndromes (AHFS), defined as a change or worsening in heart failure symptoms and signs, is complex. The variety of adverse neurohormonal adaptations includes increased levels of plasma renin, aldosterone and angiotensin II, all responsible for cardio-renal dysfunction. In fact, such alterations result in an array of clinical changes that include abnormal haemodynamics, altered ventricular filling pressures, pathological neurohormonal responses, leading to fluid overload, congestion and ultimately heart failure symptoms. Clinical pictures can be various: in spite of a usual improvement in dyspnoea, little weight change and significant morbidity are generally observed during hospitalization. Short-term outcomes are characterized by a high 60-day re-hospitalization and high mortality rates; apparently, both can be predicted from pre-discharge characteristics. The most frequently used treatments for AHF care include diuretics, inotropic agents, and vasodilator/vasoactive agents; however, the final therapeutic strategy is often individualized. Diuretics are currently the most used agents, but resistance to diuretic therapy is common. In addition, several studies have demonstrated that aggressive diuresis can contribute to reduced renal function, and high doses of diuretics have been associated with increased morbidity and mortality. Many patients with AHFS also suffer from acute or from chronic renal dysfunction (cardio-renal syndromes type 1 and 2, respectively), which further complicate the outcomes and treatment strategies. A personalized patient evaluation of the combined heart and kidney functions is advised to implement the best possible multidisciplinary diagnostic and therapeutic approach.

  18. Deoxyribonucleic Acid Base Composition in Yeasts (United States)

    Meyer, Sally A.; Phaff, H. J.


    The deoxyribonucleic acid base composition of 15 species of yeasts was determined to obtain further clues to or supporting evidence for their taxonomic position. Species examined belonged to the genera Saccharomyces, Debaryomyces, Lodderomyces, Metschnikowia, and Candida. The range of moles per cent guanine plus cytosine (GC content) for all yeasts examined extended from 34.9 to 48.3%. The sporogenous species and the asporogenous yeasts spanned the range with 36.6 to 48.3% GC and 34.9 to 48% GC, respectively. Three Saccharomyces species (S. rosei and related species) exhibited significantly higher GC contents than S. cerevisiae, whereas the fermentative species D. globosus revealed a%GC more aligned to the S. rosei group than to the nonfermentative D. hansenii. Similar GC contents were demonstrated by L. elongasporus and its proposed imperfect form C. parapsilosis. The range of GC contents of various strains of three Metschnikowia species studied was 6.1%, with the type strain of M. pulcherrima having the highest GC content (48.3%) of all of the yeasts examined. PMID:5764346

  19. Comparison of coagulation performance and floc properties using a novel zirconium coagulant against traditional ferric and alum coagulants. (United States)

    Jarvis, Peter; Sharp, Emma; Pidou, Marc; Molinder, Roger; Parsons, Simon A; Jefferson, Bruce


    Coagulation in drinking water treatment has relied upon iron (Fe) and aluminium (Al) salts throughout the last century to provide the bulk removal of contaminants from source waters containing natural organic matter (NOM). However, there is now a need for improved treatment of these waters as their quality deteriorates and water quality standards become more difficult to achieve. Alternative coagulant chemicals offer a simple and inexpensive way of doing this. In this work a novel zirconium (Zr) coagulant was compared against traditional Fe and Al coagulants. The Zr coagulant was able to provide between 46 and 150% lower dissolved organic carbon (DOC) residual in comparison to the best traditional coagulant (Fe). In addition floc properties were significantly improved with larger and stronger flocs forming when the Zr coagulant was used with the median floc sizes being 930 μm for Zr; 710 μm for Fe and 450 μm for Al. In pilot scale experiments, a similar improved NOM and particle removal was observed. The results show that when optimised for combined DOC removal and low residual turbidity, the Zr coagulant out-performed the other coagulants tested at both bench and pilot scale. Copyright © 2012 Elsevier Ltd. All rights reserved.

  20. Acid base balance in blood and cerebrospinal fluid. (United States)

    Horovitz, Y; Tal, I; Keynan, A


    Thirty four infants were studied; 21 with acute gastroenteritis, dehydration, and metabolic acidosis and 13 who served as controls. All infants with metabolic acidosis and without neurological signs had a normal to near normal cerebrospinal fluid acid base balance, but five with metabolic acidosis and severe neurological signs had cerebrospinal fluid acid base disequilibrium. Acute metabolic acidosis in infants may lead to cerebrospinal fluid acid base imbalance causing cerebral dysfunction. PMID:4015176

  1. Characterization and Applications of Organic Coagulant KOHIDRAC


    Karasa Jūlija; Kostjukovs Juris; Grinberga Solveiga


    Low cost, effective and water soluble organic coagulant is offered for the extraction of charged clay particles. Coagulation with KOHIDRAC results in simultaneous concentration and purification of the clay fraction. After treatment with KOHIDRAC the obtained clay samples were free of carbonates and feldspar. Moreover, the amount of quartz decreased significantly in finished samples. The proposed coagulant and the patented methodology can be successfully used as purification procedure or as pr...

  2. Splanchnic haemodynamic changes during acute hypoglycaemia in man. (United States)

    Braatvedt, G D; Newrick, P G; Halliwell, M; Wells, P N; Read, A E; Corrall, R J


    1. Splanchnic haemodynamic changes were studied in seven healthy subjects during hypoglycaemia induced by the intravenous infusion of insulin. Superior mesenteric artery blood flow and cardiac output were examined noninvasively by a Doppler ultrasound technique. 2. Blood glucose concentration fell from 4.5 (0.14) mmol/l basally to 1.5 (0.09) mmol/l [mean (SEM), P less than 0.003] at the hypoglycaemic reaction ('R') and recovered to baseline by 'R' + 60 min. There was an associated rise in plasma glucagon, adrenaline and noradrenaline levels. 3. Superior mesenteric artery blood flow rose at 'R' from a basal value of 532 (38) ml/min to a peak of 803 (73) ml/min at 'R' + 10 min [mean (SEM), P less than 0.005] and remained significantly elevated until 'R' + 40 min. Resistance in this vessel fell by 33% at 'R' + 10 min (P less than 0.005) and remained significantly low until 'R' + 40 min. 4. Cardiac output rose by 33% at 'R' (P less than 0.004) and returned to normal by 'R' + 20 min. This was associated with a 24% rise in pulse rate (P less than 0.03), but no change in stroke volume or mean arterial pressure. Total peripheral resistance fell by 21% at 'R' (P less than 0.005) and had returned to normal by 'R' + 20 min. 5. The sustained rise in splanchnic blood flow during hypoglycaemic recovery may be of homoeostatic importance by providing metabolic fuel to the liver for gluconeogenesis.

  3. Effects of gas exchange on acid-base balance. (United States)

    Lindinger, Michael I; Heigenhauser, George J F


    This paper describes the interactions between ventilation and acid-base balance under a variety of conditions including rest, exercise, altitude, pregnancy, and various muscle, respiratory, cardiac, and renal pathologies. We introduce the physicochemical approach to assessing acid-base status and demonstrate how this approach can be used to quantify the origins of acid-base disorders using examples from the literature. The relationships between chemoreceptor and metaboreceptor control of ventilation and acid-base balance summarized here for adults, youth, and in various pathological conditions. There is a dynamic interplay between disturbances in acid-base balance, that is, exercise, that affect ventilation as well as imposed or pathological disturbances of ventilation that affect acid-base balance. Interactions between ventilation and acid-base balance are highlighted for moderate- to high-intensity exercise, altitude, induced acidosis and alkalosis, pregnancy, obesity, and some pathological conditions. In many situations, complete acid-base data are lacking, indicating a need for further research aimed at elucidating mechanistic bases for relationships between alterations in acid-base state and the ventilatory responses. 2012 American Physiological Society. Compr Physiol 2:2037-2061, 2012.

  4. Ketamine modulation of the haemodynamic response to spreading depolarization in the gyrencephalic swine brain. (United States)

    Sánchez-Porras, Renán; Santos, Edgar; Schöll, Michael; Kunzmann, Kevin; Stock, Christian; Silos, Humberto; Unterberg, Andreas W; Sakowitz, Oliver W


    Spreading depolarization (SD) generates significant alterations in cerebral haemodynamics, which can have detrimental consequences on brain function and integrity. Ketamine has shown an important capacity to modulate SD; however, its impact on SD haemodynamic response is incompletely understood. We investigated the effect of two therapeutic ketamine dosages, a low-dose of 2 mg/kg/h and a high-dose of 4 mg/kg/h, on the haemodynamic response to SD in the gyrencephalic swine brain. Cerebral blood volume, pial arterial diameter and cerebral blood flow were assessed through intrinsic optical signal imaging and laser-Doppler flowmetry. Our findings indicate that frequent SDs caused a persistent increase in the baseline pial arterial diameter, which can lead to a diminished capacity to further dilate. Ketamine infused at a low-dose reduced the hyperemic/vasodilative response to SD; however, it did not alter the subsequent oligemic/vasoconstrictive response. This low-dose did not prevent the baseline diameter increase and the diminished dilative capacity. Only infusion of ketamine at a high-dose suppressed SD and the coupled haemodynamic response. Therefore, the haemodynamic response to SD can be modulated by continuous infusion of ketamine. However, its use in pathological models needs to be explored to corroborate its possible clinical benefit.

  5. Respiratory syncytial virus hospitalisation trends in children with haemodynamically significant heart disease, 1997-2012. (United States)

    Chu, Patricia Y; Hornik, Christoph P; Li, Jennifer S; Campbell, Michael J; Hill, Kevin D


    The aim of the study was to evaluate the trends in respiratory syncytial virus-related hospitalisations and associated outcomes in children with haemodynamically significant heart disease in the United States of America. Study design The Kids' Inpatient Databases (1997-2012) were used to estimate the incidence of respiratory syncytial virus hospitalisation among children ⩽24 months with or without haemodynamically significant heart disease. Weighted multivariable logistic regression and chi-square tests were used to evaluate the trends over time and factors associated with hospitalisation, comparing eras before and after publication of the 2003 American Academy of Pediatrics palivizumab immunoprophylaxis guidelines. Secondary outcomes included in-hospital mortality, morbidity, length of stay, and cost. Overall, 549,265 respiratory syncytial virus-related hospitalisations were evaluated, including 2518 (0.5%) in children with haemodynamically significant heart disease. The incidence of respiratory syncytial virus hospitalisation in children with haemodynamically significant heart disease decreased by 36% when comparing pre- and post-palivizumab guideline eras versus an 8% decline in children without haemodynamically significant heart disease (prespiratory syncytial virus-associated mortality (4.9 versus 0.1%, prespiratory syncytial virus hospitalisation in 2009 was $58,166 (95% CI:$46,017, $70,315). These data provide stakeholders with a means to evaluate the cost-utility of various immunoprophylaxis strategies.

  6. Characterization and Applications of Organic Coagulant KOHIDRAC

    Directory of Open Access Journals (Sweden)

    Karasa Jūlija


    Full Text Available Low cost, effective and water soluble organic coagulant is offered for the extraction of charged clay particles. Coagulation with KOHIDRAC results in simultaneous concentration and purification of the clay fraction. After treatment with KOHIDRAC the obtained clay samples were free of carbonates and feldspar. Moreover, the amount of quartz decreased significantly in finished samples. The proposed coagulant and the patented methodology can be successfully used as purification procedure or as pretreatment for qualitative and quantitative analysis of clay minerals. The possible structure of the active compound KOHIDRAC was investigated in this paper. Real applications of the coagulant were provided.

  7. Coagulation factor Xa signaling: the link between coagulation and inflammatory bowel disease?

    NARCIS (Netherlands)

    Borensztajn, Keren; Peppelenbosch, Maikel P.; Spek, C. Arnold


    Inflammatory bowel disease (IBD) is characterized by activation of the coagulation cascade and it has long been suspected that coagulation is an essential component of this still largely idiopathic group of diseases. The realization that coagulation factors are not only passive mediators in the

  8. Coagulation factor Xa signaling : the link between coagulation and inflammatory bowel disease?

    NARCIS (Netherlands)

    Borensztajn, Keren; Peppelenbosch, Maikel P.; Spek, C. Arnold

    Inflammatory bowel disease (IBD) is characterized by activation of the coagulation cascade and it has long been suspected that coagulation is an essential component of this still largely idiopathic group of diseases. The realization that coagulation factors are not only passive mediators in the

  9. Liver haemodynamics and function in alcoholic cirrhosis. Relation to testosterone treatment and ethanol consumption

    DEFF Research Database (Denmark)

    Gluud, C; Henriksen, J H


    Liver haemodynamics and liver function were measured in 34 alcoholic cirrhotic men before entry and after 12 months (median) in a double-blind, placebo-controlled study on the effect of oral testosterone treatment (200 mg t.i.d.). Comparing data at entry with those at follow-up in the total patient......, testosterone-treated patients did not differ significantly from placebo-treated patients regarding any of the measured variables. No significant relationships could be demonstrated between ethanol consumption and liver haemodynamics and liver function, but the number of patients consuming more than 100 g...... ethanol per day decreased significantly (P less than 0.001) from 22 (65%) before entry to one (3%) during follow-up. In conclusion, oral testosterone treatment of men with alcoholic cirrhosis does not explain the significant improvement of liver haemodynamics and function observed in this study. However...

  10. Effect of long-term losartan administration on renal haemodynamics and function in hypertensive patients. (United States)

    Paterna, S; Parrinello, G; Scaglione, R; Costa, R; Bova, A; Palumbo, V A; Pinto, A; Amato, P; Licata, G


    In this study the efficacy and safety of long-term losartan administration on renal haemodynamics were evaluated in mild to moderate hypertension. After a run-in period with placebo, 18 hypertensives without renal or cardiovascular disease were allocated to losartan (50 mg/die for one year) treatment. Renal haemodynamic measurements included renal plasma flow (ERPF) and glomerular filtration rate (GFR) by standardized radioisotope study. Effective renal blood flow (ERBF), filtration fraction (FF), and renal vascular resistance (RVR) were also calculated. Blood pressure was evaluated monthly, whereas renal haemodynamics and function were detected at baseline and after 6 and 12 months of losartan administration. Losartan induced a significant (p function after 6 months of treatment, but these favourable effects were attenuated after 1 year of treatment.

  11. Relationship between haemodynamic impairment and collateral blood flow in carotid artery disease

    DEFF Research Database (Denmark)

    Hartkamp, Nolan S; Petersen, Esben T; Chappell, Michael A


    Collateral blood flow plays a pivotal role in steno-occlusive internal carotid artery (ICA) disease to prevent irreversible ischaemic damage. Our aim was to investigate the effect of carotid artery disease upon cerebral perfusion and cerebrovascular reactivity and whether haemodynamic impairment...... is influenced at brain tissue level by the existence of primary and/or secondary collateral. Eighty-eight patients with steno-occlusive ICA disease and 29 healthy controls underwent MR examination. The presence of collaterals was determined with time-of-flight, two-dimensional phase contrast MRA and territorial...... arterial spin labeling (ASL) imaging. Cerebral blood flow and cerebrovascular reactivity were assessed with ASL before and after acetazolamide. Cerebral haemodynamics were normal in asymptomatic ICA stenosis patients, as opposed to patients with ICA occlusion, in whom the haemodynamics in both hemispheres...

  12. Management of cancer-associated disseminated intravascular coagulation

    NARCIS (Netherlands)

    Levi, Marcel


    Cancer may be complicated by the occurrence of disseminated intravascular coagulation (DIC). DIC is characterized by a widespread and intravascular activation of coagulation (leading to intravascular fibrin deposition) and simultaneous consumption of coagulation factors and platelets (potentially

  13. Emergency focussed assessment with sonography in trauma (FAST) and haemodynamic stability. (United States)

    Smith, Zoë A; Wood, Darryl


    Focussed assessment with sonography in trauma (FAST) has assumed a key role in the rapid non-invasive assessment of thoracoabdominal trauma and assists in decreasing disposition time. This study evaluates FAST's efficacy with respect to haemodynamic stability in a South African emergency department (ED). Data were collected prospectively by four emergency medicine doctors trained in emergency ultrasonography. FAST scans were performed by one ED doctor and timings, scan result and disposition were recorded. Patient haemodynamic stability was assessed by the emergency doctor performing the scan; subjectively at the time of scanning and objectively using calculation of the shock index. All scan results were subsequently verified by a second ED doctor in a blinded fashion and by CT scanning or operative intervention when clinically indicated. 166 FAST scans were conducted of which 36 (21.7%) were positive. Mean age was 30.6 years (SD 12.8). 74.1% of patients sustained blunt traumatic injury. Doctors' subjective haemodynamic stability assessments had higher specificity, sensitivity and predictive values than shock index alone. Haemodynamic instability and a positive FAST result were significantly related (p=0.004). Sensitivities and specificities of FAST scans for blunt and penetrating trauma were 93.1% and 100%, and 90.0% and 100%, respectively. Corresponding values for pneumothoraces were 84.6% and 100%. This study showed a valuable role for FAST in all traumas, particularly in haemodynamic compromise. As an addition to the physician's repertoire of bedside assessment tools, it improves diagnostic capabilities in comparison with simple haemodynamic assessments alone.

  14. Relation between exercise central haemodynamic response and resting cardiac structure and function in young healthy men. (United States)

    Babcock, Matthew C; Lefferts, Wesley K; Heffernan, Kevin S


    Left ventricular (LV) structure and function are predictors of cardiovascular (CV) morbidity and mortality and are related to resting peripheral haemodynamic load in older adults. The central haemodynamic response to exercise may reveal associations with LV structure and function not detected by traditional peripheral (brachial) measures in a younger population. To examine correlations between acute exercise-induced changes in central artery stiffness and wave reflections and measures of resting LV structure and function. Sixteen healthy men (age 26 ± 6 year; BMI 25·3 ± 2·7 kg m-2 ) had measures of central haemodynamic load measured before/after a 30-s Wingate anaerobic test (WAT). Common carotid artery stiffness and reflected wave intensity were assessed via wave intensity analysis as a regional pulse wave velocity (PWV) and negative area (NA), respectively. Resting LV structure (LV mass) and function [midwall fractional shortening (mFS)] were assessed using M-mode echocardiography in the parasternal short-axis view. There was a significant association between mFS and WAT-mediated change in carotid systolic BP (r = -0·57, P = 0·011), logNA (r = -0·58, P = 0·009) and PWV (r = -0·44, P = 0·045). There were no significant associations between resting mFS and changes in brachial systolic BP (r = -0·26, P>0·05). There were no associations between resting LV mass and changes in any haemodynamic variable (P>0·05). Exercise-induced increases in central haemodynamic load reveal associations with lower resting LV function in young healthy men undetected by traditional peripheral haemodynamics. © 2015 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

  15. Primer on clinical acid-base problem solving. (United States)

    Whittier, William L; Rutecki, Gregory W


    Acid-base problem solving has been an integral part of medical practice in recent generations. Diseases discovered in the last 30-plus years, for example, Bartter syndrome and Gitelman syndrome, D-lactic acidosis, and bulimia nervosa, can be diagnosed according to characteristic acid-base findings. Accuracy in acid-base problem solving is a direct result of a reproducible, systematic approach to arterial pH, partial pressure of carbon dioxide, bicarbonate concentration, and electrolytes. The 'Rules of Five' is one tool that enables clinicians to determine the cause of simple and complex disorders, even triple acid-base disturbances, with consistency. In addition, other electrolyte abnormalities that accompany acid-base disorders, such as hypokalemia, can be incorporated into algorithms that complement the Rules and contribute to efficient problem solving in a wide variety of diseases. Recently urine electrolytes have also assisted clinicians in further characterizing select disturbances. Acid-base patterns, in many ways, can serve as a 'common diagnostic pathway' shared by all subspecialties in medicine. From infectious disease (eg, lactic acidemia with highly active antiviral therapy therapy) through endocrinology (eg, Conn's syndrome, high urine chloride alkalemia) to the interface between primary care and psychiatry (eg, bulimia nervosa with multiple potential acid-base disturbances), acid-base problem solving is the key to unlocking otherwise unrelated diagnoses. Inasmuch as the Rules are clinical tools, they are applied throughout this monograph to diverse pathologic conditions typical in contemporary practice.

  16. Disorders of Acid-Base Balance: New Perspectives. (United States)

    Seifter, Julian L; Chang, Hsin-Yun


    Disorders of acid-base involve the complex interplay of many organ systems including brain, lungs, kidney, and liver. Compensations for acid-base disturbances within the brain are more complete, while limitations of compensations are more apparent for most systemic disorders. However, some of the limitations on compensations are necessary to survival, in that preservation of oxygenation, energy balance, cognition, electrolyte, and fluid balance are connected mechanistically. This review aims to give new and comprehensive perspective on understanding acid-base balance and identifying associated disorders. All metabolic acid-base disorders can be approached in the context of the relative losses or gains of electrolytes or a change in the anion gap in body fluids. Acid-base and electrolyte balance are connected not only at the cellular level but also in daily clinical practice. Urine chemistry is essential to understanding electrolyte excretion and renal compensations. Many constructs are helpful to understand acid-base, but these models are not mutually exclusive. Electroneutrality and the close interconnection between electrolyte and acid-base balance are important concepts to apply in acid-base diagnoses. All models have complexity and shortcuts that can help in practice. There is no reason to dismiss any of the present constructs, and there is benefit in a combined approach.

  17. A new representation of acid-base disturbances

    NARCIS (Netherlands)

    M. Hekking (Marcel); E.S. Gelsema; J. Lindemans (Jan)


    textabstractThe acid-base status of intensive care patients is monitored on the basis of three quantities. The graphical representation which may be of help for the monitoring task is therefore cumbersome. The classical Siggaard-Andersen acid-base chart is such a representation, but it is only

  18. Metabolic acid-base disorders in the critical care unit. (United States)

    de Morais, Helio Autran; Bach, Jonathan F; DiBartola, Stephen P


    The recognition and management of acid-base disorders is a commonplace activity in the critical care unit, and the role of weak and strong acids in the genesis of metabolic acid-base disorders is reviewed. The clinical approach to patients with metabolic alkalosis and metabolic acidosis is discussed in this article.

  19. Defects in coagulation encountered in small animal critical care. (United States)

    Brainard, Benjamin M; Brown, Andrew J


    Critically ill small animals are at risk for developing coagulation abnormalities. The processes of inflammation and coagulation are intertwined, and severe inflammation can lead to disturbances of coagulation. Severe coagulation dysfunction is associated with increased morbidity and mortality. Pathophysiology, diagnosis, and treatment of coagulation dysfunction are discussed. Defects in coagulation in small animal patients are complex and a consensus on diagnosis and treatment has yet to be reached. Copyright © 2011 Elsevier Inc. All rights reserved.

  20. [Digitalization for acute myocardial infarction: haemodynamic changes in patients with heart failure at rest (author's transl)]. (United States)

    Bachour, G; Hochrein, H


    Haemodynamic changes after intravenous administration of 0.4 mg beta-methyldigoxin or 0.4 mg digoxin daily were measured on the first to fourth day in 42 patients in heart failure after onset of transmural myocardial infarction. Regular reduction in filling pressure and increased stroke volume while arterial blood pressure remained unaltered pointed to improved contractility. Digitalization in the first few days after infarction achieved sustained tendency towards improved haemodynamics. It is concluded that early digitalization is indicated in patients with acute myocardial infarction if there are signs of heart failure.

  1. Coagulation and fibrinolysis during laparoscopic cholecystectomy

    DEFF Research Database (Denmark)

    Rahr, H B; Fabrin, K; Larsen, J F


    Laparoscopic surgery appears to be less traumatic to the patient than open surgery, but its influence upon coagulation and fibrinolysis is incompletely elucidated. Our aim was to measure markers of coagulation and fibrinolysis before, during. and after laparoscopic cholecystectomy (LC). Blood...

  2. Investigation of coagulation activity of natural coagulants from seeds of different leguminose species

    Directory of Open Access Journals (Sweden)

    Šćiban Marina B.


    Full Text Available The ability of seeds of plants: Phaseolus vulgaris, Robinia pseudoacacia Ceratonia siliqua and Amorpha fruticosa, to act as natural coagulants was tested using synthetic turbid water. This water was prepared by adding kaolin into tap water, just before the test. Active components were extracted from ground seeds with distilled water. The coagulation ability of this extract was assessed by the use of standard jar test measurements in water with various initial turbidity. Investigation of these natural coagulants was confirmed their positive coagulation activity. Of all plants that have been examined, the seed extract from Ceratonia siliqua appeared to be one of the most effective coagulants for water treatment. A dose of 20 mg/l of this coagulant resulted in 100% coagulation activity for clarification of water with 17.5 NTU initial turbidity.

  3. The Use of Tannins from Turkish Acorns (Valonia) in Water Treatment as a Coagulant and Coagulant Aid


    ŞENGİL, Mahmut ÖZACAR and İ. Ayhan


    Coagulants play an important role in the treatment of water and wastewater and in the treatment and disposal of sludge. Aluminum sulfate, alum, is the common chemical coagulant used in the coagulation process. Recently polymers have been utilized in coagulation/flocculation processes for water purification. In this study, a natural indigenous coagulant is suggested as a substitute for alum or as an aid for alum. The coagulant characteristics of the tannins obtained from valonia were examine...

  4. Respiratory Acid-Base Disorders in the Critical Care Unit. (United States)

    Hopper, Kate


    The incidence of respiratory acid-base abnormalities in the critical care unit (CCU) is unknown, although respiratory alkalosis is suspected to be common in this population. Abnormal carbon dioxide tension can have many physiologic effects, and changes in Pco 2 may have a significant impact on outcome. Monitoring Pco 2 in CCU patients is an important aspect of critical patient assessment, and identification of respiratory acid-base abnormalities can be valuable as a diagnostic tool. Treatment of respiratory acid-base disorders is largely focused on resolution of the primary disease, although mechanical ventilation may be indicated in cases with severe respiratory acidosis. Published by Elsevier Inc.

  5. Enhanced coagulation for high alkalinity and micro-polluted water: the third way through coagulant optimization. (United States)

    Yan, Mingquan; Wang, Dongsheng; Qu, Jiuhui; Ni, Jinren; Chow, Christopher W K


    Conventional coagulation is not an effective treatment option to remove natural organic matter (NOM) in water with high alkalinity/pH. For this type of water, enhanced coagulation is currently proposed as one of the available treatment options and is implemented by acidifying the raw water and applying increased doses of hydrolyzing coagulants. Both of these methods have some disadvantages such as increasing the corrosive tendency of water and increasing cost of treatment. In this paper, an improved version of enhanced coagulation through coagulant optimization to treat this kind of water is demonstrated. A novel coagulant, a composite polyaluminum chloride (HPAC), was developed with both the advantages of polyaluminum chloride (PACl) and the additive coagulant aids: PACl contains significant amounts of highly charged and stable polynuclear aluminum hydrolysis products, which is less affected by the pH of the raw water than traditional coagulants (alum and ferric salts); the additives can enhance both the charge neutralization and bridging abilities of PACl. HPAC exhibited 30% more efficiency than alum and ferric salts in dissolved organic carbon (DOC) removal and was very effective in turbidity removal. This result was confirmed by pilot-scale testing, where particles and organic matter were removed synergistically with HPAC as coagulant by sequential water treatment steps including pre-ozonation, coagulation, flotation and sand filtration.

  6. Comparison of a novel polytitanium chloride coagulant with polyaluminium chloride: coagulation performance and floc characteristics. (United States)

    Zhao, Y X; Phuntsho, S; Gao, B Y; Yang, Y Z; Kim, J-H; Shon, H K


    Polymerized inorganic coagulants are increasingly being used in the water supply and wastewater treatment process, yet there is limited research on the development of polytitanium coagulants. The aim of this study is to synthesize polytitanium chloride (PTC) coagulants and investigate their coagulation behavior and floc characteristics for humic acid removal in comparison to polyaluminum chloride (PAC). The PTC samples with different B (molar ratios of OH/Ti) values were prepared using an instantaneous base-feeding method, employing sodium carbonate as the basification agent. The coagulation efficiency was significantly influenced by different B values. The results suggest that the humic acid removal increased with the increasing B value for PAC, while the inverse trend was observed for PTC. The optimum B value was chosen at 1.0 and 2.0 for PTC and PAC, respectively. Under the optimum coagulant dose and initial solution pH conditions, the PTC coagulant performed better than the PAC coagulant and the floc properties were significantly improved in terms of floc growth rate and floc size. However, the PAC coagulants produced flocs with better floc recoverability than the PTC coagulants. Copyright © 2014 Elsevier Ltd. All rights reserved.

  7. Noradrenaline and adrenaline concentrations in various vascular beds in patients with cirrhosis. Relation to haemodynamics

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik Sahl; Christensen, N J; Ring-Larsen, H


    Plasma noradrenaline (NA) and adrenaline (A) concentrations were related to various haemodynamic parameters in fifteen patients with cirrhosis. In supine position at rest plasma NA and A in peripheral venous blood were significantly higher in patients with cirrhosis than in normal subjects. Mean...

  8. Haemodynamics in postural hypotension--effects of the beta-adrenoceptor partial agonist xamoterol, and pindolol

    DEFF Research Database (Denmark)

    Mehlsen, J; Trap-Jensen, J


    Beta-andrenoceptor agents have been used in the treatment of postural hypotension and agonist activity found to be important. The effects of xamoterol and pindolol on standing haemodynamics were compared in this study. Xamoterol was found to be of significant benefit, but pindolol was ineffective....... Xamoterol may therefore be useful in the treatment of postural hypotension....

  9. Prophylactic administration of atropine attenuates the negative haemodynamic effects of propofol/remifentanil induction of anaesthesia.

    NARCIS (Netherlands)

    Poterman, Marieke; Scheeren, Thomas; van der Velde, M.I.; Struys, Michel; Kalmar, A.F.


    Background and Goal of Study:   Induction of anaesthesia with propofol and remifentanil often induces unwanted bradycardia and hypotension. This raises the concern for preserving haemodynamic stability and adequate tissue oxygenation. We previously demonstrated that atropine significantly

  10. Onset time and haemodynamic response after thiopental vs. propofol in the elderly: a randomized trial

    DEFF Research Database (Denmark)

    Sørensen, Martin Kryspin; Dolven, T L; Rasmussen, L S


    The induction dose of hypnotic agents should be reduced in the elderly, but it is not well studied whether thiopental or propofol should be preferred in this group of patients. The aim of this study was to compare onset time, hypnosis level and the haemodynamic response after thiopental vs...

  11. Continuous blood pressure monitoring in cirrhosis. Relations to splanchnic and systemic haemodynamics

    DEFF Research Database (Denmark)

    Møller, Søren; Christensen, E; Henriksen, Jens Henrik


    . CONCLUSIONS: Although the 24-h blood pressure and the intra-arterial blood pressure were determined by different variables, the overall results indicate that abnormalities in both splanchnic and central haemodynamics and sodium-water retention are important in the pathophysiology of arterial hypotension...

  12. Continuous blood pressure monitoring in cirrhosis. Relations to splanchnic and systemic haemodynamics

    DEFF Research Database (Denmark)

    Møller, Søren; Christensen, E; Henriksen, Jens Henrik


    with cirrhosis than in matched controls (p .... CONCLUSIONS: Although the 24-h blood pressure and the intra-arterial blood pressure were determined by different variables, the overall results indicate that abnormalities in both splanchnic and central haemodynamics and sodium-water retention are important in the pathophysiology of arterial hypotension...

  13. Influence of antenatal physical exercise on haemodynamics in pregnant women: a flexible randomisation approach. (United States)

    Carpenter, Rhiannon Emma; Emery, Simon J; Uzun, Orhan; D'Silva, Lindsay A; Lewis, Michael J


    Normal pregnancy is associated with marked changes in haemodynamic function, however the influence and potential benefits of antenatal physical exercise at different stages of pregnancy and postpartum remain unclear. The aim of this study was therefore to characterise the influence of regular physical exercise on haemodynamic variables at different stages of pregnancy and also in the postpartum period. Fifty healthy pregnant women were recruited and randomly assigned (2 × 2 × 2 design) to a land or water-based exercise group or a control group. Exercising groups attended weekly classes from the 20th week of pregnancy onwards. Haemodynamic assessments (heart rate, cardiac output, stroke volume, total peripheral resistance, systolic and diastolic blood pressure and end diastolic index) were performed using the Task Force haemodynamic monitor at 12-16, 26-28, 34-36 and 12 weeks following birth, during a protocol including postural manoeurvres (supine and standing) and light exercise. In response to an acute bout of exercise in the postpartum period, stroke volume and end diastolic index were greater in the exercise group than the non-exercising control group (p = 0.041 and p = 0.028 respectively). Total peripheral resistance and diastolic blood pressure were also lower (p = 0.015 and p = 0.007, respectively) in the exercise group. Diastolic blood pressure was lower in the exercise group during the second trimester (p = 0.030). Antenatal exercise does not appear to substantially alter maternal physiology with advancing gestation, speculating that the already vast changes in maternal physiology mask the influences of antenatal exercise, however it does appear to result in an improvement in a woman's haemodynamic function (enhanced ventricular ejection performance and reduced blood pressure) following the end of pregnancy. NCT02503995. Registered 20 July 2015.

  14. Teaching acid/base physiology in the laboratory

    DEFF Research Database (Denmark)

    Friis, Ulla G; Plovsing, Ronni; Hansen, Klaus


    Acid/base homeostasis is one of the most difficult subdisciplines of physiology for medical students to master. A different approach, where theory and practice are linked, might help students develop a deeper understanding of acid/base homeostasis. We therefore set out to develop a laboratory...... exercise in acid/base physiology that would provide students with unambiguous and reproducible data that clearly would illustrate the theory in practice. The laboratory exercise was developed to include both metabolic acidosis and respiratory alkalosis. Data were collected from 56 groups of medical...... students that had participated in this laboratory exercise. The acquired data showed very consistent and solid findings after the development of both metabolic acidosis and respiratory alkalosis. All results were consistent with the appropriate diagnosis of the acid/base disorder. Not one single group...

  15. Biologist's Toolbox. Acid-base Balance: An Educational Computer Game. (United States)

    Boyle, Joseph, III; Robinson, Gloria


    Describes a microcomputer program that can be used in teaching the basic physiological aspects of acid-base (AB) balance. Explains how its game format and graphic approach can be applied in diagnostic and therapeutic exercises. (ML)

  16. Acid-base homeostasis in the human system (United States)

    White, R. J.


    Acid-base regulation is a cooperative phenomena in vivo with body fluids, extracellular and intracellular buffers, lungs, and kidneys all playing important roles. The present account is much too brief to be considered a review of present knowledge of these regulatory systems, and should be viewed, instead, as a guide to the elements necessary to construct a simple model of the mutual interactions of the acid-base regulatory systems of the body.

  17. Comparison of coagulation performance and floc properties using a novel zirconium coagulant against traditional ferric and alum coagulants


    Jarvis, Peter; Sharp, Emma; Pidou, Marc; Molinder, Roger; Parsons, Simon A.; Jefferson, Bruce


    Coagulation in drinking water treatment has relied upon iron (Fe) and aluminium (Al) salts throughout the last century to provide the bulk removal of contaminants from source waters containing natural organic matter (NOM). However, there is now a need for improved treatment of these waters as their quality deteriorates and water quality standards become more difficult to achieve. Alternative coagulant chemicals offer a simple and inexpensive way of doing this. In this work a...

  18. Covalently bound organic silicate aluminum hybrid coagulants: preparation, characterization, and coagulation behavior. (United States)

    Zhao, Huazhang; Peng, Jianxiong; Lin, Shrongshi; Zhang, Yan


    Covalently bound organic silicate aluminum hybrid coagulants were synthesized by employing two silane coupling agents [diethoxydimethylsilane (DEDMS), gamma-aminopropylmethyldiethoxysilane (APDES)] as silicon sources. An additional coagulant was synthesized using anothersilane-tetraethylorthosilicate (TEOS) for comparison. Both the coagulant with DEDMS and that with APDES as the silicon source were shown to be covalently bound by infrared (IR) analysis. All three hybrid coagulants were characterized by pH, zeta potential, Al species distribution, and transmission electron microscopy (TEM) analysis. The results indicated that the silicon source played a significant role in aspects of the chemical and physical structure, Al species distribution, and electrochemistry characteristics. Specifically, the coagulant with APDES as the silicon source featured the highest zeta potential value, the highest content of Al13, and reticulated aggregate. The coagulation behaviors of the three hybrid coagulants were also investigated by treating synthetic water containing humic acid (HA). The hybrid coagulant with APDES as the silicon source exhibited the best coagulation behavior in terms of HA removal and turbidity removal, due to the combination of the zeta potential, Al species distribution, and organic functional groups.

  19. Response surface methodology approach to optimize coagulation-flocculation process using composite coagulants

    Energy Technology Data Exchange (ETDEWEB)

    Tshukudu, Tiroyaone; Zheng, Huaili; Hua, Xuebin; Yang, Jun; Ma, Jiangya; Sun, Yongjun; Zhu, Guocheng [Chongqing University, Chongqing (China); Tan, Mingzhuo [Jiangmen Wealth Water Purifying Agent Co. Ltd., Jiangmen (China)


    Response surface method and experimental design were applied as alternatives to the conventional methods for optimization of the coagulation test. A central composite design was used to build models for predicting and optimizing the coagulation process. The model equations were derived using the least square method of the Minitab 16 software. In these equations, the removal efficiency of turbidity and COD were expressed as second-order functions of the coagulant dosage and coagulation pH. By applying RSM, the optimum condition using PFPD{sub 1} was coagulant dosage of 384 mg/L and coagulation pH of 7.75. The optimum condition using PFPD{sub 2} was coagulant dosage of 390 mg/L and coagulation pH of 7.48. Confirmation experiment demonstrated a good agreement between experimental values and model predicted. This demonstrates that RSM and CCD can be successfully applied for modeling and optimizing the coagulation process using PFPD{sub 1} and PFPD{sub 2}.

  20. Effects of Al-coagulant sludge characteristics on the efficiency of coagulants recovery by acidification. (United States)

    Chen, Yi-Jui; Wang, Wen-May; Wei, Ming-Jun; Chen, Jiann-Long; He, Ju-Liang; Chiang, Kung-Yuh; Wu, Chih-Chao


    This study evaluated the effects of Al-coagulant sludge characteristics on the efficiency ofcoagulant recovery by acidification with H2SO4. Two sludge characteristics were studied: types of coagulant and textures of the suspended solid in raw water. The coagulant types are aluminium sulphate and polyaluminium chloride (PACl); the textures of the suspended solid are sand-based and clay-based. Efficiency of aluminium recovery at a pH of 2 was compared for different sludges obtained from water treatment plants in Taiwan. The results showed that efficiency of aluminium recovery from sludge containing clayey particles was higher than that from sludge containing sandy particles. As for the effect of coagulant types, the aluminium recovery efficiency for sludge using PACl ranged between 77% and 100%, whereas it ranged between 65% and 72% for sludge using aluminium sulphate as the coagulant. This means using PACl as the coagulant could result in higher recovery efficiency of coagulant and be beneficial for water treatment plants where renewable materials and waste reduction as the factors for making decisions regarding plant operations. However, other metals, such as manganese, could be released with aluminium during the acidification process and limit the use of the recovered coagulants. It is suggested that the recovered coagulants be used in wastewater treatment processes.

  1. Preparation, characterization and coagulation behaviour of polyferric magnesium silicate (PFMSi) coagulant. (United States)

    Liu, Lvgang; Wu, Chunde; Chen, Yuancai; Wang, Haipan


    A composite coagulant polyferric magnesium silicate (PFMSi) was synthesized by co-polymerization. The structure and morphology of PFMSi were characterized by X-ray diffraction, Fourier transform infrared spectra and scanning electron microscope microphotographs; meanwhile, the coagulation efficiency was evaluated under different ratios of Fe/Si, Mg/Si, basicity ([OH]/[M] ratio), and dosage. The results suggested that the PFMSi coagulant shows an amorphous phase structure, and new chemical compounds had been formed; simultaneously, the different preparation conditions had major effects on coagulation performance. Additionally, the raw water collected from Pearl River was used as a treated water sample to verify the coagulation efficiency of PFMSi. Overall, it is suggested that PFMSi is an efficient coagulant in the removal of turbidity, UV254 and total organic carbon, and it shows a markedly better coagulation performance than polymeric aluminium and non-modified coagulant. The study of coagulation kinetics and zeta potential showed that adsorption-bridging was the main mechanism for the introduction of silicon.

  2. Current management of disseminated intravascular coagulation

    NARCIS (Netherlands)

    Levi, M. [=Marcel M.; de Jonge, E.


    Both a bleeding and a thrombotic disorder, disseminated intravascular coagulation presents diagnostic and therapeutic challenges. At present, diagnosis requires a set of blood tests; therapy focuses on reversing the underlying disorder and providing supportive treatment. Clinical studies of specific

  3. Multi-parameter based coagulant dosing control. (United States)

    Manamperuma, L; Wei, L; Ratnaweera, H


    The required coagulant dosage is strongly related to the quality of raw water or wastewater. Online sensors for most quality parameters are now readily available to treatment facilities, yet remain rarely used in treatment process control. This paper presents the evaluation of an advanced coagulant dosing control system based on online measurements in full-scale processes. The popular multivariate analytical method, partial least square regression, was used to build up the relationship between the coagulant dose and wastewater quality. The system was tested in two wastewater treatment plants (WWTPs) in Norway. Coagulant savings up to 30% in Norwegian plants were observed with feed forward calibrations. The considerable savings reduce sludge production, leading to further cost saving on sludge treatment. This paper presents the method, function and experiences of the full-scale implementation of the system in different WWTPs.

  4. A phenomenological model of milk coagulation


    A. Osintsev; Gromov, E.; Braginsky, V.


    A model of additional stabilization for the milk colloid system by means of the micelle electric charge arising owing to dissociation of micellar calcium caseinate is offered. The model allows comprehending the unique role of calcium in milk clotting and describing some features of coagulation temperature dependence, as well as explaining the nature of rennet, acid, heat-acid and heat-calcium coagulation within uniform concepts.

  5. Acute Disseminated Intravascular Coagulation in Neuroendocrine Carcinoma


    Ru-Wen Teh; Tsoi, Daphne T.


    Malignancy is a common cause of disseminated intravascular coagulation and usually presents as a chronic disorder in solid organ tumours. We present a rare case of recurrent acute disseminated intravascular coagulation in neuroendocrine carcinoma after manipulation, firstly, by core biopsy and, later, by cytotoxic therapy causing a release of procoagulants and cytokines from lysed tumour cells. This is reminiscent of tumour lysis syndrome where massive quantities of intracellular electrolytes...

  6. Effects of nucleotides and nucleosides on coagulation

    DEFF Research Database (Denmark)

    Bune, Laurids; Thaning, Pia; Johansson, Pär I


    Nucleotides, including ADP, ATP and uridine triphosphate (UTP), are discharged profusely in the circulation during many pathological conditions including sepsis. Sepsis can cause hypotension and systemic activation of the coagulation and fibrinolytic systems in humans, which may cause disseminated...... intravascular coagulation. We investigated whether nucleotide-induced cardiovascular collapse as provoked by systemic infusion of adenosine, ADP, ATP, UTP and nitric oxide affected the haemostatic system as assessed by whole blood thromboelastography (TEG) analysis. Ten pigs received a randomized infusion...

  7. Removal of silver nanoparticles by coagulation processes

    Energy Technology Data Exchange (ETDEWEB)

    Sun, Qian; Li, Yan [Key Laboratory of Urban Environment and Health, Institute of Urban Environment, Chinese Academy of Sciences, Xiamen 361021 (China); Tang, Ting [Key Laboratory of Urban Environment and Health, Institute of Urban Environment, Chinese Academy of Sciences, Xiamen 361021 (China); College of Earth and Environment, Anhui University of Science and Technology, Huainan 232001 (China); Yuan, Zhihua [Key Laboratory of Urban Environment and Health, Institute of Urban Environment, Chinese Academy of Sciences, Xiamen 361021 (China); Yu, Chang-Ping, E-mail: [Key Laboratory of Urban Environment and Health, Institute of Urban Environment, Chinese Academy of Sciences, Xiamen 361021 (China)


    Highlights: • This study investigated the removal of AgNP suspensions by four regular coagulants. • The optimal removal efficiencies for the four coagulants were achieved at pH 7.5. • The removal efficiency of AgNPs was affected by the natural water characteristics. • TEM and XRD showed that AgNPs or silver-containing NPs were adsorbed onto the flocs. -- Abstract: Commercial use of silver nanoparticles (AgNPs) will lead to a potential route for human exposure via potable water. Coagulation followed by sedimentation, as a conventional technique in the drinking water treatment facilities, may become an important barrier to prevent human from AgNP exposures. This study investigated the removal of AgNP suspensions by four regular coagulants. In the aluminum sulfate and ferric chloride coagulation systems, the water parameters slightly affected the AgNP removal. However, in the poly aluminum chloride and polyferric sulfate coagulation systems, the optimal removal efficiencies were achieved at pH 7.5, while higher or lower of pH could reduce the AgNP removal. Besides, the increasing natural organic matter (NOM) would reduce the AgNP removal, while Ca{sup 2+} and suspended solids concentrations would also affect the AgNP removal. In addition, results from the transmission electron microscopy and X-ray diffraction showed AgNPs or silver-containing nanoparticles were adsorbed onto the flocs. Finally, natural water samples were used to validate AgNP removal by coagulation. This study suggests that in the case of release of AgNPs into the source water, the traditional water treatment process, coagulation/sedimentation, can remove AgNPs and minimize the silver ion concentration under the well-optimized conditions.

  8. Disturbed acid-base transport: an emerging cause of hypertension

    Directory of Open Access Journals (Sweden)

    Ebbe eBoedtkjer


    Full Text Available Genome-wide association studies and physiological investigations have linked alterations in acid-base transporters to hypertension. Accordingly, Na+-coupled HCO3--transporters, Na+/H+-exchangers, and anion-exchangers have emerged as putative mechanistic components in blood pressure disturbances. Even though hypertension has been studied extensively over the last several decades, the cause of the high blood pressure has in most cases not been identified. Renal, cardiovascular, and neuronal dysfunctions all seem to play a role in hypertension development but their relative importance and mutual interdependency are still being debated. Multiple functional and structural alterations have been described in patients and animals with hypertension but it is typically unclear whether they are causes or consequences of hypertension or represent mechanistically unrelated associations. Perturbed blood pressure regulation has been demonstrated in several animal models with disrupted expression of acid-base transporters; and reciprocally, disturbed acid-base transport function has been described in hypertensive individuals. In addition to regulating intracellular and extracellular pH, Na+-coupled HCO3--transport, Na+/H+-exchange, and anion-exchange also contribute to water and electrolyte balance in cells and systemically. Since acid-base transporters are widely expressed, alterations in transport activities likely affect multiple cell and organ functions, and it is a significant challenge to determine the mechanisms linking perturbed acid-base transport function to hypertension. It is the purpose of this review to evaluate the current evidence for involvement of acid-base transporters in hypertension development and discuss the cellular and integrative mechanisms, which may link changes in acid-base transport to blood pressure disturbances.

  9. Inflammation and coagulation in atherosclerosis. (United States)

    Krychtiuk, K A; Kastl, S P; Speidl, W S; Wojta, J


    Cardiovascular diseases remain to be the leading cause of death in Western societies. Despite major findings in vascular biology that lead to a better understanding of the pathomechanisms involved in atherosclerosis, treatment of the disease has only changed slightly within the last years. A big body of evidence suggests that atherosclerosis is a chronic inflammatory disease of the vessel wall. Accumulation and peroxidation of LDL-particles within the vessel wall trigger a strong inflammatory response, causing macrophage and T-cell accumulation within the vessel wall. Additionally, B-cells and specific antibodies against LDL-particles, as well as the complement system are implicated in atherogenesis. Besides data from clinical trials and autopsy studies it was the implementation of mouse models of atherosclerosis and the emerging field of direct gen-modification that lead to a thorough description of the pathophysiological mechanisms involved in the disease and created overwhelming evidence for a participation of the immune system. Recently, the cross-talk between coagulation and inflammation in atherogenesis has gained attention. Serious limitations and disparities in the pathophysiology of atherosclerosis in mice and men complicated the translation of experimental data into clinical practice. Despite these limitations, new anti-inflammatory medical therapies in cardiovascular disease are currently being tested in clinical trials.

  10. Myocardial and haemodynamic responses to two fluid regimens in African children with severe malnutrition and hypovolaemic shock (AFRIM study)

    NARCIS (Netherlands)

    Obonyo, Nchafatso; Brent, Bernadette; Olupot-Olupot, Peter; Boele van Hensbroek, Michael; Kuipers, Irene; Wong, Sidney; Shiino, Kenji; Chan, Jonathan; Fraser, John; van Woensel, Job B. M.; Maitland, Kathryn


    Background: Fluid therapy in severely malnourished children is hypothesized to be deleterious owing to compromised cardiac function. We evaluated World Health Organization (WHO) fluid resuscitation guidelines for hypovolaemic shock using myocardial and haemodynamic function and safety endpoints.

  11. Randomized comparison of exercise haemodynamics of Freestyle, Magna Ease and Trifecta bioprostheses after aortic valve replacement for severe aortic stenosis. (United States)

    Bach, David S; Patel, Himanshu J; Kolias, Theodore J; Deeb, G Michael


    The purpose of this study was to compare haemodynamics at rest and during exercise after clinically indicated aortic valve replacement (AVR) for aortic stenosis among patients randomly assigned to one of three haemodynamically excellent bioprostheses. In a single-centre, prospective trial, 60 patients undergoing clinically indicated AVR were randomly assigned to Freestyle, Magna Ease or Trifecta bioprostheses. Six months after surgery, patients underwent supine bicycle stress echocardiography for the assessment of aortic valve haemodynamics. There were 5 protocol deviations from random valve assignments, and 4 patients did not return for follow-up stress echo, yielding a study group of 56 patients {17 Freestyle, 21 Magna Ease, 18 Trifecta; median age 70 [interquartile range (IQR) 63-78 years], 37 (66%) men}. There were no statistically significant differences between groups in valve size, concomitant procedures or exercise variables. Resting haemodynamics revealed significant differences between groups in mean gradient [Freestyle 7 (IQR 5-9) mmHg, Magna Ease 9 (IQR 7-11) mmHg, Trifecta 5 (IQR 4-8) mmHg; P = 0.04], effective orifice area (EOA) [2.5 (IQR 2.2-2.7), 2.1 (IQR 1.7-2.3) and 2.6 (IQR 2.3-2.8), respectively; P = 0.02] and EOA index [1.22 (IQR 1.11-1.32), 1.02 (IQR 0.89-1.14) and 1.31 (IQR 1.00-1.42), respectively; P = 0.03]; in each case, Trifecta had better haemodynamics compared with Magna Ease. With exercise, significant differences between groups were evident in peak velocity at 50 watts and peak exercise; mean gradient at 25 watts, 50 watts and maximal exercise; and EOA at 25 watts and at peak exercise; all with haemodynamic superiority of Trifecta compared with Magna Ease. There were no statistically significant differences between Trifecta and Freestyle haemodynamics at rest or with exercise. In a prospective, randomized study comparing haemodynamics after Freestyle, Magna Ease and Trifecta, all three valves exhibited good haemodynamics at rest and

  12. Ammonia Transporters and Their Role in Acid-Base Balance. (United States)

    Weiner, I David; Verlander, Jill W


    Acid-base homeostasis is critical to maintenance of normal health. Renal ammonia excretion is the quantitatively predominant component of renal net acid excretion, both under basal conditions and in response to acid-base disturbances. Although titratable acid excretion also contributes to renal net acid excretion, the quantitative contribution of titratable acid excretion is less than that of ammonia under basal conditions and is only a minor component of the adaptive response to acid-base disturbances. In contrast to other urinary solutes, ammonia is produced in the kidney and then is selectively transported either into the urine or the renal vein. The proportion of ammonia that the kidney produces that is excreted in the urine varies dramatically in response to physiological stimuli, and only urinary ammonia excretion contributes to acid-base homeostasis. As a result, selective and regulated renal ammonia transport by renal epithelial cells is central to acid-base homeostasis. Both molecular forms of ammonia, NH3 and NH4(+), are transported by specific proteins, and regulation of these transport processes determines the eventual fate of the ammonia produced. In this review, we discuss these issues, and then discuss in detail the specific proteins involved in renal epithelial cell ammonia transport. Copyright © 2017 the American Physiological Society.

  13. Assessment of acid-base balance. Stewart's approach. (United States)

    Fores-Novales, B; Diez-Fores, P; Aguilera-Celorrio, L J


    The study of acid-base equilibrium, its regulation and its interpretation have been a source of debate since the beginning of 20th century. Most accepted and commonly used analyses are based on pH, a notion first introduced by Sorensen in 1909, and on the Henderson-Hasselbalch equation (1916). Since then new concepts have been development in order to complete and make easier the understanding of acid-base disorders. In the early 1980's Peter Stewart brought the traditional interpretation of acid-base disturbances into question and proposed a new method. This innovative approach seems more suitable for studying acid-base abnormalities in critically ill patients. The aim of this paper is to update acid-base concepts, methods, limitations and applications. Copyright © 2015 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.


    Directory of Open Access Journals (Sweden)

    G. R. Nabi Bidhendi;A. Torabian;H. Ehsani;N. Razmkhah


    Full Text Available Textile industry is the major source of water consumption and wastewater pollution. There are various treatment techniques to remove textile wastewater pollution. Coagulation-flocculation is a widely used process to remove pollution due to suspended particles. In this research, different coagulants like Alum, Lime, FeCl3, FeSO4 and MgCl2 were applied to select the suitable ones with optimum removal efficiency. Settling characteristics of flocs formed in the coagulation process were studied in a laboratory scale settling column unit. Parameters such as color, COD, TSS, turbidity and settled sludge volume have been evaluated. The optimum coagulant dose and pH value were determined by comparing the effectiveness of these coagulants. Results showed other coagulants except lime could eliminate color and COD successfully. In this case, FeSO4 was chosen as an optimum coagulant for color removal because of the lowest required coagulant dose, minimum settled sludge volume and maximum decolorization.

  15. Liver haemodynamics and function in alcoholic cirrhosis. Relation to testosterone treatment and ethanol consumption

    DEFF Research Database (Denmark)

    Gluud, C; Henriksen, Jens Henrik Sahl


    Liver haemodynamics and liver function were measured in 34 alcoholic cirrhotic men before entry and after 12 months (median) in a double-blind, placebo-controlled study on the effect of oral testosterone treatment (200 mg t.i.d.). Comparing data at entry with those at follow-up in the total patient...... group, a significant change in median values of portal pressure (-23%, n = 34, P less than 0.005), hepatic blood flow (-22%, n = 28, P less than 0.001), indocyanine green clearance (+16%, n = 29, P less than 0.01), and galactose elimination capacity (+8%, n = 31, P less than 0.05) was observed. However......, testosterone-treated patients did not differ significantly from placebo-treated patients regarding any of the measured variables. No significant relationships could be demonstrated between ethanol consumption and liver haemodynamics and liver function, but the number of patients consuming more than 100 g...

  16. Continuous blood pressure monitoring in cirrhosis. Relations to splanchnic and systemic haemodynamics

    DEFF Research Database (Denmark)

    Møller, S; Christensen, E; Henriksen, Jens Henrik Sahl


    blood pressure and related to the results of an invasive haemodynamic investigation, including measurements of intra-arterial blood pressure (9.00-11.00 h) in 37 patients with cirrhosis. RESULTS: The 24-h blood pressures were significantly lower and the heart rate was significantly higher in patients......BACKGROUND/AIMS: Low arterial blood pressure is recognised as a distinctive factor in the hyperdynamic circulation in cirrhosis. 24-hour monitoring of the blood pressure and heart rate has recently revealed a reduced circadian variation with relation to liver function. However, associations...... with other clinical and haemodynamic characteristics have not been investigated and the aim of the present study was to identify splanchnic and systemic determinants of the 24-h blood pressure and heart rate in cirrhosis. METHODS: The variables were measured by an automatic ambulant device for monitoring...

  17. Effect of octreotide on systemic, central, and splanchnic haemodynamics in cirrhosis

    DEFF Research Database (Denmark)

    Møller, S; Brinch, K; Henriksen, Jens Henrik Sahl


    hypertension. However, reports on the splanchnic and systemic effects of octreotide are contradictory and therefore the aim of the present study was to assess the effects of continuous infusion of octreotide on central and systemic haemodynamics, portal pressures, and hepatic blood flow. METHODS: Thirteen......BACKGROUND/AIMS: Cirrhosis with portal hypertension is associated with changes in the splanchnic and systemic haemodynamics, and subsequent complications, such as bleeding from oesophageal varices, have led to the introduction of long-acting somatostatin analogues in the treatment of portal...... patients with cirrhosis underwent liver vein catheterisation. Portal and arterial blood pressures were determined at baseline and 10, 30, and 50 min after a bolus injection of octreotide 100 micrograms, followed by continuous infusion of octreotide 100 micrograms/ h for 1 h. Hepatic blood flow, cardiac...

  18. Effect of oxygen inhalation on systemic, central, and splanchnic haemodynamics in cirrhosis

    DEFF Research Database (Denmark)

    Møller, Søren; Becker, Povl Ulrik; Schifter, S


    BACKGROUND/AIMS: Patients with cirrhosis exhibit a hyperdynamic circulation with increased cardiac output and low arterial blood pressure. The aim of the present study was to assess the effects of oxygen inhalation on systemic, central, and splanchnic haemodynamics and vasoactive systems in patie......BACKGROUND/AIMS: Patients with cirrhosis exhibit a hyperdynamic circulation with increased cardiac output and low arterial blood pressure. The aim of the present study was to assess the effects of oxygen inhalation on systemic, central, and splanchnic haemodynamics and vasoactive systems...... (r = 0.72, p inhalation of 100% oxygen over a period of 20 min, the cardiac output decreased from 7.4 to 6.6 l/min (p ....005). The change in systemic vascular resistance was significantly greater in patients with mild liver dysfunction than in those with severe liver dysfunction (p inhalation of oxygen. Arterial concentrations...

  19. An integrated geometric modelling framework for patient-specific computational haemodynamic study on wide-ranged vascular network. (United States)

    Torii, Ryo; Oshima, Marie


    Patient-specific haemodynamic computations have been used as an effective tool in researches on cardiovascular disease associated with haemodynamics such as atherosclerosis and aneurysm. Recent development of computer resource has enabled 3D haemodynamic computations in wide-spread arterial network but there are still difficulties in modelling vascular geometry because of noise and limited resolution in medical images. In this paper, an integrated framework to model an arterial network tree for patient-specific computational haemodynamic study is developed. With this framework, 3D vascular geometry reconstruction of an arterial network and quantification of its geometric feature are aimed. The combination of 3D haemodynamic computation and vascular morphology quantification helps better understand the relationship between vascular morphology and haemodynamic force behind 'geometric risk factor' for cardiovascular diseases. The proposed method is applied to an intracranial arterial network to demonstrate its accuracy and effectiveness. The results are compared with the marching-cubes (MC) method. The comparison shows that the present modelling method can reconstruct a wide-ranged vascular network anatomically more accurate than the MC method, particularly in peripheral circulation where the image resolution is low in comparison to the vessel diameter, because of the recognition of an arterial network connectivity based on its centreline.

  20. Telemetric analysis of haemodynamic regulation during voluntary exercise training in mouse models. (United States)

    Adlam, D; De Bono, J P; Danson, E J; Zhang, M H; Casadei, B; Paterson, D J; Channon, K M


    Regular physical exercise reduces the risk of cardiovascular disease and improves outcome in patients with cardiovascular diseases. The dynamic changes in blood pressure and heart rate with acute exercise are independently predictive of prognosis. Quantification of the haemodynamic response to exercise training in genetically modified mouse models may provide insight into the molecular mechanisms underlying the beneficial effects of exercise. We describe, for the first time, the use of radiotelemetry to provide continuous blood pressure monitoring in C57BL/6J mice during a programme of voluntary wheel exercise with continuous simultaneous recording and analysis of wheel rotations and beat-by-beat haemodynamic parameters. We define distinct haemodynamic profiles at rest, during normal cage activity and during episodes of voluntary wheel running. We show that whilst cage activity is associated with significant rises both in blood pressure and in heart rate, voluntary wheel running leads to a further substantial rise in heart rate with only a small increment in blood pressure. With 5 weeks of chronic exercise training, resting heart rate progressively falls, but heart rate during episodes of wheel running initially increases. In contrast, there are minimal changes in blood pressure in response to chronic exercise training. Finally, we have quantified the acute changes in heart rate at the onset of and recovery from individual episodes of wheel running, revealing that changes in heart rate are extremely rapid and that the peak rate of change of heart rate increases with chronic exercise training. The results of this study have important implications for the use of genetically modified mouse models to investigate the beneficial haemodynamic effects of chronic exercise on blood pressure and cardiovascular diseases.

  1. Endothelin-1 and endothelin-3 in cirrhosis: relations to systemic and splanchnic haemodynamics

    DEFF Research Database (Denmark)

    Møller, Søren; Gülberg, V; Henriksen, Jens Henrik


    BACKGROUND/AIMS: Endothelins are isopeptides with potent vasoactive properties, but their implications in the hyperkinetic syndrome in cirrhosis are obscure. Therefore, the aim of the present study was to relate hepatic venous and circulating endothelin-1 and endothelin-3 to systemic and splanchn...... that the endothelin system is implicated in both systemic and portal haemodynamic abnormalities in cirrhosis, although this study does not allow conclusions on causal relationships....

  2. Efficacy and haemodynamic effects of vacuum-assisted closure for post-sternotomy mediastinitis in children. (United States)

    Takahara, Shingo; Sai, Sadahiro; Kagatani, Tomoaki; Konishi, Akinobu


    Post-sternotomy mediastinitis is a significant morbidity with controversial management. Vacuum-assisted closure (VAC) has been used to treat mediastinitis, with many reports documenting its efficacy and feasibility, particularly in adults. However, its use is not prevalent in the paediatric population because of concerns that it may deteriorate haemodynamics. This study aimed to evaluate outcomes and effects of VAC on the haemodynamics of paediatric patients with post-sternotomy mediastinitis. Six patients were treated with VAC between April 2005 and March 2013. We retrospectively investigated their profiles, clinical outcomes and haemodynamic changes, including mean blood pressure (MBP), mean heart rate (MHR), urinary output, amount of diuretics and vasoactive-inotropic score (VIS), before and after VAC initiation. The median age and body weight of patients were 6.4 months and 4.5 kg, respectively. Three patients (50%) had single ventricular physiology. The median VAC duration was 12 days. One patient died of pulmonary venous obstruction after mediastinitis was cured. The average MBPs in every 8-h period were examined, and there were no significant changes (P = 0.773); the average MHRs were examined in the same manner and they decreased significantly after initiation of VAC (P = 0.032). Only 2 patients required vasoactive agents. The VIS did not change in 1 patient and decreased in the other. The mean amount of diuretics administered and urinary output per body weight did not change significantly (P = 0.395 and 0.273, respectively). In conclusion, the haemodynamics of children were not significantly affected by the negative pressure of VAC, indicating that this therapy may be safe and effective for post-sternotomy mediastinitis, even in small children with complex cardiac anomalies. © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  3. Exercise haemodynamics and maximal exercise capacity during beta-adrenoceptor blockade in normotensive and hypertensive subjects.


    Baak, M.A.; Koene, F M; Verstappen, F T


    1. The effects of atenolol administration on maximal exercise capacity and exercise haemodynamics have been compared in eight normotensive and eight mildly hypertensive subjects, matched for sex, age, body weight, and maximal oxygen uptake, and familiar with maximal exercise testing. 2. Supine and exercise blood pressure, and exercise total peripheral resistance were significantly higher, and exercise cardiac output was significantly lower in the hypertensive than in the normotensive subjects...

  4. Onset time and haemodynamic response after thiopental vs. propofol in the elderly: a randomized trial

    DEFF Research Database (Denmark)

    Sørensen, Martin Kryspin; Dolven, T L; Rasmussen, L S


    The induction dose of hypnotic agents should be reduced in the elderly, but it is not well studied whether thiopental or propofol should be preferred in this group of patients. The aim of this study was to compare onset time, hypnosis level and the haemodynamic response after thiopental vs....... propofol for induction of anaesthesia. Our primary hypothesis was that in the elderly, thiopental had a shorter onset time than propofol, defined as time to bispectral index (BIS)...

  5. Assessing Acid-Base Status: Physiologic Versus Physicochemical Approach. (United States)

    Adrogué, Horacio J; Madias, Nicolaos E


    The physiologic approach has long been used in assessing acid-base status. This approach considers acids as hydrogen ion donors and bases as hydrogen ion acceptors and the acid-base status of the organism as reflecting the interaction of net hydrogen ion balance with body buffers. In the physiologic approach, the carbonic acid/bicarbonate buffer pair is used for assessing acid-base status and blood pH is determined by carbonic acid (ie, Paco2) and serum bicarbonate levels. More recently, the physicochemical approach was introduced, which has gained popularity, particularly among intensivists and anesthesiologists. This approach posits that the acid-base status of body fluids is determined by changes in the dissociation of water that are driven by the interplay of 3 independent variables: the sum of strong (fully dissociated) cation concentrations minus the sum of strong anion concentrations (strong ion difference); the total concentration of weak acids; and Paco2. These 3 independent variables mechanistically determine both hydrogen ion concentration and bicarbonate concentration of body fluids, which are considered as dependent variables. Our experience indicates that the average practitioner is familiar with only one of these approaches and knows very little, if any, about the other approach. In the present Acid-Base and Electrolyte Teaching Case, we attempt to bridge this knowledge gap by contrasting the physiologic and physicochemical approaches to assessing acid-base status. We first outline the essential features, advantages, and limitations of each of the 2 approaches and then apply each approach to the same patient presentation. We conclude with our view about the optimal approach. Copyright © 2016 National Kidney Foundation, Inc. All rights reserved.

  6. History of nutrition and acid-base physiology. (United States)

    Manz, F


    In the 17th century the notion of nutrition and diet changed in northern European countries. First chemical experiments fostered the idea that salts resulted from a union of acids and bases. Digestion was no more regarded as a process of cooking but a succession of fermentations controlled by a balanced production of acids and alkali. Life seemed to depend on the equilibrium of acids and alkalis. In the 19th century food was systematically analysed for the content of energy and macronutrients and first scientifically based nutritional standards were formulated. The preferred use of processed food from the new food industry resulted in epidemics of nutritional disorders. Acidosis seemed to be a plausible pathogenic factor. Practitioners (S Ishizuka, H Hay, FX Mayr) formulated holistic doctrines integrating the concept of balance of acids and bases and recommending food with an excess of alkali. New micromethods to determine the concentration of electrolytes and blood acid-base status promoted physiological and clinical research into acid-base metabolism in the 1960s. In the new physiologically based terminology of systemic acid-base status, the relationship between blood acid-base status and net acid intake or excretion was, however, incorrectly simplified. In the 1970s metabolic acidosis was observed in patients on chemically defined diets and parenteral nutrition. Based on the data of comprehensive acid-base balance studies, calculation models were used to estimate renal net acid excretion from nutrient intake and to predict the potential renal acid load of single foods. Extrapolating current trends to the future, one can say that acid-base physiology will probably remain a challenge in nutrition and functional medicine over the next few years. The challenge will include new concepts for the manipulation of nutritional acid load in sports, dietetics and preventive medicine as well as new definitions of the upper intake level of potential renal acid load in

  7. Impact of preoperative fasting times on blood glucose concentration, ketone bodies and acid-base balance in children younger than 36 months: A prospective observational study. (United States)

    Dennhardt, Nils; Beck, Christiane; Huber, Dirk; Nickel, Katja; Sander, Björn; Witt, Lars-Henrik; Boethig, Dietmar; Sümpelmann, Robert


    In contrast to preoperative fasting guidelines in paediatric anaesthesia, actual fasting times are often too long. The objective of this study was to evaluate the effect of preoperative fasting on glucose concentration, ketone bodies and acid-base balance in children. A prospective, noninterventional, clinical observational study. A single-centre trial, study period from June 2014 to November 2014. One hundred children aged 0 to 36 months scheduled for elective paediatric surgery. Patient demographics, fasting times, haemodynamic data, glucose and ketone body concentrations, and acid-base parameters after induction of anaesthesia were documented using a standardised case report form. Mean fasting period was 7.8 ± 4.5 (3.5 to 20) h, and deviation from guideline (ΔGL) was 3.3 ± 3.2 (-2 to 14) h. Linear regression showed a significant correlation between fasting times and ketone bodies, anion gap, base excess, osmolality as well as bicarbonate (for each, P base excess significantly lower than children with ΔGL less than 2 h (for each, P < 0.05). After prolonged preoperative fasting, children younger than 36 months can present with ketoacidosis and (low) normal blood glucose concentrations. Actual fasting times should be optimised according to existing guidelines. In small infants, deviations from fasting guidelines should be as short as possible and not longer than 2 h.

  8. Acid-base disturbance in patients with cirrhosis

    DEFF Research Database (Denmark)

    Henriksen, Jens H; Bendtsen, Flemming; Møller, Søren


    PURPOSE: Acid-base disturbances were investigated in patients with cirrhosis in relation to hemodynamic derangement to analyze the hyperventilatory effects and the metabolic compensation. METHODS: A total of 66 patients with cirrhosis and 44 controls were investigated during a hemodynamic study......, and effects of unidentified ions (all Pacid-base disturbances could not be identified. CONCLUSION: Hypocapnic alkalosis is related to disease severity and hyperdynamic systemic circulation in patients with cirrhosis. The metabolic compensation includes...... alterations in serum albumin and water retention that may result in a delicate acid-base balance in these patients....

  9. Acids and bases solvent effects on acid-base strenght

    CERN Document Server

    Cox, Brian G


    Acids and bases are ubiquitous in chemistry. Our understanding of them, however, is dominated by their behaviour in water. Transfer to non-aqueous solvents leads to profound changes in acid-base strengths and to the rates and equilibria of many processes: for example, synthetic reactions involving acids, bases and nucleophiles; isolation of pharmaceutical actives through salt formation; formation of zwitter- ions in amino acids; and chromatographic separation of substrates. This book seeks to enhance our understanding of acids and bases by reviewing and analysing their behaviour in non-aqueous solvents. The behaviour is related where possible to that in water, but correlations and contrasts between solvents are also presented.

  10. Postoperative haemodynamic changes in transplanted liver: Long-term follow-up with ultrasonography. (United States)

    Han, Hong; Liu, Rong; Wang, Wen-Ping; Ding, Hong; Wen, Jie-Xian; Lin, Xi-Yuan


    To investigate haemodynamic changes in the transplanted liver without postoperative complications. Colour Doppler ultrasound was used to monitor recipients of liver transplants who had no postoperative complications. The haemodynamic data for the hepatic vasculature were compared at different time-points during the first 4 years after liver transplantation. A total of 144 liver transplant patients were enrolled in the study. Portal vein flow velocity decreased significantly from 72.1 ± 30.3 cm/s at 1 day to 44.2 ± 20.1 cm/s at 1 month after liver transplantation. Hepatic artery flow velocity was 61.4 ± 33.2 cm/s at day 1; it then decreased slowly but significantly to 48.3 ± 20.4 cm/s at 3 years after transplantation. There were 81 (56.3%) patients with high hepatic artery resistance index (HARI) (>0.80) and 19 (13.2%) with low HARI (liver transplantation. Abnormal haemodynamic Doppler results should be interpreted with caution because they may not be clinically significant and may improve spontaneously. © The Author(s) 2014 Reprints and permissions:

  11. Ocular Image and Haemodynamic Features Associated with Different Gradings of Ipsilateral Internal Carotid Artery Stenosis

    Directory of Open Access Journals (Sweden)

    Hui Wang


    Full Text Available Objectives. To analyse the changes of ocular haemodynamics and morphology in Chinese patients with internal carotid artery (ICA stenosis in the current study. Methods. A retrospective case-control study was conducted with 219 patients. The haemodynamic characteristics, the calibre of retinal vessels, and the subfoveal choroidal thickness (SFChT were compared. We analysed the correlations with the degree of ipsilateral ICA stenosis. Results. There were no significant differences among the groups in the central retinal artery equivalent (CRAE, central retinal vein equivalent (CRVE, and AVR (p=0.073, p=0.188, and p=0.738, resp.. The peak systolic velocity (PSV and end diastolic velocity (EDV in the central retinal artery (CRA and the posterior ciliary artery (PCA were significantly lower than normal eyes (p<0.001. The outer retinal layer thickness and SFChT values of the ICA stenosis groups were significantly lower than normal eyes (p=0.030 and p<0.001, resp.. Conclusion. The PSV and EDV in CRA and PCA and the SFChT and outer retinal layer thickness of ICA eyes were significantly lower than normal eyes. ICA stenosis may impact choroidal haemodynamics, and decreased choroidal circulation might affect the discordance of the SFChT and the outer retinal layer thickness.

  12. The influence of flow diverter's angle of curvature across the aneurysm neck on its haemodynamics. (United States)

    Karunanithi, Kaavya; Lee, Chang Joon; Chong, Winston; Qian, Yi


    Flow diverter stents have provided a new method of endovascular reconstruction for large and complex aneurysms. Understanding the impact of the flow diverter's angle of curvature across the neck and its metal coverage rate on the haemodynamics of aneurysm is crucial to maximize the mass flow reduction inside the aneurysm, post-deployment. The aim of this study is to understand the correlation between the angle of curvature of flow diverter across the aneurysm neck and the metal coverage rate, and the aneurysm's haemodynamics, using computational fluid dynamics. Varying the flow diverter angle resulted in varying metal coverage rate across the aneurysm neck for two patient vessel geometries, A (straight artery) and B (curved artery) with aspect ratios of 3.1 and 2.9, respectively. The results indicate that there exists a relationship between the aneurysm's haemodynamics and the flow diverter's angle of curvature across its neck. Moreover, the calculations indicated that cases with a moderately curved flow diverter, with an associated metal coverage rate of 50%-60%, achieve maximum flow reduction inside the aneurysm due to a stable flow resistance in the direction normal to the blood flow. © IMechE 2015.

  13. Mapping cortical haemodynamics during neonatal seizures using diffuse optical tomography: A case study

    Directory of Open Access Journals (Sweden)

    Harsimrat Singh


    Full Text Available Seizures in the newborn brain represent a major challenge to neonatal medicine. Neonatal seizures are poorly classified, under-diagnosed, difficult to treat and are associated with poor neurodevelopmental outcome. Video-EEG is the current gold-standard approach for seizure detection and monitoring. Interpreting neonatal EEG requires expertise and the impact of seizures on the developing brain remains poorly understood. In this case study we present the first ever images of the haemodynamic impact of seizures on the human infant brain, obtained using simultaneous diffuse optical tomography (DOT and video-EEG with whole-scalp coverage. Seven discrete periods of ictal electrographic activity were observed during a 60 minute recording of an infant with hypoxic–ischaemic encephalopathy. The resulting DOT images show a remarkably consistent, high-amplitude, biphasic pattern of changes in cortical blood volume and oxygenation in response to each electrographic event. While there is spatial variation across the cortex, the dominant haemodynamic response to seizure activity consists of an initial increase in cortical blood volume prior to a large and extended decrease typically lasting several minutes. This case study demonstrates the wealth of physiologically and clinically relevant information that DOT–EEG techniques can yield. The consistency and scale of the haemodynamic responses observed here also suggest that DOT–EEG has the potential to provide improved detection of neonatal seizures.

  14. Analgesia Nociception Index (ANI) to predict intraoperative haemodynamic changes: results of a pilot investigation. (United States)

    Ledowski, T; Averhoff, L; Tiong, W S; Lee, C


    The Analgesia Nociception Index has been described to reflect different levels of intraoperative nociceptive stimulation during total intravenous anaesthesia. The association between this index and haemodynamic changes during sevoflurane-based anaesthesia was investigated in 30 patients with the hypothesis that changes in the Analgesia Nociception Index may coincide with or even predict haemodynamic changes. The Analgesia Nociception Index as well as blood pressure and heart rate were observed during induction, at skin incision, at times of an Analgesia Noceception Index decrease > 20% ('event') and pre-/post-fentanyl administration. The Analgesia Nociception Index decreased with airway manipulation [mean: 52 (before) vs. 33 (after); P 10% was low (heart rate 0.61; blood pressure 0.59). The Analgesia Nociception Index appears to reflect different levels of stimulation during sevoflurane-based general anaesthesia. However, it was of little predictive value to pre-empt significant haemodynamic changes. © 2013 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  15. Ventilation and Haemodynamic Indicators in Spontaneously Breathing Pigs under General Anaesthesia

    Directory of Open Access Journals (Sweden)

    Jiří Kobr


    Full Text Available The aim of this study was to obtain ventilation and haemodynamic data of healthy piglets under general anaesthesia for future patho-physiological experimental studies. A total of 34 domestic piglets of the Czech Black Pied (Přeštice breed were used in the study. The animals (male to female ratio 8 : 9 were six weeks old and their average body mass was 22 kg. A general anaesthetic (fentanyl and azaperon was introduced via a pulmonary artery catheter and the spontaneously breathing animals were monitored for 60 min. Cardiac output and haemodynamic indicators were established using intermittent pulmonary artery thermodilution. Blood gas data were deduced using fan dynamic parameters of ventilation and ventilation indices. The study yielded reliable data of dynamic lung indicators (p 2O/kg, and haemodynamic indicators (p < 0.01 such as cardiac output 2.12 ± 0.75 l/min, pulmonary vascular resistance 3.92 ± 0.52 and systemic vascular resistance 15.8 ± 6.81 Woods units. Reliable data regarding lung dynamics, cardiac output, preload and afterload of both heart ventricles in spontaneously breathing healthy piglets under general anaesthesia were achieved.

  16. Coagulation and fibrinolysis in gastric cancer. (United States)

    Repetto, Ombretta; De Re, Valli


    Coagulation is a highly conserved process occurring after an injury to a blood vessel and resulting in hemostasis. In the thrombus microenvironment, finely orchestrated events restore vessel integrity through platelet activation, adhesion, and aggregation (primary hemostasis), followed by the coagulation cascades, thrombin generation, and fibrin clot deposition (secondary hemostasis). Several studies on cancer have provided insight into dramatic changes to coagulation-related events (i.e., fibrin clot deposition, fibrinolysis) during tumor pathogenesis, progression, and metastasis, in addition to a tumor-driven systemic activation of hemostasis and thrombosis (Trousseau's syndrome). Diverse molecular and cellular effectors participate in the cross talk between hemostasis and tumors. Here, we focus on some aspects of the interconnection between cancer biology and hemostatic components, with particular attention to some key coagulation-related proteins (e.g., tissue factor, thrombin, fibrinogen, and D-dimers) in the particular case of gastric cancer (GC). Recent advances in deciphering the complex molecular link between GC and the coagulation system are described, showing their important roles in better management of patients affected by GC. © 2017 New York Academy of Sciences.

  17. Could light meal jeopardize laboratory coagulation tests? (United States)

    Lima-Oliveira, Gabriel; Salvagno, Gian Luca; Lippi, Giuseppe; Danese, Elisa; Gelati, Matteo; Montagnana, Martina; Picheth, Geraldo; Guidi, Gian Cesare


    Presently the necessity of fasting time for coagulation tests is not standardized. Our hypothesis is that this can harm patient safety. This study is aimed at evaluating whether a light meal (i.e. breakfast) can jeopardize laboratory coagulation tests. A blood sample was firstly collected from 17 fasting volunteers (12 h). Immediately after blood collection, the volunteers consumed a light meal. Then samples were collected at 1, 2 and 4 h after the meal. Coagulation tests included: activated partial thromboplastin time (APTT), prothrombin time (PT), fibrinogen (Fbg), antithrombin III (AT), protein C (PC) and protein S (PS). Differences between samples were assessed by Wilcoxon ranked-pairs test. The level of statistical significance was set at P coagulation tests had significant variation after comparison with RCV. A light meal does not influence the laboratory coagulation tests we assessed, but we suggest that the laboratory quality managers standardize the fasting time for all blood tests at 12 hours, to completely metabolize the lipids intake.

  18. Magnetic particle imaging of blood coagulation

    Energy Technology Data Exchange (ETDEWEB)

    Murase, Kenya, E-mail:; Song, Ruixiao; Hiratsuka, Samu [Department of Medical Physics and Engineering, Division of Medical Technology and Science, Faculty of Health Science, Graduate School of Medicine, Osaka University, Osaka 565-0871 (Japan)


    We investigated the feasibility of visualizing blood coagulation using a system for magnetic particle imaging (MPI). A magnetic field-free line is generated using two opposing neodymium magnets and transverse images are reconstructed from the third-harmonic signals received by a gradiometer coil, using the maximum likelihood-expectation maximization algorithm. Our MPI system was used to image the blood coagulation induced by adding CaCl{sub 2} to whole sheep blood mixed with magnetic nanoparticles (MNPs). The “MPI value” was defined as the pixel value of the transverse image reconstructed from the third-harmonic signals. MPI values were significantly smaller for coagulated blood samples than those without coagulation. We confirmed the rationale of these results by calculating the third-harmonic signals for the measured viscosities of samples, with an assumption that the magnetization and particle size distribution of MNPs obey the Langevin equation and log-normal distribution, respectively. We concluded that MPI can be useful for visualizing blood coagulation.

  19. Haemodynamic unloading increases the survival and affects the differentiation of cardiac stem cells after implantation into an infarcted heart. (United States)

    Kurazumi, Hiroshi; Li, Tao-Sheng; Takemoto, Yoshihiro; Suzuki, Ryo; Mikamo, Akihito; Guo, Chang-Ying; Murata, Tomoaki; Hamano, Kimikazu


    It has been anticipated that stem cell therapy is capable of repairing an injured heart but is currently limited by its marginal efficacy. We believe that mechanical stress due to haemodynamic loading may negate the therapeutic potency of stem cells and therefore investigated how haemodynamic unloading affects the survival and differentiation of stem cells after implantation into an infarcted heart. A left ventricular (LV) haemodynamic unloading model was implemented by heterotopic transplantation of an infarcted donor heart into another healthy mouse. An in situ infarcted heart with general haemodynamic loading was used as control. A total of 5 million cardiac stem cells expanded from green fluorescence protein (GFP)-transgenic mouse were intramyocardially implanted into the infarcted LVs of haemodynamically unloaded donor heart or general haemodynamic loaded heart. The survival and differentiation of the implanted cardiac stem cells were evaluated by histological analyses at 3 and 21 days after cell implantation (n = 5-6 in each time points per group). Compared with the general haemodynamic loading condition, haemodynamic unloading of the infarcted hearts significantly improved the survival, increased the proliferation and inhibited the apoptosis of cardiac stem cells at 21 days after cell implantation (P cells was much higher in the unloaded hearts than in the loaded hearts at 21 days after cell implantation, although the difference was not statistically significant (5.67 ± 5.10 vs 0.75 ± 0.50, P = 0.051). Among the surviving GFP(+) donor cells 21 days after implantation, the expressions of platelet endothelial cell adhesion molecule-1, smooth muscle actin and sarcomeric alpha actin were ~7, 38 and 27% in the loaded heart and ~19, 14 and 55% in the unloaded heart, respectively. Haemodynamic unloading favours the survival/engraftment of donor stem cells and affects their differentiation after implantation into an infarcted heart. Although further studies in a

  20. Fibrinolysis and the control of blood coagulation. (United States)

    Chapin, John C; Hajjar, Katherine A


    Fibrin plays an essential role in hemostasis as both the primary product of the coagulation cascade and the ultimate substrate for fibrinolysis. Fibrinolysis efficiency is greatly influenced by clot structure, fibrinogen isoforms and polymorphisms, the rate of thrombin generation, the reactivity of thrombus-associated cells such as platelets, and the overall biochemical environment. Regulation of the fibrinolytic system, like that of the coagulation cascade, is accomplished by a wide array of cofactors, receptors, and inhibitors. Fibrinolytic activity can be generated either on the surface of a fibrin-containing thrombus, or on cells that express profibrinolytic receptors. In a widening spectrum of clinical disorders, acquired and congenital defects in fibrinolysis contribute to disease morbidity, and new assays of global fibrinolysis now have potential predictive value in multiple clinical settings. Here, we summarize the basic elements of the fibrinolytic system, points of interaction with the coagulation pathway, and some recent clinical advances. Copyright © 2014. Published by Elsevier Ltd.

  1. Removal of algae by sonication-coagulation. (United States)

    Zhang, Guangming; Wang, Bo; Zhang, Panyue; Wang, Li; Wang, Hui


    Algae bloom in source water has caused serious problems in drinking water supplies, and conventional methods for its treatment have achieved only limited success. This paper reports a new technology, ultrasound assisted coagulation, for effective removal of algae cells from the source water in water treatment works. The results showed that ultrasonic pretreatment significantly enhanced the removal efficiency of algae cells. Ultrasonic irradiation for 5 s increased the algae removal efficiency by more than 20% when the coagulant dose was 0.4-0.8 mg/L. To achieve the same algae removal ratio of 90%, sonication for 5 s reduced the coagulant dose by 2/3. The optimal sonication parameters were determined as follows: sonication time of 1 s, ultrasonic power of 48 W, and solution pH of 8-9. The sound frequency had little impact on the algal removal efficiency. Ultrasonic pretreatment also significantly reduced the sample turbidity.

  2. Blood Coagulation and Asthma Exacerbation in Children. (United States)

    Manuyakorn, Wiparat; Mairiang, Dara; Sirachainan, Nongnuch; Kadegasem, Praguywan; Kamchaisatian, Wasu; Benjaponpitak, Suwat; Chuansumrit, Ampaiwan


    Recent studies have demonstrated the activation of coagulation pathways in asthmatic airways. This study aimed to determine systemic blood coagulation during asthma exacerbation compared with the stable state in children. Pediatric patients (aged between 5 and 15 years) suffering from asthma exacerbation were enrolled. von Willebrand factor (vWF), plasminogen activator inhibitor type-1 (PAI-1), protein C, D-dimer, prothrombin fragment 1 + 2 (F1 + 2), thrombin-antithrombin complex (TAT), and C-reactive protein (CRP) levels were measured during asthma exacerbation and stable state. A total of 22 patients were enrolled. The median vWF, PAI-1, and CRP during asthma exacerbation were significantly higher than those of the stable state: 147.5% (interquartile range, IQR: 111.05-196.57) versus 94% (IQR: 69.72-109.62, p coagulation in asthma exacerbation. © 2016 S. Karger AG, Basel.

  3. Coagulation Management During Liver Transplantation: Use of Fibrinogen Concentrate, Recombinant Activated Factor VII, Prothrombin Complex Concentrate, and Antifibrinolytics. (United States)

    Chow, Jonathan H; Lee, Khang; Abuelkasem, Ezeldeen; Udekwu, Obi R; Tanaka, Kenichi A


    Coagulation management, and transfusion practice in liver transplantation (LT) have been evolving in the recent years due to better understanding of coagulation abnormalities in end-stage liver disease, and clinical management of LT patients. Avoidance of allogeneic blood components is feasible in some patients, but multi-modal coagulation therapies may be necessary in others who develop complex coagulopathy due to hemorrhage, hemodilution, hypothermia, and acid-base disturbances. Transfusions of plasma and cryoprecipitate remain to be the mainstay therapy for procoagulant factor replacement during LT. Clinical efficacy and safety of these products are limited by logistic issues (eg, thawing), and mostly noninfectious complications. Considering potential alternatives to conventional transfusion is thus important to improve hemostatic resuscitation in complex LT cases. The present review is mainly focused on procoagulant properties of plasma and platelet transfusion, and currently available plasma-derived and recombinant factor concentrates, and antifibrinolytic agents in LT patients. The role of viscoelastic coagulation tests to guide specific component therapies will be also discussed.

  4. Soil Studies: Applying Acid-Base Chemistry to Environmental Analysis. (United States)

    West, Donna M.; Sterling, Donna R.


    Laboratory activities for chemistry students focus attention on the use of acid-base chemistry to examine environmental conditions. After using standard laboratory procedures to analyze soil and rainwater samples, students use web-based resources to interpret their findings. Uses CBL probes and graphing calculators to gather and analyze data and…

  5. Students' Understanding of Acids/Bases in Organic Chemistry Contexts (United States)

    Cartrette, David P.; Mayo, Provi M.


    Understanding key foundational principles is vital to learning chemistry across different contexts. One such foundational principle is the acid/base behavior of molecules. In the general chemistry sequence, the Bronsted-Lowry theory is stressed, because it lends itself well to studying equilibrium and kinetics. However, the Lewis theory of…

  6. Intravenous fluid administration and controversies in Acid-base. (United States)

    Story, D A


    To present an overview of acidosis following intravenous fluid infusion and to highlight the current controversy in acid-base physiology. Articles and reviews from peer reviewed journals and books on acid-base physiology and post infusion acidosis. Infusion of intravenous fluids can produce an acidosis particularly in the setting of large volume infusion. The explanation of this phenomenon has centred around dilution of plasma bicarbonate. An alternative explanation can be found in the work of Peter Stewart, which highlights the use of strong ion difference in assessing metabolic acidosis. The Stewart approach differs from the traditional Henderson-Hasselbalch approach to acid-base. Further study is required to determine which approach is correct. Solutions containing base anions such as lactate may attenuate such an infusion acidosis. Animal and clinical studies using Hartmann's solution and Plasmalyte 148 support this idea. There is controversy regarding mechanisms in acid-base physiology. The clinical significance of post infusion acidosis is unclear, however use of Hartmann's solution may minimize the acidosis.

  7. A dipstick sensor for coulometric acid-base titrations

    NARCIS (Netherlands)

    Olthuis, Wouter; van der Schoot, B.H.; Chavez, F.; Bergveld, Piet


    By performing an acid-base titration by coulometric generation of OH− or H+ ions at an inert electrode in close proximity to the pH-sensitive gate of an ISFET, it is possible to determine the acid or base concentration of a solution using the ISFET as an indicator device for the equivalence point in

  8. Application of psyllium husk as coagulant and coagulant aid in semi-aerobic landfill leachate treatment. (United States)

    Al-Hamadani, Yasir A J; Yusoff, Mohd Suffian; Umar, Muhammad; Bashir, Mohammed J K; Adlan, Mohd Nordin


    Landfill leachate is a heavily polluted and a likely hazardous liquid that is produced as a result of water infiltration through solid wastes generated industrially and domestically. This study investigates the potential of using psyllium husk as coagulant and coagulant aid for the treatment of landfill leachate. Psyllium husk has been tested as primary coagulant and as coagulant aid with poly-aluminum chloride (PACl) and aluminum sulfate (alum). As primary coagulant, the optimum dosage and pH for PACl were 7.2 and 7.5 g/L, respectively, with removal efficiencies of 55, 80 and 95% for COD, color and TSS, respectively. For alum, the optimum conditions were 11 g/L alum dosage and pH 6.5 with removal efficiencies of 58, 79 and 78% for COD, color and TSS, respectively. The maximum removal efficiencies of COD, color and TSS were 64, 90 and 96%, respectively, when psyllium husk was used as coagulant aid with PACl. Based on the results, psyllium husk was found to be more effective as coagulant aid with PACl in the removal of COD, color and TSS as compared to alum. Zeta potential test was carried out for leachate, PACl, alum and psyllium husk before and after running the jar test to enhance the results of the jar test experiments. Copyright © 2011 Elsevier B.V. All rights reserved.

  9. Coagulation characteristics of titanium (Ti) salt coagulant compared with aluminum (Al) and iron (Fe) salts. (United States)

    Zhao, Y X; Gao, B Y; Shon, H K; Cao, B C; Kim, J-H


    In this study, the performance of titanium tetrachloride (TiCl(4)) coagulation and flocculation is compared with commonly used coagulants such as aluminum sulfate (Al(2)(SO(4))(3)), polyaluminum chloride (PACl), iron chloride (FeCl(3)), and polyferric sulfate (PFS) in terms of water quality parameters and floc properties. TiCl(4) flocculation achieved higher removal of UV(254) (98%), dissolved organic carbon (DOC) (84%) and turbidity (93%) than other conventional coagulants. Charge neutralization and physical entrapment of colloids within coagulant precipitates and adsorption, seemed to play a significant role during TiCl(4) flocculation, while the main mechanism for conventional coagulants was bridge-aggregation and adsorption. The aggregated flocs after TiCl(4) flocculation showed the fastest growth rate compared to the other coagulants, with the largest floc size (801 μm) occurring within 8 min. The floc strength factor of PACl, Al(2)(SO(4))(3), PFS, FeCl(3) and TiCl(4) was 34, 30, 29, 26 and 29, respectively, while the floc recovery factor of the TiCl(4) coagulant was the lowest. Based on the results of the above study, it is concluded that the TiCl(4) flocculation can reduce the hydraulic retention time of slow and rapid mixing, however, careful handling of sludge is required due to the low recoverability of the aggregated floc. Copyright © 2010 Elsevier B.V. All rights reserved.

  10. [Relationship among coagulation effect of Al-based coagulant, content and speciation of residual aluminum]. (United States)

    Yang, Zhong-Lian; Gao, Bao-Yu; Yue, Qin-Yan; Jiang, Yi-Shuai


    The application of AlCl3, Al2 (SO4)3 and poly-aluminum chloride (PAC) in humic acid-kaolin simulated water was studied in this article. It is intended to discuss the relationship among coagulation effect of Al-based coagulants in humic acid-kaolin simulated water and content and speciation of residual aluminum. It was found that, the turbidity removal efficiency and UV254 removal efficiency could reach about 90% at the tested dosage. At higher dosage, PAC gave better coagulation effect. The residual total aluminum content and residual aluminum ratio of PAC, which was 0.9 mg/L and - 3.0% or so respectively, were greatly lower than those of AlCl3 and Al2 (SO4)3. The residual total dissolved aluminum was the predominant content in the effluent after coagulation and sedimentation by the three Al-based coagulants. For the total dissolved aluminum, the proportion of dissolved organic aluminum was significantly higher than that of other aluminum speciation. With respect to humic acid-kaolin simulated water, the content of residual total aluminum in the effluent after coagulation and sedimentation by PAC decreased obviously compared to AlCl3 and Al2 (SO4)3. PAC could effectively decrease the content of residual dissolved aluminum speciation which has higher toxicity. The content of residual total dissolved aluminum in the effluent after coagulation and sedimentation by PAC was about 0.6 mg/L.

  11. The investigation of coagulation activity of natural coagulants extracted from different strains of common bean

    Directory of Open Access Journals (Sweden)

    Šćiban Marina B.


    Full Text Available Coagulation and flocculation by adding chemicals are the methods that are usually used for removal of water turbidity. This study is concerned with the coagulation activity of extracts of various strains of bean. The aim was to ascertain if bean varieties influence coagulation activity. Active components were extracted from 1 g of ground sample with 100 ml distilled water. Contents of dry matter and nitrogen were specified in the solid samples, and the content of soluble nitrogen was determined in the extracts. These data were used to calculate the efficiency of extraction of nitrogen-containing compounds. The coagulation activity was assessed by jar test using synthetic turbid water, of the initial pH 9 and turbidity 35 NTU. The jar test was carried out by adding different amounts of extracts to model water, and stirring the content. After sedimentation for 1 h, residual turbidity was determined by turbidimeter and coagulation activity was calculated. The increment of organic matter concentration after the coagulation was also determined. These experiments confirmed that extracts of all investigated strains of bean could be used successfully as natural coagulants.

  12. Post-treatment of sanitary landfill leachate by coagulation-flocculation using chitosan as primary coagulant. (United States)

    Nascimento, Inara Oliveira do Carmo; Guedes, Ana Rosa Pinto; Perelo, Louisa Wessels; Queiroz, Luciano Matos


    Chitosan was chosen as an alternative primary coagulant in a complementary coagulation-flocculation treatment of sanitary landfill leachate with the aim of removing recalcitrant organic matter. In order to optimize the process conditions, central composite design and response surface methodology were applied. To evaluate the performance of the process using chitosan, we also carried out tests with aluminium sulphate (Al(2) (SO(4))(3).14 H(2)O) as coagulant. In addition, acute toxicity tests were carried using the duckweed Lemna minor and the guppy fish Poecilia reticulata as test organisms. The analytic hierarchy process was employed for selecting the most appropriate coagulant. Mean values of true colour removal efficiency of 80% and turbidity removal efficiency of 91.4% were reached at chitosan dosages of 960 mg L(-1) at pH 8.5. The acute toxicity tests showed that organisms were sensitive to all samples, mainly after coagulation-flocculation using chitosan. CE(50) for L. minor was not determined because there was no inhibition of the average growth rate and biomass production; LC(50) for P. reticulata was 23% (v v(-1)). Multi-criteria analysis showed that alum was the most appropriate coagulant. Therefore, chitosan as primary coagulant was not considered to be a viable alternative in the post-treatment of landfill leachate.

  13. Wireless shortwave: A new coagulation procedure. (United States)

    Al-Khuwaitir, S A; El-Hazmi, M A; Al-Mofleh, I; Al-Tuwaijri, A


    Wireless shortwave (27.12 MHz) was tested in controlling bleeding of surgical cuts on the ears of experimental rabbits and found to be effective and less traumatic in comparison with infrared and high-frequency diathermy, more common methods of coagulation. Twenty-eight rabbits were traumatized with small surgical incisions on their ears and were divided into groups of seven for surgical control, wireless shortwave, infrared and HF diathermy. Comparison was based on measurement of the area of divitalization, scar size and depth of necrosis. Results indicate that shortwave coagulation can be used effectively with less trauma and risk of sepsis than the other methods.

  14. Vitamin K: from coagulation to calcification. (United States)

    Paakkari, Ilari

    Vitamin K is not only essential for the synthesis of coagulation factors in the liver, but it also strengthens the bones and prevents calcification of the arteries. These effects are mediated through the same mechanism, i.e. carboxylation of Gla target proteins. The discovery of novel Gla proteins that are not associated with blood coagulation or calcium metabolism indicates that vitamin K has additional effects in the pancreas and the central nervous system, for example. As dietary supplements, vitamin K1 of plant origin and vitamins K2 of bacterial origin may exert different effects.

  15. Disseminated intravascular coagulation: a review for the internist

    NARCIS (Netherlands)

    Levi, Marcel; van der Poll, Tom


    Disseminated intravascular coagulation (DIC) is a syndrome characterized by systemic intravascular activation of coagulation, leading to widespread deposition of fibrin in the circulation. Recent knowledge on important pathogenetic mechanisms that may lead to DIC has resulted in novel preventive and

  16. Blood is thicker than water: coagulation challenges in the ...

    African Journals Online (AJOL)

    This manuscript serves to highlight some novel approaches to perioperative coagulation abnormalities and to address unanswered questions. Keywords: coagulation; point-of-care monitor; prothrombin complex concentrate; pharmacological procoagulants ...

  17. Assessing blood coagulation status with laser speckle rheology (United States)

    Tripathi, Markandey M.; Hajjarian, Zeinab; Van Cott, Elizabeth M.; Nadkarni, Seemantini K.


    We have developed and investigated a novel optical approach, Laser Speckle Rheology (LSR), to evaluate a patient’s coagulation status by measuring the viscoelastic properties of blood during coagulation. In LSR, a blood sample is illuminated with laser light and temporal speckle intensity fluctuations are measured using a high-speed CMOS camera. During blood coagulation, changes in the viscoelastic properties of the clot restrict Brownian displacements of light scattering centers within the sample, altering the rate of speckle intensity fluctuations. As a result, blood coagulation status can be measured by relating the time scale of speckle intensity fluctuations with clinically relevant coagulation metrics including clotting time and fibrinogen content. Our results report a close correlation between coagulation metrics measured using LSR and conventional coagulation results of activated partial thromboplastin time, prothrombin time and functional fibrinogen levels, creating the unique opportunity to evaluate a patient’s coagulation status in real-time at the point of care. PMID:24688816

  18. Effect of rivaroxaban on blood coagulation using the viscoelastic coagulation test ROTEM™. (United States)

    Casutt, M; Konrad, C; Schuepfer, G


    This study investigated the influence of the oral direct inhibitor of factor Xa rivaroxaban on blood coagulation measured by rotation thrombelastometry ROTEM™. Blood was obtained from 11 healthy male volunteers before and 2.5 h after oral administration of 10 mg rivaroxaban. In addition to standard coagulation tests clot formation was measured by ROTEM™ analyzing extrinsic (Extem) and intrinsic thrombelastometry (Intem). Significant differences to the baseline values were found in the Extem clotting time (Extem-CT, 58 ± 9 s and 87 ± 17 s, p coagulation by rivaroxaban.

  19. Estimation of lymphatic conductance. A model based on protein-kinetic studies and haemodynamic measurements in patients with cirrhosis of the liver and in pigs

    DEFF Research Database (Denmark)

    Henriksen, J H


    A model of lymphatic conductivity (i.e. flow rate per unit pressure difference = conductance) based on protein-kinetic and haemodynamic measurements is described. The model is applied to data from patients with cirrhosis and from pigs with different haemodynamic abnormalities in the hepatosplanch......A model of lymphatic conductivity (i.e. flow rate per unit pressure difference = conductance) based on protein-kinetic and haemodynamic measurements is described. The model is applied to data from patients with cirrhosis and from pigs with different haemodynamic abnormalities...

  20. Application of Dual Coagulant (Alum + Barley) in Removing Colour from Leachate


    Shaylinda Mohd Zin Nur; Azraff Zulkapli Zulazimie


    Coagulation/flocculation is one of the treatment method for highly polluted leachate. One of the main affecting factor for this process is the coagulant used. Coagulant is divided into natural and chemical coagulant. In the current study, Alum (chemical coagulant) and barley (natural coagulant) were used as dual coagulant. The aim of this study is to examine the effectiveness of dual coagulant made from alum and barley in removing colour from the effluent of Simpang Renggam landfill leachate ...

  1. Coagulant recovery and reuse for drinking water treatment


    Keeley, James; Jarvis, Peter; Smith, Andrea D.; Judd, Simon J.


    Coagulant recovery and reuse from waterworks sludge has the potential to significantly reduce waste disposal and chemicals usage for water treatment. Drinking water regulations demand purification of recovered coagulant before they can be safely reused, due to the risk of disinfection by-product precursors being recovered from waterworks sludge alongside coagulant metals. While several full-scale separation technologies have proven effective for coagulant purification, none have matched virgi...

  2. Coagulation activity in liver disease | Reza | Internet Journal of ...

    African Journals Online (AJOL)

    Patients with advanced hepatic failure may present with the entire spectrum of coagulation factor deficiencies. This study was designed to determine laboratory abnormalities in coagulation in chronic liver disease and the association of these abnormalities with the extent of chronic hepatitis and cirrhosis. Coagulation ...

  3. Two-way interactions between inflammation and coagulation

    NARCIS (Netherlands)

    Levi, Marcel; van der Poll, Tom


    Activation of inflammatory and coagulation pathways is important in the pathogenesis of vascular disease. There is ample evidence that extensive cross-talk between these two systems exists, whereby inflammation not only leads to activation of coagulation, but coagulation also markedly affects

  4. Antiplatelet agents in tissue factor-induced blood coagulation

    NARCIS (Netherlands)

    Butenas, S.; Cawthern, K. M.; van't Veer, C.; DiLorenzo, M. E.; Lock, J. B.; Mann, K. G.


    Several platelet inhibitors were examined in a tissue factor (TF)-initiated model of whole blood coagulation. In vitro coagulation of human blood from normal donors was initiated by 25 pM TF while contact pathway coagulation was suppressed using corn trypsin inhibitor. Products of the reaction were

  5. Cell-derived vesicles exposing coagulant tissue factor in saliva

    NARCIS (Netherlands)

    Berckmans, René J.; Sturk, Auguste; van Tienen, Laurens M.; Schaap, Marianne C. L.; Nieuwland, Rienk


    On vascular damage, coagulation is initiated by extravascular tissue factor (TF). Intravascular TF, which is present on circulating cell-derived vesicles, is non-coagulant under physiologic conditions but prothrombotic under pathologic conditions. Human saliva triggers coagulation, but the mechanism

  6. Performance of Solanum incunum Linnaeus as natural coagulant ...

    African Journals Online (AJOL)

    The paper reports the performance of Solanum incunum Linnaeus as coagulant and disinfectant for water purification. The coagulation-flocculation experiment was carried out using a Phipps and Bird PB-700™ Jar Tester. Results show that coagulation depends on Fe(II) content and disinfectant on bioactive natural product ...

  7. Toward a better understanding of coagulation for dissolved organic nitrogen using polymeric zinc-iron-phosphate coagulant. (United States)

    Zhu, Guocheng; Wang, Qian; Yin, Jun; Li, Zhongwu; Zhang, Peng; Ren, Bozhi; Fan, Gongduan; Wan, Peng


    The increase of agricultural related activities and the lack of effective waste control has led to an increase of organic nitrogen in water. The development of coagulants to effectively remove dissolved organic nitrogen (DON) is a high priority in the water treatment industry. We developed a polymeric zinc-iron-phosphate (ZnFeP) coagulant and investigated its coagulation effect on DON removal. Optimum coagulant for coagulation for DON and TDN removals was characterized by the dense convex-concave packing structure differing from other zinc-based coagulant, polycrystalline structure and high content colloidal species, which could account up to 87% of the total colloidal species. Coagulation experiments showed the DON removal rate to vary greatly depending on principal components and their interaction with metals, phosphate and hydroxyl. DON removal efficiency increased with the increase of colloidal species. The coagulation was also dependent on coagulant dosage and water quality parameters: Coagulation efficiency increased with coagulant dosage in the investigated range of 1-16 mg/l, and a pH of 6 was found to be superior for the coagulation. DON removal efficiency was also higher than and linearly correlated with total dissolved nitrogen (TDN) removal, which implies that an effective coagulation for TDN is also effective for DON. The findings in this study indicate that coagulation of DON is largely influenced by coagulant composition and species. We also found the removal of DON by our newly developed polymeric ZnFeP coagulant to be effective. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. Coagulation disorders in dogs with hepatic disease

    NARCIS (Netherlands)

    Prins, M.|info:eu-repo/dai/nl/304836176; Schellens, C.J.M.M.; van Leeuwen, M; Rothuizen, J.|info:eu-repo/dai/nl/071276033; Teske, E.|info:eu-repo/dai/nl/114300240


    The Veterinary Journal Volume 185, Issue 2, August 2010, Pages 163-168 -------------------------------------------------------------------------------- doi:10.1016/j.tvjl.2009.05.009 | How to Cite or Link Using DOI Copyright © 2009 Elsevier Ltd All rights reserved. Permissions & Reprints Coagulation

  9. Blood coagulation factor VIII: An overview

    Indian Academy of Sciences (India)

    Factor VIII (FVIII) functions as a co-factor in the blood coagulation cascade for the proteolytic activation of factor X by factor IXa. Deficiency of FVIII causes hemophilia A, the most commonly inherited bleeding disorder. This review highlights current knowledge on selected aspects of FVIII in which both the scientist and the ...

  10. Management of coagulation abnormalities in liver disease

    NARCIS (Netherlands)

    Potze, Wilma; Porte, Robert J.; Lisman, Ton

    Liver disease is characterized by changes in all phases of hemostasis. These hemostatic alterations were long considered to predispose patients with liver disease towards a bleeding tendency, as they are associated with prolonged conventional coagulation tests. However, these patients may also

  11. Mechanisms of Coagulation Abnormalities and Trauma (United States)


    characterized by the combination of tissue injury and severe metabolic acidosis , which we have successfully developed in our lab. We have previously...has been thought to be due to acidosis and hypothermic inhibition of clot formation as well as dilution of coagulation factors from intravenous

  12. Coagulation in Treatment of Swine Slaughterhouse Wastewater

    Directory of Open Access Journals (Sweden)

    Ha Bui Manh


    Full Text Available In this study, wastewater taken from the Nam Phong swine slaughterhouse, Ho Chi Minh City, was used to evaluate the treatment efficiency of common coagulants, including Alum (Aluminum Sulfate - Al2(SO43.18H2O, Poly-Aluminum Chloride (PAC, and Ferrous Sulfate (FeSO4.7H2O, using a jar-test system. The experiments were conducted using the one-factor-at-a-time method to examine three variables which are pH, stirring speed, and coagulant dosage. The results showed that both Alum and PAC perform over 90% removal of colour, turbidity, COD, and total phosphorus (TP from slaughterhouse wastewater at pH 7 with a stirring speed of 75 revolutions per minute (RPM and average coagulant dosages of 450 mg/L for Alum and 550 mg/L for PAC. Meanwhile, under the appropriate conditions of pH equal to 10 and 75 RPM with a chemical dosage of 350 mg/L, COD and TP removal efficiencies by Ferrous Sulfate exceed 87%, but those of turbidity and colour only reach 25%. This finding could be a promising coagulation method as a pre-treatment for the swine slaughterhouse wastewater.

  13. Tissue regenerating functions of coagulation factor XIII

    DEFF Research Database (Denmark)

    Soendergaard, C; Kvist, P H; Seidelin, J B


    -receptor 2 and the αVβ3 integrin is important for angiogenesis supporting formation of granulation tissue. Chronic inflammatory conditions involving bleeding and activation of the coagulation cascade have been shown to lead to reduced FXIII levels in plasma. Of particular importance for this review...

  14. Point of Care Assessment of Coagulation. (United States)

    Hyatt, Clare E; Brainard, Benjamin M


    Disorders of hemostasis can be difficult to fully elucidate but can severely affect patient outcome. The optimal therapy for coagulopathies is also not always clear. Point of care (POC) testing in veterinary medicine can assist in the diagnosis of hemostatic disorders and also direct treatment. Advantages of POC testing include rapid turnaround times, ease of use, and proximity to the patient. Disadvantages include differences in analytic performance compared with reference laboratory devices, the potential for operator error, and limited test options per device. Conventional coagulation tests such as prothrombin time, activated partial thromboplastin time, and activated clotting time can be measured by POC devices and can accurately diagnose hypocoagulability, but they cannot detect hypercoagulability or disorders of fibrinolysis. Viscoelastic POC coagulation testing more accurately evaluates in vivo coagulation, and can detect hypocoagulability, hypercoagulability, and alterations in fibrinolysis. POC platelet function testing methodologies can detect platelet adhesion abnormalities including von Willebrand disease, and can be used to monitor the efficacy of antiplatelet drugs. It is unlikely that a single test would be ideal for assessing the complete coagulation status of all patients; therefore, the ideal combination of tests for a specific patient needs to be determined based on an understanding of the underlying disease, and protocols must be standardized to minimize interoperator and interinstitutional variability. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Comparison of Electrocoagulation and Chemical Coagulation ...

    African Journals Online (AJOL)



    Dec 2, 2017 ... 2University of Yaoundé I, Faculty of Science, Department of inorganic Chemistry,. Laboratory of Analytical Chemistry P.O. Box 812 Yaoundé-Cameroon. * E-mail ( Tchamango S.R). ABSTRACT: In this work, electrocoagulation and chemical coagulation were applied to the ...

  16. Roles for vitamin K beyond coagulation (United States)

    Recent interest in vitamin K has been motivated by evidence of physiological roles beyond that of coagulation. Vitamin K and vitamin K-dependent proteins may be involved in regulation of calcification, energy metabolism, and inflammation. However, the evidence for many of these proposed roles in the...

  17. Pathogenesis of disseminated intravascular coagulation in sepsis

    NARCIS (Netherlands)

    Levi, M. [=Marcel M.; ten Cate, H.; van der Poll, T.; van Deventer, S. J.


    To review new insights in the pathogenetic mechanisms involved in the development of disseminated intravascular coagulation (DIC) in septic patients, in order to develop new directions for therapeutic intervention. Articles and published peer-reviewed abstracts on the mechanism of the initiation of

  18. comparison of electrocoagulation and chemical coagulation

    African Journals Online (AJOL)


    In this study, the treatment of the effluents of an artisanal tannery by electrocoagulation with iron electrodes was carried out. ... conductivity weakly. By contrast, chemical coagulation increases the acidity of the effluent and its conductivity. ... produces a huge quantity of mud and can be source of secondary pollution because ...

  19. Brownian coagulation at high particle concentrations

    NARCIS (Netherlands)

    Trzeciak, T.M.


    The process of Brownian coagulation, whereby particles are brought together by thermal motion and grow by collisions, is one of the most fundamental processes influencing the final properties of particulate matter in a variety of technically important systems. It is of importance in colloids,

  20. Coagulation-flocculation studies of wastewaters

    NARCIS (Netherlands)

    Leentvaar, J.


    Although coagulation-flocculation processes have been practiced world-wide for almost a century in water treatment, several problems both in the theoretical and in the applied field have not been resolved yet. Especially interpretation of practical results with respect to governing

  1. Comparison of electrocoagulation and chemical coagulation ...

    African Journals Online (AJOL)

    In this work, electrocoagulation and chemical coagulation were applied to the exit effluent of a textile factory located at Douala (Cameroon).The investigations were focused on the operational (pH, conductivity) and pollution parameters (COD, total phosphorus, turbidity). The electrolytic treatment was carried out with 0.4 A ...

  2. Quantifying interspecific coagulation efficiency of phytoplankton

    DEFF Research Database (Denmark)

    Hansen, J.L.S.; Kiørboe, Thomas


    . nordenskjoeldii. Mutual coagulation between Skeletonema costatum and the non-sticky cel:ls of Ditylum brightwellii also proceeded with hall the efficiency of S. costatum alone. The latex beads were suitable to be used as 'standard particles' to quantify the ability of phytoplankton to prime aggregation...

  3. Canine specific ELISA for coagulation factor VII

    DEFF Research Database (Denmark)

    Knudsen, Tom; Kjelgaard-Hansen, Mads; Tranholm, Mikael


    Canine coagulation factor VII (FVII) deficiency can be hereditary or acquired and may cause life threatening bleeding episodes if untreated. FVII procoagulant activity can be measured by FVII activity (FVII:C), but assays for measurement of canine specific FVII antigen (FVII:Ag) have not been...

  4. Haemostatic effects of recombinant coagulation factor VIIa

    NARCIS (Netherlands)

    Lisman, Johannes Antonius


    Recombinant coagulation factor VIIa (rFVIIa) has recently become available for treatment of patients with inhibitor-complicated haemophilia. It has been postulated that rFVIIa could become a universal haemostatic agent. Case reports and small studies confirm efficacy and safety of rFVIIa in a

  5. Continuous spinal anaesthesia with minimally invasive haemodynamic monitoring for surgical hip repair in two patients with severe aortic stenosis

    Directory of Open Access Journals (Sweden)

    María Mercedes López


    Full Text Available BACKGROUND AND OBJECTIVES: Aortic stenosis increases perioperative morbidity and mortality, perioperative invasive monitoring is advised for patients with an aortic valve area 30 mm Hg and it is important to avoid hypotension and arrhythmias. We report the anaesthetic management with continuous spinal anaesthesia and minimally invasive haemodynamic monitoring of two patients with severe aortic stenosis undergoing surgical hip repair. CASE REPORT: Two women with severe aortic stenosis were scheduled for hip fracture repair. Continuous spinal anaesthesia with minimally invasive haemodynamic monitoring was used for anaesthetic management of both. Surgery was performed successfully after two consecutive doses of 2 mg of isobaric bupivacaine 0.5% in one of them and four consecutive doses in the other. Haemodynamic conditions remained stable throughout the intervention. Vital signs and haemodynamic parameters remained stable throughout the two interventions. CONCLUSION: Our report illustrates the use of continuous spinal anaesthesia with minimally invasive haemodynamic monitoring as a valid alternative to general or epidural anaesthesia in two patients with severe aortic stenosis who are undergoing lower limb surgery. However, controlled clinical trials would be required to establish that this technique is safe and effective in these type or patients.

  6. Treatment of Leachate by Coagulation-Flocculation Using Different Coagulants and Polymer: a Review


    Rui, Lee Mao; Daud, Zawawi; Latif, Abdul Aziz Abdul


    Leachate will be treated by using coagulation-flocculation. Coagulation and flocculation are essential processes in a number of diverse disciplines, including biochemistry, cheese manufacturing, rubber manufacturing, and in water and waste water treatment. It is effective for removing high concentration organic pollutant and heavy metals in wastewater. However, coagulationflocculation examined the effectiveness of alum, ferric chloride and polyaluminum chloride (PAC1) as well as the use of s...

  7. Optimized coagulation of high alkalinity, low temperature and particle water: pH adjustment and polyelectrolytes as coagulant aids. (United States)

    Yu, Jianfeng; Wang, Dongsheng; Yan, Mingquan; Ye, Changqing; Yang, Min; Ge, Xiaopeng


    The Yellow River in winter as source water is characterized as high alkalinity, low temperature and low particle concentrations, which have brought many difficulties to water treatment plants. This study fully examines the optimized coagulation process of the Yellow River by conventional and pre-polymerized metal coagulants, pH adjustment and polyelectrolytes as the primary coagulants or coagulant aids. For all the metal coagulants, polyaluminum chlorides are superior to traditional metal coagulants due to their stable polymeric species and low consumption of alkalinity. The removal of natural organic matter by monomeric metal coagulants can be improved through pH adjustment, which is in accordance with the higher concentration of polymeric species formed at corresponding pH value. With the addition of polyelectrolytes as coagulant aids, the coagulation performance is significantly improved. The effective removal of dissolved organic matter is consistent with high charge density, while molecular weight is relatively important for removing particles, which is consistent with polyelectrolytes as primary coagulants. These results suggest that the coagulation mechanisms in the removal of dissolved organic matter and particles are different, which may be exploited for optimized coagulation for the typical source water in practice.

  8. Novel Ion-Exchange Coagulants Remove More Low Molecular Weight Organics than Traditional Coagulants. (United States)

    Zhao, Huazhang; Wang, Lei; Hanigan, David; Westerhoff, Paul; Ni, Jinren


    Low molecular weight (MW) charged organic matter is poorly removed by conventional coagulants but contributes to disinfection byproduct formation during chlorination of drinking waters. We hypothesized that CIEX, a new Al-based hybrid coagulant with ion-exchange functional groups, would be new mechanistic approach to remove low MW organic matter during coagulation and would perform better than polyaluminum chloride (PACl) or metal-salt based coagulants. We measured coagulation performance using dissolved organic carbon (DOC) in a high hardness surface water. CIEX achieved excellent turbidity removal and removed 20% to 46% more DOC than FeCl3, Al2(SO4)3, or PACl, depending on dose. The improved DOC removal was attributable to better removal of low MW organic matter (organic acid (salicylic acid (SA)). CIEX achieved high removal of organic acids (>90% of SA) independent of pH, whereas removal by metal salts was lower (coagulants lack. Plus, unlike other cationic polymers that react with chloramines to form N-nitrosodimethylamine (NDMA), CIEX has a low molar yield (9.3 × 10(-7) mol NDMA per mol CIEX-N).

  9. Pathophysiology of acid base balance: the theory practice relationship. (United States)

    Edwards, Sharon L


    There are many disorders/diseases that lead to changes in acid base balance. These conditions are not rare or uncommon in clinical practice, but everyday occurrences on the ward or in critical care. Conditions such as asthma, chronic obstructive pulmonary disease (bronchitis or emphasaemia), diabetic ketoacidosis, renal disease or failure, any type of shock (sepsis, anaphylaxis, neurogenic, cardiogenic, hypovolaemia), stress or anxiety which can lead to hyperventilation, and some drugs (sedatives, opioids) leading to reduced ventilation. In addition, some symptoms of disease can cause vomiting and diarrhoea, which effects acid base balance. It is imperative that critical care nurses are aware of changes that occur in relation to altered physiology, leading to an understanding of the changes in patients' condition that are observed, and why the administration of some immediate therapies such as oxygen is imperative.

  10. [Blood acid-base balance of sportsmen during physical activity]. (United States)

    Petrushova, O P; Mikulyak, N I


    The aim of this study was to investigate the acid-base balance parameters in blood of sportsmen by physical activity. Before exercise lactate concentration in blood was normal. Carbon dioxide pressure (рСО2), bicarbonate concentration (НСО3 -), base excess (BE), were increased immediately after physical activity lactate concentration increased, while pH, BE, НСО3 -, рСО2 decreased in capillary blood of sportsmen. These changes show the development of lactate-acidosis which is partly compensated with bicarbonate buffering system and respiratory alkalosis. During postexercise recovery lactate concentration decreased, while рСО2, НСО3 -, BE increased. The results of this study can be used for diagnostics of acid-base disorders and their medical treatment for preservation of sportsmen physical capacity.

  11. Preconception and early pregnancy maternal haemodynamic changes in healthy women in relation to pregnancy viability. (United States)

    Foo, F L; Collins, A; McEniery, C M; Bennett, P R; Wilkinson, I B; Lees, C C


    Are there differences in preconception cardiovascular function between women who have a viable pregnancy and those who have a first trimester miscarriage? Preconception cardiovascular function of central haemodynamics and arterial function are similar between women who have a viable pregnancy and those who have a first trimester miscarriage. Miscarriages have been associated with increased long-term cardiovascular disease risk, and arterial and cardiovascular dysfunction has been hypothesised as the common link. It is not known if these risks are present prior to pregnancy or are a reflection of poor arterial and haemodynamic adaptation to pregnancy. This prospective longitudinal preconception cohort study was conducted over 18 months. In total, 367 participants were recruited pre-pregnancy, from which 197 pregnancies were recorded; 39 of these pregnancies ended in first trimester miscarriage. Complete longitudinal data were available for 172 pregnancies (140 viable pregnancies, 32 first trimester miscarriages) from pre-pregnancy to 6 weeks gestation. This was a single site study based at a maternity hospital in London. Healthy women were recruited prior to natural conception and followed up once they became pregnant. All underwent haemodynamic [cardiac output (CO), peripheral vascular resistance (PVR)] and arterial function [aortic augmentation index (AIx) and pulse wave velocity (PWV)] testing prior to pregnancy and at 6 weeks gestation, using non-invasive devices (gas re-breathing method, Innocor® and an occilometric device, Vicorder®). Cross-sectional measurements at pre-pregnancy and 6 weeks gestation and a longitudinal analysis of changes were compared between women who had a subsequent viable pregnancy, and those who had a subsequent first trimester miscarriage. There were no differences between women destined to have a healthy ongoing pregnancy compared to those who miscarried, in terms of baseline cardiovascular function, assessed by CO, PVR, PWV or AIx

  12. Pulmonary gas exchange and acid-base balance during exercise. (United States)

    Stickland, Michael K; Lindinger, Michael I; Olfert, I Mark; Heigenhauser, George J F; Hopkins, Susan R


    As the first step in the oxygen-transport chain, the lung has a critical task: optimizing the exchange of respiratory gases to maintain delivery of oxygen and the elimination of carbon dioxide. In healthy subjects, gas exchange, as evaluated by the alveolar-to-arterial PO2 difference (A-aDO2), worsens with incremental exercise, and typically reaches an A-aDO2 of approximately 25 mmHg at peak exercise. While there is great individual variability, A-aDO2 is generally largest at peak exercise in subjects with the highest peak oxygen consumption. Inert gas data has shown that the increase in A-aDO2 is explained by decreased ventilation-perfusion matching, and the development of a diffusion limitation for oxygen. Gas exchange data does not indicate the presence of right-to-left intrapulmonary shunt developing with exercise, despite recent data suggesting that large-diameter arteriovenous shunt vessels may be recruited with exercise. At the same time, multisystem mechanisms regulate systemic acid-base balance in integrative processes that involve gas exchange between tissues and the environment and simultaneous net changes in the concentrations of strong and weak ions within, and transfer between, extracellular and intracellular fluids. The physicochemical approach to acid-base balance is used to understand the contributions from independent acid-base variables to measured acid-base disturbances within contracting skeletal muscle, erythrocytes and noncontracting tissues. In muscle, the magnitude of the disturbance is proportional to the concentrations of dissociated weak acids, the rate at which acid equivalents (strong acid) accumulate and the rate at which strong base cations are added to or removed from muscle.

  13. Antimicrobial-induced Electrolyte and Acid-Base Disturbances


    Kim, Yang Wook


    Antimicrobials are one of the most widely prescribed classes of therapeutic agents. Although adverse effects of antimicrobials are generally minimal and reversible, serious sequelae can sometimes remain, such as unusual forms of renal failure, acid base disturbance and electrolyte abnormalities. Many antimicrobials, especially vancomycin or aminoglycosides, are associated with development of acute renal failure caused by acute tubular necrosis, allergic acute interstitial nephritis, or vascul...

  14. Effects of acid-base imbalance on vascular reactivity

    Directory of Open Access Journals (Sweden)

    A.C. Celotto


    Full Text Available Acid-base homeostasis maintains systemic arterial pH within a narrow range. Whereas the normal range of pH for clinical laboratories is 7.35-7.45, in vivo pH is maintained within a much narrower range. In clinical and experimental settings, blood pH can vary in response to respiratory or renal impairment. This altered pH promotes changes in vascular smooth muscle tone with impact on circulation and blood pressure control. Changes in pH can be divided into those occurring in the extracellular space (pHo and those occurring within the intracellular space (pHi, although, extracellular and intracellular compartments influence each other. Consistent with the multiple events involved in the changes in tone produced by altered pHo, including type of vascular bed, several factors and mechanisms, in addition to hydrogen ion concentration, have been suggested to be involved. The scientific literature has many reports concerning acid-base balance and endothelium function, but these concepts are not clear about acid-base disorders and their relations with the three known mechanisms of endothelium-dependent vascular reactivity: nitric oxide (NO/cGMP-dependent, prostacyclin (PGI2/cAMP-dependent and hyperpolarization. During the last decades, many studies have been published and have given rise to confronting data on acid-base disorder and endothelial function. Therefore, the main proposal of this review is to provide a critical analysis of the state of art and incentivate researchers to develop more studies about these issues.

  15. Haemodynamics and cardiac function during robotic-assisted laparoscopic prostatectomy in steep Trendelenburg position. (United States)

    Haas, Sebastian; Haese, Alexander; Goetz, Alwin E; Kubitz, Jens C


    Robotic-assisted laparoscopic prostatectomy (RALP) is usually performed in steep Trendelenburg position, which can be associated with cardiac impairment due to positioning and capnoperitoneum. This study investigated haemodynamic consequences and cardiac function in this type of surgery and evaluated the hypothesis that steep Trendelenburg position and capnoperitoneum results in haemodynamic and ventricular impairment. 10 patients (ASA I-III) scheduled for RALP in steep Trendelenburg position with capnoperitoneum were prospectively studied. Heart rate (HR), mean arterial pressure (MAP) and central venous pressure (CVP) were recorded. Stroke volume variation (SVV) and cardiac output (CO) were measured using pulse-contour analysis. Further, cardiac function was assessed using trans-oesophageal echocardiography before positioning (T1) and 10 min (T2) and 60 min (T3) after implementation of steep Trendelenburg position and capnoperitoneum. HR did not change statistically. MAP (T1, 69.7 ± 1.55; T2, 82.9 ± 3.05; T3, 79.4 ± 2.18 mmHg), CVP (T1, 7.7 ± 1.3; T2, 17.3 ± 2.01; T3, 16.9 ± 1.66 mmHg) and CO (T1, 4.0 ± 0.15; T2, 4.9 ± 0.26; T3, 4.9 ± 0.36 l/min) increased significantly at T2 and T3. Echocardiography showed no deterioration of left or right ventricular function. In one patient with pre-existing mitral valve insufficiency (I°) an aggravation of the insufficiency (III°) was observed. No other valve dysfunctions were observed. The steep Trendelenburg position may improve haemodynamic function and does not deteriorate left or right ventricular function during RALP. However, mitral valve insufficiency may be aggravated by positioning and capnoperitoneum. Copyright © 2011 John Wiley & Sons, Ltd.

  16. A prospective observational study on tolerance and satisfaction to hepatic haemodynamic procedures. (United States)

    Casu, Stefania; Berzigotti, Annalisa; Abraldes, Juan G; Baringo, M Angels; Rocabert, Laura; Hernández-Gea, Virginia; García-Pagán, Joan Carles; Bosch, Jaume


    Understanding patients' attitudes to clinical experiences is essential for developing high-quality patient-centred healthcare, as a better knowledge of patients' tolerance and satisfaction might allow implementing measures that ameliorate comfort, care and use of resources. We aimed to describe patients' tolerance and satisfaction to invasive hepatic haemodynamic procedures, and to investigate which factors might influence patients' perspective in this field. Visual Analogue Scale (VAS) questionnaires regarding pain and duration (for tolerance), and comfort and general handling (for satisfaction) were prospectively administered to all consecutive patients (N = 327) submitted to hepatic haemodynamic procedures (N = 355) in a tertiary care setting during 2011. VAS scores ranged between 0 and 100 mm and items were defined as excellent if 20 mm. Clinical and laboratory data were also collected. Satisfaction was excellent in >95% of cases (mean 2 ± 5 mm, median 0 mm) and average tolerance was good (15 ± 18 mm; median 6 mm). A percentage of 59% of patients had excellent tolerance, 9% good and 32% had inadequate tolerance. Duration and complexity of the procedure and limited operator's experience were associated with inadequate tolerance on univariate analysis; duration of the procedure remained the only independent factor associated with inadequate tolerance on multivariate analysis. Procedures lasting 80% probability of being well tolerated. Satisfaction and tolerance to hepatic haemodynamic procedures are excellent and good respectively. Tolerance was decreased in long procedures; hence reducing as much as possible the duration of the procedures might further improve tolerance. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  17. Different haemodynamic patterns in head-up tilt test on 400 paediatric cases with unexplained syncope. (United States)

    Yozgat, Yilmaz; Karadeniz, Cem; Ozdemir, Rahmi; Doksoz, Onder; Kucuk, Mehmet; Karaarslan, Utku; Mese, Timur; Unal, Nurettin


    To assess haemodynamic patterns in head-up tilt testing on 400 paediatric cases with unexplained syncope. Medical records of 520 children who underwent head-up tilt testing in the preceding year were retrospectively evaluated, and 400 children, 264 (66%) girls and 136 (34%) boys, aged 12.6±2.6 years (median 13; range 5-18), with unexplained syncope were enrolled in the study. Age, sex, baseline heart rate, baseline blood pressure, frequency of symptoms, and/or fainting attacks were recorded. The test protocol consisted of 25 minutes of supine resting followed by 20 minutes of 70° upright positioning. Subjects were divided into nine groups according to their differing haemodynamic patterns. There were no statistically significant differences between the groups with regard to age, gender, baseline blood pressure, and frequency of syncope (p>0.05). The response was compatible with orthostatic intolerance in 28 cases (7.0%), postural orthostatic tachycardia syndrome in 24 cases (6.0%), asymptomatic postural orthostatic tachycardia syndrome in 26 cases (6.5%), orthostatic hypotension in seven cases (1.7%), vasovagal syncope in 38 cases (9.5%), and negative in 274 cases (69.2%). Vasovagal syncope response patterns were of type 3 in nine cases (2.2%), type 2A in 10 cases (2.5%), type 2B in two cases (0.5%), and type 1 (mixed) in 17 cases (4.25%). In the 400 paediatric cases with unexplained syncope, nine different haemodynamic response patterns to head-up tilt testing were discerned. Children with orthostatic intolerance syndromes are increasingly referred to hospitals because of difficulty in daily activities. Therefore, there is need for further clinical trials in these patient groups.

  18. Component reductions in oxygen delivery generate variable haemodynamic and stress hormone responses. (United States)

    Dyson, A; Ekbal, N; Stotz, M; Barnes, S; Carré, J; Tully, S; Henderson, S; Barrett, L; Singer, M


    In clinical practice, global oxygen delivery (DO2) is often considered as a whole; however pathological and adaptive responses after a decrease in individual constituents of the DO2 equation (cardiac output, haemoglobin, oxyhaemoglobin saturation) are likely to be diverse. We hypothesized that an equivalent decrease in DO2 after reductions in each separate component of the equation would result in different haemodynamic, tissue oxygenation, and stress hormonal responses. Anaesthetized, fluid-resuscitated male Wistar rats were subjected to circulatory, anaemic, or hypoxic hypoxia (by haemorrhage, isovolaemic haemodilution, and breathing a hypoxic gas mix, respectively), produced either rapidly over 5 min or graded over 30 min, to a targeted 50% decrease in global oxygen delivery. Sham-operated animals acted as controls. Measurements were made of haemodynamics, skeletal muscle tissue oxygen tension, blood gas analysis, and circulating stress hormone levels. Whereas haemorrhage generated the largest decrease in cardiac output, and the greatest stress hormone response, haemodilution had the most marked effect on arterial pressure. In contrast, rapid hypoxaemia produced a minor impact on global haemodynamics yet induced the greatest decrease in regional oxygenation. A greater degree of hyperlactataemia was observed with graded insults compared with those administered rapidly. Decreasing global oxygen delivery, achieved by targeted reductions in its separate components, induces varying circulatory, tissue oxygen tension, and stress hormone responses. We conclude that not all oxygen delivery is the same; this disparity should be emphasized in classical teaching and re-evaluated in patient management. © The Author [2014]. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email:


    Directory of Open Access Journals (Sweden)

    İsmail TİYEK


    Full Text Available In the production of acrylic fibers using wet-spinning method, fiber formation takes places in the coagulation bath. Therefore, physical properties of the fibers, produced by the wet-spinning method, is affected by coagulation bath conditions. For this reason, coagulation bath parameters have to be checked very well. In this paper, both the physical events such as diffusion and phase transition, occured in the coagulation bath, and some coagulation bath parameters that affect these physical events are studied. Furthermore, it is tried to express their affects on the physical characteristics of the fibers.

  20. Carbonic anhydrase 5 regulates acid-base homeostasis in zebrafish.

    Directory of Open Access Journals (Sweden)

    Ruben Postel

    Full Text Available The regulation of the acid-base balance in cells is essential for proper cellular homeostasis. Disturbed acid-base balance directly affects cellular physiology, which often results in various pathological conditions. In every living organism, the protein family of carbonic anhydrases regulate a broad variety of homeostatic processes. Here we describe the identification, mapping and cloning of a zebrafish carbonic anhydrase 5 (ca5 mutation, collapse of fins (cof, which causes initially a collapse of the medial fins followed by necrosis and rapid degeneration of the embryo. These phenotypical characteristics can be mimicked in wild-type embryos by acetazolamide treatment, suggesting that CA5 activity in zebrafish is essential for a proper development. In addition we show that CA5 regulates acid-base balance during embryonic development, since lowering the pH can compensate for the loss of CA5 activity. Identification of selective modulators of CA5 activity could have a major impact on the development of new therapeutics involved in the treatment of a variety of disorders.

  1. Electrolyte and acid-base abnormalities associated with purging behaviors. (United States)

    Mehler, Philip S; Walsh, Kristine


    Eating disorders that are associated with purging behaviors are complicated by frequent blood electrolyte and acid-base abnormalities. Herein, we review the major electrolyte and acid-base abnormalities and their treatment methods. The body of rigorous, eating disorder-specific literature on this topical area is not robust enough to perform a systematic review as defined by PRISMA guidelines. Therefore, a qualitative review of mostly medical literature was conducted. Hypokalemia, hyponatremia, and sodium chloride-responsive metabolic alkalosis are the most common serum changes that occur as a result of purging behaviors. They vary depending on the mode and frequency of purging behaviors. They can all potentially cause dangerous medical complications and are in need of definitive medical treatment. Eating disorders that are associated with purging behaviors are associated with a number of electrolyte and acid-base changes which are complex in their origin, documented to be medically dangerous and this definitive treatment is necessary to help achieve a successful treatment outcome, and in need of definitive treatment as described herein. © 2016 Wiley Periodicals, Inc.

  2. Acid-base balance in uremic rats with vascular calcification. (United States)

    Peralta-Ramírez, Alan; Raya, Ana Isabel; Pineda, Carmen; Rodríguez, Mariano; Aguilera-Tejero, Escolástico; López, Ignacio


    Vascular calcification (VC), a major complication in humans and animals with chronic kidney disease (CKD), is influenced by changes in acid-base balance. The purpose of this study was to describe the acid-base balance in uremic rats with VC and to correlate the parameters that define acid-base equilibrium with VC. Twenty-two rats with CKD induced by 5/6 nephrectomy (5/6 Nx) and 10 nonuremic control rats were studied. The 5/6 Nx rats showed extensive VC as evidenced by a high aortic calcium (9.2 ± 1.7 mg/g of tissue) and phosphorus (20.6 ± 4.9 mg/g of tissue) content. Uremic rats had an increased pH level (7.57 ± 0.03) as a consequence of both respiratory (PaCO2 = 28.4 ± 2.1 mm Hg) and, to a lesser degree, metabolic (base excess = 4.1 ± 1 mmol/l) derangements. A high positive correlation between both anion gap (AG) and strong ion difference (SID) with aortic calcium (AG: r = 0.604, p = 0.02; SID: r = 0.647, p = 0.01) and with aortic phosphorus (AG: r = 0.684, p = 0.007; SID: r = 0.785, p = 0.01) was detected. In an experimental model of uremic rats, VC showed high positive correlation with AG and SID.

  3. Neurologic complications of electrolyte disturbances and acid-base balance. (United States)

    Espay, Alberto J


    Electrolyte and acid-base disturbances are common occurrences in daily clinical practice. Although these abnormalities can be readily ascertained from routine laboratory findings, only specific clinical correlates may attest as to their significance. Among a wide phenotypic spectrum, acute electrolyte and acid-base disturbances may affect the peripheral nervous system as arreflexic weakness (hypermagnesemia, hyperkalemia, and hypophosphatemia), the central nervous system as epileptic encephalopathies (hypomagnesemia, dysnatremias, and hypocalcemia), or both as a mixture of encephalopathy and weakness or paresthesias (hypocalcemia, alkalosis). Disabling complications may develop not only when these derangements are overlooked and left untreated (e.g., visual loss from intracranial hypertension in respiratory or metabolic acidosis; quadriplegia with respiratory insufficiency in hypermagnesemia) but also when they are inappropriately managed (e.g., central pontine myelinolisis when rapidly correcting hyponatremia; cardiac arrhythmias when aggressively correcting hypo- or hyperkalemia). Therefore prompt identification of the specific neurometabolic syndromes is critical to correct the causative electrolyte or acid-base disturbances and prevent permanent central or peripheral nervous system injury. This chapter reviews the pathophysiology, clinical investigations, clinical phenotypes, and current management strategies in disorders resulting from alterations in the plasma concentration of sodium, potassium, calcium, magnesium, and phosphorus as well as from acidemia and alkalemia. © 2014 Elsevier B.V. All rights reserved.

  4. Clinical applications of quantitative acid-base chemistry. (United States)

    Whitehair, K J; Haskins, S C; Whitehair, J G; Pascoe, P J


    Stewart used physicochemical principles of aqueous solutions to develop an understanding of variables that control hydrogen ion concentration (H+) in body fluids. He proposed that H+ concentration in body fluids was determined by PCO2, strong ion difference (SID = sum of strong positive ion concentrations minus the sum of the strong anion concentrations) and the total concentration of nonvolatile weak acid (Atot) under normal circumstances. Albumin is the major weak acid in plasma and represents the majority of Atot. These 3 variables were defined as independent variables, which determined the values of all other relevant variables (dependent) in plasma, including H+. The major strong ions in plasma are sodium and chloride. The difference between Na+ and Cl- may be used as an estimation of SID. A decrease in SID below normal results in acidosis (increase in H+) and an increase in SID above normal results in alkalosis (decrease in H+). Unidentified strong anions such as lactate will decrease the SID, if present. Equations developed by Fencl allow Stewart's work to be easily applied clinically for evaluating the metabolic (nonrespiratory) contribution to acid-base balance. This approach separates the net metabolic abnormality into components, and allows one to easily detect mixed metabolic acid-base abnormalities. The Fencl approach provides insight into the nature and severity of the disturbances that exist in the patient. Sodium, chloride, protein, and unidentified anion derangements may contribute to the observed metabolic acid-base imbalance.

  5. How a left-to-right shunt may protect against haemodynamic deterioration in restrictive cardiomyopathy. (United States)

    Van Mieghem, Nicolas; Daenen, Wim; Budts, Werner


    Today, more and more children with complex heart lesions and underlying cardiomyopathies reach adulthood. This results in a wide range of new clinical problems encountered in later life. In particular, idiopathic restrictive cardiomyopathy is initially treated by medication to reduce symptoms, but at end-stage disease, heart or heart-lung transplantation becomes unavoidable. We describe the case of a patient with restrictive cardiomyopathy and a persistent extra-cardiac left-to-right shunt, where we hypothesize that the shunt may protect against haemodynamic deterioration in end-stage restrictive cardiomyopathie.

  6. Effects of a Ginkgo biloba extract on forearm haemodynamics in healthy volunteers

    DEFF Research Database (Denmark)

    Mehlsen, J; Drabaek, H; Wiinberg, N


    The aim was to validate possible vasodilating effects of a Ginkgo biloba extract with a secondary aim of finding a pharmacodynamic signal relating to the active component of these extracts. We studied the effect of G. biloba extract on forearm haemodynamics in 16 healthy subjects (nine females......, seven males) with a median age of 32 years (range: 21-47). The study was conducted as a randomized, double-blinded cross-over design using oral treatment with G. biloba extract (Gibidyl Forte(R) t.i.d. or placebo for 6 weeks. Forearm blood flow and venous capacity were measured by strain...

  7. The coagulation characteristics of humic acid by using acid-soluble chitosan, water-soluble chitosan, and chitosan coagulant mixtures. (United States)

    Chen, Chih-Yu; Wu, Chung-Yu; Chung, Ying-Chien


    Chitosan is a potential substitute for traditional aluminium salts in water treatment systems. This study compared the characteristics of humic acid (HA) removal by using acid-soluble chitosan, water-soluble chitosan, and coagulant mixtures of chitosan with aluminium sulphate (alum) or polyaluminium chloride (PACl). In addition, we evaluated their respective coagulation efficiencies at various coagulant concentrations, pH values, turbidities, and hardness levels. Furthermore, we determined the size and settling velocity of flocs formed by these coagulants to identify the major factors affecting HA coagulation. The coagulation efficiency of acid- and water-soluble chitosan for 15 mg/l of HA was 74.4% and 87.5%, respectively. The optimal coagulation range of water-soluble chitosan (9-20 mg/l) was broader than that of acid-soluble chitosan (4-8 mg/l). Notably, acid-soluble chitosan/PACl and water-soluble chitosan/alum coagulant mixtures exhibited a higher coagulation efficiency for HA than for PACl or alum alone. Furthermore, these coagulant mixtures yielded an acceptable floc settling velocity and savings in both installation and operational expenses. Based on these results, we confidently assert that coagulant mixtures with a 1:1 mass ratio of acid-soluble chitosan/PACl and water-soluble chitosan/alum provide a substantially more cost-effective alternative to using chitosan alone for removing HA from water.

  8. [Haemodynamics of the systemic and pulmonary circulation during surgery of hip fractures in spinal anaesthesia in elderly persons (author's transl)]. (United States)

    Franke, N; van Ackern, K; Peter, K; Plaue, R


    The haemodynamics of the pulmonary and systemic circulation during anaesthesia and surgical treatment of a hip fracture were investigated in 26 patients (mean age 73 +/- 4.5 years). After induction of spinal anaesthesia the mean arterial pressure, right atrial pressure, pulmonary capillary wedge pressure and systemic vascular resistance were significantly reduced. The cardiac index remained constant due to mild tachycardia. During the operation no significant variations of the haemodynamic parameters were observed. Implantation of methylmethacrylate in 10 patients was followed by a significant increase of the mean pulmonary pressure and pulmonary vascular resistance. The PaO2 DECREASED. 15 minutes after implantation the original values were again reached.

  9. Evaluation of the process of coagulation/flocculation of produced water using Moringa oleifera Lam. as natural coagulant

    Energy Technology Data Exchange (ETDEWEB)

    Santana, C.R.; Pereira, D.F.; Sousa, S.C S N.; Silva, G.F. [Universidade Federal de Sergipe (UFSE), Sao Cristovao, SE (Brazil). Dept. de Engenharia Quimica], e-mail:; Cavalcanti, E.B. [Universidade Tiradentes (UNIT), SE (Brazil). Inst. de Tecnologia e Pesquisa


    In the lifetime of an oil well, there comes a moment when a lot of water begins to be produced along with oil, either by the conditions of the reservoir, or as a result of water injection in the secondary recovery of the well. An important step in such process involves the treatment of the produced water by means of coagulation techniques. Therefore, the use of environmentally correct coagulants is presented as a viable alternative and has demonstrated advantages over the use of chemical coagulants. The plant of the genus Moringa, whose species is oleifera Lam, stands out as one of the most promising natural coagulants. The present study investigated the evaluation of the coagulation/flocculation of produced water, using seeds of Moringa oleifera Lam. as coagulant. The results were very significant, demonstrating that Moringa oleifera Lam. can be used as a natural coagulant in this type of treatment. (author)

  10. A mathematical model of blood-interstitial acid-base balance: application to dilution acidosis and acid-base status. (United States)

    Wolf, Matthew B; Deland, Edward C


    We developed mathematical models that predict equilibrium distribution of water and electrolytes (proteins and simple ions), metabolites, and other species between plasma and erythrocyte fluids (blood) and interstitial fluid. The models use physicochemical principles of electroneutrality in a fluid compartment and osmotic equilibrium between compartments and transmembrane Donnan relationships for mobile species. Across the erythrocyte membrane, the significant mobile species Cl⁻ is assumed to reach electrochemical equilibrium, whereas Na(+) and K(+) distributions are away from equilibrium because of the Na(+)/K(+) pump, but movement from this steady state is restricted because of their effective short-term impermeability. Across the capillary membrane separating plasma and interstitial fluid, Na(+), K(+), Ca²(+), Mg²(+), Cl⁻, and H(+) are mobile and establish Donnan equilibrium distribution ratios. In each compartment, attainment of equilibrium by carbonates, phosphates, proteins, and metabolites is determined by their reactions with H(+). These relationships produce the recognized exchange of Cl(-) and bicarbonate across the erythrocyte membrane. The blood submodel was validated by its close predictions of in vitro experimental data, blood pH, pH-dependent ratio of H(+), Cl⁻, and HCO₃⁻ concentrations in erythrocytes to that in plasma, and blood hematocrit. The blood-interstitial model was validated against available in vivo laboratory data from humans with respiratory acid-base disorders. Model predictions were used to gain understanding of the important acid-base disorder caused by addition of saline solutions. Blood model results were used as a basis for estimating errors in base excess predictions in blood by the traditional approach of Siggaard-Andersen (acid-base status) and more recent approaches by others using measured blood pH and Pco₂ values. Blood-interstitial model predictions were also used as a basis for assessing prediction errors of

  11. A comparison of haemodynamics between subcranial-intracranial bypass and the traditional extracranial-intracranial bypass. (United States)

    Yu, Zaitao; Yang, Yang; Shi, Xiang'en; Qian, Hai; Liu, Fangjun


    Ischemic cerebrovascular diseases are traditionally treated using an extracranial-intracranial (EC-IC) bypass. The use of the internal maxillary artery (IMA) in the subcranial-intracranial (SC-IC) bypass was recently described as an alternative treatment. However, the haemodynamics of this new approach have not been defined. The haemodynamic parameters (flow volume [FV], internal diameter [ID], time-averaged mean velocity [TAM], pulsatility index [PI] and resistance index [RI]) of the IMA-radial artery graft (RAG)-middle cerebral artery (MCA) (n = 12) bypass and superficial temporal artery (STA)-MCA bypass (n = 18) were measured using intraoperative duplex ultrasonography and compared. The FV was 81.36 ± 30.41 (62.05-100.70) ml/min for the IMA-RAG-MCA bypass. This was significantly higher than that of the STA-MCA bypass (27.25 ± 9.32 (22.62-31.88) ml/min; P bypass were higher than in the STA-MCA bypass (P bypass and 94% for the STA-MCA bypass. The IMA-RAG-MCA bypass provides moderate to high blood flow to the revascularized territory and blood flow was higher by this method than the STA-MCA bypass.

  12. Haemodynamic resistance model of monochorionic twin pregnancies complicated by acardiac twinning

    Energy Technology Data Exchange (ETDEWEB)

    Umur, Asli [Laser Center and Department of Obstetrics and Gynecology, Academic Medical Center, University of Amsterdam, Amsterdam(Netherlands); Gemert, Martin J C van [Laser Center and Department of Obstetrics and Gynecology, Academic Medical Center, University of Amsterdam, Amsterdam (Netherlands); Wijngaard, Jeroen P H M van den [Laser Center and Department of Obstetrics and Gynecology, Academic Medical Center, University of Amsterdam, Amsterdam (Netherlands); Ross, Michael G [Department of Obstetrics and Gynecology, Harbor University of California-Los Angeles Medical Center, Torrence, CA 9050 (United States); Nikkels, Peter G J [Department of Pathology, University Medical Center, Utrecht (Netherlands)


    An acardiac twin is a severely malformed monochorionic twin fetus that lacks most organs, particularly a heart. It grows during pregnancy, because it is perfused by its developmentally normal co-twin (called the pump twin) via a set of placental arterioarterial and venovenous anastomoses. The pump twin dies intrauterine or neonatally in about 50% of the cases due to congestive heart failure, polyhydramnios and prematurity. Because the pathophysiology of this pregnancy is currently incompletely understood, we modified our previous haemodynamic model of monochorionic twins connected by placental vascular anastomoses to include the analysis of acardiac twin pregnancies. We incorporated the fetoplacental circulation as a resistance circuit and used the fetal umbilical flow that perfuses the body to define fetal growth, rather than the placental flow as done previously. Using this modified model, we predicted that the pump twin has excess blood volume and increased mean arterial blood pressure compared to those in the acardiac twin. Placental perfusion of the acardiac twin is significantly reduced compared to normal, as a consequence of an increased venous pressure, possibly implying reduced acardiac placental growth. In conclusion, the haemodynamic analysis may contribute to an increased knowledge of the pathophysiologic consequences of an acardiac body mass for the pump twin. (note)

  13. Electrophysiological and haemodynamic effects of lidocaine and ajmaline in the management of sustained ventricular tachycardia. (United States)

    Manz, M; Mletzko, R; Jung, W; Lüderitz, B


    The electrophysiological and haemodynamic effects of lidocaine (100 mg) and ajmaline (50 mg) were evaluated while attempting to interrupt sustained ventricular tachycardia. The study was performed as a prospective, non-blinded, randomized investigation in 61 patients. Lidocaine terminated ventricular tachycardia in four of 31 patients, ajmaline in 19 of 30 patients (P less than 0.001). QRS and RR intervals during ventricular tachycardia were prolonged by ajmaline from 164 +/- 28 ms to 214 +/- 49 ms and from 371 +/- 86 ms to 479 +/- 137 ms (P less than 0.001), respectively; lidocaine did not influence these parameters. The duration of the return cycles after termination of ventricular tachycardia did not differ between the two groups. Lidocaine did not change cardiac output during ventricular tachycardia whereas cardiac output increased significantly under ajmaline from 3.5 +/- 1.21.min-1 to 5.5 +/- 1.91.min-1 (P less than 0.001). It is concluded that anti-arrhythmic agents such as ajmaline, which slow conduction velocity and prolong refractoriness, are more effective than lidocaine in the medical treatment of haemodynamically stable, sustained ventricular tachycardia.

  14. Effects of aerobic exercise in early evening on the following nocturnal sleep and its haemodynamic response. (United States)

    Miura, Akira; Myouken, Shizuka; Yamada, Masako; Fujihara, Chizuko; Miura, Kouhei; Kashima, Hideaki; Eguchi, Kouhei; Endo, Masako Y; Koga, Shunsaku; Fukuba, Yoshiyuki


    We determined effect of aerobic exercise in early evening on the quality, quantity, and haemodynamic response of subsequent nocturnal sleep in the home. Ten healthy young participants performed two protocols, with/without cycle ergometer exercise (60 min at 50% heart rate reserve) in early evening. Blood pressure (BP) (Holter) and physical activity (accelerometer) were measured from late afternoon of day 1 until noon of next day (day 2). Additionally, at bedtime participants were equipped with a small device worn on the wrist that identified sleep stage. There were no substantial differences in objective indices of sleep between two protocols (total sleep time: 438 ± 76 vs. 457 ± 64 min; P > 0.10). BP during nocturnal sleep tended to be lowered by prior exercise (MAP: 71 ± 5 vs. 68 ± 6 mmHg; P = 0.08). Aerobic exercise in early evening apparently has no acute effect on sleep per se, but seems to have a residual effect on haemodynamics, i.e. prolongation of post-exercise hypotension.

  15. Effect of a physical activity programme in the aquatic environment on haemodynamic constants in pregnant women. (United States)

    Vázquez-Lara, Juana María; Ruiz-Frutos, Carlos; Rodríguez-Díaz, Luciano; Ramírez-Rodrigo, Jesús; Villaverde-Gutiérrez, Carmen; Torres-Luque, Gema


    To evaluate the effect of a physical activity programme in the aquatic environment with immersion up to the neck, of six weeks duration, on haemodynamic constants in pregnant women. A six-week physical activity programme in the aquatic environment was carried out with a total of 46 pregnant women, who were distributed into an experimental group (n = 18), which participated in the programme, and a control group (n = 28), which followed routine care. In both groups different haemodynamic measurements were evaluated before and after the program. At the beginning of the programme the mean systolic blood pressure was similar between groups, but diastolic blood pressure was slightly higher in the experimental group. When the measurements at the last session were compared, arterial pressures (systolic, diastolic and mean) were significantly higher in the control group (p <.050). Similarly, the initial plasma volume values did not differ between groups, but after the intervention, the control group women showed a higher mean (p <.010). The fraction of sodium excretion (FENa) increased significantly in the experimental group, after the programme, with a mean three times higher (p <.050). Aldosterone plasma levels did not show significant differences between the groups in the different measurements. A programme of swimming and immersion exercises in pregnant women contributes to hydrosaline balance, preventing an excessive increase in usual plasma volume during pregnancy and in the activity of the renin-aldosterone axis. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  16. NOTE: Haemodynamic resistance model of monochorionic twin pregnancies complicated by acardiac twinning (United States)

    Umur, Asli; van Gemert, Martin J. C.; van den Wijngaard, Jeroen P. H. M.; Ross, Michael G.; Nikkels, Peter G. J.


    An acardiac twin is a severely malformed monochorionic twin fetus that lacks most organs, particularly a heart. It grows during pregnancy, because it is perfused by its developmentally normal co-twin (called the pump twin) via a set of placental arterioarterial and venovenous anastomoses. The pump twin dies intrauterine or neonatally in about 50% of the cases due to congestive heart failure, polyhydramnios and prematurity. Because the pathophysiology of this pregnancy is currently incompletely understood, we modified our previous haemodynamic model of monochorionic twins connected by placental vascular anastomoses to include the analysis of acardiac twin pregnancies. We incorporated the fetoplacental circulation as a resistance circuit and used the fetal umbilical flow that perfuses the body to define fetal growth, rather than the placental flow as done previously. Using this modified model, we predicted that the pump twin has excess blood volume and increased mean arterial blood pressure compared to those in the acardiac twin. Placental perfusion of the acardiac twin is significantly reduced compared to normal, as a consequence of an increased venous pressure, possibly implying reduced acardiac placental growth. In conclusion, the haemodynamic analysis may contribute to an increased knowledge of the pathophysiologic consequences of an acardiac body mass for the pump twin.

  17. Haemodynamic changes in hepatocellular carcinoma and liver parenchyma under balloon occlusion of the hepatic artery

    Energy Technology Data Exchange (ETDEWEB)

    Sugihara, Fumie; Murata, Satoru; Ueda, Tatsuo; Yasui, Daisuke; Yamaguchi, Hidenori; Miki, Izumi; Kumita, Shin-ichiro [Nippon Medical School, Department of Radiology, Center for Advanced Medical Technology, Tokyo (Japan); Kawamoto, Chiaki [Nippon Medical School, Department of Internal Medicine, Tokyo (Japan); Uchida, Eiji [Nippon Medical School, Department of Surgery, Tokyo (Japan)


    To investigate haemodynamic changes in hepatocellular carcinoma (HCC) and liver under hepatic artery occlusion. Thirty-eight HCC nodules in 25 patients were included. Computed tomography (CT) during hepatic arteriography (CTHA) with and without balloon occlusion of the hepatic artery was performed. CT attenuation and enhancement volume of HCC and liver with and without balloon occlusion were measured on CTHA. Influence of balloon position (segmental or subsegmental branch) was evaluated based on differences in HCC-to-liver attenuation ratio (H/L ratio) and enhancement volume of HCC and liver. In the segmental group (n = 20), H/L ratio and enhancement volume of HCC and liver were significantly lower with balloon occlusion than without balloon occlusion. However, in the subsegmental group (n = 18), H/L ratio was significantly higher and liver enhancement volume was significantly lower with balloon occlusion; HCC enhancement volume was similar with and without balloon occlusion. Rate of change in H/L ratio and enhancement volume of HCC and liver were lower in the segmental group than in the subsegmental group. There were significantly more perfusion defects in HCC in the segmental group. Hepatic artery occlusion causes haemodynamic changes in HCC and liver, especially with segmental occlusion. (orig.)

  18. Haemodynamic Monitoring in the Intensive Care Unit: Results from a Web-Based Swiss Survey

    Directory of Open Access Journals (Sweden)

    Nils Siegenthaler


    Full Text Available Background. The aim of this survey was to describe, in a situation of growing availability of monitoring devices and parameters, the practices in haemodynamic monitoring at the bedside. Methods. We conducted a Web-based survey in Swiss adult ICUs (2009-2010. The questionnaire explored the kind of monitoring used and how the fluid management was addressed. Results. Our survey included 71% of Swiss ICUs. Echocardiography (95%, pulmonary artery catheter (PAC: 85%, and transpulmonary thermodilution (TPTD (82% were the most commonly used. TPTD and PAC were frequently both available, although TPTD was the preferred technique. Echocardiography was widely available (95% but seems to be rarely performed by intensivists themselves. Guidelines for the management of fluid infusion were available in 45% of ICUs. For the prediction of fluid responsiveness, intensivists rely preferentially on dynamic indices or echocardiographic parameters, but static parameters, such as central venous pressure or pulmonary artery occlusion pressure, were still used. Conclusions. In most Swiss ICUs, multiple haemodynamic monitoring devices are available, although TPTD is most commonly used. Despite the usefulness of echocardiography and its large availability, it is not widely performed by Swiss intensivists themselves. Regarding fluid management, several parameters are used without a clear consensus for the optimal method.

  19. Coagulation and morbidity in treated HIV infection (United States)

    Funderburg, Nicholas T.; Lederman, Michael M.


    HIV infected patients are at increased risk for venous and arterial thromboembolic events. Multiple markers related to inflammation (IL-6, TNFrI, C-reative protein) and coagulation (tissue factor expression, FVIII, thrombin, fibrinogen and D-dimer levels) are increased in HIV infection, and several are predictive of thrombotic risk and mortality in HIV disease. The mechanisms behind the risk for abnormal coagulation in HIV infection have not been fully elucidated, but may be related to a chronic immune activation and inflammatory state in both untreated and treated HIV infection. The contribution of traditional risk factors, including smoking and dyslipidemia, overly represented in HIV infected patients, must also be considered when assessing thrombotic risk in this setting. Currently, several interventional studies are aimed at reducing inflammation and cardiovascular risk in HIV disease and may provide insights into the determinants of clotting events in HIV infected patients. PMID:24759134

  20. Poly(γ-glutamic acid), coagulation? Anticoagulation? (United States)

    Xu, Tingting; Peng, Fang; Zhang, Tao; Chi, Bo; Xu, Hong; Mao, Chun; Feng, Shuaihui


    Poly(γ-glutamic acid) (γ-PGA) powder was usually used as hemostatic agent because of its excellent physical properties of water-absorption and water-locking. However, if γ-PGA absorbs enough water, how about its blood compatibility? Here, the other side of the coin was investigated. The anticoagulant properties of γ-PGA were characterized by in vitro coagulation tests, hemolytic assay, platelet adhesion, and platelet activation. Moreover, cytotoxicity experiments of γ-PGA were also carried out by MTT assay. Results indicated that the sufficient water-absorbed γ-PGA has good anticoagulant property and non-cytotoxicity. It means γ-PGA has good anticoagulant property, non-cytotoxicity. If γ-PGA has absorbed enough water, it can be used as an anticoagulation biomaterial. With double effects (coagulation and anticoagulation), the γ-PGA with desirable bioproperties can be readily tailored to cater to various biomedical applications.

  1. Blood coagulation disorders in septic patients. (United States)

    Knoebl, Paul


    Host defense and blood coagulation are tightly connected and interacting systems, necessary for the integrity of an organism. Complex mechanisms regulate the intensity of a host response to invading pathogens or other potentially dangerous situations. Under regular conditions, this response is limited in time and located to the site of injury. Sometimes, however, systemic host response is overwhelming and disproportional and causes damage, not cure. Dependent on the genetical predisposition of the host, its current immunocompetence, or the type of injury, the reaction leads to the clinical picture of the different degrees of sepsis. Septic organ dysfunction is caused by intravascular fibrin deposition as a result of coagulation activation, anticoagulant breakdown, and shut down of fibrinolysis. This article describes the major pathophysiologic reactions in these situations and presents, an online tool on sepsis and associated coagulopathy.

  2. Ventricular metastasis resulting in disseminated intravascular coagulation

    Directory of Open Access Journals (Sweden)

    Davis Ian D


    Full Text Available Abstract Background Disseminated Intravascular Coagulation (DIC complicates up to 7% of malignancies, the commonest solid organ association being adenocarcinoma. Transitional Cell Carcinoma (TCC has rarely been associated with DIC. Case presentation A 74-year-old woman with TCC bladder and DIC was found to have a cardiac lesion suspicious for metastatic disease. The DIC improved with infusion of plasma and administration of Vitamin K, however the cardiac lesion was deemed inoperable and chemotherapy inappropriate; given the patients functional status. We postulate that direct activation of the coagulation cascade by the intraventricular metastasis probably triggered the coagulopathy in this patient. Conclusion Cardiac metastases should be considered in cancer patients with otherwise unexplained DIC. This may influence treatment choices.

  3. Novel chemo-enzymatic oligomers of cinnamic acids as direct and indirect inhibitors of coagulation proteinases. (United States)

    Monien, Bernhard H; Henry, Brian L; Raghuraman, Arjun; Hindle, Michael; Desai, Umesh R


    Thrombin and factor Xa, two important procoagulant enzymes, have been prime targets for regulation of clotting through the direct and indirect mechanism of inhibition. Our efforts on exploiting the indirect mechanism led us to study a carboxylic acid-based scaffold, which displayed major acceleration in the inhibition of these enzymes [J. Med. Chem.2005, 48, 1269, 5360]. This work advances the study to chemo-enzymatically prepared oligomers of 4-hydroxycinnamic acids, DHPs, which display interesting anticoagulant properties. Oligomers, ranging in size from tetramers to pentadecamers, were prepared through peroxidase-catalyzed oxidative coupling of caffeic, ferulic, and sinapic acids, and sulfated using triethylamine-sulfur trioxide complex. Chromatographic, spectroscopic, and elemental studies suggest that the DHPs are heterogeneous, polydisperse preparations composed of inter-monomer linkages similar to those found in natural lignins. Measurement of activated thromboplastin and prothrombin time indicates that both the sulfated and unsulfated derivatives of the DHPs display anticoagulant activity, which is dramatically higher than that of the reference polyacrylic acids. More interestingly, this activity approaches that of low-molecular-weight heparin with the sulfated derivative showing approximately 2- to 3-fold greater potency than the unsulfated parent. Studies on the inhibition of factor Xa and thrombin indicate that the oligomers exert their anticoagulant effect through both direct and indirect inhibition mechanisms. This dual inhibition property of 4-hydroxycinnamic acid-based DHP oligomers is the first example in inhibitors of coagulation. This work puts forward a novel, non-heparin structure, which may be exploited for the design of potent, dual action inhibitors of coagulation through combinatorial virtual screening on a library of DHP oligomers.

  4. Quality in coagulation and haemostasis testing


    Bonar, Roslyn; Favaloro, Emmanuel J.; Adcock, Dorothy M.


    The essential elements of a quality program, specifically internal quality control (IQC) and external quality assurance (EQA), should be applied to each laboratory assay performed in order to ensure test result accuracy and precision. The coagulation laboratory plays an important role in the diagnosis and treatment of individuals with bleeding or clotting (i.e., thrombotic) disorders. Test methodologies used to assess common disorders or diseases of haemostasis are reviewed as well as the cli...

  5. Patterned retinal coagulation with a scanning laser (United States)

    Palanker, Daniel; Jain, ATul; Paulus, Yannis; Andersen, Dan; Blumenkranz, Mark S.


    Pan-retinal photocoagulation in patients with diabetic retinopathy typically involves application of more than 1000 laser spots; often resulting in physician fatigue and patient discomfort. We present a semi-automated patterned scanning laser photocoagulator that rapidly applies predetermined patterns of lesions; thus, greatly improving the comfort, efficiency and precision of the treatment. Patterns selected from a graphical user interface are displayed on the retina with an aiming beam, and treatment can be initiated and interrupted by depressing a foot pedal. To deliver a significant number of burns during the eye's fixation time, each pulse should be considerably shorter than conventional 100ms pulse duration. We measured coagulation thresholds and studied clinical and histological outcomes of the application of laser pulses in the range of 1-200ms in pigmented rabbits. Laser power required for producing ophthalmoscopically visible lesions with a laser spot of 132μm decreased from 360 to 37mW with pulse durations increasing from 1 to 100ms. In the range of 10-100ms clinically and histologically equivalent light burns could be produced. The safe therapeutic range of coagulation (ratio of the laser power required to produce a rupture to that for a light burn) decreased with decreasing pulse duration: from 3.8 at 100ms, to 3.0 at 20ms, to 2.5 at 10ms, and to 1.1 at 1ms. Histology demonstrated increased confinement of the thermal damage with shorter pulses, with coagulation zone limited to the photoreceptor layer at pulses shorter than 10ms. Durations of 10-20ms appear to be a good compromise between the speed and safety of retinal coagulation. Rapid application of multiple lesions greatly improves the speed, precision, and reduces pain in retinal photocoagulation.

  6. Development of the selective coagulation process

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, R.H.; Luttrell, G.H.


    The selective hydrophobic coagulation (SHC) process is based on the recent finding that hydrophobic particles can be selectively coagulated without using traditional agglomerating agents or flocculants. The driving force for the coagulation is the attractive energy between hydrophobic surfaces, an interaction that has been overlooked in classical colloid chemistry. In most cases, selective separations can be achieved using simple pH control to disperse the mineral matter, followed by recovery of the coal coagula using techniques that take advantage of the size enlargement. In the present work, studies have been carried out to further investigate the fundamental mechanisms of the SHC process and the parameters that affect the process of separating coal from the ash-forming minerals and pyritic sulfur. Studies have included direct force measurements of the attractive interaction between model hydrophobic surfaces, in-situ measurements of the size distributions of coagula formed under a variety of operating conditions, and development of a population balance model to describe the coagulation process. An extended DLVO colloid stability model which includes a hydrophobic interaction energy term has also been developed to explain the findings obtained from the experimental studies. In addition to the fundamental studies, bench-scale process development test work has been performed to establish the best possible method of separating the coagula from dispersed mineral matter. Two types of separators, i.e., a sedimentation tank and a rotating drum screen, were examined in this study. The sedimentation tank proved to be the more efficient unit, achieving ash reductions as high as 60% in a single pass while recovering more than 90% of the combustible material. This device, which minimizes turbulence and coagula breakage, was used in subsequent test work to optimize design and operating parameters.

  7. Coagulation behavior of kaolin-anionic surfactant simulative wastewater by polyaluminum chloride-polymer dual coagulants. (United States)

    Li, Ruihua; Gao, Baoyu; Sun, Jianzhang; Yue, Qinyan


    In this study, polyaluminum chloride (PAC) and cationic polymers were used to treat kaolin suspension in the presence of sodium dodecyl benzene sulfonate (SDBS). Effects of PAC dosage, pH, and rotation rate on the coagulation efficiency and floc properties were studied. And the interaction of chemicals and kaolin-SDBS was discussed. Results showed that dual coagulants could decrease the influence of SDBS on the turbidity removal compared with PAC. PAC + polyacrylamide dual coagulant showed superior performance, and the maximal removal ratios of turbidity and dissolved organic carbon were 98.5 and 42.2%, respectively. Optimal coagulation performance was achieved at pH 5-7, where charge neutralization of Al hydrolysates and bridging of polyacrylamide were the primary mechanisms. And flocs with compact structure and small size were formed. Flocs coagulated by PAC were prone to be broken at the pH of raw water after introducing high rotation rate. After dosing polyacrylamide, floc size was enhanced under alkaline condition. Meanwhile, flocs showed stronger recoverability and an open structure because the regeneration mechanism was mainly the bridging effect of polyacrylamide.

  8. Thymoquinone Modulates Blood Coagulation in Vitro via Its Effects on Inflammatory and Coagulation Pathways (United States)

    Muralidharan-Chari, Vandhana; Kim, Jaehan; Abuawad, Ahlam; Naeem, Mubeena; Cui, Huadong; Mousa, Shaker A.


    Thymoquinone (THQ) is a major component of black seeds. Given that both THQ and black seeds exhibit anti-cancer and anti-inflammatory activities, we hypothesized that THQ will affect cancer-associated thrombosis (CAT), which is primarily triggered by tissue factor (TF) and inflammation. The effect of both black seed-extracted and purchased (“pure”) THQ on normal blood coagulation was tested with in vitro thromboelastography (TEG) and activated partial thromboplastin time (aPTT) coagulation assays. The effect of pure THQ on CAT was tested with aPTT assay using pancreatic cancer cell lines that are either positive or negative for TF, and with TEG assay using lipopolysaccharide as an inflammatory trigger. Additionally, the direct effect of THQ on the inactivation of factors IIa and Xa was assessed. Since TNF-α facilitates crosstalk between inflammation and thrombosis by triggering the NF-κB pathway, we tested THQ’s ability to interfere with this communication with a luciferase assay. Both extracted and pure THQ had minimal effects on normal blood coagulation. Pure THQ reversed CAT initiated by both TF and inflammation to basal levels (p coagulation and can reverse CAT in vitro, possibly by interfering with the crosstalk between inflammation and coagulation. This study suggests the utility of THQ as a preventative anticoagulant and/or as a supplement to existing chemotherapies and anticoagulant therapies. PMID:27043539

  9. Developing nucleic acid-based electrical detection systems. (United States)

    Gabig-Ciminska, Magdalena


    Development of nucleic acid-based detection systems is the main focus of many research groups and high technology companies. The enormous work done in this field is particularly due to the broad versatility and variety of these sensing devices. From optical to electrical systems, from label-dependent to label-free approaches, from single to multi-analyte and array formats, this wide range of possibilities makes the research field very diversified and competitive. New challenges and requirements for an ideal detector suitable for nucleic acid analysis include high sensitivity and high specificity protocol that can be completed in a relatively short time offering at the same time low detection limit. Moreover, systems that can be miniaturized and automated present a significant advantage over conventional technology, especially if detection is needed in the field. Electrical system technology for nucleic acid-based detection is an enabling mode for making miniaturized to micro- and nanometer scale bio-monitoring devices via the fusion of modern micro- and nanofabrication technology and molecular biotechnology. The electrical biosensors that rely on the conversion of the Watson-Crick base-pair recognition event into a useful electrical signal are advancing rapidly, and recently are receiving much attention as a valuable tool for microbial pathogen detection. Pathogens may pose a serious threat to humans, animal and plants, thus their detection and analysis is a significant element of public health. Although different conventional methods for detection of pathogenic microorganisms and their toxins exist and are currently being applied, improvements of molecular-based detection methodologies have changed these traditional detection techniques and introduced a new era of rapid, miniaturized and automated electrical chip detection technologies into pathogen identification sector. In this review some developments and current directions in nucleic acid-based electrical

  10. History of medical understanding and misunderstanding of Acid base balance. (United States)

    Aiken, Christopher Geoffrey Alexander


    To establish how controversies in understanding acid base balance arose, the literature on acid base balance was reviewed from 1909, when Henderson described how the neutral reaction of blood is determined by carbonic and organic acids being in equilibrium with an excess of mineral bases over mineral acids. From 1914 to 1930, Van Slyke and others established our acid base principles. They recognised that carbonic acid converts into bicarbonate all non-volatile mineral bases not bound by mineral acids and determined therefore that bicarbonate represents the alkaline reserve of the body and should be a physiological constant. They showed that standard bicarbonate is a good measure of acidosis caused by increased production or decreased elimination of organic acids. However, they recognised that bicarbonate improved low plasma bicarbonate but not high urine acid excretion in diabetic ketoacidosis, and that increasing pCO2 caused chloride to shift into cells raising plasma titratable alkali. Both indicate that minerals influence pH. In 1945 Darrow showed that hyperchloraemic metabolic acidosis in preterm infants fed milk with 5.7 mmol of chloride and 2.0 mmol of sodium per 100 kcal was caused by retention of chloride in excess of sodium. Similar findings were made but not recognised in later studies of metabolic acidosis in preterm infants. Shohl in 1921 and Kildeberg in 1978 presented the theory that carbonic and organic acids are neutralised by mineral base, where mineral base is the excess of mineral cations over anions and organic acid is the difference between mineral base, bicarbonate and protein anion. The degree of metabolic acidosis measured as base excess is determined by deviation in both mineral base and organic acid from normal.

  11. Acid-Base Balance in Uremic Rats with Vascular Calcification

    Directory of Open Access Journals (Sweden)

    Alan Peralta-Ramírez


    Full Text Available Background/Aims: Vascular calcification (VC, a major complication in humans and animals with chronic kidney disease (CKD, is influenced by changes in acid-base balance. The purpose of this study was to describe the acid-base balance in uremic rats with VC and to correlate the parameters that define acid-base equilibrium with VC. Methods: Twenty-two rats with CKD induced by 5/6 nephrectomy (5/6 Nx and 10 nonuremic control rats were studied. Results: The 5/6 Nx rats showed extensive VC as evidenced by a high aortic calcium (9.2 ± 1.7 mg/g of tissue and phosphorus (20.6 ± 4.9 mg/g of tissue content. Uremic rats had an increased pH level (7.57 ± 0.03 as a consequence of both respiratory (PaCO2 = 28.4 ± 2.1 mm Hg and, to a lesser degree, metabolic (base excess = 4.1 ± 1 mmol/l derangements. A high positive correlation between both anion gap (AG and strong ion difference (SID with aortic calcium (AG: r = 0.604, p = 0.02; SID: r = 0.647, p = 0.01 and with aortic phosphorus (AG: r = 0.684, p = 0.007; SID: r = 0.785, p = 0.01 was detected. Conclusions: In an experimental model of uremic rats, VC showed high positive correlation with AG and SID.

  12. Acid-base properties of Baltic Sea dissolved organic matter (United States)

    Hammer, Karoline; Schneider, Bernd; Kuliński, Karol; Schulz-Bull, Detlef E.


    Calculations related to the marine CO2 system that are based on alkalinity data may be strongly biased if the contributions of organic compounds are ignored. In coastal seas, concentrations of dissolved organic matter (DOM) are frequently high and alkalinity from inorganic compounds is low. In this study, based on measurements of total alkalinity, total CO2, and pH, we determined the organic alkalinity, Aorg, in water from the central Baltic Sea. The maximum Aorg measured in the surface mixed layer during the spring bloom was > 50 μmol/kg-SW but the Aorg decreased with depth and approached zero below the permanent halocline. This behavior could be attributed to the decreased pH of deeper water layers. The data were used to calculate the bulk dissociation constant, KDOM, for marine DOM and the fraction f of dissolved organic carbon (DOC) that acts as a carrier for acid-base functional groups. The p KDOM (7.27) agreed well with the value (7.34) previously estimated in a preliminary study of organic alkalinity in the Baltic Sea. The fraction of carbon atoms carrying acid-base groups was 17% and was somewhat higher than previously reported (12%). Spike experiments performed using artificial seawater and three different humic/fulvic substances tested whether the acid-base properties of these substances explain the results of our field study. Specifically, Aorg was determined at different concentrations (DOC) of the added humic/fulvic substances. The relationship between Aorg and the DOC concentrations indicated that humic/fulvic substances are more acidic (p KDOM < 6.5) than the bulk DOC natural occurring in the Baltic Sea.

  13. Developing nucleic acid-based electrical detection systems

    Directory of Open Access Journals (Sweden)

    Gabig-Ciminska Magdalena


    Full Text Available Abstract Development of nucleic acid-based detection systems is the main focus of many research groups and high technology companies. The enormous work done in this field is particularly due to the broad versatility and variety of these sensing devices. From optical to electrical systems, from label-dependent to label-free approaches, from single to multi-analyte and array formats, this wide range of possibilities makes the research field very diversified and competitive. New challenges and requirements for an ideal detector suitable for nucleic acid analysis include high sensitivity and high specificity protocol that can be completed in a relatively short time offering at the same time low detection limit. Moreover, systems that can be miniaturized and automated present a significant advantage over conventional technology, especially if detection is needed in the field. Electrical system technology for nucleic acid-based detection is an enabling mode for making miniaturized to micro- and nanometer scale bio-monitoring devices via the fusion of modern micro- and nanofabrication technology and molecular biotechnology. The electrical biosensors that rely on the conversion of the Watson-Crick base-pair recognition event into a useful electrical signal are advancing rapidly, and recently are receiving much attention as a valuable tool for microbial pathogen detection. Pathogens may pose a serious threat to humans, animal and plants, thus their detection and analysis is a significant element of public health. Although different conventional methods for detection of pathogenic microorganisms and their toxins exist and are currently being applied, improvements of molecular-based detection methodologies have changed these traditional detection techniques and introduced a new era of rapid, miniaturized and automated electrical chip detection technologies into pathogen identification sector. In this review some developments and current directions in

  14. Developing nucleic acid-based electrical detection systems (United States)

    Gabig-Ciminska, Magdalena


    Development of nucleic acid-based detection systems is the main focus of many research groups and high technology companies. The enormous work done in this field is particularly due to the broad versatility and variety of these sensing devices. From optical to electrical systems, from label-dependent to label-free approaches, from single to multi-analyte and array formats, this wide range of possibilities makes the research field very diversified and competitive. New challenges and requirements for an ideal detector suitable for nucleic acid analysis include high sensitivity and high specificity protocol that can be completed in a relatively short time offering at the same time low detection limit. Moreover, systems that can be miniaturized and automated present a significant advantage over conventional technology, especially if detection is needed in the field. Electrical system technology for nucleic acid-based detection is an enabling mode for making miniaturized to micro- and nanometer scale bio-monitoring devices via the fusion of modern micro- and nanofabrication technology and molecular biotechnology. The electrical biosensors that rely on the conversion of the Watson-Crick base-pair recognition event into a useful electrical signal are advancing rapidly, and recently are receiving much attention as a valuable tool for microbial pathogen detection. Pathogens may pose a serious threat to humans, animal and plants, thus their detection and analysis is a significant element of public health. Although different conventional methods for detection of pathogenic microorganisms and their toxins exist and are currently being applied, improvements of molecular-based detection methodologies have changed these traditional detection techniques and introduced a new era of rapid, miniaturized and automated electrical chip detection technologies into pathogen identification sector. In this review some developments and current directions in nucleic acid-based electrical

  15. Imaging of blood plasma coagulation at supported lipid membranes. (United States)

    Faxälv, Lars; Hume, Jasmin; Kasemo, Bengt; Svedhem, Sofia


    The blood coagulation system relies on lipid membrane constituents to act as regulators of the coagulation process upon vascular trauma, and in particular the 2D configuration of the lipid membranes is known to efficiently catalyze enzymatic activity of blood coagulation factors. This work demonstrates a new application of a recently developed methodology to study blood coagulation at lipid membrane interfaces with the use of imaging technology. Lipid membranes with varied net charges were formed on silica supports by systematically using different combinations of lipids where neutral phosphocholine (PC) lipids were mixed with phospholipids having either positively charged ethylphosphocholine (EPC), or negatively charged phosphatidylserine (PS) headgroups. Coagulation imaging demonstrated that negatively charged SiO(2) and membrane surfaces exposing PS (obtained from liposomes containing 30% of PS) had coagulation times which were significantly shorter than those for plain PC membranes and EPC exposing membrane surfaces (obtained from liposomes containing 30% of EPC). Coagulation times decreased non-linearly with increasing negative surface charge for lipid membranes. A threshold value for shorter coagulation times was observed below a PS content of ∼6%. We conclude that the lipid membranes on solid support studied with the imaging setup as presented in this study offers a flexible and non-expensive solution for coagulation studies at biological membranes. It will be interesting to extend the present study towards examining coagulation on more complex lipid-based model systems. Copyright © 2011 Elsevier Inc. All rights reserved.

  16. Relationship of coagulation constant to time

    Energy Technology Data Exchange (ETDEWEB)

    Nadirov, N.K.; Anisimov, B.F.; Borodkin, L.P.


    Tests were carried out for the purpose of constructing mathematical models of electrodehydration of petroleum. Work was performed in electric fields with constant current. A 1% emulsion ''water in vaseline oil'' was placed into a cell after a 5 minute treatment in a UZDN-1 ultrasound disperser. Distance between electrodes was held at 25 mm. The cell was fed high voltage current from the source (VS-20-10), which was held constant throughout the entire test period. Current was measured with a microampermeter type M266M. Changes in the emulsion were observed using a KM-6 cathetometer. It was shown that the character of changes in function M(t), are dependent on the voltage of the electric field, viscosity of the media, initial concentration and initial distribution of particles according to size. The constant of kinetic coagulation is dependent on time: during the initial moment of electro-treatment of a reverse emulsion, thermal coagulation was observed, which gradually is replaced with electro-gravitational coagulation.

  17. Boronic acid-based autoligation of nucleic acids

    DEFF Research Database (Denmark)

    Barbeyron, R.; Vasseur, J.-J.; Smietana, M.


    Abstract: The development of synthetic systems displaying dynamic and adaptive characteristics is a formidable challenge with wide applications from biotechnology to therapeutics. Recently, we described a dynamic and programmable nucleic acid-based system relying on the formation of reversible...... boronate internucleosidic linkages. The DNA- or RNA-templated system comprises a 5′-ended boronic acid probe connecting a 3′-ended ribonucleosidic oligonucleotide partner. To explore the dominant factors that control the reversible linkage, we synthesized a series of 3′-end modified ribonucleotidic strands...

  18. Advances in nucleic acid-based diagnostics of bacterial infections

    DEFF Research Database (Denmark)

    Barken, Kim Bundvig; Haagensen, Janus Anders Juul; Tolker-Nielsen, Tim


    Methods for rapid detection of infectious bacteria and antimicrobial-resistant pathogens have evolved significantly over the last decade. Many of the new procedures are nucleic acid-based and replace conventional diagnostic methods like culturing which is time consuming especially with fastidious...... of these pathogens is important to isolate patients and prevent further spreading of the diseases. Newly developed diagnostic procedures are superior with respect to turnaround time, sensitivity and specificity. Methods like multiplex real time PCR and different array-based technologies offer the possibility...

  19. Coagulation performance of a novel poly-ferric-acetate (PFC) coagulant in phosphate-kaolin synthetic water treatment

    Energy Technology Data Exchange (ETDEWEB)

    Wei, Yanxin; Lu, Jinpeng; Dong, Xiongzi; Yao, Chengli [Hefei Normal University, Hefei (China); Hao, Jianwen [Anhui Vocational and Technical College, Hefei (China)


    The process of coagulation-flocculation is increasingly applied in wastewater treatment. And the polymerized inorganic coagulants are widely used among these coagulation-flocculation processes. However, conventional coagulants using sulfates or chlorides as counter anion may give rise to corrosion. The purpose of this study was to synthesize PFC coagulants in which acetate is used as counter anion. The influences on the preparation of PFC were optimized. The synthesis was done at the optimum conditions, such as temperature of 60 .deg. C, the Fe/CH{sub 3}COOH molar ratio of 1 : 4.0 and reaction time of 6 h, respectively. The prepared PFC coagulants were characterized by Fourier transform infrared (FTIR) spectrophotometry and scanning electron microscopy (SEM). PFC was found to mainly form complexation polymeric species and present more cluster and lamellar structure. A series of jar tests were carried out to study the coagulation performance of PFC and PFS in phosphate-kaolin synthetic water treatment. Results showed that the coagulation performance of PFC was more efficient than PFS's in terms of the phosphorus removal efficiency and the residual turbidity. Due to using acetate as counter anion to iron, PFC is less harmful to the processes of water treatment and equipment than that of the conventional coagulants applied chlorides or sulfates. Therefore, PFC is a promising coagulant in the process of corrosion sensitive applications and the process of wastewater containing phosphorus treatment.

  20. Stewart's quantitative acid-base chemistry: applications in biology and medicine. (United States)

    Fencl, V; Leith, D E


    We review P.A. Stewart's quantitative approach to acid-base chemistry, starting with its historical context. We outline its implications for cellular and membrane processes in acid-base physiology; discuss its contributions to the understanding and analysis of acid-base phenomena; show how it can be applied in clinical problems; and propose a classification of clinical acid-base disturbances based on this general approach.

  1. Acid-base Balance in Acute Gastrointestinal Bleeding* (United States)

    Northfield, T. C.; Kirby, B. J.; Tattersfield, Anne E.


    Acid-base balance has been studied in 21 patients with acute upper gastrointestinal bleeding. A low plasma bicarbonate concentration was found in nine patients, accompanied in each case by a base deficit of more than 3 mEq/litre, indicating a metabolic acidosis. Three patients had a low blood pH. Hyperlactataemia appeared to be a major cause of the acidosis. This was not accompanied by a raised blood pyruvate concentration. The hyperlactataemia could not be accounted for on the basis of hyperventilation, intravenous infusion of dextrose, or arterial hypoxaemia. Before blood transfusion it was most pronounced in patients who were clinically shocked, suggesting that it may have resulted from poor tissue perfusion and anaerobic glycolysis. Blood transfusion resulted in a rise in lactate concentration in seven patients who were not clinically shocked, and failed to reverse a severe uncompensated acidosis in a patient who was clinically shocked. These effects of blood transfusion are probably due to the fact that red blood cells in stored bank blood, with added acid-citrate-dextrose solution, metabolize the dextrose anaerobically to lactic acid. Monitoring of acid-base balance is recommended in patients with acute gastrointestinal bleeding who are clinically shocked. A metabolic acidosis can then be corrected with intravenous sodium bicarbonate. PMID:5313902

  2. Influence of diet on acid-base balance. (United States)

    Remer, T


    It is well established that diet and certain food components have a clear impact on acid-base balance. For adults, the following factors are involved: 1) the chemical composition of foods (i.e., their content of protein, chloride, phosphorus, sodium, potassium, calcium, and magnesium), 2) the different intestinal absorption rates of the relevant nutrients, 3) the metabolic generation of sulfate from sulfur-containing amino acids, 4) the grade of dissociation of phosphorus at the physiologic pH of 7.4, and 5) the ionic valence of calcium and magnesium. All these factors allow us to estimate the potential renal acid load (PRAL) of any given food or diet. The PRAL (calculated for a 24-hour period), together with a relatively constant daily amount of urinary excreted organic acids (in healthy subjects proportional to body surface area or body weight), yields the daily net acid excretion. This article provides an overview of the current concepts of diet influences on acid-base balance and also focuses on the underlying physiologic and biochemical basis as well as on relevant clinical implications.

  3. Renal sodium handling and haemodynamics are equally affected by hyperinsulinaemia in salt-sensitive and salt-resistant hypertensives

    NARCIS (Netherlands)

    ter Maaten, JC; Bakker, SJL; Serne, EH; Donker, AJM; Gans, ROB

    Objective It is well-known that insulin induces renal sodium retention. It is not yet known whether insulin's renal effects are involved in the development of salt-sensitive hypertension. We assessed the effects of insulin on renal sodium handling and haemodynamics in 10 salt-sensitive (SS) and 10

  4. Impact of the Haga Braincare Strategy on the burden of haemodynamic and embolic strokes related to cardiac surgery. (United States)

    Duynstee, Friso; Keunen, Ruud W M; van Sonderen, Agnes; Keyhan-Falsafi, Ali M; Hoohenkerk, Gerard J F; Stephens, Gayleen; Teeuws, Erik; van Alphen, Jan W K; Tavy, Dénes L J; Mosch, Arne; de Bruijn, Sebastiaan F T M; van Overhagen, Hans; Treurniet, Frank E E; van Dijk, Lucas C; van Kampen, Paulien M


    This study prospectively evaluates the impact of the Haga Braincare Strategy (HBS) on the occurrence of haemodynamic and embolic stroke in a cohort of patients who underwent coronay artery bypass grafting (CABG), valve replacement of a combination of both types of surgery between 2012 and 2015 at the Haga Teaching Hospitals. The HBS is a dual strategy based on a preoperative vascular work-up of the cerebral circulation by transcranial Doppler and a perioperative monitoring of the cerebral circulation by cerebral oximetry. Duplex of the carotid arteries and/or computed tomography angiography prior to surgery was performed in high-risk patients. Patients with severe carotid artery stenosis were scheduled for carotid angioplasty prior to surgery or waived from surgery. A total of 1065 patients were included. Poor cerebral haemodynamics were identified by transcranial Doppler in 2.1% of patients (n = 22). Based on the HBS, 3 patients were waived from surgery, 4 received preoperative carotid angioplasty followed by cardiac surgery and the remaining patients were operated while being monitored with bilateral cerebral oximetry sensors. In all, 2.2% of the study group experienced a stroke (n = 23), of which none were classified as haemodynamic. Most of the remaining presumed embolic strokes showed a minor to moderate stroke severity. In this single-centre prospective follow-up study, surveillance of cerebral perfusion by the HBS eliminated the occurrence of haemodynamic stroke while most of the residual strokes had a good to favourable prognosis.

  5. Effect of oral propranolol on circulating catecholamines in cirrhosis: relationship to severity of liver disease and splanchnic haemodynamics

    DEFF Research Database (Denmark)

    Bendtsen, Flemming; Henriksen, Jens Henrik; Sørensen, T I


    Patients with cirrhosis, especially those with decompensated disease have enhanced sympathetic nervous activity. We have investigated the effect of a single oral dose of 80 mg propranolol on circulating catecholamines and related the effect to splanchnic and systemic haemodynamics in 22 patients...

  6. Mesenchymal stem cells correct haemodynamic dysfunction associated with liver injury after extended resection in a pig model. (United States)

    Tautenhahn, Hans-Michael; Brückner, Sandra; Uder, Christiane; Erler, Silvio; Hempel, Madlen; von Bergen, Martin; Brach, Janine; Winkler, Sandra; Pankow, Franziska; Gittel, Claudia; Baunack, Manja; Lange, Undine; Broschewitz, Johannes; Dollinger, Matthias; Bartels, Michael; Pietsch, Uta; Amann, Kerstin; Christ, Bruno


    In patients, acute kidney injury (AKI) is often due to haemodynamic impairment associated with hepatic decompensation following extended liver surgery. Mesenchymal stem cells (MSCs) supported tissue protection in a variety of acute and chronic diseases, and might hence ameliorate AKI induced by extended liver resection. Here, 70% liver resection was performed in male pigs. MSCs were infused through a central venous catheter and haemodynamic parameters as well as markers of acute kidney damage were monitored under intensive care conditions for 24 h post-surgery. Cytokine profiles were established to anticipate the MSCs' potential mode of action. After extended liver resection, hyperdynamic circulation, associated with hyponatraemia, hyperkalaemia, an increase in serum aldosterone and low urine production developed. These signs of hepatorenal dysfunction and haemodynamic impairment were corrected by MSC treatment. MSCs elevated PDGF levels in the serum, possibly contributing to circulatory homeostasis. Another 14 cytokines were increased in the kidney, most of which are known to support tissue regeneration. In conclusion, MSCs supported kidney and liver function after extended liver resection. They probably acted through paracrine mechanisms improving haemodynamics and tissue homeostasis. They might thus provide a promising strategy to prevent acute kidney injury in the context of post-surgery acute liver failure.

  7. Increased plasma noradrenaline concentration in patients with chronic obstructive lung disease: relation to haemodynamics and blood gases

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik Sahl; Christensen, N J; Kok-Jensen, A


    present. Plasma adrenaline concentration was normal. The results point to enhanced sympathetic nervous activity in patients with chronic obstructive lung disease, probably caused by the deranged blood gases. The pulmonary haemodynamic changes and increased pulse rate may, at least partly, be due...

  8. 78 FR 36698 - Microbiology Devices; Reclassification of Nucleic Acid-Based Systems for Mycobacterium tuberculosis (United States)


    ... Nucleic Acid-Based Systems for Mycobacterium tuberculosis Complex in Respiratory Specimens AGENCY: Food...) is proposing to reclassify nucleic acid-based in vitro diagnostic devices for the detection of... Controls Guideline: Nucleic Acid-Based In Vitro Diagnostic Devices for the Detection of Mycobacterium...

  9. How Do Undergraduate Students Conceptualize Acid-Base Chemistry? Measurement of a Concept Progression (United States)

    Romine, William L.; Todd, Amber N.; Clark, Travis B.


    We developed and validated a new instrument, called "Measuring Concept progressions in Acid-Base chemistry" (MCAB) and used it to better understand the progression of undergraduate students' understandings about acid-base chemistry. Items were developed based on an existing learning progression for acid-base chemistry. We used the Rasch…

  10. Acid-base interactions in microbial adhesion to hexadecane and chloroform

    NARCIS (Netherlands)

    Bos, R; Busscher, HJ; Geertsema-Doornbusch, GI; Van Der Mei, HC; Mittal, KL


    Acid-base interactions play an important role in adhesion, including microbial adhesion to surfaces. Qualitatively acid-base interactions in microbial adhesion can be demonstrated by comparing adhesion to hexadecane (a negatively charged interface in aqueous solutions, unable to exert acid-base

  11. Evolution of haemodynamics and outcome of fluid-refractory septic shock in children. (United States)

    Deep, Akash; Goonasekera, Chulananda D A; Wang, Yanzhong; Brierley, Joe


    Maintaining threshold values of cardiac output (CO) and systemic vascular resistance (SVR) when used as part of the American College of Critical Care Medicine (ACCM) haemodynamic protocol improves the outcomes in paediatric septic shock. We observed the evolution of CO and SVR during the intensive care admission of children with fluid-refractory septic shock and report this together with the eventual outcomes. Prospective observational study. Tertiary care Paediatric Intensive Care Unit (PICU) in London. Children admitted in fluid refractory septic shock to the Intensive Care Unit over a period of 36 months were studied. Post liver re-transplant children and delayed septic shock admissions were excluded. A non-invasive ultrasound cardiac output monitor device (USCOM) was used to measure serial haemodynamics. Children were allocated at presentation into one of two categories: (1) hospital-acquired infection and (2) community-acquired infection. Vasopressor, inotrope or inodilator therapies were titrated to maintain threshold cardiovascular parameters as per the ACCM guidelines. Thirty-six children [19 male, mean age (SD) 6.78 (5.86) years] were admitted with fluid-refractory septic shock and studied. At presentation, all 18 children with hospital-acquired (HA) sepsis and 3 from among the community-acquired (CA) sepsis group were in 'warm shock' (SVRI shock' [cardiac index (CI) shock' were initially commenced on a vasopressor (noradrenaline). Despite an initial good response, four patients developed low CI and needed adrenaline. Similarly, all 15 children in cold shock were initially commenced on adrenaline. However, two of them subsequently required noradrenaline. Five others needed milrinone as an inodilator. In general, both groups of children had normalised SVRI and CI within 42 h of therapy but required variable doses of vasopressors, inotropes or inodilators in a heterogeneous manner. The overall 28-day survival rate was 88.9 % in both groups. Central venous

  12. Haemodynamic performance of the small supra-annular Trifecta bioprosthesis: results from a French multicentre study. (United States)

    Fouquet, Olivier; Flecher, Erwan; Nzomvuama, Alphonse; Remadi, Jean Paul; Bière, Loïc; Donal, Erwan; Levy, Franck; Dalmayrac, Emilie; Szymanski, Catherine; Leguerrier, Alain; Tribouilloy, Christophe


    The St Jude Medical Trifecta bioprosthesis incorporates a single pericardial sheet externally mounted on a titanium stent that provides excellent haemodynamic results. The purpose of this multicentre study was to report on the haemodynamic performance and the expected lower risk of prosthesis-patient mismatch in patient with small aortic annulus diameters. The 19- and 21-mm Trifecta valves were implanted in 88 and 266 eligible patients, respectively between 2011 and 2013 at three centres in France (Angers, Rennes and Amiens). The mean age of the population was 78 ± 7 and 76 ± 6 years for 19- and 21-mm valve sizes of which 96.6 and 68% were female, respectively. The aortic valve replacement was associated with another surgery in 18.2 and 21.8% in each group, respectively. The mean follow-up was 20.3 ± 11.9 and 24 ± 11.4 months for 19- and 21-mm valves, respectively. Early all-cause mortality was 2.5% and late mortality occurred in 5.8% of patients. The mean pressure gradient and the effective orifice area at discharge and at 1 year were respectively 12.4 ± 4.6 and 14.7 ± 5.8 mmHg (P = 0.003), 1.5 ± 0.3 and 1.4 ± 0.9 cm(2) (P = 0.06) in the 19-mm valve group; 10.4 ± 3.8 and 11.7 ± 4.5 mmHg (P = 0.001), 1.8 ± 0.3 and 1.5 ± 0.4 cm(2) (P = 0.1) in the 21-mm valve group. At 1 year, only 38 (11%) and 28 (8.1%) patients presented a moderate or severe prosthesis-patient mismatch for the two groups. After univariate analysis, no risk factor of mismatch was found. The 19- and 21-mm St Jude Medical Trifecta provide excellent haemodynamic performance and the rate of moderate and severe prosthesis-patient mismatch is low. © The Author 2016. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.


    Directory of Open Access Journals (Sweden)

    Lucyna Przywara


    Full Text Available The article discusses the study, whose aim was to determine the efficiency of edible fats and oils wastewater treatment in the process of coagulation. In the process of coagulation volume was tested of three different coagulants containing various amount of reactive aluminum: PAX 18, PAC 16 and sodium aluminate. Efficiency of physical-chemical treatment of fatty wastewater was determined based on change in indicators of pollution; chemical oxygen demand, phosphate and sulphate.

  14. Buffer capacity of 4% succinylated gelatin does not provide any advantages over acidic 6% hydroxyethyl starch 130/0.4 for acid-base balance during experimental mixed acidaemia in a porcine model. (United States)

    Esche, V; Russ, M; Melzer, S; Grossmann, B; Boemke, W; Unger, J K


    Four percent gelatine is an alkaline compound due to NH2 groups, whereas 6% hydroxyethyl starch 130/0.4 (HES130) has acidic features. We investigated whether these solutions lead to differences in acid-base balance in pigs during acidaemia and correction of pH. Anaesthetized pigs were randomized to HES130 or gelatine infusion (n = 5 per group). Animals received acid infusion (0.4 M solution of lactic acid and HCl diluted in normal saline) and low tidal volume ventilation (6-7 mL kg(-1), PaCO2 of 80-85 mmHg, pH 7.19-7.24). Measurements were made before and after induction of acidaemia, before and after correction of pH with haemofiltration (continuous venovenous haemofiltration) and tris-hydroxymethylaminomethane infusion. We measured parameters describing acid-base balance according to Stewart's approach, ketone body formation, oxygen delivery, haemodynamics, diuresis and urinary pH. Acid-base balance did not differ significantly between the groups. In HES130-treated pigs, the haemodilution-based drop of haemoglobin (1.4 +/- 1.0 g dL(-1), median +/- SD) was paralleled by an increase in the cardiac output (0.5 +/- 0.4 L min(-1). Lacking increases in cardiac output, gelatine-treated pigs demonstrated a reduction in oxygen delivery (149.4 +/- 106.0 mL min(-1)). Tris-hydroxymethylaminomethane volumes required for pH titration to desired values were significantly higher in the gelatine group (0.7 +/- 0.1 mL kg(-1) h(-1) vs. HES130: 0.5 +/- 0.2 mL kg(-1) h(-1)). The buffer capacity of gelatine did not lead to favourable differences in acid-base balance in comparison to HES130.

  15. Effect of cyanobacterial peptides and proteins on coagulation of kaolinite

    Directory of Open Access Journals (Sweden)

    Kateřina Novotná


    Full Text Available Coagulation of peptides and proteins produced by the cyanobacterium Microcystis aeruginosa and their influence on the coagulation of hydrophobic kaolinite particles were investigated. For this purpose, the dose of ferric sulphate used as the coagulant was optimized and jar tests with kaolinite, peptides/proteins and both kaolinite and peptides/proteins were carried out under different pH conditions. At pH 4–5.5, the peptides/proteins were efficiently coagulated and peptides/proteins were also found to contribute to the coagulation of kaolinite particles at this pH. Charge neutralization and adsorption were found to be the dominant coagulation mechanisms. The coagulation efficiency and the character of the prevailing coagulation mechanism were strongly dependent on the charge characteristics of the peptides/proteins, kaolinite and hydrolysis products of iron, thus on the pH value. At a pH of about 6, the coagulation process deteriorated due to the formation of soluble Fe-peptide/protein complexes.

  16. [Evaluation of coagulation disorders with thrombelastography in patients with sepsis]. (United States)

    Zhong, Shengjian; Zhang, Chunbao; Hu, Juntao; Tang, Zhanhong


    To compare the results of thrombelastography (TEG) and the conventional coagulability test in patients with sepsis, and to discuss the value of TEG in monitoring blood coagulation dysfunction in patients with sepsis. The clinical data of 92 adult patients with sepsis admitted to Department of Critical Care Medicine of the First Affiliated Hospital of Guangxi Medical University were retrospectively analyzed. The patients were divided into sequential organ failure assessment (SOFA) score ≥ 12 group (n = 47) and SOFA coagulation function served as control group. The venous blood was collected for conventional blood coagulation test and routine examination of blood, D-dimer, procalcitonin (PCT), and TEG, and the differences were compared among three groups. Correlations between SOFA and various indexes of patients with sepsis were analyzed by Spearman rank correlation method. As shown in the results of the conventional blood coagulation test, D-dimer was gradually increased with the aggravation of the disease, the values in non-sepsis, SOFA coagulation test might not respond quickly to the change in coagulation status of sepsis patients. As shown in the results of TEG, the values of reaction time (R value) and kinetics time (K value) in SOFA 0.05; K value (minutes): 4.2 (3.4, 7.1) vs. 1.5 (1.3, 1.8), P coagulation index (CI) in SOFA coagulation in patients with sepsis, and distinguish the hypercoagulable and hypocoagulable state. TEG may be a valuable tool to evaluate degree and risk of sepsis objectively.

  17. Ictal haemodynamic changes in a patient affected by "subtle" Epilepsia Partialis Continua. (United States)

    Vaudano, Anna Elisabetta; Di Bonaventura, Carlo; Carni, Marco; Rodionov, Roman; Lapenta, Leonardo; Casciato, Sara; Fattouch, Jinane; Egeo, Gabriella; Pantano, Patrizia; Nucciarelli, Valter; Maraviglia, Bruno; Prencipe, Massimiliano; Lemieux, Louis; Giallonardo, Anna Teresa


    We report on a 64 year-old woman presenting with Epilepsia Partialis Continua (EPC) affecting the left hand since the age of 24 without neurological deficit. Structural MRI showed a region of focal cortical dysplasia (FCD) over the right central gyrus and lesions in the mesial frontal and occipital cortex secondary to perinatal hypoxic injury. Ictal spike haemodynamic mapping using simultaneous EEG-fMRI revealed significant BOLD signal changes prominent in the region of FCD (larger cluster), occipital cortex (global statistical maximum), prefrontal cortex and cerebellum. The cluster over FCD was in good agreement with the result of EEG source analysis. Our findings provide an interesting illustration of the ability of EEG-fMRI to reveal epileptogenic networks confirming the intrinsic epileptogenic properties of dysplastic neurons. Copyright © 2011 British Epilepsy Association. All rights reserved.

  18. Validation of non-invasive haemodynamic methods in patients with liver disease

    DEFF Research Database (Denmark)

    Brittain, Jane M; Busk, Troels M; Møller, Søren


    Patients with advanced cirrhosis often present a hyperdynamic circulation characterized by a decrease in systolic and diastolic blood pressure (SBP and DBP), and an increase in heart rate (HR) and cardiac output (CO). Accurate assessment of the altered circulation can be performed invasively......, SBP, DBP and HR were measured non-invasively and by femoral artery catheterization. CO was measured non-invasively and by indicator dilution technique. The non-invasive pressure monitoring was considered acceptable with a bias (accuracy) and a SD (precision) not exceeding 5 and 8 mmHg, respectively......; however, due to the disadvantages of this approach, non-invasive methods are warranted. The purpose of this study was to compare continuous non-invasive measurements of haemodynamic variables by the Finometer and the Task Force Monitor with simultaneous invasive measurements. In 25 patients with cirrhosis...

  19. Facing emotions in narcolepsy with cataplexy: haemodynamic and behavioural responses during emotional stimulation. (United States)

    de Zambotti, Massimiliano; Pizza, Fabio; Covassin, Naima; Vandi, Stefano; Cellini, Nicola; Stegagno, Luciano; Plazzi, Giuseppe


    Narcolepsy with cataplexy is a complex sleep disorder that affects the modulation of emotions: cataplexy, the key symptom of narcolepsy, is indeed strongly linked with emotions that usually trigger the episodes. Our study aimed to investigate haemodynamic and behavioural responses during emotional stimulation in narco-cataplexy. Twelve adult drug-naive narcoleptic patients (five males; age: 33.3 ± 9.4 years) and 12 healthy controls (five males; age: 30.9 ± 9.5 years) were exposed to emotional stimuli (pleasant, unpleasant and neutral pictures). Heart rate, arterial blood pressure and mean cerebral blood flow velocity of the middle cerebral arteries were continuously recorded using photoplethysmography and Doppler ultrasound. Ratings of valence and arousal and coping strategies were scored by the Self-Assessment Manikin and by questionnaires, respectively. Narcoleptic patients' haemodynamic responses to pictures overlapped with the data obtained from controls: decrease of heart rate and increase of mean cerebral blood flow velocity regardless of pictures' content, increase of systolic blood pressure during the pleasant condition, and relative reduction of heart rate during pleasant and unpleasant conditions. However, when compared with controls, narcoleptic patients reported lower arousal scores during the pleasant and neutral stimulation, and lower valence scores during the pleasant condition, respectively, and also a lower score at the 'focus on and venting of emotions' dimensions of coping. Our results suggested that adult narcoleptic patients, compared with healthy controls, inhibited their emotion-expressive behaviour to emotional stimulation, and that may be related to the development of adaptive cognitive strategies to face emotions avoiding cataplexy. © 2014 European Sleep Research Society.

  20. Acute haemodynamic effects of sodium bicarbonate administration in respiratory and metabolic acidosis in anaesthetized dogs. (United States)

    Tanaka, M; Nishikawa, T


    Twenty-seven halothane-anaesthetized, mechanically ventilated adult mongrel dogs were randomly assigned to either respiratory acidosis group [pHa 7.22 (0.03, SD), PaCO2 9.6 (1.1) kPa, base excess -0.5 (1.4) mmol.l-1, n = 9], metabolic acidosis group [pHa 7.20 (0.05), PaCO2 5.5 (0.4) kPa, base excess -11.1 (2.1) mmol.l-1, n = 9], or nonacidosis group [pHa 7.37 (0.07), PaCO2 5.2 (0.4) kPa, base excess -1.1 (1.5) mmol.l-1, n = 9]. Respiratory acidosis and metabolic acidosis were induced by decreasing respiratory rate and continuous infusion of 2 mmol.l-1 hydrochloric acid, respectively. Sodium bicarbonate solution 1 was injected into the right atrium over five seconds when haemodynamic stability was obtained. In all three groups, acute administration of sodium bicarbonate produced transient decreases in mean arterial pressure and RV dP/dtmax, and transient increase in right atrial pressure 30 seconds after injections, but these variables returned to the pre-injection values by the end of the three minutes observation period. Although no significant differences were seen in haemodynamic variables among the three groups at 30 seconds, one and three minutes, maximum reductions in both RV dP/dtmax and PBF in the metabolic acidosis group (260 (143) mmHg.s-1 and 0.38 (0.26) l.min-1) were significantly greater than those in the non-acidosis group (127 (34) mmHg.s-1 and 0.08 (0.09) l.min-1; P < 0.05).

  1. Role of melatonin in attenuation of haemodynamic responses to laryngoscopy and intubation

    Directory of Open Access Journals (Sweden)

    Priyamvada Gupta


    Full Text Available Background and Aims: Laryngoscopy and endotracheal intubation are considered as potent stimuli which lead to an increase in heart rate and blood pressure. Melatonin (N-acetyl-5-methoxytryptamine has been studied for pre-operative anxiolysis and sedation in Intensive Care Unit. We made a hypothesis that melatonin can provide haemodynamic stability during laryngoscopy and intubation when given 120 min before the procedure. Methods: Sixty American Society of Anesthesiologists physical status Grade I and II patients of either gender, 20-45 years old, 40-65 kg body weight, scheduled to undergo elective surgical procedures under general anaesthesia were assigned into two equal groups - Group C (control and Group M (melatonin. They received oral placebo or melatonin tablets 6 mg, respectively, 120 min before surgery. The haemodynamic parameters were recorded preoperatively, during laryngoscopy and endotracheal intubation and thereafter at 1, 3, 5 and 10 min. Unpaired t-test was used for between-group comparison of ratio and interval scale data. For within-group comparison of ratio and interval scale data, repeated-measures ANOVA and post hoc Bonferroni t-tests were used. Results: It was observed that in the control group, there was a significant increase in heart rate and blood pressure at laryngoscopy and intubation and persisted till 10 min post-intubation. In melatonin group, there was an insignificant increase in heart rate at the time of laryngoscopy and intubation which however settled within 1 min post-intubation. Conclusion: Melatonin is an effective drug for attenuation of cardiovascular responses to laryngoscopy and endotracheal intubation.

  2. Intracranial 4D flow magnetic resonance imaging reveals altered haemodynamics in sickle cell disease. (United States)

    Václavů, Lena; Baldew, Zelonna A V; Gevers, Sanna; Mutsaerts, Henri J M M; Fijnvandraat, Karin; Cnossen, Marjon H; Majoie, Charles B; Wood, John C; VanBavel, Ed; Biemond, Bart J; van Ooij, Pim; Nederveen, Aart J


    Stroke risk in children with sickle cell disease (SCD) is currently assessed with routine transcranial Doppler ultrasound (TCD) measurements of blood velocity in the Circle of Willis (CoW). However, there is currently no biomarker with proven prognostic value in adult patients. Four-dimensional (4D) flow magnetic resonance imaging (MRI) may improve risk profiling based on intracranial haemodynamics. We conducted neurovascular 4D flow MRI and blood sampling in 69 SCD patients [median age 15 years (interquartile range, IQR: 12-50)] and 14 healthy controls [median age 21 years (IQR: 18-43)]. We measured velocity, flow, lumen area and endothelial shear stress (ESS) in the CoW. SCD patients had lower haematocrit and viscosity, and higher velocity, flow and lumen area, with lower ESS compared to healthy controls. We observed significant age-related decline in haemodynamic 4D flow parameters; velocity (Spearman's ρ = -0·36 to -0·61), flow (ρ = -0·26 to -0·52) and ESS (ρ = -0·14 to -0·54) in SCD patients. Further analysis in only adults showed that velocity values were similar in SCD patients compared to healthy controls, but that the additional 4D flow parameters, flow and lumen area, were higher, and ESS lower, in the SCD group. Our data suggest that 4D flow MRI may identify adult patients with an increased stroke risk more accurately than current TCD-based velocity. © 2017 John Wiley & Sons Ltd.

  3. Haemodynamic impact of stent implantation for lateral tunnel Fontan stenosis: a patient-specific computational assessment. (United States)

    Tang, Elaine; McElhinney, Doff B; Restrepo, Maria; Valente, Anne M; Yoganathan, Ajit P


    The physiological importance of the lateral tunnel stenosis in the Fontan pathway for children with single ventricle physiology can be difficult to determine. The impact of the stenosis and stent implantation on total cavopulmonary connection resistance has not been characterized, and there are no clear guidelines for intervention. Methods and results A computational framework for haemodynamic assessment of stent implantation in patients with lateral tunnel stenosis was developed. Cardiac magnetic resonances images were reconstructed to obtain total cavopulmonary connection anatomies before stent implantation. Stents with 2-mm diameter increments were virtually implanted in each patient to understand the impact of stent diameter. Numerical simulations were performed in all geometries with patient-specific flow rates. Exercise conditions were simulated by doubling and tripling the lateral tunnel flow rate. The resulting total cavopulmonary connection vascular resistances were computed. A total of six patients (age: 14.4 ± 3.1 years) with lateral tunnel stenosis were included for preliminary analysis. The mean baseline resistance was 1.54 ± 1.08 WU · m(2) and dependent on the stenosis diameter. It was further exacerbated during exercise. It was observed that utilising a stent with a larger diameter lowered the resistance, but the resistance reduction diminished at larger diameters. Using a computational framework to assess the severity of lateral tunnel stenosis and the haemodynamic impact of stent implantation, it was observed that stenosis in the lateral tunnel pathway was associated with higher total cavopulmonary connection resistance than unobstructed pathways, which was exacerbated during exercise. Stent implantation could reduce the resistance, but the improvement was specific to the minimum diameter.

  4. Haemodynamic effects of adrenaline (epinephrine) depend on chest compression quality during cardiopulmonary resuscitation in pigs. (United States)

    Pytte, Morten; Kramer-Johansen, Jo; Eilevstjønn, Joar; Eriksen, Morten; Strømme, Taevje A; Godang, Kristin; Wik, Lars; Steen, Petter Andreas; Sunde, Kjetil


    Adrenaline (epinephrine) is used during cardiopulmonary resuscitation (CPR) based on animal experiments without supportive clinical data. Clinically CPR was reported recently to have much poorer quality than expected from international guidelines and what is generally done in laboratory experiments. We have studied the haemodynamic effects of adrenaline during CPR with good laboratory quality and with quality simulating clinical findings and the feasibility of monitoring these effects through VF waveform analysis. After 4 min of cardiac arrest, followed by 4 min of basic life support, 14 pigs were randomised to ClinicalCPR (intermittent manual chest compressions, compression-to-ventilation ratio 15:2, compression depth 30-38 mm) or LabCPR (continuous mechanical chest compressions, 12 ventilations/min, compression depth 45 mm). Adrenaline 0.02 mg/kg was administered 30 s thereafter. Plasma adrenaline concentration peaked earlier with LabCPR than with ClinicalCPR, median (range), 90 (30, 150) versus 150 (90, 270) s (p = 0.007), respectively. Coronary perfusion pressure (CPP) and cortical cerebral blood flow (CCBF) increased and femoral blood flow (FBF) decreased after adrenaline during LabCPR (mean differences (95% CI) CPP 17 (6, 29) mmHg (p = 0.01), FBF -5.0 (-8.8, -1.2) ml min(-1) (p = 0.02) and median difference CCBF 12% of baseline (p = 0.04)). There were no significant effects during ClinicalCPR (mean differences (95% CI) CPP 4.7 (-3.2, 13) mmHg (p = 0.2), FBF -0.2 (-4.6, 4.2) ml min(-1)(p = 0.9) and CCBF 3.6 (-1.8, 9.0)% of baseline (p = 0.15)). Slope VF waveform analysis reflected changes in CPP. Adrenaline improved haemodynamics during laboratory quality CPR in pigs, but not with quality simulating clinically reported CPR performance.

  5. Haemodynamic changes during spinal anaesthesia with slow continuous infusion or single dose of plain bupivacaine. (United States)

    Pitkänen, M; Rosenberg, P; Silvanto, M; Tuominen, M


    Forty elderly patients, scheduled for orthopaedic surgery of the hip or knee were studied. Twenty patients received a single-dose spinal anaesthesia with 3 ml of plain 0.5% bupivacaine (SDSA group). Twenty patients received continuous spinal anaesthesia using a 32- or 22-gauge catheter. A bolus of 1.0 ml of plain 0.5% bupivacaine was given to ten patients and 0.5 ml to another ten, continued by an infusion at a rate of 2 ml/h. The spread of analgesia and haemodynamic changes (central venous pressure, arterial pressures, need for sympathomimetic medication) were registered. The mean dose of bupivacaine was 2.9 ml (range 1.5-5 ml) in the CSA group (3.0 ml in the SDSA group). Eight patients in the CSA group needed medication for pain during surgery compared to five patients in the SDSA group (n.s.). The median level of pinprick analgesia at 60 min was T11 in the CSA and T6.5 in the SDSA group (P less than 0.01). The mean maximum decreases in CVP and MAP were quite similar in the CSA and SDSA group (2.1 vs 2.8 mmHg (0.3 vs 0.4 kPa) and 17 vs 21 mmHg (2.3 vs 2.8 kPa), respectively) (n.s.). Six patients in the SDSA group and four patients in the CSA group needed sympathomimetic medication. It is concluded that titration of bupivacaine for spinal anaesthesia caused only minor haemodynamic changes which were similar to those after single-dose spinal bupivacaine.

  6. Effect of generalised sympathetic activation by cold pressor test on cerebral haemodynamics in healthy humans. (United States)

    Roatta, S; Micieli, G; Bosone, D; Losano, G; Bini, R; Cavallini, A; Passatore, M


    There is no general agreement regarding several aspects of the role of the sympathetic system on cerebral haemodynamics such as extent of effectiveness, operational range and site of action. This study was planned to identify the effect of a generalised sympathetic activation on the cerebral haemodynamics in healthy humans before it is masked by secondary corrections, metabolic or myogenic in nature. A total of 35 healthy volunteers aged 20-35 underwent a 5 min lasting cold pressor test (CPT) performed on their left hand. The cerebral blood flow (CBF) velocity in the middle cerebral arteries and arterial blood pressure were recorded with transcranial Doppler sonography and with a non-invasive finger-cuff method, respectively. The ratio of arterial blood pressure to mean blood velocity (ABP/Vm) and Pulsatility Index (PI) were calculated throughout each trial. CPT induced an increase in mean ABP (range 2-54 mmHg depending on the subject) and only a slight, though significant, increase in blood velocity in the middle cerebral artery (+2.4 and +4.4% on ipsi- and contralateral side, respectively). During CPT, the ratio ABP/Vm increased and PI decreased in all subjects on both sides. These changes began simultaneously with the increase in blood pressure. The increase in ABP/Vm ratio is attributed to an increase in the cerebrovascular resistance, while the concomitant reduction in PI is interpreted as due to the reduction in the compliance of the middle cerebral artery. The results suggest that generalised increases in the sympathetic discharge, causing increases in ABP, can prevent concomitant increases in CBF by acting on both small resistance and large compliant vessels. This effect is also present when a slight increase in blood pressure occurs, which suggests a moderate increase in the sympathetic discharge, i.e. when ABP remains far below the upper limit of CBF autoregulation.

  7. Haemodynamic effects of remifentanil in children with and without intravenous atropine. An echocardiographic study. (United States)

    Chanavaz, C; Tirel, O; Wodey, E; Bansard, J Y; Senhadji, L; Robert, J C; Ecoffey, C


    Remifentanil is known to cause bradycardia and hypotension. We aimed to characterize the haemodynamic profile of remifentanil during sevoflurane anaesthesia in children with or without atropine. Forty children who required elective surgery received inhalational induction of anaesthesia using 8% sevoflurane. They were allocated randomly to receive either atropine, 20 microg kg(-1) (atropine group) or Ringer's lactate (control group) after 10 min of steady-state 1 MAC sevoflurane anaesthesia (baseline). Three minutes later (T0), all children received remifentanil 1 microg kg(-1) injected over a 60 s period, followed by an infusion of 0.25 microg kg(-1) min(-1) for 10 min then 0.5 microg kg(-1) min(-1) for 10 min. Haemodynamic variables and echocardiographic data were determined at baseline, T0, T5, T10, T15 and T20 min. Remifentanil caused a significant decrease in heart rate compared with the T0 value, which was greater at T20 than T10 in the two groups: however, the values at T10 and T20 were not significantly different from baseline in the atropine group. In comparison with T0, there was a significant fall in blood pressure in the two groups. Remifentanil caused a significant decrease in the cardiac index with or without atropine. Remifentanil did not cause variation in stroke volume (SV). In both groups, a significant increase in systemic vascular resistance occurred after administration of remifentanil. Contractility decreased significantly in the two groups, but this decrease remained moderate (between -2 and +2 sd). Remifentanil produced a fall in blood pressure and cardiac index, mainly as a result of a fall in heart rate. Although atropine was able to reduce the fall in heart rate, it did not completely prevent the reduction in cardiac index.

  8. Haemodynamic changes induced by submaximal exercise before a dive and its consequences on bubble formation (United States)

    Blatteau, Jean‐Eric; Boussuges, Alain; Gempp, Emmanuel; Pontier, Jean‐Michel; Castagna, Olivier; Robinet, Claude; Galland, Francois‐Michel; Bourdon, Lionel


    Objectives To evaluate the effects of a submaximal exercise performed 2 h before a simulated dive on bubble formation and to observe the haemodynamic changes and their influence on bubble formation. Participants and methods 16 trained divers were compressed in a hyperbaric chamber to 400 kPa for 30 min and decompressed at a rate of 100 kPa/min with a 9 min stop at 130 kPa (French Navy MN90 procedure). Each diver performed two dives 3 days apart, one without exercise and one with exercise before the dive. All participants performed a 40 min constant‐load submaximal and calibrated exercise, which consisted of outdoor running 2 h before the dive. Circulating bubbles were detected with a precordial Doppler at 30, 60 and 90 min after surfacing. Haemodynamic changes were evaluated with Doppler echocardiography. Results A single bout of strenuous exercise 2 h before a simulated dive significantly reduced circulating bubbles. Post‐exercise hypotension (PEH) was observed after exercise with reductions in diastolic and mean blood pressure (DBP and MBP), but total peripheral resistance was unchanged. Stroke volume was reduced, whereas cardiac output was unchanged. Simulated diving caused a similar reduction in cardiac output independent of pre‐dive exercise, suggesting that pre‐dive exercise only changed DBP and MBP caused by reduced stroke volume. Conclusion A single bout of strenuous exercise 2 h before a dive significantly reduced the number of bubbles in the right heart of divers and protected them from decompression sickness. Declining stroke volume and moderate dehydration induced by a pre‐dive exercise might influence inert gas load and bubble formation. PMID:17138641

  9. Acid-base transport in pancreas-new challenges

    DEFF Research Database (Denmark)

    Novak, Ivana; Haanes, Kristian Agmund; Wang, Jing


    Along the gastrointestinal tract a number of epithelia contribute with acid or basic secretions in order to aid digestive processes. The stomach and pancreas are the most extreme examples of acid (H+) and base (HCO-3) transporters, respectively. Nevertheless, they share the same challenges...... of transporting acid and bases across epithelia and effectively regulating their intracellular pH. In this review, we will make use of comparative physiology to enlighten the cellular mechanisms of pancreatic HCO-3 and fluid secretion, which is still challenging physiologists. Some of the novel transporters...... to consider in pancreas are the proton pumps (H-K-ATPases), as well as the calcium-activated K and Cl channels, such as K3.1 and TMEM16A/ANO1. Local regulators, such as purinergic signaling, fine-tune, and coordinate pancreatic secretion. Lastly, we speculate whether dys-regulation of acid-base transport...

  10. Role of Pendrin in Acid-base Balance (United States)

    Chang, Jae Hyun


    Pendrin (SLC26A4) is a Na+-independent Cl-/HCO3- exchanger which is expressed in the apical membranes of type B and non-A, non-B intercalated cells within the distal convoluted tubule, the connecting tubule, and the cortical collecting duct. In those segments it mediates HCO3- secretion and chloride (Cl-) absorption. In mice, no renal abnormalities are observed under basal conditions, and individuals with genetic disruption of the pendrin (SLC26A4) gene (Pendred syndrome) have normal acid-base balance. In contrast, there are definite differences under conditions wherein the transporter is stimulated. In animal studies, pendrin (SLC26A4) is upregulated with aldosterone analogues, Cl- restriction, and metabolic alkalosis, and is down-regulated with Cl loading and metabolic acidosis, independently. However, the exact role of pendrin in humans has not been established to date, and further examinations are necessary. PMID:21468181

  11. Boronic acid-based chemical sensors for saccharides. (United States)

    Zhang, Xiao-Tai; Liu, Guang-Jian; Ning, Zhang-Wei; Xing, Guo-Wen


    During the past decades, the interaction between boronic acids-functionalized sensors and saccharides is of great interest in the frontier domain of the interdiscipline concerning both biology and chemistry. Various boronic acid-based sensing systems have been developed to detect saccharides and corresponding derivatives in vitro as well as in vivo, which embrace unimolecular sensors, two-component sensing ensembles, functional assemblies, and boronic acid-loaded nanomaterials or surfaces. New sensing strategies emerge in endlessly with excellent selectivity and sensitivity. In this review, several typical sensing systems were introduced and some promising examples were highlighted to enable the deep insight of saccharides sensing on the basis of boronic acids. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. Evaluating Interest in Acids-Bases: Development of an Acid-Base Interest Scale (ABIS) and Assessment of Pre-Service Science Teachers' Interest (United States)

    Çiçek, Ö.; Ilhan, N.


    Students are more likely to be successful in topics they are interested in than others. This study aims to develop an Acid-Base Interest Scale (ABIS) and subsequently evaluate the interest of pre-service science teachers in acids-bases according to gender, years at the university, type of high school the pre-service science teachers attended, and…

  13. Study on coagulation property of metal-polysilicate coagulants in low turbidity water treatment. (United States)

    Yang, Hai-yan; Cui, Fu-yi; Zhao, Qing-liang; Ma, Chao


    In order to remove the low turbidity present in surface water, a novel metal-polysilicate coagulant was used to treat the raw water taken from Tanjiang River in Guangdong Province. This study on the effects of Al/Fe molar ratio on the performance of a complex compound formed by polysilicic acid, aluminium and ferric salt (PAFS) showed that PAFS with Al/Fe ratio of 10:3 seemed to have the best coagulation performance in removing turbidity and color. Experimental results showed that under the conditions of polymerization time of 15 d, sedimentation time of 12 min, and pH of 6-8, PAFS with Al/Fe molar ratio of 10:3 had the best coagulation efficiency and lowest residual Al concentration. The turbidity decreased from 23.8 NTU to 3.23 NTU and the residual Al concentration was only 0.165 mg/L in the product water. It could be speculated that colloidal impurities and particulate Al were removed by adsorption bridging and electrical neutralization of long chain inorganic polymer coagulants.

  14. [Comparison of thromboelastography and routine coagulation tests for evaluation of blood coagulation function in patients]. (United States)

    Chen, Guan-Yi; Ou Yang, Xi-Lin; Wu, Jing-Hui; Wang, Li-Hua; Yang, Jin-Hua; Gu, Li-Nan; Lu, Zhu-Jie; Zhao, Xiao-Zi


    To investigate the correlation and consistency between thromboelastography(TEG) and routine coagulation tests, and to evaluate the value of the two methods in determining the blood coagulation of patients. The TEG, routine coagulation tests and platelet counts of 182 patients from the Intensive Care Unit(ICU) and Department of Gastroenterology in our hospital from January to September 2014 were performed and analyzed retrospectively for their correlation, Kappa identity test analysis and chi-square test, and the diagnostic sensitivity and specificity of both methods in the patients with bleeding were evaluated. The TEG R time and PT, R time and APTT showed a linear dependence (P0.05) and 0.061 (P>0.05), respectively. The chi-square test values of the TEG R time with PT and APTT were 35.309 (Pcoagulation tests, but the consistency is weak. Moreover, the diagnostic sensitivity of two methods in the patients with bleeding is low. It was concluded that the TEG cannot replace the conventional coagulation tests, and the preferable method remains uncertain which could reflect the risk of bleeding.

  15. A new approach using coagulation rate constant for evaluation of turbidity removal (United States)

    Al-Sameraiy, Mukheled


    Coagulation-flocculation-sedimentation processes for treating three levels of bentonite synthetic turbid water using date seeds (DS) and alum (A) coagulants were investigated in the previous research work. In the current research, the same experimental results were used to adopt a new approach on a basis of using coagulation rate constant as an investigating parameter to identify optimum doses of these coagulants. Moreover, the performance of these coagulants to meet (WHO) turbidity standard was assessed by introducing a new evaluating criterion in terms of critical coagulation rate constant (kc). Coagulation rate constants (k2) were mathematically calculated in second order form of coagulation process for each coagulant. The maximum (k2) values corresponded to doses, which were obviously to be considered as optimum doses. The proposed criterion to assess the performance of coagulation process of these coagulants was based on the mathematical representation of (WHO) turbidity guidelines in second order form of coagulation process stated that (k2) for each coagulant should be ≥ (kc) for each level of synthetic turbid water. For all tested turbid water, DS coagulant could not satisfy it. While, A coagulant could satisfy it. The results obtained in the present research are exactly in agreement with the previous published results in terms of finding optimum doses for each coagulant and assessing their performances. On the whole, it is recommended considering coagulation rate constant to be a new approach as an indicator for investigating optimum doses and critical coagulation rate constant to be a new evaluating criterion to assess coagulants' performance.

  16. Regulation of Acid-Base Balance in Chronic Kidney Disease. (United States)

    Nagami, Glenn T; Hamm, L Lee


    The kidneys play a major role in the regulation of acid-base balance by reabsorbing bicarbonate filtered by the glomeruli and excreting titratable acids and ammonia into the urine. In CKD, with declining kidney function, acid retention and metabolic acidosis occur, but the extent of acid retention depends not only on the degree of kidney impairment but also on the dietary acid load. Acid retention can occur even when the serum bicarbonate level is apparently normal. With reduced kidney function, acid transport processes in the surviving nephrons are augmented but as disease progresses ammonia excretion and, in some individuals, the ability to reabsorb bicarbonate falls, whereas titratable acid excretion is preserved until kidney function is severely impaired. Urinary ammonia levels are used to gauge the renal response to acid loads and are best assessed by direct measurement of urinary ammonia levels rather than by indirect assessments. In individuals with acidosis from CKD, an inappropriately low degree of ammonia excretion points to the pathogenic role of impaired urinary acid excretion. The presence of a normal bicarbonate level in CKD complicates the interpretation of the urinary ammonia excretion as such individuals could be in acid-base balance or could be retaining acid without manifesting a low bicarbonate level. At this time, the decision to give bicarbonate supplementation in CKD is reserved for those with a bicarbonate level of 22 mEq/L, but because of potential harm of overtreatment, supplementation should be adjusted to maintain a bicarbonate level of <26 mEq/L. Published by Elsevier Inc.

  17. Effect of mineralocorticoids on acid-base balance. (United States)

    Wagner, Carsten A


    Aldosterone is classically associated with the regulation of salt and potassium homeostasis but has also profound effects on acid-base balance. During acidosis, circulating aldosterone levels are increased and the hormone acts in concert with angiotensin II and other factors to stimulate renal acid excretion. Pharmacological blockade of aldosterone action as well as inherited or acquired syndromes of impaired aldosterone release or action impair the renal response to acid loading and cause hyperkalemic renal tubular acidosis. The mineralocorticoid receptor (MR) mediating the genomic effects of aldosterone is expressed in all cells of the distal nephron including all subtypes of intercalated cells. In acid-secretory type A intercalated cells, aldosterone stimulates proton secretion into urine, whereas in non-type A intercalated cells, aldosterone increases the activity of the luminal anion exchanger pendrin stimulating bicarbonate secretion and chloride reabsorption. Aldosterone has also stimulatory effects on proton secretion that may be mediated by a non-genomic pathway. In addition, aldosterone indirectly stimulates renal acid excretion by enhancing sodium reabsorption through the epithelial sodium channel ENaC. Increased sodium reabsorption enhances the lumen-negative transepithelial voltage that facilitates proton secretion by neighboring intercalated cells. This indirect coupling of sodium reabsorption and proton secretion is thought to underlie the fludrocortisone-furosemide test for maximal urinary acidification in patients with suspected distal renal tubular acidosis. In patients with CKD, acidosis-induced aldosterone may contribute to progression of kidney disease. In summary, aldosterone is a powerful regulator of renal acid excretion required for normal acid-base balance. © 2014 S. Karger AG, Basel.

  18. Coagulation disorders and their cutaneous presentations: Pathophysiology. (United States)

    Chang, Yunyoung; Dabiri, Ganary; Damstetter, Elizabeth; Baiyee Ebot, Emily; Powers, Jennifer Gloeckner; Phillips, Tania


    Hypercoagulable states are inherited or acquired predispositions to venous or arterial thromboses that are best understood in the context of the coagulation cascade. Dermatologists can play a critical role in diagnosing and treating patients with hypercoagulable states because cutaneous symptoms may be a presenting manifestation, thereby reducing morbidity and mortality related to these conditions. This review focuses on the epidemiology and pathophysiology of hypercoagulable states, while the accompanying article iterates the basic clinical features, diagnostic testing, and management of patients who have these conditions. Copyright © 2015 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  19. Recovery and characterization of by-products from egg processing plant wastewater using coagulants

    National Research Council Canada - National Science Library

    Xu, L J; Sheldon, B W; Carawan, R E; Larick, D K; Chao, A C


    ...%, respectively, for all coagulants tested. Protein and fat recoveries were over 95% for all coagulants. The optimal coagulant concentration for maximum by-product recovery depended on initial wastewater concentrations of protein, total solids, and fat...

  20. Plasma and plasma components in the management of disseminated intravascular coagulation

    NARCIS (Netherlands)

    Levi, Marcel; de Jonge, Evert; van der Poll, Tom


    A variety of clinical conditions can cause systemic activation of coagulation that ranges from insignificant laboratory changes to severe disseminated intravascular coagulation (DIC). DIC consists of a widespread systemic activation of coagulation, resulting in diffuse fibrin deposition in small and

  1. New treatment strategies for disseminated intravascular coagulation based on current understanding of the pathophysiology

    NARCIS (Netherlands)

    Levi, Marcel; de Jonge, Evert; van der Poll, Tom


    A variety of clinical conditions may cause systemic activation of coagulation, ranging from insignificant laboratory changes to severe disseminated intravascular coagulation (DIC). DIC consists of a widespread, systemic activation of coagulation, resulting in diffuse fibrin deposition in small and

  2. Natural organic matters removal efficiency by coagulation (United States)

    Sapingi, Mohd Sharizal Mohd; Pishal, Munirah; Murshed, Mohamad Fared


    The presence of Natural Organic Matter (NOM) in surface water results in unwanted characteristics in terms of color, odor, and taste. NOM content reaction with free chlorine in treated water lowers the water quality further. Chlorine is added for disinfection and produces undesirable disinfection by-products (DPBs). DBPs in drinking water are carcinogenic to consumers and may promote cancerous cell development in the human body. This study was performed to compare the coagulant efficiency of aluminum sulfate (Alum) and ferric chloride (FeCl3) on NOM removal (as in UV254 absorbance) and turbidity removal under three pH conditions (pH 6, pH 7, and sample actual pH). The three sampling points for these studies were Jalan Baru River, Kerian River, and Redac Pond. Additional sampling points, such as Lubuk Buntar and a tubewell located in the Civil Engineering School, were included to observe differences in characteristics. DOC, UV absorbance, and full wavelength were tested, after which samples treated with alum were also tested to further analyze the NOM content. Based on UV254 absorbance and DOC data, specific UV value was calculated to obtain vital synopsis of the characteristics of NOM content, as well as coagulation efficiency.

  3. Coagulation studies in patients with orthopedic trauma

    Directory of Open Access Journals (Sweden)

    Rangarajan Kanchana


    Full Text Available Background : Head injury, severe acidosis, hypothermia, massive transfusion and hypoxia often complicate traumatic coagulopathy. First line investigations such as prothrombin time, activated partial thromboplastin time, thrombin time, fibrinogen level, platelet count and D-dimer levels help in the initial assessment of coagulopathy in a trauma victim. Aim : To study the coagulation profile in patients of orthopedic trauma. Settings and Design : Prospective study. Patients and Methods : Patients with head injury, severe acidosis, massive transfusion and severe hypoxia were excluded from the study. Coagulation parameters were evaluated at three intervals, at the time of admission, intra operatively and in the postoperative period. Statistical Analysis : Chi-square test was used for analysis of categorical variables. For comparison between groups, two- way ANOVA was used. Results and Conclusions : Of the 48 patients studied, 38 (80% had normal DIC scores upon admission and only 10 (20% had mild DIC scores at the time of admission. The median Injury Severity Score was 34 and they did not correlate with DIC scores. Fibrinogen levels alone were significantly different, increased progressively (mean pre op, intra op and post op levels 518 ± 31,582 ± 35 and 643 ± 27 respectively; P ≤ 0.02 since the time of admission in these patients. All the other parameters remained unchanged. Further large scale prospective studies would be required to correlate elevated fibrinogen levels with the type of trauma or surgery.

  4. The Study of Hemolysis Effects on Coagulation Parameters

    African Journals Online (AJOL)

    Background: Rejecting hemolyzed specimens received for coagulation studies is advised by the Clinical and Laboratory Standards Institute. Receiving such specimens is a common phenomenon in many laboratories. The true impact of hemolysis on coagulation studies is little studied in clinical practice. Aim: The aim of this ...

  5. Disseminated intravascular coagulation in meningococcal sepsis. Case 7

    NARCIS (Netherlands)

    Zeerleder, S.; Zürcher Zenklusen, R.; Hack, C. E.; Wuillemin, W. A.


    We report on a man (age: 49 years), who died from severe meningococcal sepsis with disseminated intravascular coagulation (DIC), multiple organ dysfunction syndrome and extended skin necrosis. We discuss in detail the pathophysiology of the activation of coagulation and fibrinolysis during sepsis.

  6. Effects of coagulation factors and inflammatory cytokines on ...

    African Journals Online (AJOL)

    mice. Blood Coagul Fibrinolysis 2015; 26(5): 515-521. 18. Soejima H, Ogawa H, Suefuji H, Kaikita K, Takazoe K,. Miyamoto S, Kajiwara I, Shimomura H, Sakamoto T,. Yoshimura M, Nakamura S. Comparison of effects of losartan versus enalapril on fibrinolysis and coagulation in patients with acute myocardial infarction.

  7. Hypothermia and acidosis synergistically impair coagulation in human whole blood. (United States)

    Dirkmann, Daniel; Hanke, Alexander A; Görlinger, Klaus; Peters, Jürgen


    Hypothermia and acidosis were reported to influence coagulopathy in different clinical settings. We evaluated whole blood coagulation to determine the effects of hypothermia and/or acidosis on hemostasis. Whole blood samples (3.000 microL) from 10 healthy volunteers (2 female, 8 male) were acidified by adding 40 microL of hydrochloric acid of increasing molarity to achieve a blood pH (alpha-stat) between 7.0 and 7.37, and coagulation was analyzed by rotational thromboelastometry after an incubation period of 30 min using both intrinsically (InTEM) and extrinsically (ExTEM) activated assays. To assess temperature-dependent effects, all tests were performed at blood/thromboelastometer temperatures of 30, 33, 36, and 39 degrees C, respectively. An additional extrinsically activated test with addition of cytochalasin D was performed to examine clot formation without platelet contribution. Hypothermia at a normal pH produced an increased coagulation time [ExTEM: 65 s +/- 3.6 (36 degrees C) vs 85 +/- 4 (30 degrees C), P coagulation time, InTEM: 181 s +/- 10 (36 degrees C) vs 226 +/- 9, P coagulation changes that were worsened by acidosis whereas acidosis without hypothermia has no significant effect on coagulation, as studied by thromboelastometry. This effect was mediated by the inhibition of coagulation factors and platelet function. Thus, thromboelastometry performed at 37 degrees C overestimated integrity of coagulation during hypothermia in particular in combination with acidosis.

  8. Coagulation pretreatment for ultrafiltration of deinking effluents containing flexographic inks (United States)

    Bruno Chabot; Gopal A. Krishnagopalan; Said Abubakr


    This study was carried out to determine the potential of coagulation pretreatment with organic or inorganic coagulants to improve ultrafiltration performance during processing of wash deinking effluents containing flexographic inks. Wash filtrate effluents generated from mixtures of old flexographic and offset newspapers and old magazines were pretreated with a...

  9. Analysis and optimization of coagulation and flocculation process (United States)

    Saritha, V.; Srinivas, N.; Srikanth Vuppala, N. V.


    Natural coagulants have been the focus of research of many investigators through the last decade owing to the problems caused by the chemical coagulants. Optimization of process parameters is vital for the effectiveness of coagulation process. In the present study optimization of parameters like pH, dose of coagulant and mixing speed were studied using natural coagulants sago and chitin in comparison with alum. Jar test apparatus was used to perform the coagulation. The results showed that the removal of turbidity was up to 99 % by both alum and chitin at lower doses of coagulant, i.e., 0.1-0.3 g/L, whereas sago has shown a reduction of 70-100 % at doses of 0.1 and 0.2 g/L. The optimum conditions observed for sago were 6 and 7 whereas chitin was stable at all pH ranges, lower coagulant doses, i.e., 0.1-0.3 g/L and mixing speed—rapid mixing at 100 rpm for 10 min and slow mixing 20 rpm for 20 min. Hence, it can be concluded that sago and chitin can be used for treating water even with large seasonal variation in turbidity.

  10. Optimization of coagulation-flocculation process for colour removal ...

    African Journals Online (AJOL)

    Overlay contour plot was used to establish an optimum condition for the multiple responses studied. The response surface approach was appropriate for optimizing the coagulation-flocculation process while minimizing the number of experiments. Coagulants studied should be considered as an alternative for conventional ...

  11. Effects of coagulation factors and inflammatory cytokines on ...

    African Journals Online (AJOL)

    be closely related to the high levels of coagulation factors and inflammatory cytokines in the blood. Keywords: Coagulation factor, Inflammatory cytokines, Acute myocardial infarction, C-reactive protein,. Tumor necrosis factor-α, ... addition, the systemic inflammation response has been documented in patients with AMI, and.

  12. Coagulation and fibrinolysis in tuberculosis, melioidosis and beyond

    NARCIS (Netherlands)

    Kager, L.M.


    The studies presented in this thesis significantly contribute to the current knowledge on the role of proteins involved in coagulation, anticoagulation and fibrinolysis during TB and melioidosis. We showed that during TB, although a chronic disease, the coagulation system becomes activated. The

  13. Polytitanium sulfate (PTS): Coagulation application and Ti species detection. (United States)

    Zhao, Yanxia; Phuntsho, Sherub; Gao, Baoyu; Shon, Hokyong


    Interest in the development of inorganic polymerized coagulants is growing; however, there are only limited studies on the synthesis of polytitanium coagulants, which are expected to exhibit improved coagulation efficiency with better floc properties. This study presents the synthesis of polytitanium sulfate (PTS) for potential application in water purification, followed by characterization of PTS flocs and titanium species detection. Stable PTS solutions were successfully synthesized and standard jar tests were conducted to evaluate their coagulation efficiency. Electrospray ionization time-of-flight mass spectrometry (ESI-TOF-MS) speciation analysis revealed that a variety of mononuclear and polynuclear complexes were formed in PTS solution, indicating the polymeric nature of the synthesized coagulant. Floc characteristics were studied through on-line monitoring of floc size using a laser diffraction particle size analyzer. Results showed that PTS had a comparable or in some cases even higher organic matter and particulate removal efficiency than Ti(SO4)2. The effluent pH after PTS coagulation significantly improved toward desirable values closer to neutral pH. Properties of flocs formed by PTS were significantly improved in terms of floc size, growth rate and structure. This study showed that PTS could be an efficient and promising coagulant for water purification, with the additional benefit that its coagulated sludge can be used to recover valuable TiO2 nanoparticles for various commercial applications. Copyright © 2016. Published by Elsevier B.V.

  14. Critical assessment of chitosan as coagulant to remove cyanobacteria

    NARCIS (Netherlands)

    Lürling, Miquel; Noyma, Natalia Pessoa; Magalhães, Leonardo de; Miranda, Marcela; Mucci, Maíra; Oosterhout, Frank van; Huszar, Vera L.M.; Marinho, Marcelo Manzi


    Removal of cyanobacteria from the water column using a coagulant and a ballast compound is a promising technique to mitigate nuisance. As coagulant the organic, biodegradable polymer chitosan has been promoted. Results in this study show that elevated pH, as may be common during cyanobacterial

  15. Allosteric activation of coagulation factor VIIa visualized by hydrogen exchange

    DEFF Research Database (Denmark)

    Rand, Kasper Dyrberg; Jørgensen, Thomas; Olsen, Ole H


    Coagulation factor VIIa (FVIIa) is a serine protease that, after binding to tissue factor (TF), plays a pivotal role in the initiation of blood coagulation. We used hydrogen exchange monitored by mass spectrometry to visualize the details of FVIIa activation by comparing the exchange kinetics...

  16. Coagulation chemistries for silica removal from cooling tower water.

    Energy Technology Data Exchange (ETDEWEB)

    Nyman, May Devan; Altman, Susan Jeanne; Stewart, Tom


    The formation of silica scale is a problem for thermoelectric power generating facilities, and this study investigated the potential for removal of silica by means of chemical coagulation from source water before it is subjected to mineral concentration in cooling towers. In Phase I, a screening of many typical as well as novel coagulants was carried out using concentrated cooling tower water, with and without flocculation aids, at concentrations typical for water purification with limited results. In Phase II, it was decided that treatment of source or make up water was more appropriate, and that higher dosing with coagulants delivered promising results. In fact, the less exotic coagulants proved to be more efficacious for reasons not yet fully determined. Some analysis was made of the molecular nature of the precipitated floc, which may aid in process improvements. In Phase III, more detailed study of process conditions for aluminum chloride coagulation was undertaken. Lime-soda water softening and the precipitation of magnesium hydroxide were shown to be too limited in terms of effectiveness, speed, and energy consumption to be considered further for the present application. In Phase IV, sodium aluminate emerged as an effective coagulant for silica, and the most attractive of those tested to date because of its availability, ease of use, and low requirement for additional chemicals. Some process optimization was performed for coagulant concentration and operational pH. It is concluded that silica coagulation with simple aluminum-based agents is effective, simple, and compatible with other industrial processes.

  17. Critical assessment of chitosan as coagulant to remove cyanobacteria

    NARCIS (Netherlands)

    Lurling, Miguel; Noyma, Natalia Pessoa; Magalhães, de Leonardo; Miranda, Marcela; Mucci, Maíra; Oosterhout, van F.; Huszar, Vera L.M.; Marinho, Marcelo Manzi


    Removal of cyanobacteria from the water column using a coagulant and a ballast compound is a promising technique to mitigate nuisance. As coagulant the organic, biodegradable polymer chitosan has been promoted. Results in this study show that elevated pH, as may be common during cyanobacterial

  18. Influence of blood flow on the coagulation cascade

    DEFF Research Database (Denmark)

    The influence of diffusion and convetive flows on the blood coagulation cascade is investigated for a controlled perfusion experiment. We present a cartoon model and reaction schemes for parts of the coagulation cascade with sunsequent set up of a mathematical model in two space dimensions plus one...

  19. Tulathromycin disturbs blood oxidative and coagulation status | Er ...

    African Journals Online (AJOL)

    Tulathromycin disturbs blood oxidative and coagulation status. ... Tulathromycin was administered to eight rabbits, and blood samples were obtained 0, 1, 5, 10 and 15 days after treatment. Indicators of serum ... In conclusion, tulathromycin may cause oxidative damage and coagulation disorders during the treatment period.

  20. The relationship between inflammation and the coagulation system

    NARCIS (Netherlands)

    Choi, Goda; Schultz, Marcus J.; Levi, Marcel; van der Poll, Tom


    Inflammation and coagulation play pivotal roles in host defence. As phylogenetically old responses, there is extensive cross-talk between inflammation and coagulation in enabling an adequate immune response against potentially injurious stimuli. Immune cells are important in the initiation of

  1. Evaluation of Moringa oleifera seed as coagulation aid for treatment ...

    African Journals Online (AJOL)

    Laboratory tests were carried out to evaluate the potentials of Moringa oleifera seed powder as a coagulation aid for removal of suspended particles in fish culture effluent. The standard jar test was used to investigate the dosage and mixing intensity required to optimize the use of the coagulant in removing of suspended ...

  2. Effects of different coagulants on the physico-chemical, microbial ...

    African Journals Online (AJOL)

    Similarly, coagulants used significantly affected the water absorption capacity, oil absorption capacity, foam capacity and gelation capacity. However, the bulk density was not significantly (p ≥ 0.05) affected. Steep water coagulated cheese had the highest total plate count. The result for sensory properties shows that, lime ...

  3. Characteristics of particle coagulation in an underground parking lot. (United States)

    Zhao, Yu; Kato, Shinsuke; Zhao, Jianing


    Particles in vehicle exhaust plumes in underground parking lots have adverse health effects due to the enclosed environment in which they are released and the temperature difference between the tailpipe and ambient environment; at the same time, particle coagulation might be obvious near the tailpipe in an underground parking lot. In the present study, airflow and temperature fields were calculated using the Realizable k-ε model, and the Eulerian particle transport model was selected in the numerical simulation of particle concentration dispersion. Polydisperse thermal coagulation due to Brownian collisions was employed to calculate the particle coagulation. The results show that particle coagulation rate and half-time were significant within 1 m from the tailpipe. The variations in the particle coagulation rate and half-time were similar, but their directions were opposite. Air exhaust time was nearly four times longer than averaged half-time and 40 times longer than minimum half-time. The peak particle diameter increased approximately 1.43 times due to coagulation. A double particle concentration at the tailpipe caused the fourfold rise in the particle coagulation rate in the distance ranging less than 1 m from the tailpipe. An increase in exhaust velocity at the tailpipe could shorten the obvious range of particle coagulation along the centerline of the tailpipe from 1 to 0.8 m in the study.

  4. Treatment of ink-containing wastewater by coagulation/flocculation ...

    African Journals Online (AJOL)

    A coagulation/flocculation process using a selection of biopolymers (chitosan and tannin) was used to treat an ink-containing effluent generated in the processing of packaging. The efficiency of the process was investigated in terms of the influence of pH, coagulant and flocculant concentrations, as well as chitosan ...

  5. Adherence and Coagulation Assays in Dabigatran-treated Patients With Atrial Fibrillation (United States)


    Atrial Fibrillation; Medication Adherence; Blood Coagulation Tests; Anticoagulants; Circulating, Hemorrhagic Disorder; Drug Effect; Drug Use; Drug Toxicity; Drug Intolerance; Blood Clot; Blood Coagulation Disorder; Laboratory Problem; Bleeding; Thrombosis

  6. Coagulation profile in open and video-assisted thoracoscopic lobectomies

    DEFF Research Database (Denmark)

    Christensen, Thomas Decker; Vad, Henrik; Pedersen, Søren


    OBJECTIVES: Lung cancer patients are perceived to have a relatively high risk of venous thromboembolic events due to an activation of the coagulation system. In terms of activation of the coagulation system, the difference between video-assisted thoracoscopic surgery (VATS) and open lobectomies...... for primary lung cancer has not been investigated. The aim of this study was to compare the impact on the coagulation system in patients undergoing curative surgery for primary lung cancer by either VATS or open lobectomies. METHODS: In total, 62 patients diagnosed with primary lung cancer were allocated...... to either VATS (n = 32) or open lobectomies (n = 30). All patients received subcutaneous injections with dalteparin (Fragmin®) 5000 IE once daily. The coagulation was assessed pre- and intraoperatively, and the first 2 days postoperatively by standard coagulation blood tests, thromboelastometry (ROTEM...

  7. Blood coagulation evaluation of N-alkylated chitosan. (United States)

    Chen, Zihao; Yao, Xinpei; Liu, Lu; Guan, Jing; Liu, Mengyuan; Li, Zhihong; Yang, Jian; Huang, Shujie; Wu, Jimin; Tian, Feng; Jing, Miaolei


    N-Alkylated chitosan (NACS) may improve the haemostatic efficiency of chitosan (CS). To study its coagulation capability and function, a series of NACS with various carbon chain lengths and substitution degrees (SD) of alkyl groups were synthesized and characterized by FTIR, NMR, and elemental analysis. Haemolysis and toxicity assays revealed that NACS showed good biocompatibility. In vitro blood clotting tests indicated that NACS had better haemostatic activity than CS, of which N-octadecyl CS with 3.85% SD showed the best results. Blood plasma coagulation tests showed that NACS was not favourable for activating coagulation factors. Platelet adhesion, intracellular Ca2+, and CD62p measurements demonstrated that the coagulation properties of NACS were not related to platelet activation. Erythrocyte adhesion examination indicated that blood coagulation of NACS may be attributable to its effects on erythrocytes. This study suggests that NACS is an ideal candidate for clotting. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Performance and characterization of a new tannin-based coagulant (United States)

    Beltrán-Heredia, J.; Sánchez-Martín, J.; Gómez-Muñoz, C.


    Diethanolamine and formaldehyde were employed to cationize tannins from black wattle. This novel coagulant called CDF was functionally characterized in removing sodium dodecylbenzene sulfonate (anionic surfactant) and Palatine Fast Black WAN (azoic dye). Refined tannin-derived commercial coagulants exhibited similar efficiency, while CDF presented higher coagulant ability than alum, a usual coagulant agent. Low doses of CDF (ca. 100 mg L-1) were able to remove more than 70 % of surfactant and more than 85 % of dye (initial pollutant concentration of ca. 100 mg L-1) and it presented no temperature affection and worked at a relatively wide pH range. Surfactant and dye removal responded to the classical coagulant-and-adsorption models, such as Frumkin-Fowler-Guggenheim or Gu and Zhu in the case of surfactant, and Langmuir and Freundlich in the case of dye.

  9. Delayed liver regeneration in C3H/HeJ mice: possible involvement of haemodynamic and structural changes in the hepatic microcirculation

    National Research Council Canada - National Science Library

    Marlini, Muhamad; Mabuchi, Ayako; Mallard, Beth L; Hairulhisyam, Ngatiman; Akashi‐Takamura, Sachiko; Harper, Jacquie L; Wheatley, Antony M


    ... in these haemodynamic events resulted in impaired liver regeneration in lipopolysaccharide-insensitive, C3H/HeJ mice. Toll-like receptor 4 signalling is required for restoration of normal liver architecture during the liver regenerative process...

  10. Coagulant recovery and reuse for drinking water treatment. (United States)

    Keeley, James; Jarvis, Peter; Smith, Andrea D; Judd, Simon J


    Coagulant recovery and reuse from waterworks sludge has the potential to significantly reduce waste disposal and chemicals usage for water treatment. Drinking water regulations demand purification of recovered coagulant before they can be safely reused, due to the risk of disinfection by-product precursors being recovered from waterworks sludge alongside coagulant metals. While several full-scale separation technologies have proven effective for coagulant purification, none have matched virgin coagulant treatment performance. This study examines the individual and successive separation performance of several novel and existing ferric coagulant recovery purification technologies to attain virgin coagulant purity levels. The new suggested approach of alkali extraction of dissolved organic compounds (DOC) from waterworks sludge prior to acidic solubilisation of ferric coagulants provided the same 14:1 selectivity ratio (874 mg/L Fe vs. 61 mg/L DOC) to the more established size separation using ultrafiltration (1285 mg/L Fe vs. 91 mg/L DOC). Cation exchange Donnan membranes were also examined: while highly selective (2555 mg/L Fe vs. 29 mg/L DOC, 88:1 selectivity), the low pH of the recovered ferric solution impaired subsequent treatment performance. The application of powdered activated carbon (PAC) to ultrafiltration or alkali pre-treated sludge, dosed at 80 mg/mg DOC, reduced recovered ferric DOC contamination to water quality parameters. Several PAC-polished recovered coagulants provided the same or improved DOC and turbidity removal as virgin coagulant, as well as demonstrating the potential to reduce disinfection byproducts and regulated metals to levels comparable to that attained from virgin material. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. Contact activation of blood-plasma coagulation (United States)

    Golas, Avantika

    Surface engineering of biomaterials with improved hemocompatibility is an imperative, given the widespread global need for cardiovascular devices. Research summarized in this dissertation focuses on contact activation of FXII in buffer and blood plasma frequently referred to as autoactivation. The extant theory of contact activation imparts FXII autoactivation ability to negatively charged, hydrophilic surfaces. According to this theory, contact activation of plasma involves assembly of proteins comprising an "activation complex" on activating surfaces mediated by specific chemical interactions between complex proteins and the surface. This work has made key discoveries that significantly improve our core understanding of contact activation and unravel the existing paradigm of plasma coagulation. It is shown herein that contact activation of blood factor XII (FXII, Hageman factor) in neat-buffer solution exhibits a parabolic profile when scaled as a function of silanized-glass-particle activator surface energy (measured as advancing water adhesion tension t°a=g° Iv costheta in dyne/cm, where g°Iv is water interfacial tension in dyne/cm and theta is the advancing contact angle). Nearly equal activation is observed at the extremes of activator water-wetting properties --36 cocktail, and plasma solutions is shown herein. Activation of blood plasma coagulation in vitro by contact with material surfaces is demonstrably dependent on plasma-volume-to-activator-surface-area ratio. However, activation of factor XII dissolved in buffer, protein cocktail, heat-denatured serum, and FXI deficient plasma does not exhibit activator surface-area dependence. Instead, a highly-variable burst of procoagulant-enzyme yield is measured that exhibits no measurable kinetics, sensitivity to mixing, or solution-temperature dependence. Thus, FXII activation in both buffer and protein-containing solutions does not exhibit characteristics of a biochemical reaction but rather appears to be a

  12. Water-wire catalysis in photoinduced acid-base reactions. (United States)

    Kwon, Oh-Hoon; Mohammed, Omar F


    The pronounced ability of water to form a hyperdense hydrogen (H)-bond network among itself is at the heart of its exceptional properties. Due to the unique H-bonding capability and amphoteric nature, water is not only a passive medium, but also behaves as an active participant in many chemical and biological reactions. Here, we reveal the catalytic role of a short water wire, composed of two (or three) water molecules, in model aqueous acid-base reactions synthesizing 7-hydroxyquinoline derivatives. Utilizing femtosecond-resolved fluorescence spectroscopy, we tracked the trajectories of excited-state proton transfer and discovered that proton hopping along the water wire accomplishes the reaction more efficiently compared to the transfer occurring with bulk water clusters. Our finding suggests that the directionality of the proton movements along the charge-gradient H-bond network may be a key element for long-distance proton translocation in biological systems, as the H-bond networks wiring acidic and basic sites distal to each other can provide a shortcut for a proton in searching a global minimum on a complex energy landscape to its destination.

  13. The Acid-Base balance history (Part I

    Directory of Open Access Journals (Sweden)

    Mario Tarantino


    Full Text Available In the History of Medicine, the Acid-Base balance is unusual in that it has undergone constant evolution, not merely and not so much as a result of the progress of knowledge in physiological and physiopathological and clinical fields - which is common to all fields of Medical Science, but rather in relation to its very biochemical foundations, as was demonstrated by P. Stewart’s recent critical review and the reviews of J. Corey and J.A. Kellum, which are still valid today - and this is rather unusual. Although it started centuries ago, the history of the acidbase balance has experienced a slow and difficult evolution, and modern concepts almost exploded a couple of decades into the 20th century. It is therefore with even greater wonder and admiration that we look back on the pioneering intuitions of scholars such as R. Boyle, J.B. van Helmont and A.L. Lavoisier, to mention but a few of the scientists who laid the foundations for current knowledge in this fascinating chapter of physiology and clinical practice that belongs transversally to all medical and clinical disciplines.

  14. Acid-base machines: electrical work from neutralization reactions. (United States)

    Lima, Gilberto; Morais, William G; Gomes, Wellington J A S; Huguenin, Fritz


    We have developed an electrochemical system that performs electrical work due to changes in alkaline ion and proton activities associated with acidic solution neutralization. This system can be used to treat wastewater, contributing to sustainable growth. The system includes an electrochemical machine that operates between an acidic and a basic reservoir to produce work in cycles comprising four stages: two isothermal ionic insertion/de-insertion steps and two steps involving acid and base injection. On the basis of the mixing free energy associated with the reaction free energy, we have developed the thermodynamic formalism by considering reversible electrochemical processes to determine the maximum work performed by this acid-base machine and the efficiency. Electrochemical methods in the time and frequency domains helped in investigating the kinetics of sodium ions and proton insertion in host matrices consisting of copper hexacyanoferrate and phosphomolybdic acid, respectively, to improve our understanding of the factors underlying dissipation as a function of pH and pNa. The full cell composed of these insertion electrodes was used as a proof of concept. It performed a maximum work of 26.4 kJ per mol of electro-inserted ion from HCl solution neutralization with the addition of NaOH, to simulate acidic wastewater treatment in a profitable and sustainable way.

  15. Acid-base transport in pancreas – new challenges

    Directory of Open Access Journals (Sweden)

    Ivana eNovak


    Full Text Available Along the gastrointestinal tract a number of epithelia contribute with acid or basic secretions in order to aid digestive processes. The stomach and pancreas are the most extreme examples of acid (H+ and base (HCO3- transporters, respectively. Nevertheless, they share the same challenges of transporting acid and bases across epithelia and effectively regulating their intracellular pH. In this review, we will make use of comparative physiology to enlighten the cellular mechanisms of pancreatic HCO3- and fluid secretion, which is still challenging physiologists. Some of the novel transporters to consider in pancreas are the proton pumps (H+-K+-ATPases, as well as the calcium-activated K+ and Cl- channels, such as KCa3.1 and TMEM16A/ANO1. Local regulators, such as purinergic signalling, fine-tune and coordinate pancreatic secretion. Lastly, we speculate whether dys-regulation of acid-base transport contributes to pancreatic diseases including cystic fibrosis, pancreatitis and cancer.

  16. Patient-specific modelling of whole heart anatomy, dynamics and haemodynamics from four-dimensional cardiac CT images. (United States)

    Mihalef, Viorel; Ionasec, Razvan Ioan; Sharma, Puneet; Georgescu, Bogdan; Voigt, Ingmar; Suehling, Michael; Comaniciu, Dorin


    There is a growing need for patient-specific and holistic modelling of the heart to support comprehensive disease assessment and intervention planning as well as prediction of therapeutic outcomes. We propose a patient-specific model of the whole human heart, which integrates morphology, dynamics and haemodynamic parameters at the organ level. The modelled cardiac structures are robustly estimated from four-dimensional cardiac computed tomography (CT), including all four chambers and valves as well as the ascending aorta and pulmonary artery. The patient-specific geometry serves as an input to a three-dimensional Navier-Stokes solver that derives realistic haemodynamics, constrained by the local anatomy, along the entire heart cycle. We evaluated our framework with various heart pathologies and the results correlate with relevant literature reports.

  17. Acute postoperative digitalization of patients with arteriosclerotic heart disease after major surgery. A randomized haemodynamic study and proposal for therapy. (United States)

    Bille-Brahe, N E; Engell, H C; Sørensen, M B


    Twenty patients with impaired left ventricular function during exercise, who underwent major vascular surgery for arteriosclerotic disease, were randomly digitalized in the immediate postoperative period. All patients had a smooth postoperative course. Haemodynamic measurements showed improved left ventricular function in those who received digitalis, since 60 min after full digitalization the digitalized patients had a highly significant decrease in pulmonary capillary wedge pressure (PCWP) with unchanged stroke volume index (SVI) and left ventricular stroke work index (LVSWI). The same improvement in cardiac function was present the next morning. The present study provides haemodynamic data in support of clinical studies showing a beneficial effect of prophylactic digitalization in surgical patients with clinical signs of arteriosclerotic heart disease, though not in overt failure.

  18. Comparison of coagulants and coagulation aids for treatment of meat processing wastewater by column flotation. (United States)

    de Sena, Rênnio F; Moreira, Regina F P M; José, Humberto J


    The physicochemical treatment of the wastewater from a meat processing industry was studied using three ferric salts as coagulants in conjunction with four different polymers as coagulation aids by batch column flotation. The effluent was characterized in terms of pH (6.5-6.7), turbidity (1000-12000 NTU), total solids (TS) (2300-7000mgl(-1)), oils and greases (OG) (820-1050mgl(-1)), and biochemical and chemical oxygen demands (BOD(5) and COD) (1200-1760 and 2800-3230mgl(-1)), respectively. The treatments achieved typical organic load reductions of oils and greases, and total solids (up to 85%), as well as biochemical and chemical oxygen demands (between 62.0-78.8% and 74.6-79.5%, respectively). The research also found that the utilization of a column flotation achieved high efficiency of organic matter removal and its operation as a primary treatment showed no significant dependence of pollutant removal and air flow rate.

  19. Patient-specific modelling of whole heart anatomy, dynamics and haemodynamics from four-dimensional cardiac CT images


    Mihalef, Viorel; Ionasec, Razvan Ioan; Sharma, Puneet; Georgescu, Bogdan; Voigt, Ingmar; Suehling, Michael; Comaniciu, Dorin


    There is a growing need for patient-specific and holistic modelling of the heart to support comprehensive disease assessment and intervention planning as well as prediction of therapeutic outcomes. We propose a patient-specific model of the whole human heart, which integrates morphology, dynamics and haemodynamic parameters at the organ level. The modelled cardiac structures are robustly estimated from four-dimensional cardiac computed tomography (CT), including all four chambers and valves a...

  20. The effects of music intervention on the emotion, haemodynamics and endocrine hormone level of senile patients during the perianesthesia period


    Liang Feng; Han Fang-lei; Qi Shuang


    Purpose: to explore the effects of music intervention on haemodynamics and endocrine hormone level of senile patients. Methods: choosing ASA II-III level and selecting 60 senile patients performed with intraspinal anesthesia; randomly dividing them into the intervention group and control group with 30 cases in each group. Both the two groups of patients completed the SAS before entering the operating room. When the patients of the intervention group entered the operating room, selected music ...

  1. Beyond the N400: complementary access to early neural correlates of novel metaphor comprehension using combined electrophysiological and haemodynamic measurements. (United States)

    Schneider, Sabrina; Rapp, Alexander M; Haeußinger, Florian B; Ernst, Lena H; Hamm, Friedrich; Fallgatter, Andreas J; Ehlis, Ann-Christine


    The simultaneous application of different neuroimaging methods combining high temporal and spatial resolution can uniquely contribute to current issues and open questions in the field of pragmatic language perception. In the present study, comprehension of novel metaphors was investigated using near-infrared spectroscopy (NIRS) combined with the simultaneous acquisition of electroencephalography (EEG)/event-related potentials (ERPs). For the first time, we investigated the effects of figurative language on early electrophysiological markers (P200, N400) and their functional relationship to cortical haemodynamic responses within the language network (Broca's area, Wernicke's area). To this end, 20 healthy subjects judged 120 sentences with respect to their meaningfulness, whereby phrases were either literal, metaphoric, or meaningless. Our results indicated a metaphor-specific P200 reduction and a linear increase of N400 amplitudes from literal over metaphoric to meaningless sentences. Moreover, there were metaphor related effects on haemodynamic responses accessed with NIRS, especially within the left lateral frontal cortex (Broca's area). Significant correlations between electrophysiological and haemodynamic responses indicated that P200 reductions during metaphor comprehension were associated with an increased recruitment of neural activity within left Wernicke's area, indicating a link between variations in neural activity and haemodynamic changes within Wernicke's area. This link may reflect processes related to interindividual differences regarding the ability to classify novel metaphors. The present study underlines the usefulness of simultaneous NIRS measurements in language paradigms - especially for investigating the functional significance of neurophysiological markers that have so far been rarely examined - as these measurements are easily and efficiently realizable and allow for a complementary examination of neural activity and associated metabolic

  2. Oesophageal Doppler guided goal-directed haemodynamic therapy in thoracic surgery - a single centre randomized parallel-arm trial. (United States)

    Kaufmann, K B; Stein, L; Bogatyreva, L; Ulbrich, F; Kaifi, J T; Hauschke, D; Loop, T; Goebel, U


    Postoperative pulmonary and renal complications are frequent in patients undergoing lung surgery. Hyper- and hypovolaemia may contribute to these complications. We hypothesized that goal-directed haemodynamic management based on oesophageal Doppler monitoring would reduce postoperative pulmonary complications in a randomized clinical parallel-arm trial. One hundred patients scheduled for thoracic surgery were randomly assigned to either standard haemodynamic management (control group) or goal-directed therapy (GDT group) guided by an oesophageal Doppler monitoring-based algorithm. The primary endpoint was postoperative pulmonary complications, including spirometry. Secondary endpoints included haemodynamic variables, renal, cardiac, and neurological complications, and length of hospital stay. The investigator assessing outcomes was blinded to group assignment. Forty-eight subjects of each group were analysed. Compared to the control group, fewer subjects in the GDT group developed postoperative pulmonary complications (6 vs. 15 patients; P  = 0.047), while spirometry did not differ between groups. Compared to the control group, patients of the GDT group showed higher cardiac index (2.9 vs. 2.1 [l min - 1 m  - 2 ]; P  < 0.001) and stroke volume index (43 vs. 34 [ml m 2 ]; P  < 0.001) during surgery. Renal, cardiac and neurological complications did not differ between groups. Length of hospital stay was shorter in the GDT compared to the control group (9 vs. 11 days; P  = 0.005). Compared to standard haemodynamic management, oesophageal Doppler monitor-guided GDT was associated with fewer postoperative pulmonary complications and a shorter hospital stay. The study was registered in the German Clinical Trials Register (DRKS 00006961).

  3. Optimized alumina coagulants for water treatment (United States)

    Nyman, May D [Albuquerque, NM; Stewart, Thomas A [Albuquerque, NM


    Substitution of a single Ga-atom or single Ge-atom (GaAl.sub.12 and GeAl.sub.12 respectively) into the center of an aluminum Keggin polycation (Al.sub.13) produces an optimal water-treatment product for neutralization and coagulation of anionic contaminants in water. GaAl.sub.12 consistently shows .about.1 order of magnitude increase in pathogen reduction, compared to Al.sub.13. At a concentration of 2 ppm, GaAl.sub.12 performs equivalently to 40 ppm alum, removing .about.90% of the dissolved organic material. The substituted GaAl.sub.12 product also offers extended shelf-life and consistent performance. We also synthesized a related polyaluminum chloride compound made of pre-hydrolyzed dissolved alumina clusters of [GaO.sub.4Al.sub.12(OH).sub.24(H.sub.2O).sub.12].sup.7+.

  4. Quinine-Induced Disseminated Intravascular Coagulation

    Directory of Open Access Journals (Sweden)

    Firas Abed


    Full Text Available Every drug comes with some side effect. It is the benefit/risk ratio that determines the medical use of the drug. Quinine, a known antimalarial drug, has been used for nocturnal leg cramps since the 1930s; it is associated with severe life-threatening hematological and cardiovascular side effects. Disseminated intravascular coagulation (DIC, albeit rare, is a known coagulopathy associated with Quinine. It is imperative to inquire about the Quinine intake in medication history in patients with coagulopathy, as most patients still consider it a harmless home remedy for nocturnal leg cramps. In this report, we present a case of coagulopathy in a middle-aged woman, who gave a history of taking Quinine for nocturnal leg cramps, as her home remedy. Early identification of the offending agent led to the diagnosis, prompt discontinuation of the medication, and complete recovery and prevented the future possibility of recurrence.

  5. Treatment of Textile Wastewaterby Adsorption and Coagulation

    Directory of Open Access Journals (Sweden)

    Himanshu Patel


    Full Text Available The composite of wastewater treatment was carried out using activated charcoal as adsorbent to remove COD, BOD, color in which various parameters like adsorbent dose, contact duration, temperature and agitator speed were considered. The adsorbent behavior can be explained on the basis of Freundlich and Langmuir adsorption isotherm model. Maximum removal (87.6, 81.0 and 90.0% of COD, BOD and color respectively was found at adsorbent dosage of 11 g/L. Also, the textile mill wastewater was treated with different doses of coagulants like alum, ferric sulphate and ferrous sulphate at constant contact duration (4 hours and room temperature (300 K. Percentage reduction (maximum corresponds to 80.2, 74.0 and 84.9% was obtained for removal of COD, BOD and color respectively.

  6. Laboratory testing in disseminated intravascular coagulation. (United States)

    Toh, C H


    The lack of improvement in the clinical prognosis of disseminated intravascular coagulation (DIC) poses searching questions on the value of current laboratory testing in this area. There is little immediate chance of advancement unless new tests or new modes of analyzing currently available tests place an emphasis on identifying the early phase of DIC. An equal emphasis is also required on practicality to ensure that recommendations are applicable to the routine clinical setting. These two priorities need to be fulfilled to facilitate earlier therapeutic intervention in the clinical trials required for formal assessment of promising and emerging new molecules from successful animal studies. This article therefore discusses the advantages and disadvantages of available assays in DIC with these perspectives in mind. It also proposes a format to bring together the necessary elements required to make an impact on ultimately delivering clinical improvement in this critical area.

  7. Effects of Phenytoin Therapy on Bispectral Index and Haemodynamic Changes Following Induction and Tracheal Intubation

    Directory of Open Access Journals (Sweden)

    Parmod P Bithal


    Full Text Available Laryngoscopy and tracheal intubation (LTI increase blood pressure and heart rate (HR. Intensity of these changes is influenced by the anaesthetic depth assessed by the bispectral index (BIS. We determined the effect of phenytoin on anaesthetic depth and its influence on haemodynamics following LTI. Fifty patients of ASA grades I and II on oral phenytoin 200 to 300mg per day for more than one week were compared with 48 control patients. Standard anaesthesia technique was followed. BIS, non invasive mean blood pressure (MBP and HR were recorded 30, 60, 90 and 120 sec after LTI. Phenytoin group needed lesser thiopentone for induction, 5 mg (1.1 vs. 4.3 mg (0.7 [p=0.036]. BIS was significantly lower in the phenytoin group vs. the control 30, 60, 90 and 120 sec after LTI [43.1 (16.0 vs. 48.9 (14.9, p=0.068, 56.3 (16.7 vs. 64.3 (14.4, p=0.013, 59.8 (15.8 vs. 67.5 (12.1, p=0.008, 62.6 (14 vs. 68.9 (11.2, p=0.017, and 64.2 (11.3 vs. 69 (11.7, p=0.033], respectively. MBP was also lower in the phenytoin group 30, 60, 90 and 120 sec after LTI [112.8 mmHg (13.8, vs. 117.9 mmHg (18 p=0.013, 108.6 (12.8 vs. 117.5 (16 p=0.003, 106.1 mmHg (14.1 vs. 113.2 mmHg (14.9, p=0.017, 101.8 mmHg (13.8 vs. 109.5 mmHg (14.1, p=0.007], respectively. HR was lower in phenytoin group at 30 sec. (p=0.027, 60 sec (p=0.219, and again at 120 sec (p=0.022. Oral phenytoin therapy for over a week results in greater anaesthetic depth as observed using BIS, which also attenuated haemodynamic response of LTI.

  8. Inverse association of total testosterone with central haemodynamics and left ventricular mass in hypertensive men. (United States)

    Vlachopoulos, Charalambos; Pietri, Panagiota; Ioakeimidis, Nikolaos; Aggelis, Athanasios; Terentes-Printzios, Dimitrios; Abdelrasoul, Mahmoud; Gourgouli, Ioanna; Stefanadis, Christodoulos; Tousoulis, Dimitrios


    There is evidence for inverse association between endogenous testosterone and blood pressure. Furthermore, low plasma testosterone is associated with increased risk of major cardiovascular events in middle-aged hypertensive men. Central (aortic) blood pressures determine left ventricular hypertrophy and predict cardiovascular mortality. The aim of the present study was to assess the relationship of total testosterone (TT) with central haemodynamics and left ventricular mass in hypertensive men. We investigated 134 non-diabetic, middle-aged, hypertensive men and 60 age-matched normotensive males. All participants were subject to measurement of aortic systolic (aoSBP) and pulse pressure (aoPP) by pulse wave analysis using the SphygmoCor device. Wave reflections were assessed by the measurement of heart rate corrected augmentation index (AIx75). Echocardiography was performed in all individuals and left ventricular mass (LVM) was calculated using the Devereux's formula. Plasma TT was measured by enzyme immunoassay. In hypertensive men, univariate analysis showed an inverse, significant correlation between TT and aoSBP (r = -20, p = 0.02), aoPP (r = -0.21, p = 0.01), AIx75 (r = -0.22, p = 0.01) and LVM (r = -0.19, p = 0.008). Multivariate regression analysis demonstrated an independent inverse association of TT with aoPP (b = -0.21, p = 0.02), AIx75 (b = -0.19, p = 0.03) and LVM (b = -0.28, p = 0.005) after adjustment for age, BMI, smoking, total cholesterol, triglycerides, fasting glucose, mean arterial pressure, antihypertensive treatment and statin use. Independent associations were retained even after inclusion of normotensive subjects in the analysis. In hypertensive men, TT is independently and inversely associated with central pulse pressure, wave reflections and left ventricular mass. Considering the adverse prognostic role of central blood pressures and LV hypertrophy on cardiovascular outcomes in hypertensive patients, the present

  9. Peripheral haemodynamic effects of inhibition of prostaglandin synthesis in congestive heart failure and interactions with captopril. (United States)

    Townend, J. N.; Doran, J.; Lote, C. J.; Davies, M. K.


    adverse effects of indomethacin on central and peripheral haemodynamic and renal function suggest that prostaglandins have a significant role in the regulation of peripheral blood flow and renal function in patients with stable chronic heart failure. The attenuation by indomethacin of captopril induced improvements in haemodynamic function and renal blood flow is consistent with the hypothesis that captopril may act in part via an increase in prostaglandin synthesis. PMID:7786658

  10. Effects of open and closed suction systems on the haemodynamic parameters in cardiac surgery patients. (United States)

    Özden, Dilek; Görgülü, Refia S


    This study was carried out to determine the effects of open and closed suction systems on haemodynamic parameters of the patients who underwent open heart surgery. Nurses should work meticulously and carefully as many complications may develop if the method used to perform suctioning is not appropriate. The quasi-experimental study design was used. The study sample comprised 120 patients who underwent open heart surgery in the cardiovascular surgery intensive care unit of a state hospital in Turkey. Haemodynamic parameters were determined just before, right after, at the 5th and 15th minute after suctioning. The data were evaluated with the One-Way Analysis of Variance (ANOVA) for Repeated Measures, independent t-test and Bonferroni's test for further analysis (post hoc). The difference between heart rate (HR) and mean blood pressure, mean PaO2 and PaCO2 , SaO2 and pH values measured before, right after and at the 5th and 15th minute after suctioning was found to be significant in patients who underwent the open suctioning procedure. It was determined that the difference between mean PaO2 values was not significant and that SaO2 versus SpO2 values increased in patients who underwent the closed suctioning procedure. When the open and closed suction systems were compared, statistically significant difference was determined in terms of MAP, SpO2 . It was determined that HR, arterial blood pressure and arterial blood gases of the patients who underwent open heart surgery were negatively affected by the open suction system but did not increase significantly as soon as suctioning was over during the closed suctioning procedure. The data obtained indicate that closed system suctioning, compared with open system suctioning, can be used safely on this patient group. The closed suction system is recommended since it contributes to the enhancement of patient safety and the quality of nursing care. © 2014 The Authors. Nursing in Critical Care published by John Wiley & Sons

  11. Influence of ABO type on global coagulation assay results: effect of coagulation factor VIII. (United States)

    Choi, Qute; Kim, Ji-Eun; Kim, Seon Young; Han, Kyou Sup; Kim, Hyun Kyung


    As ABO blood type influences the plasma level of coagulation factor VIII (FVIII), it likely also affects activated partial thromboplastin time (aPTT) and thrombin generation assay (TGA) values. Here, we aimed to investigate the effect of ABO type on the normal values of three global coagulation assays: prothrombin time (PT), aPTT, and TGA. PT, aPTT, TGA [1 or 5 pmol/L tissue factor (TF)], coagulation factors, anticoagulation factors, and ABO type were measured in 200 healthy adults. aPTT was significantly prolonged in those with type O compared with those with type non-O, whereas PT was not significantly different between those with type O and type non-O. The time to peak induced by 5 pmol/L TF was significantly prolonged, and the peak thrombin level was decreased in those with type O compared with those with type non-O. FVIII was a major contributor to the ABO-specific reference range of aPTT, 5 pmol/L TF-induced time to peak, and peak thrombin level. The reference ranges of aPTT and TGA (time to peak and peak thrombin level) differed by ABO type. FVIII level is considered a major contributor to ABO type-specific differences with respect to aPTT and TGA.

  12. Decolorization of dyeing wastewater and characterization of flocs during coagulation by a new composite coagulant. (United States)

    Sun, Cuizhen; Zhao, Yang; Zhang, Zhibin; Zhang, Yanhao; Zhang, Xiaorui


    A composite coagulant, polymeric aluminum ferric chloride-poly-epichlorohydrin-ethylenediamine (PAFC-EPI-ETA), was synthesized and then used for the treatment of synthetic reactive brilliant red (RBR) dyeing wastewater. Effects of (Fe+Al) to EPI-ETA mass ratio (P) on the color removal and zeta potential were investigated under different coagulant dosages and initial pHs. Experimental results indicate that the removal of reactive dye and the charge neutralization ability of composite coagulant were improved by increasing the content of organic EPI-ETA. PAFC-EPI-ETA with P=1 achieved the best color removal percentage and strongest charge neutralization ability. Decolorization efficiency using PAFC-EPI-ETA was quite effecient with pH range of 6.0-7.5 for RBR dye removal. Characteristics of the formed floc were investigated with the dosage of PAFC-EPI-ETA under different P values. The low (Fe+Al) to EPI-ETA mass ratio contributed to the formation of flocs with high growth rate, large size and large size variation.

  13. Effect of ophthalmic administration of S-596 (Arotinolol) on intraocular pressure and haemodynamics in health volunteers: comparison with timolol. (United States)

    Nakashima, M; Uematsu, T; Takiguchi, Y; Hashimoto, H; Watanabe, I; Morioka, S; Hibino, T


    The effects on intraocular pressure (IOP) and haemodynamics of two beta-blockers, arotinolol and timolol, administered topically to the eye, were studied in 6 healthy volunteers in a cross-over trial. 0.5% timolol or 0.5% arotinolol ophthalmic solutions drop was instilled in both eyes of the volunteers at an interval of 48 hours. Timolol lowered IOP by about 31.9% 1 hour after administration and the effect continued until 3 h, whilst arotinolol lowered it significantly 2 h after instillation and the same maximum effect as that of timolol was obtained after 3 h. Arotinolol was detected in blood in all subject and timolol in blood in one subject, although it was found in all subjects in urine. Both drugs lowered heart rate at rest and attenuated the increase in the double product (products of blood pressure and heart rate) at exercise. The effect of timolol on the double products was larger. Thus, arotinolol and timolol decreased IOP to similar extent, although the maximal effect of arotinolol was delayed. Arotinolol as well as timolol affected haemodynamics through absorption into circulation, but the former had less effect on haemodynamics during exercise.

  14. A clinical manifestation-based prediction of haemodynamic patterns of orthostatic intolerance in children: a multi-centre study. (United States)

    Chen, Li; Li, Xueying; Todd, Ochs; Wang, Cheng; Jin, Hongfang; Du, Junbao


    At present, the haemodynamic diagnosis of orthostatic intolerance is based mainly on the head-up tilt table test, which is sometimes risky for patients. Thus, it is important to find objective and safe methods to differentiate haemodynamic patterns of orthostatic intolerance cases. In all, 629 children with orthostatic intolerance, either vasovagal syncope or postural orthostatic tachycardia syndrome, were included in the multi-centre clinical study. We analysed the association between the clinical manifestation and haemodynamic patterns of the patients. Syncope after motion with a prodrome of chest distress or palpitations and the concomitant symptom(s) after a syncopal attack, with debilitation, dizziness or headache, were the most important variables in predicting the diagnosis of vasovagal syncope. The overall diagnostic accuracy was 71.5%. Complaint of syncope after motion with prodromal chest distress or palpitation and the concomitant symptom after a syncopal attack, with subsequent debilitation, dizziness or headache, were the most important variables in the diagnosis of vasovagal syncope in children with orthostatic intolerance.

  15. Heart-rate adjustment of transcatheter haemodynamics improves the prognostic evaluation of paravalvular regurgitation after transcatheter aortic valve implantation. (United States)

    Jilaihawi, Hasan; Chakravarty, Tarun; Shiota, Takahiro; Rafique, Asim; Harada, Kenji; Shibayama, Kentaro; Doctor, Niraj; Kashif, Mohammad; Nakamura, Mamoo; Mirocha, James; Rami, Tejas; Okuyama, Kazuaki; Cheng, Wen; Sadruddin, Omar; Siegel, Robert; Makkar, Raj R


    Paravalvular aortic regurgitation (PVAR) after balloon-expandable transcatheter aortic valve implantation (TAVI) remains difficult to quantify, and the utility of the AR index (ARi) to create a composite aortic insufficiency (CAI) score was an important advance. Heart rate (HR) influences the ARi but the clinical relevance of this phenomenon remains poorly appreciated. We sought to validate a new composite heart-rate-adjusted haemodynamic-echocardiographic aortic insufficiency (CHAI) score in the prognostic evaluation of PVAR after balloon-expandable TAVI. The severity of PVAR was assessed immediately post TAVI by transoesophageal echocardiography (TOE) with simultaneous assessment of transcatheter haemodynamics. A total of 303 patients were studied. The CHAI score, incorporating the HR-adjusted diastolic-delta (HRA-DD, the difference between left ventricular and aortic diastolic pressures/HR*80), had a greater discriminatory value for one-year mortality than both PVAR by TOE (p=0.0018) and the previously proposed CAI score, based on the ARi without HR adjustment (p=0.0029). The CHAI score also better stratified percentage increases in left ventricular systolic chamber dimensions at one month and serum natriuretic peptide levels at one to three months. Prognostication of PVAR in the intermediate range of echocardiographic severity remains unreliable and is greatly enhanced by the integration of heart-rate-adjusted transcatheter haemodynamics.

  16. Treatment of waste water by coagulation and flocculation using biomaterials (United States)

    Muruganandam, L.; Saravana Kumar, M. P.; Jena, Amarjit; Gulla, Sudiv; Godhwani, Bhagesh


    The present study deals with the determination of physical and chemical parameters in the treatment process of waste water by flocculation and coagulation processes using natural coagulants and assessing their feasibility for water treatment by comparing the performance with each other and with a synthetic coagulant. Initial studies were done on the synthetic waste water to determine the optimal pH and dosage, the activity of natural coagulant, followed by the real effluent from tannery waste. The raw tannery effluent was bluish-black in colour, mildly basic in nature, with high COD 4000mg/l and turbidity in the range 700NTU, was diluted and dosed with organic coagulants, AloeVera, MoringaOleifera and Cactus (O.ficus-indica). The study observed that coagulant Moringa Oleifera of 15 mg/L dose at 6 pH gave the best reduction efficiencies for major physicochemical parameters followed by Aloe Vera and Cactus under identical conditions. The study reveals that the untreated tannery effluents can be treated with environmental confirmative naturally occurring coagulants.

  17. Nanoparticles and the blood coagulation system. Part II: safety concerns (United States)

    Ilinskaya, Anna N; Dobrovolskaia, Marina A


    Nanoparticle interactions with the blood coagulation system can be beneficial or adverse depending on the intended use of a nanomaterial. Nanoparticles can be engineered to be procoagulant or to carry coagulation-initiating factors to treat certain disorders. Likewise, they can be designed to be anticoagulant or to carry anticoagulant drugs to intervene in other pathological conditions in which coagulation is a concern. An overview of the coagulation system was given and a discussion of a desirable interface between this system and engineered nanomaterials was assessed in part I, which was published in the May 2013 issue of Nanomedicine. Unwanted pro- and anti-coagulant properties of nanoparticles represent significant concerns in the field of nanomedicine, and often hamper the development and transition into the clinic of many promising engineered nanocarriers. This part will focus on the undesirable effects of engineered nanomaterials on the blood coagulation system. We will discuss the relationship between the physicochemical properties of nanoparticles (e.g., size, charge and hydrophobicity) that determine their negative effects on the blood coagulation system in order to understand how manipulation of these properties can help to overcome unwanted side effects. PMID:23730696

  18. Coagulation pretreatment of highly concentrated acrylonitrile wastewater from petrochemical plants. (United States)

    Zheng, Dongju; Qin, Lin; Wang, Tao; Ren, Xiaojing; Zhang, Zhongguo; Li, Jiding


    Acrylonitrile (AN) wastewater is a heavily polluted and a likely hazardous liquid that is generated during the production of AN. Several chemical methods for the pretreatment of AN wastewater are available in laboratory scale. However, the harsh reaction conditions and high operational cost make these methods undesirable. Until now, four-effect evaporation is the only pretreatment method used for AN wastewater in industry despite its huge energy consumption and high cost. It is difficult to find an energy-saving pretreatment technique from the perspective of industrial application. In this study, a safe and low-cost coagulation technique was developed for the pretreatment of AN wastewater. Three types of inorganic coagulant and three types of polymer coagulant were investigated for the coagulation treatment of highly concentrated AN wastewater from petrochemical plants. The effects of coagulant type, dosage, and coagulation conditions on the pretreatment efficiency of AN wastewater were investigated. The results show that a combination of inorganic and polymer coagulants is effective for the pretreatment of AN wastewater.

  19. Evaluation of acid-base disorders in dogs and cats presenting to an emergency room. Part 1: comparison of three methods of acid-base analysis. (United States)

    Hopper, Kate; Epstein, Steven E; Kass, Philip H; Mellema, Matthew S


    To compare the diagnostic performance of the traditional approach to acid-base analysis with the Stewart approach and a semiquantitative approach. Prospective cohort study. University teaching hospital. A total number of 84 dogs and 14 cats presenting to a university teaching hospital emergency room. All dogs and cats in which venous blood samples for acid-base, lactate, and serum biochemical analysis were all collected within 60 minutes of each other, over a 5-month enrollment period. Acid-base analysis was performed using the traditional approach, Stewart approach, and a semiquantitative approach. Traditional acid-base analysis identified respiratory acid-base abnormalities in 14/98 animals and metabolic acid-base abnormalities in 67/98. A mixed disorder of metabolic acidosis and respiratory alkalosis was most common occurring in 29/98 patients. The Stewart approach identified metabolic abnormalities in 82/98 patients; strong ion difference abnormalities were evident in 68/98 cases; an increased strong ion gap acidosis was identified in 49/98 cases; and changes in the quantity of weak acids in 25/98 cases. The semiquantitative approach identified abnormalities in all cases evaluated. Of the 14 patients with a primary respiratory acid-base abnormality, the Stewart approach identified metabolic abnormalities in 9 and the semiquantitative approach found abnormalities in all animals. The physicochemical approaches diagnosed more acid-base abnormalities in this population than the traditional approach although many of the abnormalities identified were small and of unknown clinical relevance. The physicochemical approaches may provide greater insight as to the underlying etiology of abnormalities, which maybe of particular relevance to cases with changes in albumin and/or phosphorus concentration. © Veterinary Emergency and Critical Care Society 2014.

  20. Acid-base thermochemistry of gaseous aliphatic α-aminoacids. (United States)

    Bouchoux, Guy; Huang, Sihua; Inda, Bhawani Singh


    Acid-base thermochemistry of isolated aliphatic amino acids (denoted AAA): glycine, alanine, valine, leucine, isoleucine and proline has been examined theoretically by quantum chemical computations at the G3MP2B3 level. Conformational analysis on neutral, protonated and deprotonated species has been used to identify the lowest energy conformers and to estimate the population of conformers expected to be present at thermal equilibrium at 298 K. Comparison of the G3MP2B3 theoretical proton affinities, PA, and ΔH(acid) with experimental results is shown to be correct if experimental thermochemistry is re-evaluated and adapted to the most recent acidity-basicity scales. From this point of view, a set of evaluated proton affinities of 887, 902, 915, 916, 919 and 941 kJ mol(-1), and a set of evaluated ΔH(acid) of 1433, 1430, 1423, 1423, 1422 and 1426 kJ mol(-1), is proposed for glycine, alanine, valine, leucine, isoleucine and proline, respectively. Correlations with structural parameters (Taft's σ(α) polarizability parameter and molecular size) suggest that polarizability of the side chain is the major origin of the increase in PA and decrease in ΔH(acid) along the homologous series glycine, alanine, valine and leucine/isoleucine. Heats of formation of gaseous species AAA, AAAH(+) and [AAA-H](-) were computed at the G3MP2B3 level. The present study provides previously unavailable Δ(f)H°(298) for the ionized species AAAH(+) and [AAA-H](-). Comparison with Benson's estimate, and correlation with molecular size, show that several experimental Δ(f)H°(298) values of neutral or gaseous AAA might be erroneous.

  1. Pathophysiological aspect of metabolic acid-base disorders

    Directory of Open Access Journals (Sweden)

    Nešović-Ostojić Jelena


    Full Text Available Maintaing the arterial pH values (in normal range of 7,35-7,45 is one of the main principles of homeostasis. Regulatory responses, including chemical buffering (extracellular, intracellular, sceletal, the regulation of pCO2 by the respiratory system, and the regulation of [HCO3-] by the kidneys, act in concert to maintain normal arterial pH value. The main extracellular chemical buffer is bicarbonate-carbonic acid buffer system. The kidneys contribute to the regulation of hydrogen (and bicarbonate in body fluids in two ways. Proximal tubules are important in bicarbonate reabsorption and distal tubules excrete hydrogen ion (as ammonium ion or titratable acid. There are four simple acid-base disorders: metabolic acidosis and metabolic alkalosis; respiratory acidosis and respiratory alkalosis. Metabolic acidosis can occur because of an increase in endogenous acid production (such as lactate and ketoacids, loss of bicarbonate (as in diarrhea, or accumulation of endogenous acids (as in renal failure. Metabolic acidosis can also be with high and normal (hyperchloremic metabolic acidosis anion gap. Renal tubular acidosis (RTA is a form of hyperchloremic metabolic acidosis which occurs when the renal damage primarily affects tubular function. The main problem in distal RTA is reduced H+ excretion in distal tubule. Type 2 RTA is also called proximal RTA because the main problem is greatly impaired reabsorption of bicarbonate in proximal tubule. Impaired cation exchange in distal tubule is the main problem in RTA type 4. Metabolic alkalosis occurs as a result of net gain of [HCO3-] or loss of nonvolatile acid from extracellular fluids. Metabolic alkalosis can be associated with reduced or increased extracellular volume.

  2. Polarizable model potential function for nucleic acid bases. (United States)

    Nakagawa, Setsuko


    A polarizable model potential (PMP) function for adenine (A), cytosine (C), guanine (G), thymine (T), and uracil (U) is developed on the basis of ab initio molecular orbital calculations at the MP2/6-31+G* level. The PMP function consists of Coulomb, van der Waals, and polarization terms. The permanent atomic charges of the Coulomb term are determined by using electrostatic potential (ESP) optimization. The multicenter polarizabilities of the polarization term are determined by using polarized one-electron potential (POP) optimization in which the electron density changes induced by a test charge are target. Isotropic and anisotropic polarizabilities are adopted as the multicenter polarizabilities. In the PMP calculations using the optimized parameters, the interaction energies of Watson-Crick type A-T and C-G base pairs were -15.6 and -29.4 kcal/mol, respectively. The interaction energy of Hoogsteen type A-T base pair was -17.8 kcal/mol. These results reproduce well the quantum chemistry calculations at the MP2/6-311++G(3df,2pd) level within the differences of 0.6 kcal/mol. The stacking energies of A-T and C-G were -9.7 and -10.9 kcal/mol. These reproduce well the calculation results at the MP2/6-311++G (2d,2p) level within the differences of 1.3 kcal/mol. The potential energy surfaces of the system in which a sodium ion or a chloride ion is adjacent to the nucleic acid base are calculated. The interaction energies of the PMP function reproduced well the calculation results at the MP2/6-31+G* or MP2/6-311++G(2d,2p) level. The reason why the PMP function reproduces well the high-level quantum mechanical interaction energies is addressed from the viewpoint of each energy terms. Copyright (c) 2007 Wiley Periodicals, Inc.

  3. Usefulness of human coagulation and fibrinolysis assays in domestic pigs

    DEFF Research Database (Denmark)

    Münster, Anna-Marie Bloch; Olsen, Aage Kristian; Bladbjerg, Else-Marie


    Pigs are often used as animal models in research on blood coagulation and fibrinolysis. The usefulness of the assays applied within this field, and the knowledge of reference intervals are therefore essential and of utmost importance. In the study reported here, we investigated the applicability...... of commercial human coagulation and fibrinolysis assays for use with porcine plasma. In total, 22 functional and immunologic assays were applied to plasma obtained from domestic pigs, and the following blood coagulation and fibrinolysis variables were measured: prothrombin time, activated partial thromboplastin...

  4. A loop of coagulation factor VIIa influencing macromolecular substrate specificity

    DEFF Research Database (Denmark)

    Bjelke, Jais R; Persson, Egon; Rasmussen, Hanne B


    Coagulation factor VIIa (FVIIa) belongs to a family of proteases being part of the stepwise, self-amplifying blood coagulation cascade. To investigate the impact of the mutation Met(298{156})Lys in FVIIa, we replaced the Gly(283{140})-Met(298{156}) loop with the corresponding loop of factor Xa....../Met(298{156})Lys-FVIIa with almost the same activity and specificity profile. We conclude that a lysine residue in position 298{156} of FVIIa requires a hydrophilic environment to be fully accommodated. This position appears critical for substrate specificity among the proteases of the blood coagulation...

  5. Implementation of a microcontroller-based semi-automatic coagulator. (United States)

    Chan, K; Kirumira, A; Elkateeb, A


    The coagulator is an instrument used in hospitals to detect clot formation as a function of time. Generally, these coagulators are very expensive and therefore not affordable by a doctors' office and small clinics. The objective of this project is to design and implement a low cost semi-automatic coagulator (SAC) prototype. The SAC is capable of assaying up to 12 samples and can perform the following tests: prothrombin time (PT), activated partial thromboplastin time (APTT), and PT/APTT combination. The prototype has been tested successfully.

  6. Investigation of depth dependent changes in cerebral haemodynamics during face perception in infants

    Energy Technology Data Exchange (ETDEWEB)

    Blasi, A [Biomedical Optics Research Lab, Department of Medical Physics and Bioengineering, Malet Place Engineering Building, University College London, London WC1E 6BT (United Kingdom); Fox, S [Centre for Brain and Cognitive Development, Henry Wellcome Building, Birkbeck College, University of London, Malet Street, London WC1E 7HX (United Kingdom); Everdell, N [Biomedical Optics Research Lab, Department of Medical Physics and Bioengineering, Malet Place Engineering Building, University College London, London WC1E 6BT (United Kingdom); Volein, A [Centre for Brain and Cognitive Development, Henry Wellcome Building, Birkbeck College, University of London, Malet Street, London WC1E 7HX (United Kingdom); Tucker, L [Centre for Brain and Cognitive Development, Henry Wellcome Building, Birkbeck College, University of London, Malet Street, London WC1E 7HX (United Kingdom); Csibra, G [Centre for Brain and Cognitive Development, Henry Wellcome Building, Birkbeck College, University of London, Malet Street, London WC1E 7HX (United Kingdom); Gibson, A P [Biomedical Optics Research Lab, Department of Medical Physics and Bioengineering, Malet Place Engineering Building, University College London, London WC1E 6BT (United Kingdom); Hebden, J C [Biomedical Optics Research Lab, Department of Medical Physics and Bioengineering, Malet Place Engineering Building, University College London, London WC1E 6BT (United Kingdom); Johnson, M H [Centre for Brain and Cognitive Development, Henry Wellcome Building, Birkbeck College, University of London, Malet Street, London WC1E 7HX (United Kingdom); Elwell, C E [Biomedical Optics Research Lab, Department of Medical Physics and Bioengineering, Malet Place Engineering Building, University College London, London WC1E 6BT (United Kingdom)


    Near-infrared spectroscopy has been used to record oxygenation changes in the visual cortex of 4 month old infants. Our in-house topography system, with 30 channels and 3 different source-detector separations, recorded changes in the concentration of oxy-, deoxy- and total haemoglobin (HbO{sub 2}, HHb and HbT) in response to visual stimuli (face, scrambled visual noise and cartoons as rest). The aim of this work was to demonstrate the capability of the system to spatially localize functional activation and study the possibility of depth discrimination in the haemodynamic response. The group data show both face stimulation and visual noise stimulation induced significant increases in HbO{sub 2} from rest, but the increase in HbO{sub 2} with face stimulation was not significantly different from that seen with visual noise stimulation. The face stimuli induced increases in HbO{sub 2} were spread across a greater area across all depths than visual noise induced changes. In results from a single subject there was a significant increase of HbO{sub 2} in the inferior area of the visual cortex in response to both types of stimuli, and a larger number of channels (source-detector pairs) showed HbO{sub 2} increase to face stimuli, especially at the greatest depth. Activation maps were obtained using 3D reconstruction methods on multi source-detector separation optical topography data.

  7. Percutaneous balloon dilatation of calcific aortic valve stenosis: anatomical and haemodynamic evaluation. (United States)

    Commeau, P; Grollier, G; Lamy, E; Foucault, J P; Durand, C; Maffei, G; Maiza, D; Khayat, A; Potier, J C


    Two groups of elderly patients with calcified aortic stenosis were treated by balloon dilatation. In group 1, the valve was dilated just before surgical replacement of the valve. The valvar and annular changes occurring during dilatation were examined visually. In 20 of the 26 patients in this group there was no change. In the six remaining patients mobilisation of friable calcific deposits (1 case), slight tearing of the commissure (4 cases), or tearing of the aortic ring (1 case) were seen. Dilatation did not appear to alter valvar rigidity. In 14 patients (group 2) the haemodynamic gradient across the aortic valve was measured before and immediately after dilatation and one week after the procedure. Dilatation produced an immediate significant decrease of the aortic mean gradient and a significant increase of the aortic valve area. Eight days later the mean gradient had increased and the aortic valve area had decreased. Nevertheless there was a significant difference between the initial gradient and the gradient eight days after dilatation. The initial aortic valve area was also significantly larger than the area eight days after dilatation. The aortic valve gradient rose significantly in the eight days after dilatation and at follow up the gradients were those of severe aortic stenosis. Images Fig 1 Fig 2 Fig 3 Fig 4 Fig 5 Fig 6 Fig 7 PMID:3342163

  8. SPH simulations of WBC adhesion to the endothelium: the role of haemodynamics and endothelial binding kinetics. (United States)

    Gholami, Babak; Comerford, Andrew; Ellero, Marco


    A multiscale Lagrangian particle solver introduced in our previous work is extended to model physiologically realistic near-wall cell dynamics. Three-dimensional simulation of particle trajectories is combined with realistic receptor-ligand adhesion behaviour to cover full cell interactions in the vicinity of the endothelium. The selected stochastic adhesion model, which is based on a Monte Carlo acceptance-rejection method, fits in our Lagrangian framework and does not compromise performance. Additionally, appropriate inflow/outflow boundary conditions are implemented for our SPH solver to enable realistic pulsatile flow simulation. The model is tested against in-vitro data from a 3D geometry with a stenosis and sudden expansion. In both steady and pulsatile flow conditions, results show close agreement with the experimental ones. Furthermore we demonstrate, in agreement with experimental observations, that haemodynamics alone does not account for adhesion of white blood cells, in this case U937 monocytic human cells. Our findings suggest that the current framework is fully capable of modelling cell dynamics in large arteries in a realistic and efficient manner.

  9. First clinical evaluation of an atrial haemodynamic sensor lead for automatic optimization of cardiac resynchronization therapy. (United States)

    Duncker, David; Delnoy, Peter Paul; Nägele, Herbert; Mansourati, Jacques; Mont, Lluís; Anselme, Frédéric; Stengel, Petra; Anselmi, Francesca; Oswald, Hanno; Leclercq, Christophe


    One option to improve cardiac resynchronization therapy (CRT) responder rates lies in the optimization of pacing intervals. A haemodynamic sensor embedded in the SonRtip atrial lead measures cardiac contractility and provides a systematic automatic atrioventricular and interventricular delays optimization. This multi-centre study evaluated the safety and performance of the lead, up to 1 year. A total of 99 patients were implanted with the system composed of the lead and a CRT-Defibrillator device. Patients were followed at 1, 3, 6, and 12 months post-implant. The primary safety objective was to demonstrate that the atrial lead complication free rate was superior to 90% at 3-months follow-up visit. A lead handling questionnaire was filled by implanting investigators. Lead electrical performances and the performance of the system to compute AV and VV delays were evaluated at each study visit over 1 year. The complication free rate at 3 months post-implant was 99.0% [95%CI 94.5-100.0%], P 75% of the weeks. The atrial lead is safe to implant and shows stable electrical performance over time. It therefore offers a promising tool for automatic CRT optimization to further improve responder rates to CRT. © The Author 2015. Published by Oxford University Press on behalf of the European Society of Cardiology.

  10. Effects of magnesium sulphate on cerebral haemodynamics in healthy volunteers: a transcranial Doppler study. (United States)

    Sherman, R; Armory, P; Moody, P; Hope, T; Mahajan, R P


    Magnesium is increasingly being considered as a neuroprotective agent. We aimed to study its effects on middle cerebral artery blood flow velocity (V(mca)), cerebral autoregulation and cerebral vascular reactivity to carbon dioxide (CRCO(2)) in healthy volunteers. Fifteen healthy volunteers were recruited. Using transcranial Doppler ultrasonography, V(mca) was recorded continuously. The strength of autoregulation was assessed by the transient hyperaemic response test, and the CRCO(2) was measured by assessing changes in V(mca) to the induced changes in end-tidal carbon dioxide. I.V. infusion of magnesium sulphate was then started (loading dose of 16 mmol followed by an infusion at the rate of 2.7 mmol h(-1)) for 45 min. The cerebral haemodynamic variables were measured again near the end of the infusion of magnesium sulphate. Total serum magnesium levels were doubled by the infusion regimen. However, there were no significant changes in V(mca), strength of autoregulation, or CRCO(2). Five of the volunteers reported marked nausea and two developed significant hypotension during the loading dose. Infusion of magnesium sulphate, in a dose that doubles its concentration in plasma, does not affect V(mca), strength of autoregulation or CRCO(2) in healthy volunteers. However, it can be associated with nausea and hypotension.

  11. Qualitative haemodynamic validation of a percutaneous temporary aortic valve: a proof of concept study. (United States)

    Ho, P C


    The concept of temporary aortic valves has been suggested in the clinical settings of acute aortic regurgitation and transcatheter aortic valve replacement procedure (TAVR). In TAVR, suggestions have been made to pre-treat or remove the diseased aortic valve prior to implantation of the replacement valve. A successful temporary aortic valve must demonstrate the ability to prevent life-threatening haemodynamics of massive aortic regurgitation. A novel temporary aortic valve (TAV) design, comprised of inflatable balloon elements as a check-valve, can readily be deployed and retrieved via a catheter-system. A simple flow model is set up to test the TAV's performance in severe aortic regurgitation. With induced aortic regurgitation, placement of the TAV is found to increase the distal aortic diastolic pressure, to reduce the widened pulse pressure, to protect proximal aorta-left ventricle from diastolic pressure elevation and to reduce the aortic regurgitant volume. In conclusion, continued development of the TAV system can lead to a successful temporary aortic valve to be used in various appropriate clinical settings.

  12. Downhill exercise training in monocrotaline-injected rats: Effects on echocardiographic and haemodynamic variables and survival. (United States)

    Enache, Irina; Favret, Fabrice; Doutreleau, Stéphane; Goette Di Marco, Paola; Charles, Anne-Laure; Geny, Bernard; Charloux, Anne


    Eccentric exercise training has been shown to improve muscle force strength without excessive cardiovascular stress. Such an exercise modality deserves to be tested in pulmonary arterial hypertension. We aimed to assess the effects of an eccentric training modality on cardiac function and survival in an experimental monocrotaline-induced model of pulmonary arterial hypertension with right ventricular dysfunction. Forty rats were randomly assigned to one of four groups: 40mg/kg monocrotaline-injected sedentary rats; 40mg/kg monocrotaline-injected eccentric-trained rats; sedentary control rats; or eccentric-trained control rats. Eccentric exercise training consisted of downhill running on a treadmill with a -15° slope for 30minutes, 5 days a week for 4 weeks. Training tolerance was assessed by echocardiography, right ventricle catheterization and the rats' maximal eccentric speed. Survival in monocrotaline-injected eccentric-trained rats was not different from that in monocrotaline-injected sedentary rats. Monocrotaline-injected eccentric-trained rats tolerated this training modality well, and haemodynamic status did not deteriorate further compared with monocrotaline-injected sedentary rats. The eccentric maximal speed decline was less pronounced in trained compared with sedentary pulmonary arterial hypertension rats. Eccentric exercise training had no detrimental effects on right heart pressure, cardiac function and survival in rats with stable monocrotaline-induced pulmonary hypertension. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  13. Interrelationship between haemodynamic state and serum intact parathyroid hormone levels in patients with chronic heart failure. (United States)

    Sugimoto, Tadafumi; Dohi, Kaoru; Onishi, Katsuya; Watanabe, Kiyotaka; Sato, Yuichi; Sugiura, Emiyo; Nakamori, Shiro; Nakajima, Hiroshi; Nakamura, Mashio; Ito, Masaaki


    To assess the impact of serum intact parathyroid hormone (PTH) levels on haemodynamic state and their relations by comparing plasma B-type natriuretic peptide (BNP) levels. Cross-sectional study in molecular epidemiology. Mie University Hospital, Tsu, Japan. Consecutive 105 patients with chronic heart failure (CHF). Serum intact PTH and plasma BNP levels were assessed simultaneously with right heart catheterisation. Although serum intact PTH levels (46±25 pg/ml) were within the normal range (levels significantly correlated with pulmonary capillary wedge pressure (PCWP: 15±9 mm Hg, r=0.55, pheart rate (73±14/min, r=0.40, plevels were inversely correlated with stroke volume index (SVI: 38±11 ml/m(2), r=-0.52, plevels (β=0.40 and -0.37, plevels were an independent determinant of PCWP, SVI, heart rate and cardiac index (β=0.38, -0.33, 0.32, and -0.25, plevels using stepwise multivariate regression analyses. Increased PCWP and decreased SVI independently contribute to elevated intact PTH in patients with CHF.

  14. Neonatal haemodynamic effects following foetal exposure to labetalol in hypertensive disorders of pregnancy. (United States)

    Thewissen, Liesbeth; Pistorius, Lou; Baerts, Wim; Naulaers, Gunnar; Van Bel, Frank; Lemmers, Petra


    Hypertensive disorders of pregnancy (HDP) affect foetal outcome. Labetalol is frequently used to lower maternal blood pressure and prolong pregnancy. Conflicting evidence exists for specific neonatal side effects described after maternal labetalol treatment. Our aim was to investigate neonatal effects of foetal exposure to labetalol on cerebral oxygenation and extraction. In a prospective observational study, clinical characteristics, vital parameters and cerebral oxygen delivery and extraction were collected during the first 24 h of life in labetalol-exposed preterm neonates and compared with two control groups. Twenty-two infants with a mean gestational age of 28.9 weeks, born from labetalol-treated mothers with HDP were included and matched with 22 infants with non-labetalol-treated mothers with HDP and 22 infants without maternal HDP. No significant differences between groups were found neither in heart rate, blood pressure and inotropic support, nor in mean regional cerebral oxygen saturation and fractional tissue oxygen extraction. Foetal labetalol exposure associated effects on preterm heart rate, blood pressure, cerebral oxygenation and extraction are not demonstrated. Maternal disease severity seems to play a more important role in neonatal cerebral haemodynamics. Maternal labetalol treatment has no clinically important short term side effects in the preterm neonate.

  15. Randomized study of coagulation and fibrinolysis during and after gasless and conventional laparoscopic cholecystectomy

    DEFF Research Database (Denmark)

    Larsen, J F; Ejstrud, P; Svendsen, F


    BACKGROUND: Carbon dioxide pneumoperitoneum may be an important pathophysiological factor stimulating the coagulation system during conventional laparoscopic cholecystectomy. The aim of this study was to test the hypothesis that gasless laparoscopy produces smaller changes in the coagulation...... increased significantly in both groups (P coagulation and fibrinolysis associated with laparoscopic cholecystectomy. The coagulation and fibrinolytic systems are activated during and after gasless as well...

  16. Calculation of the rate of coagulation of hydrophobic colloids in the non-steady state

    NARCIS (Netherlands)

    Roebersen, G.J.; Wiersema, P.H.


    In accurate coagulation measurements, the observed coagulation rate should be extrapolated to time zero to find the rate of formation of doublets from singlet particles. In the theoretical calculation of coagulation rates, generally a steady state is assumed. At the onset of coagulation, however, a

  17. Effect of copper(II) on natural organic matter removal during drinking water coagulation using aluminum-based coagulants. (United States)

    Liu, Guojing; Zhang, Xiangru; Talley, Jeffrey W


    Coagulation has been proposed as a best available technology for controlling natural organic matter (NOM) during drinking water treatment. The presence of heavy metals such as copper(II) in source water, which may form copper-NOM complexes and/or interact with a coagulant, may pose a potential challenge on the coagulation of NOM. In this work, the effect of copper(II) on NOM removal by coagulation using alum or PAX-18 (a commercial polymerized aluminum chloride from Kemiron Inc., Bartow, Florida) was examined. The results show that the presence of 1 to 10 mg/L of copper(H) in the simulated waters improved the total organic carbon (TOC) removal by up to 25% for alum coagulation and by up to 22% for PAX-18 coagulation. The increased NOM removal with the presence of copper(II) in the waters can most likely be ascribed to the formation copper-NOM complexes that may be more adsorbable on aluminum precipitates and to the formation of copper(II) co-precipitates that may also adsorb NOM. The presence of 1 to 5 mg/L of copper(I) in the waters containing 3 mg/L NOM as carbon was reduced below the maximum contaminant level goal (1.3 mg/L as copper) using either coagulant. The results suggest that the presence of copper(H) in source water may not adversely affect the NOM removal by coagulation. A good linear correlation was observed between the TOC removal efficiency and the log-total moles of the precipitated metals, which include the metal ion from a coagulant and the divalent metal ion(s) in source water.

  18. Removal of titanium dioxide nanoparticles by coagulation: effects of coagulants, typical ions, alkalinity and natural organic matters. (United States)

    Wang, H T; Ye, Y Y; Qi, J; Li, F T; Tang, Y L


    To investigate the possibility of removing titanium dioxide nanoparticles (TiO2 NPs) from water by coagulation, as well as to find the optimal coagulant and experimental conditions for TiO2 NP removal, four types of coagulant were adopted: polyferric sulfate (PFS), ferric chloride (FeCl3), polyaluminum chloride (PACl), and alum (Al2(SO4)3). It was found that the removal of TiO2 NPs by coagulation was affected by ionic strength, alkalinity, as well as types and dosages of coagulants. PFS and FeCl3 achieved much higher removal efficiency of TiO2 NPs than PACl and Al2(SO4)3 did. For 30 mg/L TiO2 NPs, a dosage of 0.3 mM PFS (as Fe) achieved 84% removal after coagulation followed by 30 min settlement. Optimal ionic strength (0.1 M NaCl or 0.03 M CaCl2) is of vital importance for the performance of PFS. Na2SO4 is unfavorable for the performance of PFS. Optimal alkalinity (0.01-0.03 M NaHCO3) is necessary for FeCl3 to remove TiO2 NPs. Natural organic matter, as represented by humic acid (HA) up to 11 mg/L, reduces the removal of TiO2 NPs by coagulation. These findings indicate that coagulation is a good option for the removal of TiO2 NPs from water, and more attention should be paid to the effects of water quality when using coagulation to remove TiO2 NPs from aqueous matrices. This provides a possible solution to alleviate the potential hazard caused by TiO2 NPs.

  19. Potential Use of Polyaluminium Chloride and Tobacco Leaf as Coagulant and Coagulant Aid in Post-Treatment of Landfill Leachate


    Nurfarahim Rusdizal; Hamidi Abdul Aziz; Mohd Omar Fatehah


    A study was conducted to treat stabilized leachate by applying polyaluminium chloride (PAC) and tobacco leaf extract as a coagulant and coagulant aid. Experimental results indicated that the tobacco leaves were positively charged. The removal rate of the chemical oxygen demand, using 1500 mg/L PAC as a sole coagulant, was approximately 63% and increased to 91% when 1000 mg/L PAC was mixed with 1000 mg/L tobacco leaf. Additionally, 1500 mg/L PAC with 250 - 1000 mg/L tobacco leaf and 54% ammoni...

  20. Stewart analysis of apparently normal acid-base state in the critically ill

    NARCIS (Netherlands)

    Moviat, M.; Boogaard, M. van den; Intven, F.; Voort, P. van der; Hoeven, H. van der; Pickkers, P.


    PURPOSE: This study aimed to describe Stewart parameters in critically ill patients with an apparently normal acid-base state and to determine the incidence of mixed metabolic acid-base disorders in these patients. MATERIALS AND METHODS: We conducted a prospective, observational multicenter study of

  1. Using the Logarithmic Concentration Diagram, Log "C", to Teach Acid-Base Equilibrium (United States)

    Kovac, Jeffrey


    Acid-base equilibrium is one of the most important and most challenging topics in a typical general chemistry course. This article introduces an alternative to the algebraic approach generally used in textbooks, the graphical log "C" method. Log "C" diagrams provide conceptual insight into the behavior of aqueous acid-base systems and allow…

  2. A Comparative Study of French and Turkish Students' Ideas on Acid-Base Reactions (United States)

    Cokelez, Aytekin


    The goal of this comparative study was to determine the knowledge that French and Turkish upper secondary-school students (grades 11 and 12) acquire on the concept of acid-base reactions. Following an examination of the relevant curricula and textbooks in the two countries, 528 students answered six written questions about the acid-base concept.…

  3. Thai Grade 11 Students' Alternative Conceptions for Acid-Base Chemistry (United States)

    Artdej, Romklao; Ratanaroutai, Thasaneeya; Coll, Richard Kevin; Thongpanchang, Tienthong


    This study involved the development of a two-tier diagnostic instrument to assess Thai high school students' understanding of acid-base chemistry. The acid-base diagnostic test (ABDT) comprising 18 items was administered to 55 Grade 11 students in a science and mathematics programme during the second semester of the 2008 academic year. Analysis of…

  4. High School Students' Understanding of Acid-Base Concepts: An Ongoing Challenge for Teachers (United States)

    Damanhuri, Muhd Ibrahim Muhamad; Treagust, David F.; Won, Mihye; Chandrasegaran, A. L.


    Using a quantitative case study design, the "Acids-Bases Chemistry Achievement Test" ("ABCAT") was developed to evaluate the extent to which students in Malaysian secondary schools achieved the intended curriculum on acid-base concepts. Responses were obtained from 260 Form 5 (Grade 11) students from five schools to initially…

  5. Collaborative Strategies for Teaching Common Acid-Base Disorders to Medical Students (United States)

    Petersen, Marie Warrer; Toksvang, Linea Natalie; Plovsing, Ronni R.; Berg, Ronan M. G.


    The ability to recognize and diagnose acid-base disorders is of the utmost importance in the clinical setting. However, it has been the experience of the authors that medical students often have difficulties learning the basic principles of acid-base physiology in the respiratory physiology curriculum, particularly when applying this knowledge to…

  6. Canonical Pedagogical Content Knowledge by Cores for Teaching Acid-Base Chemistry at High School (United States)

    Alvarado, Clara; Cañada, Florentina; Garritz, Andoni; Mellado, Vicente


    The topic of acid-base chemistry is one of the oldest in general chemistry courses and it has been almost continuously in academic discussion. The central purpose of documenting the knowledge and beliefs of a group of ten Mexican teachers with experience in teaching acid-base chemistry in high school was to know how they design, prepare and…

  7. [Dynamics of blood gases and acid-base balance in patients with carbon monoxide acute poisoning]. (United States)

    Polozova, E V; Shilov, V V; Bogachova, A S; Davydova, E V


    Evaluation of blood gases and acid-base balance covered patients with carbon monoxide acute poisoning, in accordance with inhalation trauma presence. Evidence is that thermochemical injury of respiratory tract induced severe acid-base dysbalance remaining decompensated for a long time despite the treatment.

  8. Diet-induced modification of the acid-base balance in rats: toxicological implications

    NARCIS (Netherlands)

    Lina, Berend Adriaan Rene


    The composition of the diet can strongly affect the acid-base balance of the body. The studies described in this thesis deal with toxicological implications of dietary modulation of the acid-base balance in rats. These studies included 4-wk, 13-wk and 18-month toxicity studies, and a 30-month

  9. Water-Electrolytic and Acid-Base Balance in Critically Ill Patients

    Directory of Open Access Journals (Sweden)

    L. V. Gerasimov


    Full Text Available The review deals with some aspects of correction of water-electrolytic and acid-base balance and this problem-associated infusion therapy. It characterizes various electrolytic solutions and considers the efficacy and safety of their use in terms of homeostatic maintenance. Key words: homeostasis, dyshidria, acid-base balance, acidosis, infusion therapy, crystalloid solutions.

  10. Approach to acid-base disorders – a clinical chemistry perspective

    African Journals Online (AJOL)

    Approach to acid-base disorders – a clinical chemistry perspective. Acid-base disorders are frequently encountered in clinical practice and have a significant impact on patient morbidity and mortality. Nicholette M Oosthuizen, MB ChB, FC Path (SA) Chem. Acting Head, Department of Chemical Pathology, University of ...

  11. Mixed acid-base disorder secondary to topiramate use in traumatic brain injury

    Directory of Open Access Journals (Sweden)

    S Golla


    Full Text Available We report a case of a man with traumatic brain injury. He was started on to prophylactic topiramate which led to a mixed acid-base disorder. He had severe metabolic acidosis secondary to renal tubular acidification defect and respiratory alkalosis secondary to hyperventilation. Withdrawal of the offending drug led to the prompt resolution of the acid-base disturbance.

  12. Effects of coagulating enzyme types (commercial calf rennet ...

    African Journals Online (AJOL)

    Effects of coagulating enzyme types (commercial calf rennet, Aspergillus niger var. awamori as recombinant chymosin and rhizomucor miehei as microbial rennet) on the chemical and sensory characteristics of white pickled cheese.

  13. Carbon dioxide pressure-induced coagulation of microalgae. (United States)

    Lee, Roland; Jessop, Philip G; Champagne, Pascale


    The move to a low-carbon economy has generated renewed interest in microalgae for the production of biofuels with the potential mutual benefit of wastewater treatment. However, harvesting has been identified as a limiting factor to the economic viability of this process. This paper explores the harvesting of microalgae using high-pressure gas without the addition of coagulants. Coagulation of microalgae under high-pressure gas was found to be an efficient method to separate algae from suspension. The critical coagulation pressures (CCPs) for H(2) and CO(2) were determined to be 6.1 and 6.2 MPa, respectively. The CO(2)-induced decrease in solution pH positively influenced coagulation rates, without appearing to affect the CCP. This approach could be beneficial for the economic removal of microalgae from solution for the production of both biofuels and biomedical compounds without the addition of non-environmentally friendly chemicals. © 2015 The Author(s).

  14. Thrombomodulin: A Bifunctional Modulator of Inflammation and Coagulation in Sepsis

    Directory of Open Access Journals (Sweden)

    Takayuki Okamoto


    Full Text Available Deregulated interplay between inflammation and coagulation plays a pivotal role in the pathogenesis of sepsis. Therapeutic approaches that simultaneously target both inflammation and coagulation hold great promise for the treatment of sepsis. Thrombomodulin is an endogenous anticoagulant protein that, in cooperation with protein C and thrombin-activatable fibrinolysis inhibitor, serves to maintain the endothelial microenvironment in an anti-inflammatory and anticoagulant state. A recombinant soluble form of thrombomodulin has been approved to treat patients suffering from disseminated intravascular coagulation (DIC and has thus far shown greater therapeutic potential than heparin. A phase II clinical trial is currently underway in the USA to study the efficacy of thrombomodulin for the treatment of sepsis with DIC complications. This paper focuses on the critical roles that thrombomodulin plays at the intersection of inflammation and coagulation and proposes the possible existence of interactions with integrins via protein C. Finally, we provide a rationale for the clinical application of thrombomodulin for alleviating sepsis.

  15. Hyperglycemia stimulates coagulation, whereas hyperinsulinemia impairs fibrinolysis in healthy humans

    NARCIS (Netherlands)

    Stegenga, Michiel E.; van der Crabben, Saskia N.; Levi, Marcel; de Vos, Alex F.; Tanck, Michael W.; Sauerwein, Hans P.; van der Poll, Tom


    Type 2 diabetes and insulin resistance syndromes are associated with an increased risk for cardiovascular and thrombotic complications. A disturbed balance between coagulation and fibrinolysis has been implicated in the pathogenesis hereof. To determine the selective effects of hyperglycemia and

  16. Coagulation profile in patients undergoing video-assisted thoracoscopic lobectomy

    DEFF Research Database (Denmark)

    Christensen, Thomas Decker; Vad, Henrik; Pedersen, Søren


    Background: Knowledge about the impact of Low-Molecular-Weight Heparin (LMWH) on the coagulation system in patients undergoing minimal invasive lung cancer surgery is sparse. The aim of this study was to assess the effect of LMWH on the coagulation system in patients undergoing Video......-Assisted Thoracoscopic Surgery (VATS) lobectomy for primary lung cancer. Methods: Sixty-three patients diagnosed with primary lung cancer undergoing VATS lobectomy were randomized to either subcutaneous injection with dalteparin (Fragmin®) 5000 IE once daily or no intervention. Coagulation was assessed pre-, peri......-, and the first two days postoperatively by standard coagulation blood test, thromboelastometry (ROTEM®) and thrombin generation. Results: Patients undergoing potential curative surgery for lung cancer were not hypercoagulable preoperatively. There was no statistically significant difference in the majority...

  17. [Coagulation disorders after endoscopic resection of the prostate]. (United States)

    Benizri, E; Raucoules-Aimé, M; Amiel, J; Toubol, J; Grimaud, D


    Endoscopic resection of the prostate is a well defined surgical procedure. Nevertheless, certain coagulation disorders (hypercoagulability with risk of deep vein thrombosis, haemorrhage) can raise special problems. In patients not given heparin prophylaxis, the incidence of deep vein thrombosis is 10% in transurethral resections of the prostate (TURP). The risk is higher for cancer. Among the diagnostic tools (D-dimer assay, continuous Doppler, pulsed echo-Doppler, thermography, plethysmography, ...) ascending phlebography or pulmonary angiography in case of suspected pulmonary emboli remains the gold standard. Haemorrhage is rarely related to defribination but frequently to dilution coagulopathy favoured by high blood pressure, resorption of irrigation fluid, deficient haemostasis with loss of coagulation factors or massive transfusions. Only clinically patent coagulation disorders leading to haemorrhage should be treated. For dilution coagulopathies and diffuse intravascular coagulation, treatment is based on viro-inactive fresh plasma infusion. Aprotinine is the first choice in case of fibrinolysis.


    Directory of Open Access Journals (Sweden)

    Khromysheva О.О.


    Full Text Available Physical and chemical regularities of coagulant treatment of sewage of Open Joint-Stock Company «GidrosylaMZTG» from heavy metals, chlorides and sulfates by with aluminum sulphate are studied.

  19. Moringa coagulant as a stabilizer for amorphous solids: Part I. (United States)

    Bhende, Santosh; Jadhav, Namdeo


    Stabilization of amorphous state is a focal area for formulators to reap benefits related with solubility and consequently bioavailability of poorly soluble drugs. In the present work, an attempt has been made to explore the potential of moringa coagulant as an amorphous state stabilizer by investigating its role in stabilization of spray-dried (amorphous) ibuprofen, meloxicam and felodipine. Thermal studies like glass forming ability, glass transition temperature, hot stage microscopy and DSC were carried out for understanding thermodynamic stabilization of drugs. PXRD and dissolution studies were performed to support contribution of moringa coagulant. Studies showed that hydrogen bonding and electrostatic interactions between drug and moringa coagulant are responsible for amorphous state stabilization as explored by ATR-FTIR and molecular docking. Especially, H-bonding was found to be predominant mechanism for drug stabilization. Therein, arginine (basic amino acid in coagulant) exhibited various interactions and played important role in stabilization of aforesaid amorphous drugs.

  20. The effect of rouleaux formation on blood coagulation. (United States)

    Riha, P; Liao, F; Stoltz, J F


    The coagulation of whole blood resulting a blood clot is initiated in vitro for studying the effect of rouleaux formation on the kinetics of coagulation and clot formation. The clot formation is monitored in the rotational viscosimeter and in the erythroaggregometer using a light backscattered technique. The intensity of flow as well as hematocrit were changed in a way to determine a tendency in the effect of rouleaux size on the rate of coagulation. The results indicate that the clot formation is promoted when size of rouleaux is small at higher shear rates and low hematocrit in comparison with the coagulation at low shear rates and high hematocrit when the size of rouleaux is increased.

  1. Surgical Coagulator With Carbon Dioxide Laser For Gynecology (United States)

    Wolinski, Wieslaw; Kazmirowski, Antoni; Korobowicz, Witold; Olborski, Zbigniew


    The technical data and parameters of the CO2 surgical laser for gynecology are given. Coagulator was designed and constructed in Institute of Microelectronics and Optoelectronics Warsaw Technical University.

  2. Application of Dual Coagulant (Alum + Barley in Removing Colour from Leachate

    Directory of Open Access Journals (Sweden)

    Shaylinda Mohd Zin Nur


    Full Text Available Coagulation/flocculation is one of the treatment method for highly polluted leachate. One of the main affecting factor for this process is the coagulant used. Coagulant is divided into natural and chemical coagulant. In the current study, Alum (chemical coagulant and barley (natural coagulant were used as dual coagulant. The aim of this study is to examine the effectiveness of dual coagulant made from alum and barley in removing colour from the effluent of Simpang Renggam landfill leachate aeration lagoon through coagulation/flocculation method. Coagulation/flocculation process with single alum coagulant, single barley coagulant and dual coagulant (alum+barley were examined by evaluating the optimum values of pH and dose. Optimum dose and pH for alum and barley as single coagulant were; 3 g/L & pH 5; 0.8 g/L & pH 6. Higher removal of colour was recorded for alum compared to barley. Application of alum and barley as dual coagulant had higher colour removal than alum and barley as single coagulant. The optimum pH and dose for dual coagulant were at pH 6, 3.0 g/L of alum and 0.8 g/L of barley respectively. However, at pH 6, 2 g/L alum and 1.6 g/L barley, the removal of colour was similar to alum at 3 g/L. It can be concluded that barley as coagulant aid able to reduce 33 % usage of alum at par removals of colour. Thus, the dual coagulant consist of alum and barley has the potential to be applied as a coagulant for leachate treatment.

  3. Coagulation aggravates blood-induced joint damage in dogs. (United States)

    van Meegeren, Monique E R; Roosendaal, Goris; Barten-van Rijbroek, Angelique D; Schutgens, Roger E G; Lafeber, Floris P J G; Mastbergen, Simon C


    Joint bleeding due to trauma, major joint surgery, or hemophilia leads to joint damage. It is unclear if there are differences between coagulating blood and anticoagulated blood with respect to joint degeneration, especially in vivo. Therefore, we undertook this study to evaluate in a canine in vivo model whether intraarticular exposure to coagulating blood is more destructive than exposure to anticoagulated blood, and whether inflammation plays a role in the cartilage- damaging process. In 7 dogs the left knees were injected with coagulating blood 4 times a week during weeks 1 and 4, and the right knees were injected with saline. In 7 other dogs, anticoagulated heparinized blood was injected, and heparinized saline was used as control. Ten weeks after the last injection, cartilage matrix turnover and synovial inflammation were analyzed. To study inflammation-independent cartilage damage, explants of cartilage from at least 6 human donors per group were exposed in vitro to coagulating and anticoagulated blood, plasma, and serum for 4 days. Cartilage matrix turnover was determined after a recovery period of 12 days. Canine knees injected with coagulating blood showed more disturbed proteoglycan turnover than knees injected with anticoagulated blood. Synovial inflammation was present only after intraarticular injections with coagulating blood. In in vitro experiments, exposure of human cartilage explants to coagulating blood resulted in more damage than did exposure to anticoagulated blood, while exposure to plasma and serum did not alter cartilage matrix turnover. This study shows that coagulating blood causes more long-lasting in vivo joint damage than anticoagulated blood, thereby suggesting that along with joint bleeding in hemophilia, exposure to intraarticular blood should also be avoided during surgery and trauma to prevent joint damage. Copyright © 2012 by the American College of Rheumatology.

  4. A different insight into blood coagulation in vitro


    Hanım Karahan; Beri Hocaoğlu Bozarslan; Birgül Işık; M. Kemal Başaralı; Selvi Kelekçi; Osman Evliyaoğlu


    Objectives: The known model of blood coagulation involves a series of zymogen activation reaction sequences. At each stage, a zymogen is converted to an active protease by cleavage of one or more peptide bonds in the precursor molecule. The aim of this study was to investigate amino acid profiles during coagulation process in different conditions in vitro.Methods: Samples of serum and plasma (treated by EDTA or citrate) were obtained from healthy donors and from patients with Phenylketonuria ...

  5. [Coagulation factor XIII: more than just a fibrin stabilizer]. (United States)

    Messaoudi, N; Lamaalmi, F; Chakour, M; Belmekki, A; Naji, M


    The role played by coagulation factor XIII in the scarring process is considered. Identified in 1923, the role of factor XIII or the fibrin stabilizing factor in coagulation has been accurately described. Its role in scarring was defined as long ago as 1960 but continues to be unknown to haematologists and doctors treating burn patients. The aim of this paper is to cast more light on this role, which remains a mystery still to be unfolded.

  6. Removal of Arsenic from Drinking Water by Adsorption and Coagulation (United States)

    Zhang, M.; Sugita, H.; Hara, J.; Takahashi, S.


    Removal of arsenic from drinking water has been an important issue worldwide, which has attracted greater attentions in recent years especially for supplying safe drinking water in developing countries. Although many kinds of treatment approaches that are available or applicable both in principle and practice, such as adsorption, coagulation, membrane filtration, ion exchange, biological process, electrocoagulation and so on, the first 2 approaches (i.e., adsorption and coagulation) are most promising due to the low-cost, high-efficiency, simplicity of treating systems, and thus can be practically used in developing countries. In this study, a literature survey on water quality in Bangladesh was performed to understand the ranges of arsenic concentration and pH of groundwater in Bangladesh. A series of tests were then organized and performed to investigate the effects of arsenic concentration, arsenic forms, pH, chemical compositions of the materials used for adsorption and coagulation, particle size distribution and treatment time on quality of treated water. The experimental results obtained in the study illustrated that both adsorption and coagulation can be used to effectively reduce the concentrations of either arsenic (V) or arsenic (III) from the contaminated water. Coagulation of arsenic with a magnesium-based material developed in this study can be very effective to remove arsenic, especially arsenic (V), from contaminated water with a concentration of 10 ppm to an undetectable level of 0.002 ppm by ICP analyses. Compared to arsenic (III), arsenic (V) is easier to be removed. The materials used for adsorption and coagulation in this study can remove arsenic (V) up to 9 mg/g and 6 mg/g, and arsenic (III) up to 4 mg/g and 3 mg/g, respectively, depending on test conditions and compositions of the materials being used. The control of pH during treatment can be a challenging technical issue for developing both adsorbent and coagulant. Keywords: Water Treatment

  7. Colloids removal from water resources using natural coagulant: Acacia auriculiformis (United States)

    Abdullah, M.; Roslan, A.; Kamarulzaman, M. F. H.; Erat, M. M.


    All waters, especially surface waters contain dissolved, suspended particles and/or inorganic matter, as well as several biological organisms, such as bacteria, algae or viruses. This material must be removed because it can affect the water quality that can cause turbidity and colour. The objective of this study is to develop water treatment process from Seri Alam (Johor, Malaysia) lake water resources by using natural coagulant Acacia auriculiformis pods through a jar test experiment. Jar test is designed to show the effectiveness of the water treatment. This process is a laboratory procedure that will simulate coagulation/flocculation with several parameters selected namely contact time, coagulant dosage and agitation speed. The most optimum percentage of colloids removal for each parameter is determined at 0.2 g, 90 min and 80 rpm. FESEM (Field-emission Scanning Electron Microscope) observed the small structures of final floc particles for optimum parameter in this study to show that the colloids coagulated the coagulant. All result showed that the Acacia auriculiformis pods can be a very efficient coagulant in removing colloids from water.

  8. The role of coagulation and fibrinolysis in preeclampsia. (United States)

    Bonnar, J; Redman, C W; Denson, K W


    The coagulation and fibrinolytic systems play a key role in maintaining the integrity and patency of the vascular compartment. Pregnancy induces extensive physiological changes in these systems, thus creating an enhanced capacity to produce fibrin and a diminished ability to remove it. Fibrin deposition localized to the uteroplacental circulation is a feature of normal pregnancy. In women with fatal eclampsia, disseminated intravascular coagulation with fibrin deposition in the renal glomeruli is well documented. The condition of preeclampsia is not well defined. Nonetheless, evidence of intravascular coagulation, as shown by elevated levels of fibrin degradation products and reduced platelet counts, has been found in many women with preeclampsia. Serial studies showed that thrombin generation, as indicated by the ratio of factor VIII-related antigen to factor VIII coagulant activity, is considerably in excess of that which occurs in normal pregnancy, and its appearance coincides with the development of the clinical features of preeclampsia. Heparin therapy has bot been proven of value in established preeclampsia, but this fact does not disprove that role that intravascular coagulation may play in the pathogenesis of the disease. A controlled trial ina high-risk group of low-dose he;arin and an antiplatelet agent from the 16th to the 18th weeks of pregnancy onwards is required to elucidate the role of intravascular coagulation in preeclapmsia and its effect on the fetus.

  9. Activation of blood coagulation in cancer: implications for tumour progression (United States)

    Lima, Luize G.; Monteiro, Robson Q.


    Several studies have suggested a role for blood coagulation proteins in tumour progression. Herein, we discuss (1) the activation of the blood clotting cascade in the tumour microenvironment and its impact on primary tumour growth; (2) the intravascular activation of blood coagulation and its impact on tumour metastasis and cancer-associated thrombosis; and (3) antitumour therapies that target blood-coagulation-associated proteins. Expression levels of the clotting initiator protein TF (tissue factor) have been correlated with tumour cell aggressiveness. Simultaneous TF expression and PS (phosphatidylserine) exposure by tumour cells promote the extravascular activation of blood coagulation. The generation of blood coagulation enzymes in the tumour microenvironment may trigger the activation of PARs (protease-activated receptors). In particular, PAR1 and PAR2 have been associated with many aspects of tumour biology. The procoagulant activity of circulating tumour cells favours metastasis, whereas the release of TF-bearing MVs (microvesicles) into the circulation has been correlated with cancer-associated thrombosis. Given the role of coagulation proteins in tumour progression, it has been proposed that they could be targets for the development of new antitumour therapies. PMID:23889169

  10. Adaptive force sonorheometry for assessment of whole blood coagulation. (United States)

    Mauldin, F William; Viola, Francesco; Hamer, Theresa C; Ahmed, Eman M; Crawford, Shawna B; Haverstick, Doris M; Lawrence, Michael B; Walker, William F


    Viscoelastic diagnostics that monitor the hemostatic function of whole blood (WB), such as thromboelastography, have been developed with demonstrated clinical utility. By measuring the cumulative effects of all components of hemostasis, viscoelastic diagnostics have circumvented many of the challenges associated with more common tests of blood coagulation. We describe a new technology, called sonorheometry, that adaptively applies acoustic radiation force to assess coagulation function in WB. The repeatability (precision) of coagulation parameters was assessed using citrated WB samples. A reference range of coagulation parameters, along with corresponding measurements from prothrombin time (PT) and partial thromboplastin time (PTT), were obtained from WB samples of 20 healthy volunteers. In another study, sonorheometry monitored anticoagulation with heparin (0-5 IU/ml) and reversal from varied dosages of protamine (0-10 IU/ml) in heparinized WB (2 IU/ml). Sonorheometry exhibited low CVs for parameters: clot initiation time (TC1), 0.98 for all coagulation parameters. We observed maximum reversal of heparin anticoagulation at protamine to heparin ratios of 1.4:1 from TC1 (P=0.6) and 1.2:1 from theta (P=0.55). Sonorheometry is a non-contact method for precise assessment of WB coagulation. Copyright 2010 Elsevier B.V. All rights reserved.

  11. Does whole blood coagulation analysis reflect developmental haemostasis? (United States)

    Ravn, Hanne Berg; Andreasen, Jo Bønding; Hvas, Anne-Mette


    : Developmental haemostasis has been well documented over the last 3 decades and age-dependent reference ranges have been reported for a number of plasmatic coagulation parameters. With the increasing use of whole blood point-of-care tests like rotational thromboelastometry (ROTEM) and platelet function tests, an evaluation of age-dependent changes is warranted for these tests as well. We obtained blood samples from 149 children, aged 1 day to 5.9 years, and analysed conventional plasmatic coagulation tests, including activated partial prothrombin time, prothrombin time, and fibrinogen (functional). Whole blood samples were analysed using ROTEM to assess overall coagulation capacity and Multiplate analyzer to evaluate platelet aggregation. Age-dependent changes were analysed for all variables. We found age-dependent differences in all conventional coagulation tests (all P values coagulation assessment when applying ROTEM, apart from clotting time in the EXTEM assay (P coagulation test. However, these age-dependent changes were not displayed in whole blood monitoring using ROTEM or Multiplate analyzer. Type of anticoagulant had a significant influence on platelet aggregation across all age groups.

  12. Diplazium esculentum leaf extract as coagulant aid in leachate treatment (United States)

    Zainol, Noor Ainee; Aziz, Hamidi Abdul; Lutpi, Nabilah Aminah


    The use of extracts from Diplazium esculentum leaves as coagulant and coagulant aid has not been discussed in literature. In this research, the capability of extracts from D. esculentum leaves, namely, D. esculentum aqueous (DEaqs) and D. esculentum powder (DEpowd), to act as coagulant aid in combination with polyaluminum chloride (PACl) was evaluated using stabilized leachate from the Kuala Sepetang Landfill Site (KSLS) and the Kulim Landfill Site (KLS) through a Jar test. Identified as polymers with high molecular weight, DEaqs (221 kDa) and DEpowd (275 kDa) act as anionic coagulants and are capable of promoting the coagulation process in leachate saturated with negative particles. The main functional groups that induce the coagulation-flocculation process by DEaqs and DEpowd are carboxyl, hydroxyl, and amine groups, which all contain hydrogen in their molecules. Jar test results were analyzed based on the removal efficiency (RE) of suspended solids (SS), turbidity, colour, chemical oxygen demand (COD), and ammonia-N. A 50% reduction in the volume of PACl from its optimum dosage, with the DEaqs and DEpowd dosages below 1000 mg/L, exhibited a synergic effect of all the measured parameters in KSLS leachates.

  13. Coagulation-flocculation in leachate treatment using modified micro sand (United States)

    Thaldiri, Nur Hanani; Halim, Azhar Abdul


    Sanitary landfill leachate is considered as highly polluted wastewater, without any treatment, discharging into water system will cause underground water and surface water pollutions. This study was to investigate the treatability of the semi-aerobic landfill leachate via coagulation-flocculation using poly-aluminum chloride (PAC), cationic polymer, and modified micro sand. Leachate was collected from Pulau Burung Sanitary Landfill (PBSL) located in Penang, Malaysia. Coagulation-flocculation was performed by using jar test equipment and the effect of pH, dose of coagulant and dose of polymer toward removal of chemical oxygen demand (COD), color and suspended solid (SS) were examined. Micro sand was also used in this study to compare settling time of coagulation-flocculation process. The optimum pH, dose of coagulant (PAC) and dose of polymer (cationic) achieved were 7.0, 1000 mg/L and 8 mg/L, respectively. The dose of micro sand used for the settling time process was 300 mg/L. Results showed that 52.66% removal of COD, 97.16% removal of SS and 96.44% removal of color were achieved under optimum condition. The settling times for the settling down of the sludge or particles that formed during coagulation-flocculation process were 1 min with modified sand, 20 min with raw micro sand and 45 min without micro sand.

  14. Coagulation and the vessel wall in thrombosis and atherosclerosis. (United States)

    Kleinegris, Marie-Claire; Ten Cate-Hoek, Arina J; Ten Cate, Hugo


    The blood coagulation system is a key survival mechanism that has developed to protect man against lethal bleeding. A second function of blood coagulation is its close interaction with immunity. The immune-mediated coagulation responses may broadly be regarded as an element of response to injury. Pathological coagulation responses, including thromboembolism and disseminated intravascular coagulation (DIC), could therefore be regarded as excessive immune responses to a vessel wall injury. Virchow's triad, which comprises changes in the components of the blood, the state of the vessel wall, and the blood flow, was originally proposed for venous thrombosis. However, lately it appears that the same principles can be applied to arterial thrombosis and even DIC. It has even been postulated that all forms of thrombosis may be part of a continuous spectrum of the same disease. Over the past few years, an accumulation of evidence has shown that the etiopathogenetic mechanisms behind venous and arterial thrombosis are quite similar. The traditional elements of Virchow's triad are found to apply to both arterial and venous thrombosis. Yet, nowadays more emphasis is placed on the vessel wall and vascular bed specificity and the interaction with inflammation and hypercoagulability. This narrative review will discuss recent advances in research on the possible interactions between coagulation, the vascular endothelium, and atherosclerosis as well as the consequences of such interactions for venous and arterial thrombosis.

  15. Monitoring soft tissue coagulation by optical spectroscopy (United States)

    Lihachev, A.; Lihacova, I.; Heinrichs, H.; Spigulis, J.; Trebst, T.; Wehner, M.


    Laser tissue welding (LTW) or laser tissue soldering (LTS) is investigated since many years for treatment of incisions, wound closure and anastomosis of vessels [1, 2]. Depending on the process, a certain temperature in the range between 65 °C to 85 °C must be reached and held for a few seconds. Care has to be taken not to overheat the tissue, otherwise necrosis or tissue carbonization may occur and will impair wound healing. Usually the temperature is monitored during the process to control the laser power [3]. This requires either bulky equipment or expensive and fragile infrared fibers to feed the temperature signal to an infrared detector. Alternatively, changes in tissue morphology can be directly observed by analysis of spectral reflectance. We investigate spectral changes in the range between 400 nm to 900 nm wavelength. Characteristic spectral changes occur when the temperature of tissue samples increase above 70 °C which is a typical setpoint value for temperature control of coagulation. We conclude that simple spectroscopy in the visible range can provide valuable information during LTS and LTW and probably replace the delicate measurement of temperature. A major advantage is that optical measurements can be performed using standard optical fibers and can be easily integrated into a surgical tool.

  16. Alginate microbeads are coagulation compatible, while alginate microcapsules activate coagulation secondary to complement or directly through FXII. (United States)

    Gravastrand, Caroline; Hamad, Shamal; Fure, Hilde; Steinkjer, Bjørg; Ryan, Liv; Oberholzer, Josè; Lambris, John D; Lacík, Igor; Mollnes, Tom Eirik; Espevik, Terje; Brekke, Ole-Lars; Rokstad, Anne Mari


    Alginate microspheres are presently under evaluation for future cell-based therapy. Their ability to induce harmful host reactions needs to be identified for developing the most suitable devices and efficient prevention strategies. We used a lepirudin based human whole blood model to investigate the coagulation potentials of alginate-based microspheres: alginate microbeads (Ca/Ba Beads), alginate poly-l-lysine microcapsules (APA and AP microcapsules) and sodium alginate-sodium cellulose sulfate-poly(methylene-co-cyanoguanidine) microcapsules (PMCG microcapsules). Coagulation activation measured by prothrombin fragments 1+2 (PTF1.2) was rapidly and markedly induced by the PMCG microcapsules, delayed and lower induced by the APA and AP microcapsules, and not induced by the Ca/Ba Beads. Monocytes tissue factor (TF) expression was similarly activated by the microcapsules, whereas not by the Ca/Ba Beads. PMCG microcapsules-induced PTF1.2 was abolished by FXII inhibition (corn trypsin inhibitor), thus pointing to activation through the contact pathway. PTF1.2 induced by the AP and APA microcapsules was inhibited by anti-TF antibody, pointing to a TF driven coagulation. The TF induced coagulation was inhibited by the complement inhibitors compstatin (C3 inhibition) and eculizumab (C5 inhibition), revealing a complement-coagulation cross-talk. This is the first study on the coagulation potentials of alginate microspheres, and identifies differences in activation potential, pathways and possible intervention points. Alginate microcapsules are prospective candidate materials for cell encapsulation therapy. The material surface must be free of host cell adhesion to ensure free diffusion of nutrition and oxygen to the encapsulated cells. Coagulation activation is one gateway to cellular overgrowth through deposition of fibrin. Herein we used a physiologically relevant whole blood model to investigate the coagulation potential of alginate microcapsules and microbeads. The


    Pietri, P; Vlachopoulos, C; Ioakeimidis, N; Aggelis, A; Terentes-Printzios, D; Paschalidis, E; Abdelrasoul, M; Gourgouli, I; Gravos, A; Tousoulis, D


    There is evidence for an inverse association between plasma testosterone and blood pressure. Recently, low plasma testosterone was associated with increased risk of major cardiovascular events in middle-aged hypertensive men. Central (aortic) blood pressures predict cardiovascular mortality with equal ability compared to peripheral (brachial) blood pressures. The aim of the present study was to assess the relationship of plasma total testosterone (TT) with peripheral and central haemodynamics in hypertensive men. We studied 70 non-diabetic, hypertensive men (mean age = 60 years old). Office brachial systolic (bSBP) and diastolic (bDBP) blood pressures were measured according to the ESH guidelines. Pulse pressure (bPP) was calculated as SBP minus DBP. All patients were subject to measurement of aortic systolic (aoSBP), diastolic (aoDBP) and pulse pressures (aoPP) by pulse wave analysis using the Sphygmocor device. Wave reflections were assessed by the measurement of heart-rate corrected augmentation index (AIx75). Plasma TT was measured in all subjects by enzyme immunoassay. The mean value of TT in the whole population was 4.6 ng/ml (hypogonadism was defined as TT < 3.4 ng/ml). Plasma TT was inversely and significantly related to aoSBP (r = -0.26, p = 0.03), aoPP (r = -0.30, p = 0.01) and AIx75 (r = -0.31, p = 0.01) but only marginally related to bSBP (r = -0.22, p = 0.07) and bPP (r = -0.23, p = 0.06). In linear regression analysis, after adjustment for age, smoking, BMI, plasma glucose, total cholesterol and presence of antihypertensive treatment, aoSBP (b = -0.29, p = 0.03), aoPP (b = -0.31, p = 0.02) and AIx75 (b = -0.30, p = 0.03) were independently associated with TT but the relationship of TT with bSBP (b = -0.25, p = 0.06) and bPP (b = -0.23, p = 0.07) remained weak. In hypertensive men, plasma TT is independently and inversely associated with central blood pressures

  18. Enhanced WWTP effluent organic matter removal in hybrid ozonation-coagulation (HOC) process catalyzed by Al-based coagulant

    Energy Technology Data Exchange (ETDEWEB)

    Jin, Xin [School of Environmental and Municipal Engineering, Xi’an University of Architecture and Technology, Xi’an, Shaanxi Province, 710055 (China); Jin, Pengkang, E-mail: [School of Environmental and Municipal Engineering, Xi’an University of Architecture and Technology, Xi’an, Shaanxi Province, 710055 (China); Hou, Rui [School of Environmental and Municipal Engineering, Xi’an University of Architecture and Technology, Xi’an, Shaanxi Province, 710055 (China); Yang, Lei [Department of Materials Science and Engineering, Monash University, Clayton, VIC, 3800 (Australia); Wang, Xiaochang C., E-mail: [School of Environmental and Municipal Engineering, Xi’an University of Architecture and Technology, Xi’an, Shaanxi Province, 710055 (China)


    Highlights: • A novel HOC process was firstly put forward to apply in wastewater reclamation. • Interactions between ozone and Al-based coagulants was found in the HOC process. • Ozonation can be catalyzed and enhanced by Al-based coagulants in the HOC process. • HOC process showed better organics removal than pre-ozonation-coagulation process. - Abstract: A novel hybrid ozonation-coagulation (HOC) process was developed for application in wastewater reclamation. In this process, ozonation and coagulation occurred simultaneously within a single unit. Compared with the conventional pre-ozonation-coagulation process, the HOC process exhibited much better performance in removing dissolved organic matters. In particular, the maximal organic matters removal efficiency was obtained at the ozone dosage of 1 mgO{sub 3}/mg DOC at each pH value (pH 5, 7 and 9). In order to interpret the mechanism of the HOC process, ozone decomposition was monitored. The results indicated that ozone decomposed much faster in the HOC process. Moreover, by using the reagent of O{sub 3}-resistant hydroxyl radical (·OH) probe compound, para-chlorobenzoic acid (pCBA), and electron paramagnetic resonance (EPR) analysis, it was observed that the HOC process generated higher content of ·OH compared with pre-ozonation process. This indicates that the ·OH oxidation reaction as the key step can be catalyzed and enhanced by Al-based coagulants and their hydrolyzed products in this developed process. Thus, based on the catalytic effects of Al-based coagulants on ozonation, the HOC process provides a promising alternative to the conventional technology for wastewater reclamation in terms of higher efficiency.

  19. Metabolic Effects of a Succinic Acid Substrate Antihypoxant

    Directory of Open Access Journals (Sweden)

    B. N. Shakh


    Full Text Available The paper discusses promises for clinical use of substrate antihypoxants.Objective: to investigate the efficacy of succinate containing  substrate  antihypoxants  on  systemic  oxygen  consumption,  blood  buffer  capacity,  and  changes  in  the  mixed venous blood level of lactate when they are used in gravely sick patients and victims with marked metabolic posthypoxic disorders.Subjects and methods. The trial enrolled 30 patients and victims who had sustained an episode of severe hypoxia of mixed genesis, the severity of which was evaluated by the APACHE II scale and amounted to 23 to 30 scores with a 46 to 70.3% risk of death. The standard infusion program in this group involved the succinate-containing drug 1.5% reamberin solution  in  a  total  dose  of  800  ml.  A  comparison  group  included  15  patients  who  had  undergone  emergency  extensive surgery for abdominal diseases. 400 ml of 10% glucose solution was used as an infusion medium. Oxygen consumption (VO2ml/min and carbon dioxide production (VCO2ml/min were measured before infusion and monitored for 2 hours. Arterial blood gases and acid-base balance (ABB parameters and mixed venous blood lactate levels were examined. Measurements were made before and 30 minutes after the infusion of reamberin or glucose solution.Results. Infusion of 1.5% reamberin solution was followed by a significant increase in minute oxygen consumption from 281.5±21.2 to 310.4±24.4 ml/min. CO2 production declined (on average, from 223.3±6.5 to 206.5±7.59 ml/min. During infusion of 10% glucose solution, all the patients of the comparison group showed a rise in oxygen consumption from 303.6±33.86 to 443.13±32.1 ml/min, i.e. about 1.5-fold. VCO2 changed similarly. The intravenous infusion of 800 ml of 1.5% reamberin solution raised arterial blood buffer capacity, which was reflected by changes in pH, BE, and HCO3. There was a clear trend for lactate values to drop in the

  20. Haemodynamic assessment of human coronary arteries is affected by degree of freedom of artery movement. (United States)

    Javadzadegan, Ashkan; Yong, Andy S C; Chang, Michael; Ng, Martin K C; Behnia, Masud; Kritharides, Leonard


    Abnormal haemodynamic parameters are associated with atheroma plaque progression and instability in coronary arteries. Flow recirculation, shear stress and pressure gradient are understood to be important pathogenic mediators in coronary disease. The effect of freedom of coronary artery movement on these parameters is still unknown. Fluid-structure interaction (FSI) simulations were carried out in 25 coronary artery models derived from authentic human coronaries in order to investigate the effect of degree of freedom of movement of the coronary arteries on flow recirculation, wall shear stress (WSS) and wall pressure gradient (WPG). Each FSI model had distinctive supports placed upon it. The quantitative and qualitative differences in flow recirculation, maximum wall shear stress (MWSS), areas of low wall shear stress (ALWSS) and maximum wall pressure gradient (MWPG) for each model were determined. The results showed that greater freedom of movement was associated with lower MWSS, smaller ALWSS, smaller flow recirculation zones and lower MWPG. With increasing percentage diameter stenosis (%DS), the effect of degree of freedom on flow recirculation and WSS diminished. Freedom of movement is an important variable to be considered for computational modelling of human coronary arteries, especially in the setting of mild to moderate stenosis. 3D: Three-dimensional; 3DR: Three-dimensional Reconstruction; 3D-QCA: Three-dimensional quantitative coronary angiography; ALWSS: Areas of low wall shear stress; CAD: Coronary artery disease; CFD: Computational fluid dynamics; %DS: Diameter stenosis percentage; EPCS: End point of counter-rotating streamlines; FSI: Fluid-structure interaction; IVUS: Intravascular ultrasound; LAD: Left anterior descending; MWSS: Maximum wall shear stress; SST: Shear stress transport; TAWSS: Time-averaged wall shear stress; WSS: wall shear stress; WPG: Wall pressure gradient; MWPG: Maximum wall pressure gradient; FFR: Fractional flow reserve; i

  1. Anthropometric, haemodynamic, humoral and hormonal evaluation in patients with incidental adrenocortical adenomas before and after surgery. (United States)

    Bernini, Giampaolo; Moretti, Angelica; Iacconi, Pietro; Miccoli, Paolo; Nami, Renato; Lucani, Barbara; Salvetti, Antonio


    To compare clinical and humoral parameters before and after surgery in patients with incidental adrenocortical adenomas. Six patients with subclinical Cushing's syndrome and nine with non-functioning adenomas were investigated before and 12 Months after removal of the mass. Anthropometric (body weight, body mass index and waist to hip ratio), haemodynamic (blood pressure and heart rate), metabolic (lipids and oral glucose tolerance test (OGTT)), hormonal (cortisol, plasma renin activity, aldosterone, androgens and catecholamines) and bone metabolism (hydroxyproline, parathyroid hormone, osteocalcin and ostase) parameters were evaluated. In the whole group, a significant decrease in body weight (69.7+/-3.5 vs 70.8+/-3.5 kg, P<0.03), in systolic (135.3+/-5.1 vs 145.6+/-4.9 mmHg, P<0.009) and diastolic (83.7+/-1.9 vs 91.0+/-3.5 mmHg, P<0.03) blood pressure and in glucose levels in response to OGTT (106.4+/-9.6 vs 127.5+/-6.5 mg/dl, P<0.05) was observed after surgery. All other parameters examined did not change significantly. This trend was also found in both groups separately. Analytical data showed a high frequency of overweight/obesity (66.6%), hypertension (66.6%) and impaired glucose profile (26.6%) in our patients, with a greater prevalence of these cardiovascular risk factors in the subclinical Cushing's syndrome group. After surgery, values normalized or improved in eight out of ten hypertensive patients and in three out of four patients with impaired glucose profile. Solid adrenocortical incidentalomas are associated with some cardiovascular risk factors which may be corrected after removal of the mass. Therefore, surgery may be an appropriate choice in patients with subclinical Cushing's syndrome but also in those with solid non-functioning adenomas and coexistent cardiovascular risk factors.

  2. Reduced Haemodynamic Response in the Ageing Visual Cortex Measured by Absolute fNIRS.

    Directory of Open Access Journals (Sweden)

    Laura McKernan Ward

    Full Text Available The effect of healthy ageing on visual cortical activation is still to be fully explored. This study aimed to elucidate whether the haemodynamic response (HDR of the visual cortex altered as a result of ageing. Visually normal (healthy participants were presented with a simple visual stimulus (reversing checkerboard. Full optometric screening was implemented to identify two age groups: younger adults (n = 12, mean age 21 and older adults (n = 13, mean age 71. Frequency-domain Multi-distance (FD-MD functional Near-Infrared Spectroscopy (fNIRS was used to measure absolute changes in oxygenated [HbO] and deoxygenated [HbR] haemoglobin concentrations in the occipital cortices. Utilising a slow event-related design, subjects viewed a full field reversing checkerboard with contrast and check size manipulations (15 and 30 minutes of arc, 50% and 100% contrast. Both groups showed the characteristic response of increased [HbO] and decreased [HbR] during stimulus presentation. However, older adults produced a more varied HDR and often had comparable levels of [HbO] and [HbR] during both stimulus presentation and baseline resting state. Younger adults had significantly greater concentrations of both [HbO] and [HbR] in every investigation regardless of the type of stimulus displayed (p<0.05. The average variance associated with this age-related effect for [HbO] was 88% and [HbR] 91%. Passive viewing of a visual stimulus, without any cognitive input, showed a marked age-related decline in the cortical HDR. Moreover, regardless of stimulus parameters such as check size, the HDR was characterised by age. In concurrence with present neuroimaging literature, we conclude that the visual HDR decreases as healthy ageing proceeds.


    Directory of Open Access Journals (Sweden)

    Talisetti Jamuna


    Full Text Available BACKGROUND The commonly used intravenous (I.V. Induction agents in anaesthetic practice are propofol, Thiopentone, Ketamine. But haemodynamic instability is common like use of ketamine results in tachycardia and hypertension while propofol and thiopentone results in hypotension. But ideally an induction agent should provide hypnosis, amnesia, analgesia without undesirable cardiac and respiratory depression. So here a combination of induction agents was used. This study was conducted to compare the hemodynamic effects of propofol-ketamine combination as induction agents to propofol-thiopentone Combination. MATERIALS AND METHODS This study was carried out at Sri Venkateswara Medical College Tirupathi. Sixty ASA 1 and 2 patients in the age group of 18-50 years, undergoing elective surgery under general anaesthesia were enrolled for this study and were randomly allotted into two groups (A and B of 30 each. Group A was induced with propofol-thiopentone and Group B was given propofol-ketamine combination. The hemodynamic parameters- heart rate, systolic, diastolic and mean arterial pressures were monitored starting from baseline up to 10 minutes. RESULTS There is statistically significant difference of mean systolic blood pressure at pre intubation, fourth and seventh minute (p<0.05 between two groups. But there was no statistically significant difference between two groups in mean diastolic pressure. Whereas in mean arterial pressure there was statistically significant difference in two groups at pre intubation, first minute (p<0.01 and at seventh minute (p<0.05. The heart rate was high in group A when compared to group B at first, four, seven, ten minutes after intubation. CONCLUSION Administration of ketamine with propofol was comparatively better in maintaining the hemodynamic stability after induction as compared to Thiopentone-propofol combination.

  4. Data-driven haemodynamic response function extraction using Fourier-wavelet regularised deconvolution

    Directory of Open Access Journals (Sweden)

    Roerdink Jos BTM


    Full Text Available Abstract Background We present a simple, data-driven method to extract haemodynamic response functions (HRF from functional magnetic resonance imaging (fMRI time series, based on the Fourier-wavelet regularised deconvolution (ForWaRD technique. HRF data are required for many fMRI applications, such as defining region-specific HRFs, effciently representing a general HRF, or comparing subject-specific HRFs. Results ForWaRD is applied to fMRI time signals, after removing low-frequency trends by a wavelet-based method, and the output of ForWaRD is a time series of volumes, containing the HRF in each voxel. Compared to more complex methods, this extraction algorithm requires few assumptions (separability of signal and noise in the frequency and wavelet domains and the general linear model and it is fast (HRF extraction from a single fMRI data set takes about the same time as spatial resampling. The extraction method is tested on simulated event-related activation signals, contaminated with noise from a time series of real MRI images. An application for HRF data is demonstrated in a simple event-related experiment: data are extracted from a region with significant effects of interest in a first time series. A continuous-time HRF is obtained by fitting a nonlinear function to the discrete HRF coeffcients, and is then used to analyse a later time series. Conclusion With the parameters used in this paper, the extraction method presented here is very robust to changes in signal properties. Comparison of analyses with fitted HRFs and with a canonical HRF shows that a subject-specific, regional HRF significantly improves detection power. Sensitivity and specificity increase not only in the region from which the HRFs are extracted, but also in other regions of interest.

  5. Cerebral haemodynamic response to acute intracranial hypertension induced by head-down tilt. (United States)

    Bosone, Daniele; Ozturk, Vesile; Roatta, Silvestro; Cavallini, Anna; Tosi, Piera; Micieli, Giuseppe


    The aim of this study was to evaluate, in a context of general inhibition of the sympathetic nervous system, the cerebral haemodynamic response to -30 degrees head-down tilt (HDT), a manoeuvre that produces an increase in intracranial arterial pressure. Nineteen healthy subjects were studied according to the following protocol: 10 min lying in supine position, 10 min HDT, 10 min recovery. Inhibition of the sympathetic system was confirmed by the decrease in heart rate (-3.6 bpm) and arterial blood pressure (-5.9 mmHg, p<0.05) in the late phase of the test. Blood velocity and blood pusatility index initially increased (+3.2 cm s(-1) and +9% respectively, p<0.01) then returned towards baseline before the end of HDT, while the cerebrovascular resistance index (=arterial blood pressure/blood velocity) dropped significantly and remained below control level (-7%, p<0.01) throughout the test. The changes in both these indices were opposite to those reported in several sympathetic activation tests, such as the handgrip and cold pressor tests. Conversely, arterial pressure at cranial level increased during HDT (as it also does during sympathetic activation tests), due to the development of a hydrostatic pressure gradient between heart and brain levels. Therefore, the effects observed on the pulsatility and resistance indices are not secondary to the increase in intracranial arterial pressure. It is suggested that the changes in these cerebrovascular indices are mediated by a reduction of sympathetic tone that presumably involves the cerebral as well as the peripheral vascular bed.

  6. Haemodynamic Responses to Selective Vagal Nerve Stimulation under Enalapril Medication in Rats.

    Directory of Open Access Journals (Sweden)

    Mortimer Gierthmuehlen

    Full Text Available Selective vagal nerve stimulation (sVNS has been demonstrated to lower blood pressure (BP in rats without causing major side effects. This method might be adapted for the treatment of therapy-resistant hypertension in patients. Converting enzyme inhibitors (CEIs are among the first drugs that are administered for arterial hypertension and prominently reduce BP primarily by interacting with the renin-angiotensin system of the kidneys. Beyond the reduction of BP, CEI have a positive effect on the survival rate after myocardial infarction; they reduce the rates of stroke and improve the neurohormonal status in heart-failure patients. If sVNS might be introduced as a therapy against resistant hypertension, patients will at least partially stay on their CEI medication. It is therefore the aim of this study to investigate the influence of the CEI enalapril on the haemodynamic and respiratory effects of sVNS. In 10 male Wistar rats, a polyimide-based multichannel-cuff-electrode was placed around the vagal nerve bundle to selectively stimulate the aortic depressor nerve fibres. Stimulation parameters were adapted to the thresholds of the individual animals and included repetition frequencies between 30 and 50 Hz, amplitudes of 0.5 to 1.5 mA and pulse widths between 0.4 ms and 1.0 ms. BP responses were detected with a microtip transducer in the left carotid artery, and electrocardiography was recorded with subcutaneous electrodes. After intravenous administration of enalapril (2 mg/kg bodyweight, the animals' mean arterial blood pressures (MAPs decreased significantly, while the heart rates (HRs were not significantly influenced. The effects of sVNS on BP and HR were attenuated by enalapril but were still present. We conclude that sVNS can lower the MAP during enalapril treatment without relevant side effects.

  7. Haemodynamic responses to dehydration in the resting and exercising human leg. (United States)

    Pearson, James; Kalsi, Kameljit K; Stöhr, Eric J; Low, David A; Barker, Horace; Ali, Leena; González-Alonso, José


    Dehydration and hyperthermia reduces leg blood flow (LBF), cardiac output ([Formula: see text]) and arterial pressure during whole-body exercise. It is unknown whether the reductions in blood flow are associated with dehydration-induced alterations in arterial blood oxygen content (C aO2) and O2-dependent signalling. This study investigated the impact of dehydration and concomitant alterations in C aO2 upon LBF and [Formula: see text]. Haemodynamics, arterial and femoral venous blood parameters and plasma [ATP] were measured at rest and during one-legged knee-extensor exercise in 7 males in four conditions: (1) control, (2) mild dehydration, (3) moderate dehydration, and (4) rehydration. Relative to control, C aO2 and LBF increased with dehydration at rest and during exercise (C aO2: from 199 ± 1 to 208 ± 2, and 202 ± 2 to 210 ± 2 ml L(-1) and LBF: from 0.38 ± 0.04 to 0.77 ± 0.09, and 1.64 ± 0.09 to 1.88 ± 0.1 L min(-1), respectively). Similarly, [Formula: see text] was unchanged or increased with dehydration at rest and during exercise, whereas arterial and leg perfusion pressures declined. Following rehydration, C aO2 declined (to 193 ± 2 mL L(-1)) but LBF remained elevated. Alterations in LBF were unrelated to C aO2 (r (2) = 0.13-0.27, P = 0.48-0.64) and plasma [ATP]. These findings suggest dehydration and concomitant alterations in C aO2 do not compromise LBF despite reductions in plasma [ATP]. While an additive or synergistic effect cannot be excluded, reductions in LBF during exercise with dehydration may not necessarily be associated with alterations in C aO2 and/or intravascular [ATP].

  8. Real-time phase contrast magnetic resonance imaging for assessment of haemodynamics: from phantom to patients

    Energy Technology Data Exchange (ETDEWEB)

    Traber, Julius; Wurche, Lennart; Dieringer, Matthias A.; Utz, Wolfgang; Knobelsdorff-Brenkenhoff, Florian von; Schulz-Menger, Jeanette [Max-Delbrueck-Centrum and Charite -Medical University Berlin and HELIOS Klinikum Berlin-Buch, Department of Cardiology and Nephrology, Working Group on Cardiovascular Magnetic Resonance Imaging, Experimental and Clinical Research Center, Berlin (Germany); Greiser, Andreas [Siemens AG Healthcare Sector, Erlangen (Germany); Jin, Ning [Siemens Medical Solutions USA, Inc., Columbus, OH (United States)


    Assessment of haemodynamics is crucial in many cardiac diseases. Phase contrast MRI (PC-MRI) can accurately access it. Arrhythmia is a major limitation in conventional segmented PC-MRI (SEG). A real-time PC-MRI sequence (RT) could overcome this. We validated RT by comparing to SEG. A prototype RT using shared velocity encoding was tested against SEG at 1.5 T in a flow phantom and consecutively included patients with (n = 55) or without (n = 59) aortic valve disease. In patients with atrial fibrillation (Afib, n = 15), only RT was applied. Phantom: PC images were acquired in front of and behind an interchangeable aortic-stenosis-like inlay. Mean velocity and flow were quantified. Patients: PC images were acquired in the ascending aorta, pulmonary trunk and superior caval vein. Peak velocity, stroke volume and regurgitant fraction were quantified. Phantom: Mean velocities (11 ± 1 to 207 ± 10 cm/s) and flow correlated closely between SEG and RT (r ≥ 0.99, ICC ≥ 0.98, p < 0.0005). Patients without AVD or with aortic regurgitation: Concordance of SEG and RT was excellent regarding peak velocities, stroke volumes (r ≥ 0.91, ICC ≥ 0.94, p < 0.0005) and regurgitant fractions (r = 0.95, ICC = 0.95, p < 0.0005). RT was feasible in all patients with Afib. The real-time sequence is accurate compared to conventional segmented PC-MRI. Its applicability in Afib was shown. Real-time PC-MRI might become a valuable tool in arrhythmia. (orig.)

  9. Effect of Fontan geometry on exercise haemodynamics and its potential implications. (United States)

    Tang, Elaine; Wei, Zhenglun Alan; Whitehead, Kevin K; Khiabani, Reza H; Restrepo, Maria; Mirabella, Lucia; Bethel, James; Paridon, Stephen M; Marino, Bradley S; Fogel, Mark A; Yoganathan, Ajit P


    Exercise intolerance afflicts Fontan patients with total cavopulmonary connections (TCPCs) causing a reduction in quality of life. Optimising TCPC design is hypothesised to have a beneficial effect on exercise capacity. This study investigates relationships between TCPC geometries and exercise haemodynamics and performance. This study included 47 patients who completed metabolic exercise stress test with cardiac magnetic resonance (CMR). Phase-contrast CMR images were acquired immediately following supine lower limb exercise. Both anatomies and exercise vessel flow rates at ventilatory anaerobic threshold (VAT) were extracted. The vascular modelling toolkits were used to analyse TCPC geometries. Computational simulations were performed to quantify TCPC indexed power loss (iPL) at VAT. A highly significant inverse correlation was found between the TCPC diameter index, which factors in the narrowing of TCPC vessels, with iPL at VAT (r=-0.723, pexercise performance variables, including minute oxygen consumption (VO2) at VAT (r=0.373, p=0.01), VO2 at peak exercise (r=0.485, p=0.001) and work at VAT/weight (r=0.368, p=0.01). iPL at VAT was negatively correlated with VO2 at VAT (r=-0.337, p=0.02), VO2 at peak exercise (r=-0.394, p=0.007) and work at VAT/weight (r=-0.208, p=0.17). Eliminating vessel narrowing in TCPCs and reducing elevated iPL at VAT could enhance exercise tolerance for patients with TCPCs. These findings could help plan surgical or catheter-based strategies to improve patients' exercise capacity. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  10. Penile veins play a pivotal role in erection: the haemodynamic evidence. (United States)

    Hsieh, Cheng-Hsing; Wang, Chii-Jye; Hsu, Geng-Long; Chen, Shyh-Chyan; Ling, Pei-Ying; Wang, Tsu; Fong, Tsorng-Harn; Tseng, Guo-Fang


    Although penile venous surgery has almost been abandoned and the venous factor eliminated as a contributing factor to erectile dysfunction, new concepts of erection-related veins has recently been described and reported in literature. We sought to conduct a haemodynamic study on human cadavers in order to elucidate to what extent penile veins act in erection, and to explore the possible role of erection-related veins as an important contributor to impotence. From November 2002 to December 2003, seven fresh human cadavers of men who had no sexual activity for at least 6 months prior to death, and in whom the penis was intact were used for this study. Infusion cavernosometry was carried out with an induction flow of 150 mL/min before and after the erection-related veins were removed. A rigid erection was attained in all subjects, lasting significantly longer (p = 0.043) after removal of erection-related veins. Similarly, there were significant differences in the maintenance flow (p = 0.043), T(max) (p = 0.043), V(max) (p = 0.043), and pressure loss (p = 0.043). In cadaveric penises, a rigid erection could be maintained in spite of the fact that the low flow rate of 21 mL/min is much lower than the average arterial perfusion rate observed in cases of arterial insufficiency. We therefore concluded that penile veins may play a significant role in attaining sufficient erection, and further research is required to study this possible clinical implication.

  11. Coagulation of humic waters for diffused pollution control and the influence of coagulant type on DOC fractions removed. (United States)

    Heiderscheidt, Elisangela; Leiviskä, Tiina; Kløve, Bjørn


    This study examined the suitability of organic coagulants for treatment of typically humic peat extraction runoff water by comparing their performance with that of ferric sulphate (FS). The influence of coagulant type on dissolved organic carbon (DOC) fractions removed was analysed in detail using LC-OCD-OND (size exclusion liquid chromatography coupled with organic carbon and organic nitrogen detection) fractionation techniques. In general, lower coagulant dosage was needed under acidic (pH 4.5) than neutral (pH 6.5) conditions. Chitosan (Chit) and poly (diallyldimethyl) ammonium chloride (pDMAC) required significantly lower dosage (40-55%) than FS for acceptable purification, while a tannin-based coagulant (Tan2) required substantially higher dosage (55-75%) independent of water pH. FS demonstrated the best removal of DOC (coagulants, with FS being the most efficient (biopolymers 69% and humic substances 91%), followed by Tan2. FS also displayed satisfactory removal of lower MW fractions (building blocks ∼46% and low MW neutrals 62%). Overall, FS was the best performing coagulant. Nevertheless, the organic polymers demonstrated satisfactory overall performance, achieving purification rates mostly inside the requirements set by Finnish environmental authorities. Copyright © 2016. Published by Elsevier Ltd.

  12. Optimum coagulant forecasting by modeling jar test experiments using ANNs

    Directory of Open Access Journals (Sweden)

    S. Haghiri


    Full Text Available Currently, the proper utilization of water treatment plants and optimizing their use is of particular importance. Coagulation and flocculation in water treatment are the common ways through which the use of coagulants leads to instability of particles and the formation of larger and heavier particles, resulting in improvement of sedimentation and filtration processes. Determination of the optimum dose of such a coagulant is of particular significance. A high dose, in addition to adding costs, can cause the sediment to remain in the filtrate, a dangerous condition according to the standards, while a sub-adequate dose of coagulants can result in the reducing the required quality and acceptable performance of the coagulation process. Although jar tests are used for testing coagulants, such experiments face many constraints with respect to evaluating the results produced by sudden changes in input water because of their significant costs, long time requirements, and complex relationships among the many factors (turbidity, temperature, pH, alkalinity, etc. that can influence the efficiency of coagulant and test results. Modeling can be used to overcome these limitations; in this research study, an artificial neural network (ANN multi-layer perceptron (MLP with one hidden layer has been used for modeling the jar test to determine the dosage level of used coagulant in water treatment processes. The data contained in this research have been obtained from the drinking water treatment plant located in Ardabil province in Iran. To evaluate the performance of the model, the mean squared error (MSE and correlation coefficient (R2 parameters have been used. The obtained values are within an acceptable range that demonstrates the high accuracy of the models with respect to the estimation of water-quality characteristics and the optimal dosages of coagulants; so using these models will allow operators to not only reduce costs and time taken to perform

  13. [Procedural analysis of acid-base balance disorder: case serials in 4 patents]. (United States)

    Ma, Chunyuan; Wang, Guijie


    To establish the standardization process of acid-base balance analysis, analyze cases of acid-base balance disorder with the aid of acid-base balance coordinate graph. The acid-base balance theory were reviewed systematically on recent research progress, and the important concepts, definitions, formulas, parameters, regularity and inference in the analysis of acid-base balance were studied. The analysis of acid-base balance disordered processes and steps were figured. The application of acid-base balance coordinate graph in the cases was introduced. The method of "four parameters-four steps" analysis was put forward to analyze the acid-base balance disorders completely. "Four parameters" included pH, arterial partial pressure of carbon dioxide (PaCO2), HCO3- and anion gap (AG). "Four steps" were outlined by following aspects: (1) according to the pH, PaCO2 and HCO3-, the primary or main types of acid-base balance disorder was determined; (2) primary or main types of acid-base disorder were used to choose the appropriate compensation formula and to determine the presence of double mixed acid-base balance disorder; (3) the primary acid-base balance disorders were divided into two parts: respiratory acidosis or respiratory alkalosis, at the same time, the potential HCO3- should be calculated, the measured HCO3- should be replaced with potential HCO3-, to determine whether there were three mixed acid-base disorders; (4) based on the above analysis the data judged as the simple AG increased-metabolic acidosis was needed to be further analyzed. The ratio of ΔAG↑/ΔHCO3-↓ was also needed to be calculated, to determine whether there was normal AG metabolic acidosis or metabolic alkalosis. In the clinical practice, PaCO2 (as the abscissa) and HCO3- (as the ordinate) were used to establish a rectangular coordinate system, through origin (0, 0) and coordinate point (40, 24) could be a straight line, and all points on the straight line pH were equal to 7.40. The acid-base

  14. Veno-veno-arterial extracorporeal membrane oxygenation for respiratory failure with severe haemodynamic impairment: technique and early outcomes. (United States)

    Ius, Fabio; Sommer, Wiebke; Tudorache, Igor; Avsar, Murat; Siemeni, Thierry; Salman, Jawad; Puntigam, Jakob; Optenhoefel, Joerg; Greer, Mark; Welte, Tobias; Wiesner, Olaf; Haverich, Axel; Hoeper, Marius; Kuehn, Christian; Warnecke, Gregor


    Patients with respiratory failure may benefit from veno-venous and veno-arterial extracorporeal membrane oxygenation (ECMO) support. We report on our initial experience of veno-veno-arterial (v-v-a) ECMO in patients with respiratory failure. Between January 2012 and February 2014, 406 patients required ECMO support at our institution. Here, we retrospectively analysed the characteristics and outcomes of patients commenced on either veno-venous or veno-arterial ECMO due to respiratory failure, and then switched to v-v-a ECMO. Ten (2%) patients proceeded to v-v-a ECMO. The underlying conditions were acute respiratory distress syndrome (n = 3), end-stage pulmonary fibrosis (n = 5) and respiratory failure after major thoracic surgery (n = 1) and Caesarean section (n = 1). In all of these patients, ECMO was initially started as veno-venous (n = 9) or veno-arterial (n = 1) ECMO but was switched to a veno-veno-arterial (v-v-a) approach after a mean of 2 (range, 0-7) days. Reasons for switching were: haemodynamic instability (right heart failure, n = 5; pericardial tamponade, n = 1; severe mitral valve regurgitation, n = 1; haemodynamic instability following cardiopulmonary resuscitation, n = 1 and evidence of previously unknown atrial septal defect with pulmonary hypertension and Eisenmenger syndrome, n = 1) and upper-body hypoxaemia (n = 1). ECMO-related complications were bleeding (n = 3) and leg ischaemia (n = 2). Seven patients were successfully taken off ECMO with 4 being bridged to recovery and a further 3 to lung transplantation after a mean of 11 (range, 9-18) days. Five patients survived until hospital discharge and all of them were alive at the end of the follow-up. Veno-veno-arterial ECMO is a technically feasible rescue strategy in treating patients presenting with combined respiratory and haemodynamic failure. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  15. Integrated SPECT/CT for assessment of haemodynamically significant coronary artery lesions in patients with acute coronary syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Rispler, Shmuel [Technion - Israel Institute of Technology, Department of Cardiology, Rambam Health Care Campus and the B. Rappaport Faculty of Medicine, Haifa (Israel); Technion - Israel Institute of Technology, Department of Nuclear Medicine, Rambam Health Care Campus and the B. Rappaport Faculty of Medicine, Haifa (Israel); Aronson, Doron; Roguin, Ariel; Beyar, Rafael [Technion - Israel Institute of Technology, Department of Cardiology, Rambam Health Care Campus and the B. Rappaport Faculty of Medicine, Haifa (Israel); Abadi, Sobhi; Engel, Ahuva [Technion - Israel Institute of Technology, Department of Medical Imaging, Rambam Health Care Campus and the B. Rappaport Faculty of Medicine, Haifa (Israel); Israel, Ora; Keidar, Zohar [Technion - Israel Institute of Technology, Department of Nuclear Medicine, Rambam Health Care Campus and the B. Rappaport Faculty of Medicine, Haifa (Israel)


    Early risk stratification in patients with non-ST elevation acute coronary syndromes (NSTE-ACS) is important since the benefit from more aggressive and costly treatment strategies is proportional to the risk of adverse clinical events. In the present study we assessed whether hybrid single photon emission computed tomography (SPECT)/coronary computed tomography angiography (CCTA) technology could be an appropriate tool in stratifying patients with NSTE-ACS. SPECT/CCTA was performed in 90 consecutive patients with NSTE-ACS. The Thrombolysis in Myocardial Infarction risk score (TIMI-RS) was used to classify patients as low- or high-risk. Imaging was performed using SPECT/CCTA to identify haemodynamically significant lesions defined as >50% stenosis on CCTA with a reversible perfusion defect on SPECT in the corresponding territory. CCTA demonstrated at least one lesion with >50% stenosis in 35 of 40 high-risk patients (87%) as compared to 14 of 50 low-risk patients (35%; TIMI-RS <3; p <0.0001). Of the 40 high-risk and 50 (16%) low-risk TIMI-RS patients, 16 (40%) and 8 (16%), respectively, had haemodynamically significant lesions (p = 0.01). Patients defined as high-risk by a high TIMI-RS, a positive CCTA scan or both (n = 45) resulted in a sensitivity of 95%, specificity of 49%, PPV of 35% and NPV of 97% for having haemodynamically significant coronary lesions. Those with normal perfusion were spared revascularization procedures, regardless of their TIMI-RS. Noninvasive assessment of coronary artery disease by SPECT/CCTA may play an important role in risk stratification of patients with NSTE-ACS by better identifying the subgroup requiring intervention. (orig.)

  16. To evaluate the effects of dexmedetomidine on intraocular pressure and haemodynamic changes in response to laryngoscopy and tracheal intubation

    Directory of Open Access Journals (Sweden)



    Full Text Available Background: The most important prerequisites for neurosurgeries are brain relaxation, need of stable haemodynamics with less fluctuation in intracranial pressure and speedy recovery from anaesthesia. Endotracheal intubation is the major stressful stimuli that can elicit a marked pressor response. Various drugs have been used to attenuate these reflexes. Dexmedetomidine, a highly selective alpha 2-adrenoceptor agonist, have neuroprotective, cardioprotective, and sedative effects so it is potentially useful during neuroanaesthesia. This is a prospective randomised control trial carried out to see whether administration of Dexmedetomidine prior to intubation can attenuate the various haemodynamic responses, intraocular pressure (IOP and the requirement of induction dose of propofol in control and study group. Materials and Methods: Fifty patients (ASA grade 1, 2 scheduled for intracranial tumour surgeries were divided into two groups (25 each. Group D received Dexmedetomidine 0.8 μg/kg i.v. over 10 mins and group C received 20 ml saline. Anaesthesia induced with Propofol, dose adjusted using bispectral index monitor. The groups were compared with IOP, Heart rate (HR, Mean arterial pressure (MAP, and dose of Propofol required for induction. Results : Groups were well matched for their demographic data and pre-operative. IOP in both the eyes decreases significantly after premedication and remained below baseline even after 10 th min of intubation in group D while in Group C; it increased significantly after intubation and remained above baseline. The difference between groups was also statistically significant. HR and MAP decreased significantly in patients of group D compared to group C (P < 0.05. Patients were more haemodynamicaly stable at all time points after premedication in group D (P < 0.05. Propofol requirements for induction was lesser in group D (P < 0.05. Bradycardia and hypotension incidences were higher in group D. Conclusion

  17. Effects of amiodarone on erect and supine exercise haemodynamics and exercise capacity in patients with hypertrophic cardiomyopathy. (United States)

    Frenneaux, M P; Counihan, P J; Porter, A; Lipkin, D P; McKenna, W J


    Hypertrophic cardiomyopathy (HCM) is a primary heart muscle disease associated with a high incidence of sudden death. Amiodarone is of benefit in those patients with a high risk profile for sudden death. Amiodarone has also been reported to improve symptoms dramatically in some patients with HCM but to cause functional deterioration in others. In the acute phase of oral amiodarone therapy there are few discernable changes in cardiovascular haemodynamics and the mechanisms of any beneficial effects on symptoms remain unclear. To determine the effect of amiodarone on exercise responses we measured haemodynamic indices in 10 patients during maximal supine- and symptom-limited erect treadmill exercise before and 6 weeks after amiodarone therapy. Following amiodarone therapy there was a significant reduction in resting and peak heart rate during erect exercise (76 +/- 13 vs 97 +/- 19 b.min-1; P = 0.001 and 114 +/- 26 vs 146 +/- 21 b.min-1; P = 0.001 respectively). Despite increases in peak pulmonary and systemic artery pressures with amiodarone therapy there was no difference in the peak left ventricular filling pressure or maximum cardiac output achieved. Similarly, during supine exercise the resting and peak heart rates were less following the 6 weeks amiodarone therapy. Comparison of supine and erect exercise haemodynamic indices demonstrated higher peak LV filling and higher peak systolic and pulmonary artery pressures during supine than during erect exercise (29 +/- 10 vs 25 +/- 12; P less than 0.04; 151 +/- 42 vs 126 +/- 48; P = 0.01 and 66 +/- 27 vs 62 +/- 21; P = 0.08 respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

  18. Normalisation of haemodynamics in patients with end-stage heart failure with continuous-flow left ventricular assist device therapy. (United States)

    Gupta, Sunil; Woldendorp, Kei; Muthiah, Kavitha; Robson, Desiree; Prichard, Roslyn; Macdonald, Peter S; Keogh, Anne M; Kotlyar, Eugene; Jabbour, Andrew; Dhital, Kumud; Granger, Emily; Spratt, Phillip; Jansz, Paul; Hayward, Christopher S


    New generation continuous-flow left ventricular assist devices (LVADs) utilise centrifugal pumps. Data concerning their effect on patient haemodynamics, ventricular function and tissue perfusion is limited. We aimed to document these parameters following HeartWare centrifugal continuous-flow LVAD (HVAD) implantation and to assess the impact of post-operative right heart failure (RHF). We reviewed 53 consecutive patients (mean age 49.5 ± 14.1 yrs) with HVAD implanted in the left ventricle, at St. Vincent's Hospital, Sydney, between January 2007 and August 2012. Available paired right heart catheterisation (n=35) and echocardiography (n=39) data was reviewed to assess response of invasive haemodynamics and ventricular function to LVAD support. A total of 28 patients (53%) were implanted from interim mechanical circulatory support. Seventeen patients (32%) required short-term post-implant veno-pulmonary artery extracorporeal membrane oxygenation. At 100 ± 61 days post-implant, mean pulmonary artery pressure and mean pulmonary capillary wedge pressure decreased from 38.8 ± 7.7 to 22.9 ± 7.7 mmHg and 28.3 ± 6.4 to 13.4 ± 5.4 mmHg respectively (pRHF patients (72.2%, n=18) compared to those without (96.9%, n=35, p=0.01). HVAD support improves haemodynamics, LV dimensions and renal function. Following implantation with a centrifugal continuous-flow LVAD, RHF remains a significant risk with a tendency to worse outcomes in the short to medium term. Crown Copyright © 2014. Published by Elsevier B.V. All rights reserved.

  19. Haemodynamic response to crystalloids or colloids in shock: an exploratory subgroup analysis of a randomised controlled trial. (United States)

    Heming, Nicholas; Elatrous, Souheil; Jaber, Samir; Dumenil, Anne Sylvie; Cousson, Joël; Forceville, Xavier; Kimmoun, Antoine; Trouillet, Jean Louis; Fichet, Jérôme; Anguel, Nadia; Darmon, Michael; Martin, Claude; Chevret, Sylvie; Annane, Djillali


    To compare the haemodynamic effect of crystalloids and colloids during acute severe hypovolaemic shock. Exploratory subgroup analysis of a multicentre randomised controlled trial (Colloids Versus Crystalloids for the Resuscitation of the Critically Ill, CRISTAL, NCT00318942). CRISTAL was conducted in intensive care units in Europe, North Africa and Canada. Current analysis included all patients who had a pulmonary artery catheter in place at randomisation. 220 patients (117 received crystalloids vs 103 colloids) underwent pulmonary artery catheterisation. Crystalloids versus colloids for fluid resuscitation in hypovolaemic shock. Haemodynamic data were collected at the time of randomisation and subsequently on days 1, 2, 3, 4, 5, 6 and 7. Median cumulative volume of fluid administered during the first 7 days was higher in the crystalloids group than in the colloids group (3500 (2000-6000) vs 2500 (1000-4000) mL, p=0.01). Patients in the colloids arm exhibited a lower heart rate over time compared with those allocated to the crystalloids arm (p=0.014). There was no significant difference in Cardiac Index (p=0.053), mean blood pressure (p=0.4), arterial lactates (p=0.9) or global Sequential Organ Failure Assessment score (p=0.3) over time between arms. During acute severe hypovolaemic shock, patients monitored by a pulmonary artery catheter achieved broadly similar haemodynamic outcomes, using lower volumes of colloids than crystalloids. The heart rate was lower in the colloids arm. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  20. Intraoperative Changes in Blood Coagulation and Thrombelastographic Monitoring in Liver Transplantation (United States)

    Kang, Yoo Goo; Martin, Douglas J.; Marquez, Jose; Lewis, Jessica H.; Bontempo, Franklin A.; Shaw, Byers W.; Starzl, Thomas E.; Winter, Peter M.


    The blood coagulation system of 66 consecutive patients undergoing consecutive liver transplantations was monitored by thrombelastograph and analytic coagulation profile. A poor preoperative coagulation state, decrease in levels of coagulation factors, progressive fibrinolysis, and whole blood clot lysis were observed during the preanhepatic and anhepatic stages of surgery. A further general decrease in coagulation factors and platelets, activation of fibrinolysis, and abrupt decrease in levels of factors V and VIII occurred before and with reperfusion of the homograft. Recovery of blood coagulability began 30–60 min after reperfusion of the graft liver, and coagulability had returned toward baseline values 2 hr after reperfusion. A positive correlation was shown between the variables of thrombelastography and those of the coagulation profile. Thrombelastography was shown to be a reliable and rapid monitoring system. Its use was associated with a 33% reduction of blood and fluid infusion volume, whereas blood coagulability was maintained without an increase in the number of blood product donors. PMID:3896028

  1. Identification of causal relations between haemodynamic variables, auditory evoked potentials and isoflurane by means of fuzzy logic

    DEFF Research Database (Denmark)

    Jensen, E W; Nebot, A; Caminal, P


    The aim of this study was to identify a possible relationship between haemodynamic variables, auditory evoked potentials (AEP) and inspired fraction of isoflurane (ISOFl). Two different models (isoflurane and mean arterial pressure) were identified using the fuzzy inductive reasoning (FIR......) methodology. A fuzzy model is able to identify non-linear and linear components of a causal relationship by means of optimization of information content of available data. Nine young female patients undergoing hysterectomy under general anaesthesia were included. Mean arterial pressure (MAP), heart rate (HR...

  2. Haemodynamic evaluation of the cerebral circulation by periorbital Doppler examination and cerebral blood flow (CBF) measurement in carotid artery disease

    DEFF Research Database (Denmark)

    Sillesen, H; Schroeder, T; Buchardt Hansen, H J


    by Doppler technique, and cerebral blood flow reactivity to vasodilation, by i.v. xenon-133 technique, in 35 patients before carotid endarterectomy. The results were related to the actual perfusion pressures, measured during surgery in the distal ICA. All 15 patients with normal orthograde periorbital flow...... with the remaining 12 patients with inverted periorbital flow (p less than 0.001), who in turn had lower perfusion pressures than the 15 patients with orthograde flow (p less than 0.005). Based on these results, we suggest periorbital Doppler examination as a haemodynamic adjunct to direct ICA visualization...

  3. New evidence for favourable effects on haemodynamics and ventricular performance after Parachute(®) implantation in humans. (United States)

    Schmidt, Tobias; Frerker, Christian; Thielsen, Thomas; Dotz, Inge; Wohlmuth, Peter; Kuck, Karl-Heinz; Schäfer, Ulrich


    The Parachute(®) Ventricular Partitioning Device offers an additional strategy for heart failure patients with exclusion of the infarcted wall to decrease left ventricular volumes, myocardial work, and wall stress. The aim of the present study was to evaluate if Parachute implantation might influence acute haemodynamic and functional performance in patients with left ventricular aneurysm after anteroapical infarction. Sixteen patients underwent a Parachute device implantation. Invasive right and left heart haemodynamic assessments as well as left ventricular analysis for evaluating left ventricle end-diastolic and end-systolic volumes, and regional ventricular function were analysed. After implantation a significant increase in stroke volume (+25.4%, P = 0.0005), stroke volume index (+26.5%, P = 0.0005), cardiac output (+25.8%, P < 0.0001) and cardiac index (+25.9%, P < 0.0001) was found. In addition to an increase in mean aortic (P = 0.0050) and pulmonary pressure (P = 0.0347), there were significant increases in stroke work index (P = 0.0003), left (P = 0.0015) and right (P = 0.0024) ventricular stroke work index as well as left and right cardiac work index (both P = 0.0001), while the remaining haemodynamic parameters remained unchanged. Left ventricular analysis showed an acute reduction of the left ventricular end-diastolic volume (-18.0%, P < 0.0001) and left ventricular end-systolic volume (-26.3%, P < 0.0001) and an increase in ejection fraction from 22.9 to 30.6% (+38.4%, P < 0.0001). Most interestingly, the basal wall segments displayed an increased contribution to the left ventricular ejection fraction with increased wall motion in nearly all segments (except the apex region). The data demonstrate the acute haemodynamic efficacy of Parachute device implantation. The implantation of the device displays immediate significant left ventricular volume reduction leading to an acute improved right and left


    Directory of Open Access Journals (Sweden)

    D. Afzaal, M. Nisa, M. A. Khan and M. Sarwar


    Full Text Available The acid base status of a dairy cow is maintained within a narrow range. The key mechanisms involving blood, cells and lungs, perform this function. Although other minerals have an impact on acid base metabolism, the minerals used in dietary cation-anion balance (DCAB namely sodium (Na, potassium (K and chloride (Cl have the greatest effect. Hence, acid base status implicates other biological functions of dairy cows. Low DCAB prepartum reduces the incidence of milk fever and increases the productivity by simmering down the severity of hypocalcaemia. High DCAB diets have proved to increase dry mater and water intake and production and to mitigate the effects of heat stress.

  5. Evaluation of standard haemodynamic tests of autonomic function and HbA1c as predictors of delayed gastric emptying in patients with type 1 diabetes mellitus.

    LENUS (Irish Health Repository)

    Lydon, A


    We examined the relation between chronic glycaemic control (using glycosylated haemoglobin), haemodynamic autonomic function and rate of gastric emptying in 16 patients with type 1 diabetes mellitus. Gastric emptying was measured using a paracetamol absorption technique. Parameters of gastric emptying include area under the plasma paracetamol concentration time curve. Patients were classified as diabetic autonomic neuropathy positive or negative using five standardized haemodynamic reflex tests. Area under the plasma paracetamol concentration time curve in the neuropathy positive (10.36 (4.5) mmol.-1. min) and negative (9.84 (3.0) mmol.-1. min) groups were similar (.P.=0.42) using unpaired Student\\'s.t. -tests. Glycosylated haemoglobin concentration and area under the plasma paracetamol concentration time curve (.n.=16) demonstrated a Pearson\\'s correlation co-efficient of 0.24. Neither tests of haemodynamic autonomic function, nor concentration of glycosylated haemoglobin, are predictive of diabetic gastroparesis.


    Directory of Open Access Journals (Sweden)



    Full Text Available BACKGROUND AND AIMS To study and compare Labetalol and Clonidine as premedication to attenuate haemodynamic changes to Laparoscopy through oral route, as it is safe method of administration and easy to prescribe. METHODS In a prospective, comparative randomised study, 60 adult patients of both sexes of ASA Grade I and II were divided randomly into 2 groups of 30 each, Group L and Group C. Group L were given Tab. Labetalol 200mg orally 60-90 minutes before induction. Group C were given Tab. Clonidine 300µg orally 60-90 minutes before induction. We compared the degree of attenuation of haemodynamic changes during laparoscopic surgeries. RESULTS Oral Clonidine has better control on the rise in heart rate and mean arterial pressure (MAP during laryngoscopy for laparoscopy compared to oral Labetalol. CONCLUSION We conclude that oral Clonidine showed better attenuation of haemodynamic changes than oral Labetalol.


    Directory of Open Access Journals (Sweden)

    Larisa Postolachi


    Full Text Available The aim of presented research was to optimize the treatment process of the Prut River water. In order to realize the proposed goal, there were studied the following factors which can improve the process of coagulation: (i the influence of stirring speed during coagulation and (ii the influence of the concentration of the coagulant solution added in the process of coagulation. The optimal conditions of coagulation were established using the Jar-test method. Application of the recommended procedure contribute to the reduction of the coagulant dose, the contact time, the aluminum concentration in water and the expenses for water treatment.

  8. Comparison of Moringa stenopetala seed extract as a clean coagulant with Alum and Moringa stenopetala-Alum hybrid coagulant to remove direct dye from Textile Wastewater. (United States)

    Dalvand, Arash; Gholibegloo, Elham; Ganjali, Mohammad Reza; Golchinpoor, Najmeh; Khazaei, Mohammad; Kamani, Hossein; Hosseini, Sara Sadat; Mahvi, Amir Hossein


    In this study, the efficiency of Moringa stenopetala seed extract was compared with alum and M. stenopetala-alum hybrid coagulant to remove Direct Red 23 azo dye from textile wastewater. The effects of parameters such as pH, coagulant dose, type of salt used for the extraction of coagulant and initial dye concentration on dye removal efficiency were investigated. Moreover, the existing functional groups on the structure of M. stenopetala coagulant (MSC) were determined by Fourier transform infrared spectroscopy, and the morphology of sludge produced by MSC, alum, and hybrid coagulant was characterized by scanning electron microscopy. Ninhydrin test was also used to determine the quantity of primary amines in the MSC and Moringa oleifera coagulant (MOC). According to the results, with increasing the coagulant dose and decreasing the initial dye concentration, dye removal efficiency has increased. The maximum dye removal of 98.5, 98.2, and 98.3 % were obtained by using 240, 120, and 80 mg/L MSC, alum and hybrid coagulant at pH 7, respectively. The results also showed MSC was much more effective than MOC for dye removal. The volume of sludge produced by MSC was one fourth and half of those produced by alum and hybrid coagulant, respectively. Based on the results, hybrid coagulant was the most efficient coagulant for direct dye removal from colored wastewater.

  9. Polymorphisms of the coagulation system and risk of cancer. (United States)

    Tinholt, Mari; Sandset, Per Morten; Iversen, Nina


    Hypercoagulability is a frequently finding in patients with cancer, and is associated with an increased risk of venous thrombosis (VT). Cancer-associated VT is associated with poor prognosis and represents the leading non-cancer cause of death among these patients. Conversely, patients experiencing VT are at increased risk of subsequent cancer, suggesting an epidemiological bidirectional link between cancer and hemostasis, and indicating a role of the hemostatic system in cancer development. How the coagulation system relates to cancer etiology at the genetic level is largely unexplored. Data on the association of polymorphisms in genes involved in coagulation with cancer development is important to clarify the role of the coagulation system in cancer pathogenesis. Effects of coagulation-related gene polymorphisms on cancer risk may possibly be translated into novel treatment- and prevention strategies of cancer-associated thrombosis and the cancer itself. This article reviews the current knowledge of the relation between polymorphisms in genes involved in coagulation and cancer risk in solid tumors. © 2016 Elsevier Ltd. All rights reserved.

  10. Clay-catalyzed reactions of coagulant polymers during water chlorination (United States)

    Lee, J.-F.; Liao, P.-M.; Lee, C.-K.; Chao, H.-P.; Peng, C.-L.; Chiou, C.T.


    The influence of suspended clay/solid particles on organic-coagulant reactions during water chlorination was investigated by analyses of total product formation potential (TPFP) and disinfection by-product (DBP) distribution as a function of exchanged clay cation, coagulant organic polymer, and reaction time. Montmorillonite clays appeared to act as a catalytic center where the reaction between adsorbed polymer and disinfectant (chlorine) was mediated closely by the exchanged clay cation. The transition-metal cations in clays catalyzed more effectively than other cations the reactions between a coagulant polymer and chlorine, forming a large number of volatile DBPs. The relative catalytic effects of clays/solids followed the order Ti-Mont > Fe-Mont > Cu-Mont > Mn-Mont > Ca-Mont > Na-Mont > quartz > talc. The effects of coagulant polymers on TPFP follow the order nonionic polymer > anionic polymer > cationic polymer. The catalytic role of the clay cation was further confirmed by the observed inhibition in DBP formation when strong chelating agents (o-phenanthroline and ethylenediamine) were added to the clay suspension. Moreover, in the presence of clays, total DBPs increased appreciably when either the reaction time or the amount of the added clay or coagulant polymer increased. For volatile DBPs, the formation of halogenated methanes was usually time-dependent, with chloroform and dichloromethane showing the greatest dependence. ?? 2003 Elsevier Inc. All rights reserved.

  11. Wastewater Treatment of Stone Cutting Industries by Coagulation Process

    Directory of Open Access Journals (Sweden)

    Mohammad Fahiminia


    Full Text Available Background & Aims of the Study: The wastewater created as a result of stone cutting industries enters some pools for re-consumption so that its suspended solids settle by gravity. By taking to account the high volume of water and sludge, treatment of wastewater and removal of sludge cause many problems for stone cutting units. The objective of this study was to determine the quality of wastewater and to investigate the effects of coagulants on suspended solids removal efficiency from wastewater of some stone cutting industries (Qom, Iran. Materials & Methods: In this experimental study, the effects of different doses of coagulants including Alum, poly aluminum chloride, Polymer, Ferric chloride (Fecl3 and Lime on Turbidity, “total suspended solids” (TSS and “total solids” (TS removal were investigated by Jar Test. Removal efficiency of different coagulates was estimated. Results: The results indicated that lime in dose 100 PPM is the best coagulant for turbidity removal and the highest efficiency for TS removal is related to using Alum in dose 100 PPM. Conclusions: Considering the findings of this study, it can be concluded that using coagulants causes reduction in settling time and speeds up the return of water to the consumption cycle of stone cutting factories, and also increases turbidity removal efficiency.

  12. Improvement of wastewater treatment by use of natural coagulants

    Directory of Open Access Journals (Sweden)

    Jelena Prodanović


    Full Text Available An activated sludge and other organic sludges from wastewater treatment processes are usually anaerobically digested prior to application on land. The purpose of digestion is to convert bulky, odorous sludges to relatively inert material that can be rapidly dewatering. The important benefit of this process is a biogas production, too. It is proper to enlarge primary sludge production in a primary settler by adding some coagulation aids, with aim to increase a biogas production, as much as possible. The most common coagulant is alum, but presence of large quantities of aluminum salts in sludge has a harmful impact on digestion and digested sludge application. Some natural coagulants, that have a numerous advantages, can be used instead of alum. Natural coagulants could be extracted from a different plant material, and considering the fact that they are of organic nature, the biogas yield can be enhanced by their presence. A plant material that remains after extraction can be used as a feed. The aim of this paper is a consideration of potential environmental benefits of substitution of alum by natural coagulant extracted from common bean seeds in sewage wastewater treatment process.

  13. Vegetable coagulants as alternative for treatment of wastewater in Mexico

    Directory of Open Access Journals (Sweden)

    Servando López-León


    Full Text Available This review addresses the various properties of natural coagulants, water, the chemical substance essential for life and the ideal solvent for a large number of compounds, it is commonly used with domestic, commercial and industrial purposes. After its use, it presents sewage to be retired before use it once again. To remove pollutant, water is subject to different physical, chemical and biological processes. Here, the clarification process uses aluminum and iron materials to remove the solids present; these materials are reported as health hazardous and toxic. In Mexico, regulatory frame work stablish that treated wastewater should do not exceed 0.2 mg/L of aluminum even though has been reported an increased risk of Alzheimer's in populations when water exceeds 0.1 mg/L. Natural coagulants have showed coagulation properties when are used in the clarification process, proven its advantages over traditional ones; such as low cost, good coagulant properties and safe health and non-toxic properties. Here, we enlist some vegetable species as alternatives to the traditional based on aluminum and iron. Additionally, these species are known to have origins on Mexico or being present extensively in the territory, making possible to think about them as alternative coagulants in the clarification process of the wastewater treatment process.


    Directory of Open Access Journals (Sweden)

    Vikulina Vera Borisovna


    Full Text Available The authors carried out experiments on the in-fluence of ultrasound on the subsidence of suspended materials. The efficiency of coagulation process in wa-ter purification in ultrasound field is estimated. The influence of ultrasound on the water with suspended materials before introducing coagulant was a condition of the experiment. The magnetostriction method for obtaining ultrasound oscillations with the help of ultra-sound generator of batch production was applied. The samples were chosen and the coagulation process was controlled using standard procedures. The experimental data was obtained which estimate the efficiency in-crease in the subsidence of suspended materials de-pending on the duration of ultrasound processing. Dur-ing one minute of ultrasound processing the following results were obtained: the subsidence efficiency in-creased by 25.83 % in case of coagulant share Al2O3 2.5 mg/l; the subsidence efficiency increased by 23.70 % in case of coagulant share Al2O3 5.0 mg/l.

  15. Principles of dielectric blood coagulometry as a comprehensive coagulation test. (United States)

    Hayashi, Yoshihito; Brun, Marc-Aurèle; Machida, Kenzo; Nagasawa, Masayuki


    Dielectric blood coagulometry (DBCM) is intended to support hemostasis management by providing comprehensive information on blood coagulation from automated, time-dependent measurements of whole blood dielectric spectra. We discuss the relationship between the series of blood coagulation reactions, especially the aggregation and deformation of erythrocytes, and the dielectric response with the help of clot structure electron microscope observations. Dielectric response to the spontaneous coagulation after recalcification presented three distinct phases that correspond to (P1) rouleau formation before the onset of clotting, (P2) erythrocyte aggregation and reconstitution of aggregates accompanying early fibrin formation, and (P3) erythrocyte shape transformation and/or structure changes within aggregates after the stable fibrin network is formed and platelet contraction occurs. Disappearance of the second phase was observed upon addition of tissue factor and ellagic acid for activation of extrinsic and intrinsic pathways, respectively, which is attributable to accelerated thrombin generation. A series of control experiments revealed that the amplitude and/or quickness of dielectric response reflect platelet function, fibrin polymerization, fibrinolysis activity, and heparin activity. Therefore, DBCM sensitively measures blood coagulation via erythrocytes aggregation and shape changes and their impact on the dielectric permittivity, making possible the development of the battery of assays needed for comprehensive coagulation testing.

  16. Coagulation tests show significant differences in patients with breast cancer. (United States)

    Tas, Faruk; Kilic, Leyla; Duranyildiz, Derya


    Activated coagulation and fibrinolytic system in cancer patients is associated with tumor stroma formation and metastasis in different cancer types. The aim of this study is to explore the correlation of blood coagulation assays for various clinicopathologic factors in breast cancer patients. A total of 123 female breast cancer patients were enrolled into the study. All the patients were treatment naïve. Pretreatment blood coagulation tests including PT, APTT, PTA, INR, D-dimer, fibrinogen levels, and platelet counts were evaluated. Median age of diagnosis was 51 years old (range 26-82). Twenty-two percent of the group consisted of metastatic breast cancer patients. The plasma level of all coagulation tests revealed statistically significant difference between patient and control group except for PT (p50 years) was associated with higher D-dimer levels (p=0.003). Metastatic patients exhibited significantly higher D-dimer values when compared with early breast cancer patients (p=0.049). Advanced tumor stage (T3 and T4) was associated with higher INR (p=0.05) and lower PTA (p=0.025). In conclusion, coagulation tests show significant differences in patients with breast cancer.

  17. Coagulation Management in Jersey Calves: An ex vivo Study. (United States)

    Gröning, Sabine; Maas, Judith; van Geul, Svenja; Rossaint, Rolf; Steinseifer, Ulrich; Grottke, Oliver


    Jersey calves are frequently used as an experimental animal model for in vivo testing of cardiac assist devices or orthopedic implants. In this ex vivo study, we analyzed the coagulation system of the Jersey calves and the potential of human-based coagulation management to circumvent perioperative bleeding complications during surgery. Experimental Procedure: Blood from 7 Jersey calves was subjected to standard laboratory tests and thromboelastometry analysis. An ex vivo model of dilutional coagulopathy was used to study the effects of fibrinogen or prothrombin complex concentrate supplementation. Fibrinolysis was induced with tissue plasminogen activator to identify potential therapeutic strategies involving tranexamic acid or aprotinin. Furthermore, anticoagulation strategies were evaluated by incubating the blood samples with dabigatran or rivaroxaban. Baseline values for thromboelastometry and standard laboratory parameters, including prothrombin time, activated partial thromboplastin time, fibrinogen, antithrombin III, and D-dimers, were established. Fifty percent diluted blood showed a statistically significant impairment of hemostasis. The parameters significantly improved after the administration of fibrinogen or prothrombin complex concentrate. Tranexamic acid and aprotinin ameliorated tissue plasminogen activator-induced fibrinolysis. Both dabigatran and rivaroxaban significantly prolonged the coagulation parameters. In this ex vivo study, coagulation factors, factor concentrate, antifibrinolytic reagents, and anticoagulants regularly used in the clinic positively impacted coagulation parameters in Jersey calf blood. © 2017 S. Karger AG, Basel.

  18. Infrared coagulation: a preferred option in treating early hemorrhoids

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    Gupta Pravin J.


    Full Text Available BACKGROUND: The ideal therapy for hemorrhoids is always debated. For early grades of the disease, many different modalities of treatment have been proposed. Some are effective but are more painful, others are less painful but their efficacy is not assured on long term. Infrared photocoagulation has emerged as a new addition to the list. In this procedure, the tissue is coagulated by infrared radiation. During treatment, mechanical pressure and radiation energy are applied simultaneously to ablate the blood supply to the hemorrhoidal mass. METHODS: In the present retrospective study, the effect of infrared coagulation on patients with early grades of hemorrhoids is described. In a separate study, a comparison is made between Infrared coagulation and rubber band ligation in terms of their effectiveness and discomfort. RESULTS: 212 patients were treated by infrared coagulation and were followed up for a period of 18 months. Only 28 patients had persistence or recurrence of bleeding. Overall ratio of comfort and patient satisfaction from pain and bleeding was quite satisfactory. The comparative study showed that though rubber band ligation is more effective, it is a more painful procedure. CONCLUSION: These studies shows that Infrared coagulation for hemorrhoids in early stages could prove to be a easy and effective alternative to conventional methods as it is quick, less painful and safe. The procedure can be repeated in case of recurrence and should be considered as the first choice in early hemorrhoids.

  19. Cell-derived vesicles exposing coagulant tissue factor in saliva. (United States)

    Berckmans, René J; Sturk, Auguste; van Tienen, Laurens M; Schaap, Marianne C L; Nieuwland, Rienk


    On vascular damage, coagulation is initiated by extravascular tissue factor (TF). Intravascular TF, which is present on circulating cell-derived vesicles, is noncoagulant under physiologic conditions but prothrombotic under pathologic conditions. Human saliva triggers coagulation, but the mechanism and physiologic relevance are unknown. Because saliva is known to contain TF, we hypothesized that this TF may also be associated with cell-derived vesicles to facilitate coagulation when saliva directly contacts blood. The saliva-induced shortening of the clotting time of autologous plasma and whole blood from healthy subjects (n = 10) proved TF-dependent. This TF was associated with various types of cell-derived vesicles, including microparticles and exosomes. The physiologic function was shown by adding saliva to human pericardial wound blood collected from patients undergoing cardiac surgery. Addition of saliva shortened the clotting time from 300 ± 96 to 186 ± 24 seconds (P = .03). Our results show that saliva triggers coagulation, thereby reducing blood loss and the risk of pathogens entering the blood. We postulate that our reflex to lick a wound may be a mechanism to enable TF-exposing vesicles, present in saliva, to aid in the coagulation process and thus protect the organism from entering pathogens. This unique compartmentalization may be highly conserved because also animals lick their wounds.

  20. Why and How To Teach Acid-Base Reactions without Equilibrium. (United States)

    Carlton, Terry S.


    Recommends an approach to the treatment of acid-base equilibria that involves treating each reaction as either going to completion or not occurring at all. Compares the method with the traditional approach step by step. (DDR)

  1. Efficacy of pretreating oil palm fronds with an acid-base mixture catalyst. (United States)

    Jung, Young Hoon; Park, Hyun Min; Park, Yong-Cheol; Park, Kyungmoon; Kim, Kyoung Heon


    Oil palm fronds are abundant but recalcitrant to chemical pretreatment. Herein, an acid-base mixture was applied as a catalyst to efficiently pretreat oil palm fronds. Optimized conditions for the pretreatment were a 0.1M acidic acid-base mixture and 3min ramping to 190°C and 12min holding. The oil palm fronds pretreated and washed with the acid-base mixture exhibited an enzymatic digestibility of 85% by 15 FPU Accellerase 1000/g glucan after 72h hydrolysis, which was significantly higher than the enzymatic digestibilities obtained by acid or alkali pretreatment alone. This could be attributed to the synergistic actions of the acid and base, producing an 87% glucose recovery with 100% and 40.3% removal of xylan and lignin, respectively, from the solids. Therefore, an acid-base mixture can be a feasible catalyst to deconstruct oil palm fronds for sugar production. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Effects of dietary strong acid anion challenge on regulation of acid-base balance in sheep

    National Research Council Canada - National Science Library

    Las, J. E; Odongo, N. E; Lindinger, M. I; AlZahal, O; Shoveller, A. K; Matthews, J. C; McBride, B. W


    ...{at} The acid-base status of the extracellular fluid is directly affected by the concentrations of strong basic cations and strong acid anions that are absorbed into the bloodstream from the diet...

  3. Effect of selective laser trabeculoplasty on ocular haemodynamics in primary open-angle glaucoma. (United States)

    Pillunat, Karin R; Spoerl, Eberhard; Terai, Naim; Pillunat, Lutz E


    Selective laser trabeculoplasty (SLT) is known to reduce intraocular pressure (IOP) effectively. The aim of this study, however, was to evaluate the effect of SLT on ocular haemodynamics. A total of 69 eyes of 69 patients (age 67.8 ± 9.9 years) with already treated primary open-angle glaucoma who were assigned for SLT for further IOP reduction were consecutively enrolled in this prospective interventional case series. Intraocular pressure, the ocular pulse amplitude (OPA), ocular pulse volume (OPV) and pulsatile ocular blood flow (pOBF) were assessed with the Ocular Blood Flow Analyzer prior to and 3 months after SLT. Intraocular pressure was statistically significantly reduced from 16.0 ± 5.4 mmHg to 12.8 ± 4.0 mmHg (p = 0.001). The OPA did not change (p = 0.783) after IOP reduction following SLT. OPV and pOBF increased statistically significantly. OPV increased from 7.33 ± 3.05 to 8.59 ± 3.35 μl (17.2%; p = 0.001) and pOBF from 17.11 ± 5.42 to 19.74 ± 6.59 μl/s (15.4%; p = 0.002). Selective laser trabeculoplasty probably does not induce any pharmacological changes effecting systemic blood pressure or ocular blood flow as topical IOP-lowering medication might do, nor does it change biomechanical properties of the eye as surgery could. Therefore, an increase in ocular blood flow following SLT can only be explained by the reduction in IOP and might be a sign of dysfunctional autoregulation in glaucoma patients. © 2017 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  4. Comparative studies on chemical and natural coagulants and preservatives to get biocrude from the latex of Calotropsis procera (Ait. ) R. Br. and an alternative light-scattering technique to screen the coagulants

    Energy Technology Data Exchange (ETDEWEB)

    Arora, M.; Behera, B.K. (MD Univ., Rohtak (India). Dept. of Bio-Sciences); Sharma, D.K. (Indian Inst. of Tech., New Delhi (India). Centre of Energy Studies)


    Preservation of Calotropis procera (Ait.) R.Br. latex was studied in terms of changes in pH, colour and the extent of coagulation on using various preservatives. In addition, a comparison of synthetic and natural coagulating agents was made for coagulation of C. procera latex for biocrude production. Natural coagulant (bark extract) was found to be better than synthetic coagulants. A quick light-scattering technique was developed to study the extent of coagulation and the yield of biocrude. (Author)

  5. Recent advances in understanding trans-epithelial acid-base regulation and excretion mechanisms in cephalopods


    Hu, Marian Y.; Hwang, Pung-Pung; Tseng, Yung-Che


    Cephalopods have evolved complex sensory systems and an active lifestyle to compete with fish for similar resources in the marine environment. Their highly active lifestyle and their extensive protein metabolism has led to substantial acid-base regulatory abilities enabling these organisms to cope with CO2 induced acid-base disturbances. In convergence to teleost, cephalopods possess an ontogeny-dependent shift in ion-regulatory epithelia with epidermal ionocytes being the major site of embry...

  6. Removal Natural Organic Matter (NOM in Peat Water from Wetland Area by Coagulation-Ultrafiltration Hybrid Process with Pretreatment Two-Stage Coagulation

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    Mahmud Mahmud


    Full Text Available The primary problem encountered in the application of membrane technology was membrane fouling. During this time, hybrid process by coagulation-ultrafiltration in drinking water treatment that has been conducted by some research, using by one-stage coagulation. The goal of this research was to investigate the effect of two-stage coagulation as a pretreatment towards performance of the coagulation-ultrafiltration hybrid process for removal NOM in the peat water. Coagulation process, either with the one-stage or two-stage coagulation was very good in removing charge hydrophilic fraction, i.e. more than 98%. NOM fractions of the peat water, from the most easily removed by the two-stage coagulation and one-stage coagulation process was charged hydrophilic>strongly hydrophobic>weakly hydrophobic>neutral hydrophilic. The two-stage coagulation process could removed UV254 and colors with a little better than the one-stage coagulation at the optimum coagulant dose. Neutral hydrophilic fraction of peat water NOM was the most influential fraction of UF membrane fouling. The two-stage coagulation process better in removing the neutral hidrophilic fraction, while removing of the charged hydrophilic, strongly hydrophobic and weakly hydrophobic similar to the one-stage coagulation. Hybrid process by pretreatment with two-stage coagulation, beside can increased removal efficiency of UV254 and color, also can reduced fouling rate of the ultrafiltration membraneIt must not exceed 250 words, contains a brief summary of the text, covering the whole manuscript without being too elaborate on every section. Avoid any abbreviation, unless it is a common knowledge or has been previously stated.

  7. Relative myotoxic and haemodynamic effects of the beta-agonists fenoterol and clenbuterol measured in conscious unrestrained rats. (United States)

    Burniston, Jatin G; Tan, Lip-Bun; Goldspink, David F


    The beta(2)-adrenoceptor (beta(2)-AR) agonists clenbuterol and fenoterol have similar beneficial effects in animal models of heart failure. However, large doses of clenbuterol can induce cardiomyocyte death, and it is not known which of these agents has the most favourable therapeutic profile. We have investigated the cardiotoxicity of clenbuterol and fenoterol alongside that of isoprenaline, and compared their haemodynamic effects. Wistar rats (n = 6 per group) were subcutaneously injected with each beta-agonist (0.003-3 mmol kg(-1)) or saline, and cardiomyocyte apoptosis was detected by caspase 3 immunohistochemistry. In a separate experiment, rats (n = 4) were given equivalent doses to those used in the myotoxicity studies, in a randomized cross-over design, and their blood pressure recorded via radiotelemetry. Injection of 0.3 mmol kg(-1) fenoterol or isoprenaline, but not clenbuterol, induced significant cardiomyocyte apoptosis (0.4 +/- 0.05%; P clenbuterol, 0.4 +/- 0.07%; P clenbuterol-induced apoptosis could also be prevented by 96% (P Clenbuterol decreased diastolic (1.3- to 1.6-fold; P 0.3 mmol kg(-1) increased heart rate (1.4-fold; P 0.3 mmol kg(-1) decreased diastolic blood pressure (1.3-fold; P clenbuterol, and fenoterol had less desirable haemodynamic effects.

  8. Relative myotoxic and haemodynamic effects of the β-agonists fenoterol and clenbuterol measured in conscious unrestrained rats (United States)

    Burniston, Jatin G; Tan, Lip-Bun; Goldspink, David F


    The β2-adrenoceptor (β2-AR) agonists clenbuterol and fenoterol have similar beneficial effects in animal models of heart failure. However, large doses of clenbuterol can induce cardiomyocyte death and it is not known which of these agents has the most favourable therapeutic profile. We have investigated the cardiotoxicity of clenbuterol and fenoterol alongside that of isoproterenol, and compared their haemodynamic effects. Wistar rats (n=6, per group) were subcutaneously injected with each β-agonist (0.003 mmol kg−1 to 3 mmol kg−1) or saline and cardiomyocyte apoptosis was detected by caspase 3 immunohistochemistry. In a separate experiment rats (n=4) were given equivalent doses to those used in the myotoxicity studies, in a randomised crossover design, and their blood pressure recorded via radio telemetry. Injection of 0.3 mmol kg−1 fenoterol or isoproterenol, but not clenbuterol, induced significant cardiomyocyte apoptosis (0.4±0.05%; Pclenbuterol 0.4±0.07%; Pclenbuterol-induced apoptosis could also be prevented (96%; PClenbuterol decreased diastolic (1.3-1.6 fold; P0.3 mmol kg−1 increased heart rate (1.4 fold; P0.3 mmol kg−1 decreased diastolic blood pressure (1.3 fold; Pclenbuterol, and fenoterol had less desirable haemodynamic effects. PMID:16973691

  9. Comparison of the effects of two intrathecal anaesthetic techniques for transurethral prostatectomy on haemodynamic and pulmonary function.

    LENUS (Irish Health Repository)

    Walsh, K H


    BACKGROUND AND OBJECTIVE: Transurethral prostatectomy is routinely performed under spinal anaesthesia. This technique can cause hypotension, which is particularly undesirable in the elderly. The objective was to compare spinal anaesthesia for transurethral prostatectomy using hyperbaric bupivacaine 15 mg (control group) and hyperbaric bupivacaine 10 mg (limiting spread by maintaining the upright position for 15 min) and fentanyl 25 microg (fentanyl group) in terms of haemodynamic and pulmonary function. METHODS: Thirty ASA I-III patients were randomly selected and underwent spinal anaesthesia with either hyperbaric bupivacaine 15 mg (immediately positioned supine) or hyperbaric bupivacaine 10 mg (upright for 15 min) and fentanyl 25 microg. RESULTS: The greatest changes in mean arterial pressure (P = 0.9), ephedrine requirements (P = 0.8) and mean maximum change in forced vital capacity (P = 0.5) were similar in both groups. CONCLUSIONS: The addition of fentanyl 25 microg to bupivacaine 10 mg and limiting the spread of the block does not improve either haemodynamic or pulmonary function compared with bupivacaine 15 mg in patients undergoing transurethral prostatectomy.

  10. Influence of oxygen administration on pulmonary haemodynamics and tissue oxygenation during exercise in COPD patients with different ACE genotypes. (United States)

    Kanazawa, Hiroshi; Hirata, Kazuto; Yoshikawa, Junichi


    We previously found that the angiotensin-converting enzyme (ACE) DD genotype is associated with exaggerated pulmonary hypertension and disturbance of tissue oxygenation during exercise in chronic obstructive pulmonary disease (COPD) patients. This study was designed to compare the effect of oxygen administration on pulmonary haemodynamics and tissue oxygenation during exercise in COPD patients with different ACE genotypes. Forty-three COPD patients (II=16, ID=12, DD=15) underwent right heart catheterization, and then performed an exercise test with room air or oxygen. We measured pulmonary haemodynamic variables and indices of tissue oxygenation such as mixed venous oxygen tension (PVO2) and arterial lactate concentration, both at rest and after exercise. The magnitude of difference in mean pulmonary arterial pressure and pulmonary vascular resistance after exercise between breathing of room air and breathing of oxygen did not significantly differ among the three groups. PVO2 after exercise with room air or oxygen was significantly higher in patients with the II genotype than in those with the ID or DD genotype. In contrast, lactate concentration after exercise with room air or oxygen was significantly lower in patients with the II genotype than in those with the ID or DD genotype. Moreover, the magnitude of difference in PVO2 and lactate concentration after exercise between breathing of room air and breathing of oxygen was the II>ID>DD genotype. These findings suggest that the ability of oxygen administration to improve tissue oxygenation during exercise is associated with the ACE genotypes in COPD patients.

  11. Evaluation of basal ganglia haemodynamic changes with perfusion-weighted magnetic resonance imaging in patients with Parkinson's disease. (United States)

    Gaudiello, F; Garaci, F G; Marziali, S; Ludovici, A; Brusa, L; Stanzione, P; Floris, R; Simonetti, G


    The aim of our study was to assess the regional cerebral blood flow (rCBF) of basal ganglia and thalami in patients with Parkinson's disease (PD) using perfusion-weighted magnetic resonance imaging (PW-MRI). Twenty subjects affected by idiopathic PD according to the United Kingdom Brain Bank criteria were enrolled in the study. Twenty normal subjects matched for age and gender were included as controls. After 20-day therapy withdrawal, the PD patients underwent PW-MRI. The rCBF was calculated both in patients and in controls. The regions of interest were manually positioned on rCBF maps over the caudate nucleus, the putamen, the external and internal globus pallidus, and over the ventrolateral nucleus of the thalamus. Data were normalised with those obtained from parieto-occipital white matter (POWM). Statistical analysis was performed using a parametric ANOVA test. Patients showed a significant (pMRI is a valuable tool for assessing haemodynamic changes in PD patients. Haemodynamic change pattern may be useful in the early diagnosis of PD.

  12. Comparison of coagulation pretreatment of produced water from natural gas well by polyaluminium chloride and polyferric sulphate coagulants. (United States)

    Zhai, Jun; Huang, Zejin; Rahaman, Md Hasibur; Li, Yue; Mei, Longyue; Ma, Hongpu; Hu, Xuebin; Xiao, Haiwen; Luo, Zhiyong; Wang, Kunping


    This study aimed to optimise coagulation pretreatment of the produced water (PW) collected from a natural gas field. Two coagulants, polyferric sulphate (PFS) and polyaluminium chloride (PACl), were applied separately for the organics, suspended solids (SS), and colour removal. Treatment performance at different coagulant dosages, initial pH values, stirring patterns, and the addition of cationic polyacrylamide (PAM) was investigated in jar tests. The optimal coagulation conditions were dosage of PACl 25 g/L or PFS 20 g/L with that of PAM 30 mg/L, initial pH of 11, and fast mixing of 1.5 min (for PACl) or 2 min (for PFS) at 250 rpm followed by slow mixing of 15 min at 50 rpm for both coagulants. PACl performed better than PFS to remove chemical oxygen demand (COD), total organic carbon (TOC), SS, and colour, and achieved a removal efficiency of 90.1%, 89.4%, 99.0%, and 99.9%, respectively, under the optimal condition; while PFS efficiency was 86.1%, 86.1%, 99.0%, and 98.2%, respectively. However, oil removal was higher in PFS coagulation compared to PACl and showed 98.9% and 95.3%, respectively. Biodegradability, ratio of the biological oxygen demand (five-day) (BOD5)/COD, of the PW after pretreatment increased from 0.08 to 0.32 for PFS and 0.43 for PACl. Zeta potential (Z-potential) analysis at the optimum coagulant dosage of PACl and PFS suggests that charge neutralisation was the predominant mechanism during coagulation. Better efficiency was observed at higher pH. The addition of PAM and starring pattern had a minor influence on the removal performance of both coagulants. The results suggest that PACl or PFS can be applied for the pretreatment of PW, which can provide substantial removal of carbon, oil, and colour, a necessary first step for subsequent main treatment units such as chemical oxidation or biological treatment.

  13. Evaluation of acid-base status in patients admitted to ED-physicochemical vs traditional approaches. (United States)

    Antonogiannaki, Elvira-Markela; Mitrouska, Ioanna; Amargianitakis, Vassilis; Georgopoulos, Dimitris


    The aim of this study is to evaluate the value of physicochemical, base excess (BE), and plasma bicarbonate concentration ([HCO3(-)]) approaches on the assessment of acid-base status in patients presented to the emergency department (ED). Upon presentation at ED, patients whose arterial blood was deemed in need of analysis were studied. Arterial blood gases, serum electrolytes, and proteins were measured and used to derive [HCO3(-)], BE, anion gap (AG), AG adjusted for albumin (AGadj), strong ion difference, strong ion gap (SIG) and SIG corrected for water excess/deficit (SIGcor). In each patient the acid-base status was evaluated using the BE, [HCO3(-)], and physicochemical approaches. A total of 365 patients were studied. Compared with BE (n = 202) and [HCO3(-)] (n = 151), physicochemical approach (n = 279) identified significantly more patients with metabolic acid-base disturbances (P physicochemical approach. The corresponding values with [HCO3(-)] approach were 108 and 95 (88%) patients. When patients with high AGadj were excluded, 44 patients with BE and 67 with [HCO3(-)] approach had normal acid-base status, and most of them exhibited at least 1 acid-base disturbance with the physicochemical approach, whereas 12 and 21 patients, respectively, had high SIGcor. Compared with the BE and [HCO3(-)] methods, the physicochemical approach has a better diagnostic accuracy to identify metabolic acid-base disturbances. Copyright © 2014 Elsevier Inc. All rights reserved.

  14. Comparison of electrocoagulation and chemical coagulation for heavy metal removal

    Energy Technology Data Exchange (ETDEWEB)

    Akbal, F.; Camci, S. [Ondokuz Mayis University, Engineering Faculty, Environmental Engineering Department, Kurupelit, Samsun (Turkey)


    Copper (Cu), chromium (Cr), and nickel (Ni) removal from metal plating wastewater by electrocoagulation and chemical coagulation was investigated. Chemical coagulation was performed using either aluminum sulfate or ferric chloride, whereas electrocoagulation was done in an electrolytic cell using aluminum or iron electrodes. By chemical coagulation, Cu-, Cr-, and Ni-removal of 99.9 % was achieved with aluminum sulfate and ferric chloride dosages of 500, 1000, and 2000 mg L{sup -1}, respectively. Removal of metals by electrocoagulation was affected by the electrode material, wastewater pH, current density, number of electrodes, and electrocoagulation time. Electrocoagulation with iron electrodes at a current density of 10 mA cm{sup -2}, electrocoagulation time of 20 min, and pH 3.0 resulted in 99.9 % Cu-, 99.9 % Cr-, and 98 % Ni-removal. (Abstract Copyright [2010], Wiley Periodicals, Inc.)

  15. Combined coagulation flocculation pre treatment unit for municipal wastewater

    Directory of Open Access Journals (Sweden)

    Ibrahim M. Ismail


    Full Text Available The potentials of using the hydraulic technique in combined unit for municipal wastewater treatment were studied. A combined unit in which processes of coagulation, flocculation and sedimentation, has been designed utilizing hydraulic mixing instead of mechanical mixing. A jar test treatability study has been conducted to locate the optimum dose of the coagulants to be used. Alum, ferrous sulfate, ferric sulfate, a mixture of ferric and ferrous sulfates, and mixture of lime and ferrous sulfate were all tested. A pilot unit was constructed in the existing wastewater treatment plant at El Mansoura governorate located in north Egypt. The optimum dose of coagulants used in the combined unit gives removal efficiencies for COD, BOD, and total phosphorous as 65%, 55%, and 83%, respectively.

  16. Point-of-care testing apparatus. Measurement of coagulation. (United States)

    Hirsch, J; Wendt, T; Kuhly, P; Schaffartzik, W


    Point-of-care testing of coagulation parameters provides a more rapid assessment of test results compared with laboratory testing. A new coagulation monitor (GEM PCL, Instrumentation Laboratory, Kirchheim, Germany) was evaluated. Point-of-care data for activated partial thromboplastin time and prothrombin time (expressed as the international normalised ratio) and turn-around-time were compared. Coagulation parameters were compared in the blood of 57 patients with and without heparin therapy. The point-of-care and laboratory test results showed a bias (SD) of -0.26 (4.55) s for activated partial thromboplastin time and -0.011 (0.150) s for prothrombin time. The average turn-around-time was 3 min for point-of-care testing vs. 52 min for laboratory testing. We conclude that the reliability of point-of-care testing is sufficient for clinical use.

  17. Feasibility of a transurethral ultrasound applicator for coagulation in prostate. (United States)

    Lafon, Cyril; Koszek, Laurent; Chesnais, Sabrina; Theillère, Yves; Cathignol, Dominique


    Transurethral resection of the prostate (TURP) is the surgical method routinely used in clinics to treat benign prostate hyperplasia (BPH). The purpose of this work is to demonstrate the feasibility of a transurethral ultrasound (US) applicator based on a miniature US flat transducer to coagulate prostatic tissues. Rabbit liver was found to comply well with human prostate. A significant fall in Doppler signal amplitude immediately after treatment demonstrated the applicator's ability to achieve haemostasis. The therapeutic depth extended from 6 to 10 mm, depending on conditions of exposure, and the coagulation rate ranged between 51% and 99%. The coagulated zone pinpointed on histological examination could be easily correlated to a permanent hypoechoic zone observed on B-scans of treated zones. This observation is most likely due to temperature-related changes in the acoustic attenuation of liver and, unfortunately, may not be visible in the prostate.

  18. Mutations targeting the coagulation pathway are enriched in brain metastases. (United States)

    Richichi, Cristina; Fornasari, Lorenzo; Melloni, Giorgio E M; Brescia, Paola; Patanè, Monica; Del Bene, Massimiliano; Mustafa, Dana A M; Kros, Johan M; Pollo, Bianca; Pruneri, Giancarlo; Sciandivasci, Angela; Munzone, Elisabetta; DiMeco, Francesco; Pelicci, Pier Giuseppe; Riva, Laura; Pelicci, Giuliana


    Brain metastases (BMs) are the most common malignancy of the central nervous system. Recently it has been demonstrated that plasminogen activator inhibitor serpins promote brain metastatic colonization, suggesting that mutations in serpins or other members of the coagulation cascade can provide critical advantages during BM formation. We performed whole-exome sequencing on matched samples of breast cancer and BMs and found mutations in the coagulation pathway genes in 5 out of 10 BM samples. We then investigated the mutational status of 33 genes belonging to the coagulation cascade in a panel of 29 BMs and we identified 56 Single Nucleotide Variants (SNVs). The frequency of gene mutations of the pathway was significantly higher in BMs than in primary tumours, and SERPINI1 was the most frequently mutated gene in BMs. These findings provide direction in the development of new strategies for the treatment of BMs.

  19. Heparanase—A Link between Coagulation, Angiogenesis, and Cancer

    Directory of Open Access Journals (Sweden)

    Yona Nadir


    Full Text Available Heparanase that was cloned from and is abundant in the placenta is implicated in cell invasion, tumor metastasis, and angiogenesis. Recently we have demonstrated that heparanase may also affect the hemostatic system in a non-enzymatic manner. Heparanase was shown to up-regulate tissue factor (TF expression and interact with tissue factor pathway inhibitor (TFPI on the cell surface, leading to dissociation of TFPI from the cell membrane of endothelial and tumor cells, resulting in increased cell surface coagulation activity. More recently, we have shown that heparanase directly enhances TF activity, resulting in increased factor Xa production and activation of the coagulation system. Data indicate increased levels and possible involvement of heparanase in vascular complications in pregnancy. Taking into account the prometastatic and proangiogenic functions of heparanase, overexpression in human malignancies, and abundance in platelets and placenta, its involvement in the coagulation machinery is an intriguing novel arena for further research.

  20. Obstetric hemorrhage and coagulation: an update. Thromboelastography, thromboelastometry, and conventional coagulation tests in the diagnosis and prediction of postpartum hemorrhage. (United States)

    de Lange, Natascha M; Lancé, Marcus D; de Groot, Reneé; Beckers, Erik A M; Henskens, Yvonne M; Scheepers, Hubertina C J


    Globally, postpartum hemorrhage (PPH) is the leading cause of maternal morbidity and mortality. In the current treatment of severe PPH, first-line therapy includes transfusion of packed cells and fresh-frozen plasma in addition to uterotonic medical management and surgical interventions. In persistent PPH, tranexamic acid, fibrinogen, and coagulation factors are often administered. Secondary coagulopathy due to PPH or its treatment is often underestimated and therefore remains untreated, potentially causing progression to even more severe PPH. In most cases, medical and transfusion therapy is not based on the actual coagulation state because conventional laboratory test results are usually not available for 45 to 60 minutes. Thromboelastography and rotational thromboelastometry are point-of-care coagulation tests. A good correlation has been shown between thromboelastometric and conventional coagulation tests, and the use of these in massive bleeding in nonobstetric patients is widely practiced and it has been proven to be cost-effective. As with conventional laboratory tests, there is an influence of fluid dilution on coagulation test results, which is more pronounced with colloid fluids. Fibrinogen seems to play a major role in the course of PPH and can be an early predictor of the severity of PPH. The FIBTEM values (in thromboelastometry, reagent specific for the fibrin polymerization process) decline even more rapidly than fibrinogen levels and can be useful for early guidance of interventions. Data on thromboelastography and thromboelastometry in pregnant women are limited, particularly during the peripartum period and in women with PPH, so more research in this field is needed.