WorldWideScience

Sample records for parenteral factores ambientales

  1. Los factores ambientales en las negociaciones comerciales internacionales.

    OpenAIRE

    Albán Ricaurte, María Amparo

    1995-01-01

    Esta investigación tiene el propósito de adentrarse en el estudio de la relación del comercio y el medio ambiente, exponiendo de una manera suscinta algunos acuerdos comerciales, especialmente aquellos que consideran como importante el aspecto ambiental, lo cual podría convertirse en un plazo no muy lejano, en una estricta determinante. El análisis de las posibilidades que los factores ambientales a mediano o largo plazo sean un requisito indispensable en toda negociación...

  2. Niveles de plomo en sangre y factores ambientales asociados, en una poblacion infantil venezolana

    OpenAIRE

    Espinosa, Carlos; Nobrega, Doris; Seijas, David; Sarmiento, Alves; Medina, Evelyn

    2008-01-01

    Se evaluo la contribucion de factores ambientales a la concentracion de plomo en sangre en niños de edad escolar del sector Michelena en Valencia, Venezuela. Participaron 60 niños (4-9 anos). Se determinaron niveles de plomo en sangre de los niños, niveles de plomo en agua de grifo y polvo de piso de sus casas. Los resultados obtenidos revelan que el 76,2 % de las casas muestreadas presentaron niveles de plomo en agua en grifo significativamente superiores a los limites recomendados por la le...

  3. Factores personales y ambientales asociados con el desplazamiento activo al colegio de los escolares españoles

    OpenAIRE

    Villa-González, Emilio

    2012-01-01

    Objetivos: Los factores personales y ambientales pueden influir en el transporte activo al colegio. Los objetivos fueron: a) examinar los patrones de los desplazamientos a la escuela entre los escolares y, b) analizar la asociaci??n de factores personales y ambientales con el desplazamiento activo a la escuela. M??todo: Los participantes fueron 745 escolares de 8,9 a??os (SD: 1,7), (363 ni??as), de cuatro colegios en la provincia de Granada. Los escolares rellenaron un cuestionario sobre e...

  4. Factores de riesgo ambientales y alimentarios para la fluorosis dental, Andes, Antioquia, 2015

    Directory of Open Access Journals (Sweden)

    Gustavo A. Posada-Jaramillo

    2017-01-01

    Full Text Available Objetivo: determinar los factores ambientales y alimentarios asociados a la fluorosis dental en la población de 12 a 15 años del municipio de Andes en el año 2015, para generar propuestas de intervención en salud bucal. Metodología: estudio de casos y controles, con un control por caso. Con una población de 206 adolescentes de 12 a 15 años. Criterios de selección: adolescentes con diagnóstico de fluorosis dental entre 2012 y 2014, reportados al Sistema de Vigilancia Epidemiológica; se excluyeron aquellas personas que no tuvieran dientes erupcionados en más de un 50%, restauraciones amplias o caries extensas, dientes fracturados y edentulos totales. Los casos fueron seleccionados por muestreo aleatorio simple, los controles a conveniencia. Se realizó examen clínico para clasificar según el Índice de Dean la presencia y nivel de fluorosis dental, se aplicó encuesta a los padres para indagar sobre hábitos de autocuidado, e identificar posibles fuentes de exposición a flúor. Se analizaron variables sociodemográficas, alimentarias y comportamentales, ambientales y clínicas, se utilizaron Chi2 de Pearson – or con intervalos de confianza del 95%. Se efectúo análisis de contenido de concentración de flúor en muestras de agroquímicos, alimentos, agua de consumo humano, sal, cremas dentales y suelos. Resultados: mediante regresión logística binaria usando el método stepwise los resultados mostraron una asociación entre manipulación de agroquímicos y fluorosis dental (or = 2,093; 95% 1,017 y 4,307. Conclusión: la manipulación de agroquímicos es un factor de riesgo para la aparición de la fluorosis dental en los adolescentes del municipio de Andes.

  5. Factores de jerarquización de las informaciones ambientales en el diarismo impreso zuliano

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    Lorena Velásquez González

    2007-09-01

    Full Text Available La investigación evalúa los factores de jerarquización que los medios impresos zulianos utilizan a la hora de publicar informaciones de corte ambientalista, así como el tratamiento que realizan de las mismas. El estudio es de tipo descriptivo-no experimental. La población objeto de estudio estuvo constituida por las informaciones ambientales tomadas de los meses marzo a mayo de los períodos de 1999 y 2004 de Panorama, La Verdad y El Regional del Zulia. Igualmente el estudio abarcó las características que presentan 23 periodistas que cubren la fuente ambiental, así como de 3 jefes de información y redacción, utilizando para ello el censo como método de investigación. Los fundamentos teóricos están basados en los postulados de Pasquali, sobre la masificación cultural de las sociedades por los medios de comunicación social y de Maxwell McCombs y Donald Show, sobre la Agenda Setting. El estudio es de tipo descriptivo-no experimental, empleándose para el análisis de las informaciones ambientales la técnica de la Hemerografía Estructural. Para ello se establecieron las pautas informativas sobre el tema, el nivel de formación ambiental que poseen los jefes de información y los periodistas que elaboran las mismas, el tipo de fuente ambiental que es consultada; así como el género periodístico más utilizado y los elementos visuales que acompañan algunas de estas informaciones. Entre los hallazgos que arrojó este estudio se advierte cómo los medios impresos utilizan la noticia de emergencia para darle jerarquización al periodismo ambiental dentro de su agenda temática.

  6. Tumores cerebrales primarios (gliomas) en relación con factores demográficos y ambientales

    OpenAIRE

    Montero, Guadalupe

    2010-01-01

    Objetivo del trabajo: Explorar la relación entre probables factores de riesgo ambientales de cáncer cerebral (gliomas) en pacientes mayores de 16 años con diagnóstico de tumor primario de cerebro que asistieron al Policlínico Neuquén durante enero del 2006 hasta octubre del 2011. Facultad de Ciencias Médicas

  7. FACTORES AMBIENTALES QUE AFECTAN LOS COMPONENTES DE PRODUCCION Y PRODUCTIVIDAD DURANTE LA VIDA DE LAS CERDAS

    Directory of Open Access Journals (Sweden)

    Jesús Enrique Ek Mex

    2014-12-01

    Full Text Available El objetivo de esta revisión fue describir algunos factores ambientales que influyen sobre los componentes de producción y productividad durante la estancia de las cerdas en el hato. La productividad de la cerda puede ser medida como el número o kilogramos de cerdos nacidos vivos o destetados por camada, por año o durante la estancia en el hato. El efecto de año y granja son importantes fuentes de variación, se deben principalmente a los cambios climatológicos y diferencias en el manejo. El efecto de época en las regiones tropicales es debido al estrés calórico y la alta humedad en la época de calor. Las cerdas de primer parto tienen intervalo entre partos e intervalo destete a la concepción mayor y camadas pequeñas en comparación con las cerdas multíparas. La productividad durante la vida productiva es afectada por el manejo particular de cada unidad de producción, la edad y el número de lechones nacidos al primer parto y la causa de desecho. La mayoría de los estudios son en zonas templadas. En conclusión, la productividad de las cerdas es afectada por las diferentes condiciones climáticas de cada región y a diferencias de manejo entre granjas en diferentes años y épocas, así como por el número de parto, por lo que es importante realizar la caracterización de las condiciones específicas de cada granja o región.

  8. Asociación entre sobrepeso-obesidad y factores socio-ambientales en escolares del partido de Brandsen

    OpenAIRE

    Cesani Rossi, María Florencia; Castro, Luis Eduardo; Luis, María Antonia; Torres, María Fernanda; Quintero, Fabián; Luna, Maria E.; Bergel, María L.; Oyhenart, Evelia Edith

    2009-01-01

    El ambiente o entorno "obesogénico" refiere al conjunto de situaciones ambientales, sociales y culturales que favorecen el aumento de individuos con sobrepeso (S) y obesidad (O). Si bien el tipo de alimentación y los estilos de vida cada vez más sedentarios, resultan ser los principales responsables de este aumento, factores tales como el bajo nivel de instrucción de los padres, los ingresos monetarios familiares y el acceso restringido a los servicios de salud pueden incidir en la probabilid...

  9. FACTORES AMBIENTALES Y GENÉTICOS QUE INFLUYEN SOBRE LA EDAD AL PRIMER PARTO EN HEMBRAS DE LA RAZA ROMOSINUANO

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    Marco Suárez

    2006-05-01

    Full Text Available Objetivo. Estudiar los factores ambientales y genéticos que influyen sobre la edad al primer parto dehembras romosinuano. Materiales y métodos. Fueron estudiados 932 datos de la edad al primer partode hembras de la raza Romosinuano, nacidas en el Centro de Investigación Turipaná de CORPOICA,Cereté, Colombia, en el período de 1980 a 2001. Para el estudio de los factores ambientales se utilizóel análisis de varianza mediante modelos lineales utilizando el procedimiento GLM de SAS (1995.Resultados. La edad al primer parto fue de 1162.3±4.2 días, con un coeficiente de variación del 11.19%.El análisis de varianza reveló que el año y mes de nacimiento fueron causas estadísticamente significativasde variación de la edad al primer parto. La heredabilidad, calculada por la correlación intraclase entremedias hermanas paternas fue de 0.16±0.08. Conclusión. El año y mes de nacimiento influyeron en laedad al primer parto de hembras romosinuano, pero la heredabilidad de la edad al primer parto y elsexo de la cría no se constituyen en características importantes a tener en cuenta.

  10. Estrategias ambientales

    Directory of Open Access Journals (Sweden)

    Gino Lofredo

    2015-01-01

    Full Text Available El concepto de desarrollo sustentable es central y común a todas las estrategias ambientales. Básicamente, no compromete la capacidad de futuras generaciones de satisfacer sus propias necesidades.Los comunicadores sociales no formados en el área al reportar sobre temas ecológicos se ven muy complicados de resolverlos pues es imposible analizar de manera aislada y, porque igual, la solución requiere de la confluencia de acciones diversa y desligadas entre sí. El objetivo de un reportero es ofrecer en sus artículos un mapa de ruta para ubicar los problemas y soluciones dentro de una estrategia global.

  11. Incidence and Risk Factors of Parenteral Nutrition-Associated Cholestasis in Omani Neonates; Single centre experience

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    Sharef W. Sharef

    2015-05-01

    Full Text Available Objectives: Parenteral nutrition-associated cholestasis (PNAC is one of the most challenging complications of prolonged parenteral nutrition (PN in neonates. There is a lack of research investigating its incidence in newborn infants in Oman and the Arab region. Therefore, this study aimed to assess the incidence of PNAC and its risk factors in Omani neonates. Methods: This retrospective study took place between January and April 2014. All neonates who received PN for ≥14 days during a four-year period (June 2009 to May 2013 at the neonatal intensive care unit (NICU in Sultan Qaboos University Hospital, Muscat, Oman, were enrolled. Results: A total of 1,857 neonates were admitted to the NICU over the study period and 135 neonates (7.3% received PN for ≥14 days. Determining the incidence of PNAC was only possible in 97 neonates; of these, 38 (39% had PNAC. The main risk factors associated with PNAC were duration of PN, duration of enteral starvation, gastrointestinal surgeries, blood transfusions and sepsis. Neonates with PNAC had a slightly higher incidence of necrotising enterocolitis in comparison to those without PNAC. Conclusion: This study found a PNAC incidence of 39% in Omani neonates. There were several significant risk factors for PNAC in Omani neonates; however, after logistic regression analysis, only total PN duration remained statistically significant. Preventive strategies should be implemented in NICUs so as to avoid future chronic liver disease in this population.

  12. Asociación de factores de riesgo ambientales en el desarrollo de las cataratas preseniles

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    Gloria López-Valverde

    2017-03-01

    Conclusiones: El consumo de tabaco o alcohol y la presencia de HTA son factores de riesgo para la formación de cataratas preseniles en nuestra población. El consumo de alcohol también se encuentra implicado en la formación de cataratas de tipo senil.

  13. Factores de riesgo sociales y ambientales relacionados con casos de leptospirosis de manejo ambulatorio y hospitalario, Turbo, Colombia

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    Dionisia Yusti

    2013-08-01

    Full Text Available Introducción. La leptospirosis es un problema de salud pública en el Urabá colombiano y poco se sabe sobre las condiciones ambientales y sociales de esta enfermedad en la región. Objetivo. Explorar algunos factores de riesgo relacionados con leptospirosis de manejo hospitalario y ambulatorio, en pacientes del municipio de Turbo durante los años 2010 y 2011. Materiales y métodos. Mediante un estudio descriptivo se exploraron factores relacionados conla exposición a Leptospira spp. (aspectos socio-demográficos, hábitos, condiciones físicas y de saneamiento de la vivienda, hacinamiento, fuentes de agua potable, presencia de roedores sinantrópicos y convivencia con animales en pacientes con leptospirosis que requirieron manejo hospitalario en el municipio de Turbo durante los años 2010 y 2011. Se utilizaron medidas estadísticas estandarizadas para estudios descriptivos. Resultados. Se encontró que el hábito de caminar descalzo en ambientes domésticos representó 4,27 (1,32-13,82 veces el riesgo para presentar leptospirosis de manejo hospitalario (p=0,012. El análisis multivariado exploratorio mostró que la presencia de fauna silvestre en las viviendas puede estar relacionada también con casos de manejo hospitalario. Este hallazgo representó 4,22 (1,13-15,72 veces el riesgo comparado con los casos ambulatorios que manifestaron no tener este tipo deanimales dentro de la vivienda (p=0,032. Conclusión. Este estudio plantea bases para diseñar e implementar intervenciones efectivas, orientadas desde el perfil de riesgos al que se exponen sus habitantes, en un área geográfica queexhibe una epidemiología dinámica de contexto complejo para leptospirosis.   doi: http://dx.doi.org/10.7705/biomedica.v33i0.1457

  14. Significance of pretreatment cardiovascular morbidity as a risk factor during treatment with parenteral oestrogen or combined androgen deprivation of 915 patients with metastasized prostate cancer

    DEFF Research Database (Denmark)

    Johansson, Robert; Damber, Jan Erik; Hagerman, Inger

    2011-01-01

    This study aimed to evaluate prognostic risk factors for cardiovascular events during treatment of metastatic prostate cancer patients with high-dose parenteral polyoestradiol phosphate (PEP, Estradurin®) or combined androgen deprivation (CAD) with special emphasis on pretreatment cardiovascular...

  15. Factores de riesgo ambientales y componentes del síndrome metabólico en adolescentes con exceso de peso

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    Nora Elena Múnera

    2012-03-01

    Conclusiones. Los factores de riesgo ambientales asociados con los componentes del síndrome metabólico en este estudio fueron el mayor consumo de calorías, carbohidratos complejos y simples, todos relacionados directamente con el IMC; por el contrario, el nivel de actividad física, los antecedentes familiares y los personales no mostraron ninguna asociación. El síndrome metabólico sólo se presentó en jóvenes con obesidad.   DOI: http://dx.doi.org/10.7705/biomedica.v32i1.595

  16. Factors contributing to the development of hypophosphataemia when refeeding using parenteral nutrition.

    Science.gov (United States)

    Marvin, Vanessa A; Brown, David; Portlock, Jane; Livingstone, Callum

    2008-08-01

    To identify individual attributes or risk factors which predispose to the development of refeeding hypophosphataemia in patients on parenteral nutrition (PN). The Royal Surrey County Hospital (RSCH) a 530 bed, non-teaching Trust with a cancer centre, medical and surgical inpatients and intensive care unit (ICU). Subjects were recruited prospectively from all adult inpatients referred for initiation of PN. Seventy patients (cases) with refeeding hypophosphataemia were matched with controls who had not experienced a fall in phosphate levels when commenced on PN. Their nutritional requirements, nutrition intake, and biochemical test results were compared and statistical analyses performed to show if any differences between cases and controls were due to chance. Independent risk factors for developing refeeding hypophosphataemia were: significant malnutrition measured as a Nutrition Risk Screening (NRS) score of three or more; less than 12 mmols total phosphate in the first day's PN regimen; and an initial rate of infusion of PN of more than 70% of calculated requirements. In addition increasing amounts of non-lipid phosphate in the first day's PN regimen were found to be protective. Hypomagnesaemia prior to starting PN was non-significantly associated with refeeding hypophosphataemia. Other biochemical markers included in the study: albumin, calcium, C-reactive protein, glucose and urea, did not show an association. ICU, cancer and postoperative patients were not found to be more at risk. Patients with a high NRS score prior to commencing nutrition support may be more at risk than others of refeeding hypophosphataemia. The first 24 h PN regimen should be run slowly providing less than 70% of calculated protein and calorie requirements but containing more than 12 mmol phosphate.

  17. Factores ambientales y hábitos vocales en docentes y funcionarios de pre-escolar con alteraciones de voz

    OpenAIRE

    Barreto, Deisy Paola; Cháux Ramos, Oriana Mireya; Estrada Rangel, Monica Andrea; Sánchez Morales, Jenifer; Moreno Angarita, Marisol; Camargo Mendoza, Maryluz

    2012-01-01

    Objetivo Determinar la relación existente entre los hábitos vocales y condiciones ambientales/ ocupacionales, con la presencia de alteraciones vocales (disfonía) en docentes y funcionarios de centros sociales de educación inicial. Método Estudio descriptivo transversal en una población de 198 sujetos, que se llevó a cabo en tres fases. Fase 1: Identificación de los sujetos con mayor riesgo de presentar una alteración vocal. Fase 2: Observación-análisis del uso de la voz y los hábitos vocales...

  18. Alteraciones osteomusculares asociadas a factores físicos y ambientales en estudiantes de odontología Musculoskeletal alterations associated factors physical and environmental in dental students

    Directory of Open Access Journals (Sweden)

    Juntzo Fals Martínez

    2012-12-01

    Full Text Available OBJETIVO: Describir las alteraciones osteomusculares y su asociación con factores físicos y ambientales en estudiantes de odontología. MÉTODOS: Estudio analítico de corte transversal. Se realizó muestreo aleatorio simple por fijación proporcional de acuerdo al ciclo académico cursado, seleccionado una muestra de 182 estudiantes. La recolección de la información de las exposiciones físicas, ambientales relacionadas con la práctica clínica odontológica y diferentes a estas fueron valoradas mediante un cuestionario validado tipo encuesta estructurada. La valoración muscular se realizó mediante un análisis visual con el Scan-test. Para los factores relacionados con la posición de trabajo, se utilizó el instrumento RULA. Para el análisis bivariable se utilizaron las razones de disparidad con intervalos de confianza del 95%. Para el análisis multivariable se utilizó la regresión logística nominal. RESULTADOS: El 58,2% de los estudiantes presentaron dolor a la palpación en trapecio superior y el 45,6% en zona cervical. En los movimientos de lateralidad cervical se encontró dolor en un 35,7%, junto con el de flexión cervical en 35,1%. La prevalencia de dolor estuvo relacionada con factores propios de la práctica clínica odontológica y no hubo relación con otros factores externos. CONCLUSIONES: La aparición de dolor muscular en esta población está influida por múltiples variables, la mayoría de éstas, relacionadas con la práctica odontológica de los estudiantes, las cuales al interactuar entre sí pueden desencadenar sintomatología a nivel de espalda y cuello.OBJECTIVE: To describe the musculoskeletal disorders and association with physical and environmental in students of Dentistry. METHODS: Cross sectional study. Simple random sampling was conducted obtaining a proportional sample of 182 students per semester. Collecting information from physical and environmental exposures related to different clinical practice

  19. Parenteral nutrition.

    Science.gov (United States)

    Inayet, N; Neild, P

    2015-03-01

    Over the last 50 years, parenteral nutrition has been recognised as an invaluable and potentially lifesaving tool in the physician's arsenal in the management of patients with intestinal failure or inaccessibility; however, it may also be associated with a number of potentially life-threatening complications. A recent NCEPOD report (2010) identified a number of inadequacies in the overall provision and management of parenteral nutrition and recommendations were made with the aim of improving clinical practice in the future. This paper focuses on the practical aspects relating to parenteral nutrition for adults, including important concepts, such as patient selection, as well as general management. We also explore the various pitfalls and potential complications and how these may be minimised.

  20. ¿Existen relaciones entre los factores ambientales rurales y la salud reproductiva en la Pampa Húmeda Argentina? Is there any relationship between rural environmental factors and reproductive health in the Pampa Humeda in Argentina?

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    Alejandro Oliva

    2008-04-01

    Full Text Available La relación entre factores ambientales y salud es un hecho reconocido. La influencia de ambientes rurales sobre la salud reproductiva ha sido fehacientemente probada en diferentes regiones del mundo, tanto en la fauna como en humanos. En América Latina pocas investigaciones han sido realizadas en este campo. El presente proyecto se establece sobre la base de la describir las relaciones entre salud reproductiva y factores ambientales en poblaciones rurales, caracterizada por aspectos ambientales particulares. Tres variables han sido evaluadas: relación de nacimientos masculinos/femeninos; incidencia de malformaciones uro-genitales masculinas (hipospadias y criptorquidias; e incidencia de cánceres hormono-dependientes. Se seleccionaron cinco comunidades rurales de la Pampa Húmeda de Argentina, comparándose los datos obtenidos con medias nacionales. Los datos bio-médicos y las fuentes ambientales de riesgo fueron relacionados entre sí a través de un sistema de geo-referenciación. La relación de nacimientos no mostró significación. Las malformaciones presentaron una muy significativa incidencia. Los cánceres hormono-dependientes presentaron incidencia mayores a las medias nacionales, particularmente en algunas de las comunidades estudiadas. Se concluye que existe una relación entre condiciones de salud reproductiva y factores ambientales en esta región.The relationship between environmental factors and health is well known. Rural environmental influences on reproductive health have been properly proved, both in animals and humans. In Latin America, few studies have been conducted in this area. The current project is based on the description of relationships between reproductive health and environmental factors in rural populations, characterized by specific environmental characteristics. Three variables were evaluated: male-to-female birth ratio, male urogenital malformations (cryptorchidism and hypospadias, and endocrine

  1. Metabolism of oral trefoil factor 2 (TFF2) and the effect of oral and parenteral TFF2 on gastric and duodenal ulcer healing in the rat

    DEFF Research Database (Denmark)

    Poulsen, Steen Seier; Thulesen, J; Christensen, L

    1999-01-01

    Trefoil factors (TFFs) are peptides produced by mucus-secreting cells in the gastrointestinal tract. A functional association between these peptides and mucus, leading to stabilisation of the viscoelastic gel overlying the epithelia, has been suggested. Both oral and parenteral administration of ...

  2. Una variante del gen CAPN10 y los factores ambientales muestran asociación con el exceso de peso en jóvenes colombianos

    Directory of Open Access Journals (Sweden)

    Ana C. Orozco

    2014-12-01

    Full Text Available Introducción. La obesidad resulta de la interacción entre factores de riesgo genéticos y ambientales. Objetivo. Evaluar el efecto de tres variantes genéticas y factores ambientales en el exceso de peso en jóvenes de 10 a 18 años de Medellín, Colombia. Materiales y métodos. Se hizo un estudio transversal en 424 jóvenes divididos en tres grupos: 100 obesos, 112 jóvenes con sobrepeso, y, pareados con ellos, 212 jóvenes con peso adecuado, que conformaron el grupo de control. Se evaluó la asociación entre tres polimorfismos genéticos (UCP3-rs1800849, FTO-rs17817449 y CAPN10-rs3842570 y el exceso de peso, así como su interacción con antecedentes familiares de enfermedad, el tiempo dedicado a ver televisión y a jugar videojuegos y el consumo de alimentos. Resultados. Los antecedentes familiares de obesidad, la dedicación de más de dos horas al día a ver televisión y jugar videojuegos, la falta de lactancia materna, el bajo consumo de cereales, legumbres, frutas y verduras y el gran consumo de comidas rápidas fueron más frecuentes entre los obesos que en los controles. Se observó una asociación significativa entre el genotipo I/I (SNP19 del CAPN10 y el exceso de peso, incluso en los jóvenes que llevaban una vida activa. Además, se encontró una asociación significativa entre los genotipos C/C del UCP3 y G/G y T/T del FTO y el exceso de peso, pero solo en los jóvenes sedentarios. Conclusiones. En esta población, la alimentación inadecuada y el sedentarismo aumentaron el riesgo de exceso de peso. El genotipo I/I de SNP19 del CAPN10 se asoció significativamente con el exceso de peso. Algunas variantes del FTO y el UCP3 mostraron tener efecto solo en jóvenes sedentarios.

  3. Interdisciplinary Discrepancies Between Parenteral Nutrition Macronutrient Prescribing and Recommendations: Is Body Mass Index a Factor?

    Science.gov (United States)

    Elliott, Katie L; Kandiah, Jay; Walroth, Todd A

    2017-07-01

    Formal nutrition training in medical schools and residencies is lacking and needed. Registered dietitians (RDs) are formally trained in nutrition support and considered experts in the nutrition field. Our purpose was to examine prescribing and recommending discrepancies of parenteral nutrition macronutrients between medical residents (MRs) and RDs and compare results with the ASPEN clinical care guidelines. We also looked at discrepancies among obese patients, due to their increased risk of mortality. The primary end point of this retrospective review was discrepancies in nonprotein calories (NPCs) and grams of protein (PRO) between MRs and RDs. The secondary end point was discrepancies in NPCs and PRO between MRs and RDs among patients stratified by body mass index category. MRs prescribed 300 NPCs more versus RDs ( P < .001). When compared with RDs, MRs prescribed fewer NPCs for underweight patients and more for obese patients ( P < .001). The same analysis found that the PRO discrepancies significantly varied by body mass index classification as well ( P = .022). When these results were compared with the ASPEN clinical care guidelines, RDs adhered closer to the guidelines than did MRs in terms of permissive underfeeding of obese patients. It is widely accepted that MRs are in need of increased formal training, and the results of our study confirm this need and suggest a short-term solution of increasing order-writing privileges for the RD. RDs with this privilege may adhere more closely to clinical care guidelines and therefore increase patient safety.

  4. Mercadeando causas ambientales

    OpenAIRE

    Diana Forero

    2013-01-01

    En el presente escrito se presentan varias alternativas para el desarrollo del mercadeo de causas ambientales a través de entidades sin ánimo de lucro. En la primera parte se exploran los modelos de mercadeo que se han empelado con mayor regula-ridad: la filantropía estratégica, el mercadeo social y el mercadeo de causas. Se muestran las actividades más comunes en cada tipo de mercadeo y algunos puntos clave para desarrollarlo. En la segunda parte se presentan las barreras para la gestión del ...

  5. Factores ambientales asociados con la preferencia de hábitat de larvas de tricópteros en cuencas con bosque seco tropical (Tolima, Colombia

    Directory of Open Access Journals (Sweden)

    Jesús M. Vásquez-Ramos

    2014-04-01

    Full Text Available Los ríos de bosques secos tropicales están amenazados en todo el mundo, y en Suramérica son una de las prioridades en términos de conservación. En este estudio se determinó la influencia de variables ambientales (por ejemplo precipitación y la vegetación ribereña sobre las comunidades del orden Trichoptera en cuatro sustratos (roca, grava, arena y hojarasca en las cuencas Opia y Venadillo (Tolima, Colombia. En cada río, en dos segmentos de 100m (uno a ~550 y otro a ~250msnm, fueron evaluados los sustratos mencionados anteriormente. Se realizaron análisis físico-químicos, y se aplicó el índice QBR (calidad del bosque de ribera en ambos ríos. Se recolectaron 6 282 larvas, pertenecientes a 11 familias y 22 géneros, que representan el 73.30% y 43.13% de la fauna Trichoptera registrada en Colombia, respectivamente. Las familias más abundantes fueron Hydropsychidae (49.86% y Philopotamidae (25.44%. Los géneros Smicridea, Chimarra, Protoptila, Neotrichia y Leptonema fueron comunes en periodos de baja y alta precipitación. Las asociaciones de tricópteros no mostraron diferencias significativas a nivel de sustrato. Los principales factores que determinaron la composición, riqueza y abundancia de tricópteros fueron la estacionalidad y la vegetación de ribera. Sin embargo, las localidades situadas a mayor altitud y no urbanizadas, ofrecen mayor variedad de sustratos y mayor riqueza de géneros. Nuestros resultados indican que a futuro las larvas de Trichoptera constituyen un elemento biótico relevante en los ecosistemas dulceacuícolas, debido a que son sensibles a disturbios ambientales. Por ende, sugerimos el uso de los tricópteros para biomonitoreo en ríos tropicales. La implementación de estos estudios es urgente, teniendo en cuenta que la degradación de los ecosistemas dulceacuícolas tiende a ser intensa y persistente.

  6. Factores ambientales que afectan el recuento de células somáticas en leche de búfalos (Bubalus bubalis

    Directory of Open Access Journals (Sweden)

    Geovanny Mendoza-Sánchez

    2009-12-01

    Full Text Available Considerando que el recuento de células somáticas (RCS de muestras de leche es una valioso indicador de la salud de la ubre de búfalas, se desarrolló el presente trabajo con el fin de estimar la relación existente entre algunos factores ambientales y el RCS, verificando la frecuencia de ocurrencia de muestras analizadas en clases de recuentos muy altos, altos, medios y bajos. Fueron analizadas informaciones de 23.534 muestras de controles de leche (RCS, referentes a 2.198 lactancias de animales de la raza murrah con edades entre los dos y quince años, hijas de 187 reproductores; estos muestreos fueron realizados durante siete años. Los resultados indicaron que de manera general, ocurrieron bajos, medios, altos y muy altos RCS para, 96,34%, 2,3%, 0,96% y 0,4% de las muestras, respectivamente. Las clases de bajos y medios RCS, fueron las que presentaron las mayores frecuencias, confirmando que en búfalos, hay una tendencia a menores recuentos que en los bovinos. Se presentaron diferencias entre las medias del RCS por orden de parto y por estación de parto, y hubo diferencias estadísticamente significativas (P < 0,05 para las medias del RCS en algunos controles. En relación con el orden de parto fueron observadas diferencias entre las frecuencias de los RCS, siendo que, de modo general, a medida que aumentó el orden del parto, disminuyó el porcentaje de bajos recuentos y aumentaron las frecuencias de recuentos medios, altos y muy altos. Los resultados indicaron que los efectos de hacienda, año y orden de parto deben ser considerados en la comparación entre animales.

  7. Factores personales y ambientales asociados con el desplazamiento activo al colegio de los escolares españoles

    Directory of Open Access Journals (Sweden)

    Emilio Villa-Gonz\\u00E1lez

    2012-01-01

    Full Text Available The purpose of this study was to analyse the associations of personal and environmental factors with mode of commuting to school in children. A total of 745 schoolchildren (363 girls aged 6-12 years from the province of Granada (Spain participated in the study. Participants completed a questionnaire about mode of commuting to school, personal factors (i.e. barriers to walking to school, enjoyment on the way to school, who they go to school with and environmental factors (i.e. time from house to school, distance to school, and safety on the way. A total of 57.2% children walked to school, 40.3% used the car, 1.2% motorcycled, .7% used the bus and .6% bicycled. Travelling alone to school [Odds ratio (OR, 10.049; 95% confidence interval (CI, 3.950 - 25.567], living close to the school (OR, 16.439; 95%CI, 5.717- 47.271 and perceiving a safe way to school (OR, 2.365; 95%CI, 1.665- 3.360 were associated with active commuting to school.

  8. Estudio de hiperglicemia en pacientes no críticos tratados con nutrición parenteral: incidencia y factores de riesgo

    OpenAIRE

    Llop, J. M.; Leiva, E.; Mateu-de Antonio, J.; Berlana, D.; Badia, M.; Casasín, T.; Miana, M.; Pons, M.; Maroto, M.; Chicharro, L.; López-Suñé, E.; Díaz-Munio, E.; Sevilla, D.; Martínez, I.; Vitales, M.

    2012-01-01

    Background: The objectives of our study on non-critically ill patients receiving parenteral nutrition (PN) are to assess the incidence of hyperglycemia, the risk factors associated to its development and its influence in patient's evolution. Methods: A multicentric prospective observational study was performed in 9 hospitals. Four multivariate studies were developed to study the temporal risk in the occurrence of hyperglycemia (endpoint), intensive care unit (ICU) admission, length of stay (L...

  9. Total parenteral nutrition - infants

    Science.gov (United States)

    ... medlineplus.gov/ency/article/007239.htm Total parenteral nutrition - infants To use the sharing features on this page, please enable JavaScript. Total parenteral nutrition (TPN) is a method of feeding that bypasses ...

  10. Total parenteral nutrition

    Science.gov (United States)

    ... medlineplus.gov/ency/patientinstructions/000177.htm Total parenteral nutrition To use the sharing features on this page, please enable JavaScript. Total parenteral nutrition (TPN) is a method of feeding that bypasses ...

  11. Factores ambientales y genéticos asociados a la esquizofrenia paranoide en el área de salud "28 de septiembre"

    Directory of Open Access Journals (Sweden)

    Antonio César Núñez Copo

    Full Text Available Introducción: la esquizofrenia es una enfermedad con una marcada expresividad variable, que sugiere la existencia de factores etiológicos y procesos fisiopatológicos heterogéneos y donde se considera cada vez más la hipótesis de la interacción gen-ambiente como su principal modo de transmisión. Objetivo: determinar los posibles factores ambientales y genéticos asociados con en el debut de la esquizofrenia. Método: se realizó un estudio analítico observacional de casos y controles en el área de salud "28 de Septiembre" del municipio Santiago de Cuba, durante el cuatrimestre enero-abril de 2011, que incluyó 40 casos con diagnóstico de esquizofrenia paranoide seleccionados mediante muestreo aleatorio estratificado por sexo y a 80 controles sin este diagnóstico. Se aplicó la prueba de chi cuadrado, se calculó la oportunidad relativa (odds ratio y el intervalo de confianza. Resultados: el estado civil soltero resultó significativo al debut y en tres cuartas partes de los casos se constató algún acontecimiento estresante al inicio de la misma. Hubo asociación de los antecedentes familiares de la afección en los casos; se registró un mayor número de familiares de primer grado afectados en ambos grupos, más significativo en el grupo de los casos, lo que explica la agregación familiar de la afección más frecuentemente en las personas que padecen la enfermedad. Conclusiones: existió asociación de los antecedentes familiares de la enfermedad en los pacientes con esquizofrenia paranoide; hubo mayor porcentaje de personas afectadas en familiares de primer grado en ambos grupos; se observó agregación familiar de la enfermedad; los antecedentes prenatales aumentaron el riesgo de la enfermedad y los patrones premórbidos desde la niñez resultaron altamente significativos.

  12. Factores técnicos y ambientales implicados en la electrocución de aves en los tendidos eléctricos

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    Izquierdo Rosigue, A.

    1997-10-01

    Full Text Available Technical and environmental factors responsible of bird electrocution have been analyzed in low and medium tension power lines in a bird important area placed in the south of Alicante province (SE Spain. One hundred eighty six dead birds (119 birds of prey have been located in 182 poles inspected. Most species are legally protected and some are in jeopardy. Some pole types with suspended insulators have caused the same number of victims than poles with rigid insulators. Poles with rigid insulators in two levels produce more accidents than poles with one level. A different pole use according to the habitat has been observed. Birds of prey avoid poles in cultures, in the vicinity of roads and in flatlands or in hill tops. Furthermore, more electrocutions occur near bath zones. Poles in high places and located near to human altered habitats, where feeding is easy, are preferred by remainder birds.

    Se analizan los factores técnicos y ambientales responsables de la electrocución de aves en tendidos de media y baja intensidad -situados en un área con una valiosa población de aves- en el sur de la provincia de Alicante. Se han localizado 186 aves muertas (119 rapaces en 182 postes visitados. La mayoría han sido especies protegidas, encontrándose, algunas de ellas, especialmente amenazadas. Los resultados muestran que algunos tipos de poste, con aisladores suspendidos, provocan un número de accidentes similar a otros tipos de postes con aisladores rígidos. Los postes con aisladores rígidos en dos planos producen más víctimas que los que presentan un único plano. Se observa que las aves realizan un uso diferente del poste en función del hábitat que lo rodea. Las rapaces evitan los postes situados sobre cultivos, los más próximos a las carreteras y los ubicados en zonas llanas o en las partes más altas de las laderas. Se encuentran más rapaces electrocutadas en aquellos postes próximos a zonas de baño. Para el resto de aves los

  13. Variación estacional del zooplancton del embalse Ignacio Allende, Guanajuato, México y su relación con el fitoplancton y factores ambientales

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    Eugenia López- López

    1999-12-01

    Full Text Available Se estudiaron las comunidades planctónicas y los factores ambientales del embalse Ignacio Allende de julio de 1990 a junio de 1991. Se presentó una proliferación de cianofíceas en el verano coincidente con el mayor nivel de agua, seguido por la dominacia de bacilariofíceas en los meses fríos, en primavera con el incremento en la temperatura las cloroficeas alcanzaron sus mayores densidades. Las dinofíceas y euglenofíceas presentaron la menor riqueza específica. La proliferación de Anabaena variabilis en el verano y la alta frecuencia de Ceratium hirundinella, Aulacosseira granulata y Fragilaria crotonensis se asocian con cuerpos de agua tropicales eutróficos. Se encontraron 39 taxones zooplanctónicos, de los cuales Diaphanosoma birgei, Bosmina longirostris, Daphnia parvula, Diaptomus (Mastigodiaptomus montezumae, Acanthocyclops vernalis, Keratella cochlearis, Polyarthra vulgaris y Asplanchna priodonta, fueron persistentes en todo el ciclo. Un análisis de correspondencias canónicas mostró las relaciones que guardan los cambios en composición del zooplancton con las características físicas y químicas del embalse.The plankton communities and environmental factors of the Ignacio Allende reservoir were surveyed from July 1990 to June 1991. A total of 57 phytoplankton species were identified. There was a blue green algae bloom in the summer, simultaneously with highest water levels, followed by the dominance of diatoms in the coldest months (February and March. Chlorophyceans became dominant in the spring, consonant with highest temperature records. Bacillariophyceans and cyanophyceans had the greater species richness, while dinophyceans and euglenophyceans had the lowest values. The summer bloom of Anabaena variabilis and the abundance of Ceratium hirundinella, Aulacosseira granulata and Fragilaria crotonensis are associated with tropical eutrophic waters. The zooplankton was composed by 39 species, from these, Diaphanosoma birgei

  14. Discovery of a Parenteral Small Molecule Coagulation Factor XIa Inhibitor Clinical Candidate (BMS-962212).

    Science.gov (United States)

    Pinto, Donald J P; Orwat, Michael J; Smith, Leon M; Quan, Mimi L; Lam, Patrick Y S; Rossi, Karen A; Apedo, Atsu; Bozarth, Jeffrey M; Wu, Yiming; Zheng, Joanna J; Xin, Baomin; Toussaint, Nathalie; Stetsko, Paul; Gudmundsson, Olafur; Maxwell, Brad; Crain, Earl J; Wong, Pancras C; Lou, Zhen; Harper, Timothy W; Chacko, Silvi A; Myers, Joseph E; Sheriff, Steven; Zhang, Huiping; Hou, Xiaoping; Mathur, Arvind; Seiffert, Dietmar A; Wexler, Ruth R; Luettgen, Joseph M; Ewing, William R

    2017-12-14

    Factor XIa (FXIa) is a blood coagulation enzyme that is involved in the amplification of thrombin generation. Mounting evidence suggests that direct inhibition of FXIa can block pathologic thrombus formation while preserving normal hemostasis. Preclinical studies using a variety of approaches to reduce FXIa activity, including direct inhibitors of FXIa, have demonstrated good antithrombotic efficacy without increasing bleeding. On the basis of this potential, we targeted our efforts at identifying potent inhibitors of FXIa with a focus on discovering an acute antithrombotic agent for use in a hospital setting. Herein we describe the discovery of a potent FXIa clinical candidate, 55 (FXIa K i = 0.7 nM), with excellent preclinical efficacy in thrombosis models and aqueous solubility suitable for intravenous administration. BMS-962212 is a reversible, direct, and highly selective small molecule inhibitor of FXIa.

  15. What are the factors that influence the attainment of satisfactory energy intake in pediatric intensive care unit patients receiving enteral or parenteral nutrition?

    Science.gov (United States)

    de Menezes, Fernanda Souza; Leite, Heitor Pons; Nogueira, Paulo Cesar Koch

    2013-01-01

    Children admitted to the intensive care unit (ICU) are at risk of inadequate energy intake. Although studies have identified factors contributing to an inadequate energy supply in critically ill children, they did not take into consideration the length of time during which patients received their estimated energy requirements after having achieved a satisfactory energy intake. This study aimed to identify factors associated with the non-attainment of estimated energy requirements and consider the time this energy intake is maintained. This was a prospective study involving 207 children hospitalized in the ICU who were receiving enteral and/or parenteral nutrition. The outcome variable studied was whether 90% of the estimated basal metabolic rate was maintained for at least half of the ICU stay (satisfactory energy intake). The exposure variables for outcome were gender, age, diagnosis, use of vasopressors, malnutrition, route of nutritional support, and Pediatric Index of Mortality and Pediatric Logistic Organ Dysfunction scores. Satisfactory energy intake was attained by 20.8% of the patients, within a mean time of 5.07 ± 2.48 d. In a multivariable analysis, a diagnosis of heart disease (odds ratio 3.62, 95% confidence interval 1.03-12.68, P = 0.045) increased the risk of insufficient energy intake, whereas malnutrition (odds ratio 0.43, 95% confidence interval 0.20-0.92, P = 0.030) and the use of parenteral nutrition (odds ratio 0.34, 95% confidence interval 0.15-0.77, P = 0.001) were protective factors against this outcome. A satisfactory energy intake was reached by a small proportion of patients during their ICU stay. Heart disease was an independent risk factor for the non-attainment of satisfactory energy intake, whereas malnutrition and the use of parenteral nutrition were protective factors against this outcome. Copyright © 2013 Elsevier Inc. All rights reserved.

  16. Parasitosis intestinal, su relación con factores ambientales en niños del sector "Altos de Milagro", Maracaibo Intestinal parasitosis, its relation to environmental factors in children from the "Altos de Milagro", Maracaibo

    Directory of Open Access Journals (Sweden)

    Madeline Espinosa Morales

    2011-09-01

    Full Text Available INTRODUCCIÓN: El parasitismo intestinal de conjunto con otras enfermedades infecciosas trasmisibles, constituye el motivo por el cual un gran número de pacientes acude a los consultorios populares en la República Bolivariana de Venezuela; dentro de ellos predominan los niños y adolescentes, debido a la pobre condición higiénico- sanitaria de las barriadas. OBJETIVO: Determinar la presencia de algunos factores ambientales condicionantes en niños parasitados, del sector "Altos de Milagro"Norte, Maracaibo estado Zulia, entre diciembre de 2008 y diciembre de 2009. MÉTODOS: Se realizó un estudio descriptivo, retrospectivo para determinar el comportamiento de la parasitosis intestinal en los niños del sector y su relación con algunos factores ambientales, para lo cual se utilizó una encuesta realizada por la autora, con la finalidad de obtener la información relacionada con las diferentes variables a estudiar. RESULTADOS: Fueron atendidos 56 pacientes, 51,7 % representó al sexo masculino, este último fue el más parasitado con un 42,7 %, predominaron las edades comprendidas entre 1-4 años con 39,2 %, la disposición inadecuada de excretas estuvo presente en un 86,6 %, así como la presencia de vectores en un 94,6 %, y 26 pacientes consumían agua no tratada (57,8 %. CONCLUSIONES: Existió una elevada presencia de la enfermedad, el sexo masculino fue el más afectado; sin embargo no mostró diferencias significativas con el otro sexo. Predominó el grupo etario de 1-4 años. El alto porcentaje obtenido en los factores ambientales estudiados, mostró que fueron importantes en el comienzo, transmisión y propagación de la parasitosis. Se recomendó efectuar programas de intervención comunitaria que impidan o limiten la aparición de estas enfermedades.INTRODUCTION: The intestinal parasitism together with other transmissible and infectious disease is the reason by which many patients come to popular consulting rooms in the Bolivarian

  17. El cambio climático y las migraciones por causas ambientales: dos factores desestabilizadores de las relaciones bilaterales entre India y Bangladesh

    OpenAIRE

    Jaime Garzó, Mateo Andrés

    2016-01-01

    La presente investigación tiene como objetivo principal evaluar de qué manera el cambio climático y las migraciones por causas ambientales generan efectos en las relaciones bilaterales entre Estados, en particular en el caso de India y Bangladesh. En este sentido, el presente estudio de caso analiza las relaciones bilaterales entre estos dos Estados desde diferentes perspectivas, haciendo énfasis en el componente de las migraciones medioambientales y los fenómenos naturales asociados al camb...

  18. EFECTO DE FACTORES GENÉTICOS Y AMBIENTALES SOBRE EL RECUENTO DE CÉLULAS SOMÁTICAS EN GANADO LECHERO DE COSTA RICA

    Directory of Open Access Journals (Sweden)

    María Gabriela Mora

    2016-01-01

    Full Text Available El estudio evaluó el efecto de factores genéticos y ambientales sobre el Score de Célu - las Somáticas [SCS= log 2 (RCS/100 000+3] en ganado lechero de Costa Rica. Se analizaron 198 685 registros diarios, provenientes de 43 535 lactancias, 23 749 vacas lecheras, 237 hatos y 3 grupos raciales. Se utilizó un modelo animal mixto para evaluar efectos fijos de zona, hato dentro de zona, raza, número de lactancia, mes/ año de registro, periodo de lactancia y la cova - riable de producción de leche diaria; también para efectos aleatorios de ambiente permanente, hato×semental y vaca. Se calcularon la heredabi - lidad (h 2 y repetibilidad (r para el Recuento de Células Somáticas (SCS, así como los valores de cría (BLUP y confiabilidad para los individuos en la población. El promedio de SCS fue 3,30 (DE=1,87 todos los efectos fijos, significati - vos. Entre zonas, SCS varió desde 3,4 (bh-p a 3,7 (bmh-p. Para hatos dentro de zona, el SCS osciló entre 1,6 y 5,5. El SCS aumentó desde 2,7 en primera lactancia hasta 4,0 para lactancias ≥6. El SCS fue mayor en Enero (3,6 y menor en Abril (3,4. Se observó un patrón descendente no lineal en SCS desde el 2004 (4,3 hasta el 2015 (3,3 y un patrón no lineal de SCS a lo largo de la lactancia, que inició en 3,7 para disminuir hasta 3,1 al día 60 posparto, mientras que aumentó 3,9 al día 365. Se detectó una reducción de 0,051 en SCS por cada aumento de 1 kg en producción diaria de leche. Los valores de h 2 y r fueron 0,08 (DE=0,008 y 0,33 (DE=0,004, respectivamente. La confiabilidad de los BLUP en vacas y toros fue de 0,40 (DE=0,16 y 0,44 (DE=0,20, res- pectivamente. Estos resultados son útiles para un mejor control de SCS a nivel de hato, basado en el manejo preventivo de grupos más propensos, la optimización del descarte y la selección de sementales.

  19. Factores sociodemográficos y ambientales asociados con la actividad física deportiva en la población urbana del Perú

    Directory of Open Access Journals (Sweden)

    Juan A. Seclén-Palacín

    2003-10-01

    Full Text Available OBJETIVOS: Determinar la frecuencia de la actividad deportiva en la población urbana del Perú e identificar los factores sociodemográficos, económicos y ambientales asociados con ella. MÉTODOS: Se utilizó la información recogida por la Encuesta Nacional de Hogares del segundo trimestre del año 1997, Perú (ENAHO 97-II, a cargo del Instituto Nacional de Estadística e Informática del Perú. ENAHO-97 se basó en un muestreo probabilístico, multietápico y estratificado de todo el territorio nacional urbano dividido en ocho regiones geográficas: Lima metropolitana, costa norte, costa centro, costa sur, sierra norte, sierra centro, sierra sur y selva. En total se visitaron 14 913 hogares y fueron entrevistadas 45 319 personas de 15 años o mayores. La información sobre la frecuencia de la práctica deportiva fue clasificada en diaria, interdiaria (en días alternos, semanal u ocasional. La actividad deportiva regular (ADR se definió como la práctica de cualquier deporte con una frecuencia diaria o interdiaria. Además se examinaron las preferencias y obstáculos para la práctica deportiva. Se realizó un análisis descriptivo de los niveles de ADR según el sexo mediante la prueba de ji al cuadrado. Se analizaron los factores asociados con la ADR mediante regresión logística múltiple condicional y análisis de residuos, multicolinearidad e interacciones. El nivel de significación utilizado fue de 0,05. RESULTADOS: La práctica de deportes al menos una vez a la semana y de ADR fue mayor entre los hombres (44,5 y 12,8%, respectivamente que ente las mujeres (32,4 y 10,5%. El grupo de edad en que hubo una mayor práctica de ADR fue el de 50­55 años en los hombres (20% y el de 40­45 años en las mujeres (18%. Se encontró que en la zona de la selva, sierra centro y costa centro se practica más deporte (15,3, 12,8 y 12,1%, respectivamente, mientras que en Lima metropolitana y sierra sur se observan los valores más bajos (10,6 y 9

  20. Variación mensual del índice gonadosomatico de Colossoma macropomum relacionado a factores ambientales en Cañas, Costa Rica.

    Directory of Open Access Journals (Sweden)

    Jorge Boza

    2016-03-01

    Full Text Available Con el fin de determinar la variación mensual en el índice gonadosomático de Colossoma macropomum en estanques, se tomaron muestras mensuales de 10 individuos desde setiembre de 1993 hasta setiembre de 1994. Se midieron además, durante todo el período experimental los siguientes parámetros ambientales: precipitación, temperatura del agua y oxígeno disuelto. El índice gonadosomático (IGS en las hembras presentó un rápido incremento de abril a mayo, permaneciendo alto de junio hasta agosto, decreciendo de setiembre hasta noviembre y mostrando los valores más bajos de diciembre hasta marzo. Esto indica que el desarrollo gonadal inicia un mes después del inicio de las lluvias (finales de abril y que la regresión gonadal esta relacionada con la finalización de esta estación (noviembre, manteniéndose en reposo durante la estación seca (noviembre-marzo. Los valores en el índice gonadosomático para machos, muestran una tendencia similar al de las hembras. Para los otros parámetros obtenidos (temperatura del agua y oxígeno disuelto no se observaron variaciones estacionales que pudieran inducir un cambio en el índice gonadosomático, ya que los valores presentan variaciones muy pequeñas.

  1. Efecto de factores ambientales y la asignación del esfuerzo pesquero sobre las capturas de la raya Aetobatus narinari (Rajiformes: Myliobatidae en el sur del Golfo de México

    Directory of Open Access Journals (Sweden)

    Elizabeth Cuevas

    2013-09-01

    Full Text Available Aunque existen estudios sobre las pesquerías de batoideos en aguas Mexicanas, falta información sobre la influencia de factores sobre las operaciones pesqueras y las tasas de captura. Para evaluar el efecto de algunos factores en la pesquería dirigida sobre la raya pinta Aetobatus narinari en el Sur del Golfo de México, se realizaron registros diarios de las operaciones pesqueras de cuatro embarcaciones menores en dos localidades (Campeche y Seybaplaya, de enero a julio 2009 (temporada de pesca completa. Fueron registradas 896 rayas en 280 viajes de pesca. Se utilizó el Modelo General Lineal para evaluar la influencia de los factores en las operaciones de pesca y las tasas de captura. La operación pesquera fue predicha por el ciclo lunar (frente a Campeche y la velocidad del viento (frente a Seybaplaya. Las tasas de captura frente a Seybaplaya fueron predichas por el factor embarcación, la temporada de frentes fríos y la temperatura superficial del mar. Este estudio demuestra que tanto los factores ambientales como las diferencias en la asignación del esfuerzo pesquero entre embarcaciones, influyen en las tasas de captura, por lo que deben ser considerados en estudios futuros que comparen tasas de captura entre estaciones del año y regiones.

  2. Assessment of anti-factor Xa activity of heparin in binary parenteral nutrition admixtures for premature neonates.

    Science.gov (United States)

    Foinard, A; Perez, M; Barthélémy, C; Lannoy, D; Flamein, F; Storme, L; Tournoys, A; Décaudin, B; Odou, P

    2015-07-01

    An in vitro study was carried out to determine the anti-Xa activity of heparin in binary parenteral nutrition (BPN) admixtures for premature neonates in our neonatal intensive care unit (NICU) after a 24-hour infusion, as well as to assess drug interaction with a 50% glucose solution. Two types of bags were prepared: (1) BPN admixtures (composition defined in the NICU) including sodium heparin at 77 UI/mL and (2) bags containing only G50% with sodium heparin at 193 UI/mL. The anti-Xa activity of heparin was measured in bags at T0, after the 24-hour infusion and in eluates at the outlet of the infusion line after 24hours, using a validated chromogenic anti-Xa method. Comparisons of the mean concentration observed with the theoretical value for anti-Xa activity were performed with the Student t-test. Mean values of anti-Xa activity do not differ significantly from the values expected for all conditions. We found a slight variation in anti-Xa activity when infused over 24hours for both types of bags, with and without in-line filtration, showing that heparin remains stable during this infusion period in both BPN admixtures and G50%. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  3. Análisis de los factores ambientales y ocupacionales en la concentración de aerobacterias en unidades de cuidado intensivo del Hospital Universitario Fernando Troconis, 2009 Santa Marta - Colombia

    Directory of Open Access Journals (Sweden)

    Andrés M. Vélez-Pereira

    2014-06-01

    Full Text Available Introducción: La evaluación de la calidad biológica del aire de ambientes hospitalarios resulta de especial interés debido a que los pacientes puedan servir como una fuente de bacterias patógenas para el personal del hospital, los visitantes y otros pacientes, siendo relevante en unidades de asistencia especializadas en atención de patologías crónicas como cáncer, SIDA y pacientes con trasplante de órganos o con complicaciones severas en su estado de salud, y que requieren una intervención masiva para su tratamiento en salas de cirugía y/o unidades de cuidado intensivo. Evaluar la influencia de factores ambientales y de ocupación de la unidad en la concentración de aerobacterias de unidades de cuidado intensivo del Hospital Universitario Fernando Troconis. Materiales y Métodos: Se colectaron muestras triplicadas con agar selectivo para Staphylococcus spp. y Pseudomonas spp., en dos estaciones de cada una de las tres UCI, mediante impactador de 2 etapas ubicado a altura de1.5m y caudal constante (28.3l/min durante 5min, incubándolas a 37°C por 48h. Los factores ambientales se registraron con anemómetro Kestrel 4500 y ocupación de la unidad mediante registro manual del número de pacientes y personal asistencial de la unidad. Resultados: La máxima concentración fue 979.9±31.3UFC/m3 y el máximo promedio, 315.6±59.7UFC/m3. Staphylococcus spp. Superaron la concentración de Pseudomonas spp. La máxima ocupación fue en UCI Adulto, mayor temperatura en UCI Pediátrica y humedad más baja en UCI Adulto. Discusión y Conclusiones: La concentración de aerobacterias superó valores reportados por estudios  aerobiológicos hospitalarios, y presenta relaciones leves con temperatura y escasa o nula con ocupación de la unidad.Palabras clave: Partículas Viables en el Aire, Ambiente, Infección Hospitalaria, Ocupación de Camas, Cuidados Intensivos, Viabilidad Microbiana. (Fuente: DeCS BIREME.Cómo citar este artículo: V

  4. FACTORES AMBIENTALES Y PROPORCIÓN RACIAL QUE INFLUYEN EN EL PESO AL NACIMIENTO, AL DESTETE Y EDAD AL PRIMER PARTO EN BOVINOS SUIZO PARDO EN MÉXICO

    Directory of Open Access Journals (Sweden)

    Ricardo del Carmen Chin Colli

    2012-01-01

    Full Text Available Se evaluaron los efectos de algunos factores ambientales y proporción racial en el peso al nacimiento (PN, peso al destete ajustado a 240 (PD240 días de edad y edad al primer parto (EPP en bovinos Suizo Pardo. El modelo estadístico utilizado para analizar las variables dependientes, después de eliminar factores e interacciones de primer orden no significativos (P>0.05, incluyó los efectos de rancho como efecto aleatorio anidado dentro de región y los efectos fijos de año (A y época (E de nacimiento, sexo de la cría (para PN y PD240, grado de pureza, la interacción AxE, así como las covariables edad de la vaca al parto en su función lineal y cuadrática (para PN y PD240. Los análisis se realizaron utilizando modelos de efectos mixtos. Las medias para PN, PD240 y EPP fueron 37.7 ± 5.1, 233.8 ± 46.9 kg y 1209.6 ± 338.0 días, respectivamente. Todos los efectos principales fueron significativos (P

  5. Home parenteral nutrition in children

    International Nuclear Information System (INIS)

    Kalousova, J.; Rouskova, B.; Styblova, J.

    2011-01-01

    Parenteral nutrition delivered at home presents a major improvement in the quality of life of children dependent on long term parenteral nutrition. Indications, technical conditions, logistics, complications, prognosis of home parenteral nutrition as well as some health-care issues to be addressed by pediatric practitioner are summarized. (author)

  6. Composición de especies leñosas en comunidades invadidas en montañas del centro de Argentina: su relación con factores ambientales locales

    Directory of Open Access Journals (Sweden)

    Sebastián R. Zeballos

    2014-12-01

    Full Text Available En todo el mundo, las invasiones de especies leñosas exóticas están amenazando las funciones ecosistémicas. La dispersión y el subsecuente reemplazo de bosques de especies nativas por comunidades dominadas por exóticas es evidente, particularmente, en proximidad a centros urbanos donde la presión de propágulos de especies exóticas es alta. Sin embargo, existe una falta de información sobre los factores ambientales que subyacen este reemplazo. En este estudio nos propusimos responder las siguientes preguntas: (1 ¿se observa una segregación espacial a escala local entre especies leñosas exóticas y/o nativas dominantes?, y (2 si existe esa segregación, ¿está asociada a variables ambientales? En el 2010 se establecieron 31 parcelas distribuidas en 16 laderas en los bosques Chaqueños de las Sierras de Córdoba, en Argentina central. En cada uno de los sitios de muestreo se relevó la composición y abundancia de todas las especies leñosas con un diámetro a la altura de la base superior a 5cm. Para caracterizar el ambiente en cada una de las parcelas medimos la posición topográfica (pendiente y orientación y algunas propiedades asociadas con la física (densidad aparente y compactación, estructura (profundidad y textura y con la química (pH y el contenido de nutrientes y agua del suelo. A través, de un análisis jerárquico de agrupamiento, se identificaron cinco comunidades de leñosas coexistiendo: (1 Bosques dominados por Ligustrum lucidum, (2 Bosques mixtos dominados por Lithraea molleoides y Celtis australis, (3 Matorrales de Condalia buxifolia, (4 Matorrales de Cotoneaster glaucophyllus, y (5 Pajonales con emergentes de Pyracantha angustifolia. Estas comunidades se asociaron diferencialmente a las variables topográficas y edáficas locales. La segregación ambiental observada sugiere que las especies invasoras tienen una capacidad potencial para colonizar casi todos los ambientes en el área de estudio (variando la

  7. Proteínas del gluten y reología de trigos harineros mexicanos influeciados por factores ambientales y genotípicos Gluten proteins and rheology of Mexican bread wheats as affected by environmental and genotypic factors

    Directory of Open Access Journals (Sweden)

    Micaela De la O Olán

    2010-09-01

    Full Text Available El objetivo de este estudio fue conocer el efecto de factores ambientales y genotípicos sobre los parámetros de calidad industrial y sobre la cantidad y relación de proteínas monoméricas y poliméricas del gluten en 24 líneas recombinantes de trigos harineros de temporal. El cultivo se desarrolló en cinco condiciones ambientales generadas por manejo agronómico, ciclo otoño-invierno 2006/2007, en Roque, Guanajuato, México. Se evaluaron el tiempo de amasado (TMA, fuerza (ALVW, extensibilidad (ALVPL de la masa, fracción rica en gliadina (50PS y en glutenina (50PI, y su relación (50PS/50PI. Las mejores combinaciones de gluteninas de alto y bajo peso molecular para TMA y ALVW fueron los genotipos con 1, 17+18, 5+10/Glu-A3c, Glu-B3g, Glu-D3b; 1, 17+18, 5+10/Glu-A3c, Glu-B3h, Glu-D3b, y 2*, 17+18, 5+10/Glu-A3c, Glu-B3g, Glu-D3b; para ALVPL, 2*, 17+18, 2+12/Glu-A3e, Glu-B3h, Glu-D3b; para 50PS, 2*, 17+18, 2+12/Glu-A3e, Glu-B3h, Glu-D3b; y 1, 17+18, 5+10/Glu-A3e, Glu-B3h, Glu-D3b. La relación 50PS/50PI fue mayor en genotipos con 2*, 17+18, 2+12/Glu-A3e, Glu-B3g, Glu-D3b. El TMA es mayor cuando aumenta la temperatura y la mejor ALVPL se obtiene en el ambiente bajo condiciones normales. La fracción 50PS y la relación 50PS/50PI son mayores cuando se realiza la fertilización con azufre, y se obtiene incremento de 50PI con riego limitado y aumento de temperaturas durante el llenado de grano.The objective of this study was to determine the effect of environmental and genotypic factors on industrial quality and on the monomeric and polymeric protein contents and ratio of 24 rainfed bread wheat recombinant lines. The cultivation was done in five environmental conditions generated by agronomic management in the autumn-winter 2006/2007 cycle, at Roque, Guanajuato, Mexico. The mixing time (TMA, strength (ALVW and extensibility (ALVPL of the dough, gliadin (50PS and glutenin (50PI rich fractions, and their ratio (50PS/50PI, were evaluated. The best

  8. Desgaste profesional en el personal sanitario y su relación con los factores personales y ambientales Burnout syndrome in health workers and relationship with personal and environmental factors

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    Armand Grau

    2005-12-01

    Full Text Available Objetivos: Entre los profesionales sanitarios se han hallado altos índices de desgaste profesional. Nuestro objetivo fue estudiar la prevalencia del síndrome de desgaste profesional en los trabajadores sanitarios hospitalarios, y valorar su relación con los factores personales y ambientales. Métodos: Un total de 2.290 trabajadores sanitarios de 5 hospitales de Girona fueron invitados a participar. Se les administró un cuestionario de elaboración propia, una encuesta del clima organizacional, y el Maslach Burnout Inventory, que incluye tres dimensiones: cansancio emocional, despersonalización y baja realización personal. Resultados: Contestaron la encuesta 1.095 trabajadores (con un 47,8% de participación. Un 41,6% presentó un alto nivel de cansancio emocional, sobre todo los médicos y el personal de enfermería; un 23% tuvo un alto nivel de despersonalización, sobre todo los médicos, y un 27,9% tuvo una baja realización personal, en especial los técnicos y los médicos. Mediante un análisis de regresión logística múltiple, se asoció un alto nivel de cansancio emocional al consumo de tranquilizantes o antidepresivos con asiduidad, mientras que el optimismo y la satisfacción profesional mostraron una asociación inversa. Los años de profesión, el optimismo, valorar como útil el trabajo y percibir que se es valorado por los demás se asociaron inversamente con un alto nivel de despersonalización. La baja realización personal se asoció inversamente con el optimismo, la valoración de la utilidad del trabajo y el equipo de trabajo. Conclusiones: A partir de los resultados obtenidos, recomendamos mejorar el clima organizacional y potenciar el optimismo y la autoestima individual, para disminuir el desgaste profesional en los hospitales.Objectives: High rates of professional burnout syndrome have been found among health service professionals. Our objective was to study the prevalence of burnout syndrome in hospital health

  9. Tóxicos ambientales y su efecto sobre el neurodesarrollo

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    Hugo A. Arroyo

    2013-09-01

    Full Text Available Los trastornos del neurodesarrollo son consecuencia de un disturbio de la función cerebral. Son frecuentes, se manifiestan con sintomatología variada, en distintos momentos de la vida y suelen ser persistentes con repercusión a nivel individual, familiar y social. La asociación de estos trastornos del desarrollo con entidades genéticas neurológicas es baja. Aunque las investigaciones apoyan un modo de herencia genética los factores epigenéticos y ambientales pueden jugar un rol importante. En los últimos años hubo un llamativo incremento de estos trastornos, especialmente del trastorno por déficit de atención con hiperactividad y del trastorno generalizado del desarrollo y se comenzó a comprender y profundizar que la exposición a sustancias tóxicas ambientales puede provocar alteraciones en el neurodesarrollo y en la salud. Dentro de los factores ambientales se reconocen que la intoxicación del feto por metales pesados, especialmente plomo y mercurio, son los responsables en algunos niños de estos trastornos. Otras sustancias de amplio uso, escasa degradación y mantenimiento en la cadena alimenticia como los pesticidas, los bifenilos policlorados y ahora el reciclado de residuos electrónicos pone especialmente a lactantes y niños a riesgo y aún más en los países subdesarrollados.

  10. Intestinal parasitoses and environmental factors in a rural population of Argentina, 2002-2003 Parasitosis intestinales y factores ambientales en una población rural de Argentina, 2002-2003

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    Juan A. Basualdo

    2007-08-01

    Full Text Available We evaluate the prevalence of intestinal parasites in 504 people and the degree of association between environmental variables and parasites found in population, soil and water in a rural area of Argentina during 2002-2003. A structured survey was used to evaluate the environmental variables and fecal-human, soil and water samples were analyzed. The prevalence of parasites was 45.4%. Most prevalent protozoa were Blastocystis hominis (27.2% and Giardia lamblia (6.9%, while the most prevalent helminth was Ascaris lumbricoides (3.8%. The analyzed environmental variables showing association (p Hemos evaluado la prevalencia de parásitos intestinales en 504 personas y el grado de asociación entre las variables ambientales y los parásitos intestinales hallados en la población, el suelo y el agua de una zona rural de Argentina durante 2002-2003. Se utilizó una encuesta estructurada para relevar las variables ambientales y se examinaron muestras fecales humanas, de agua y de suelo. La prevalencia parasitaria fue de 45,4%. Los protozoos prevalentes fueron Blastocystis hominis (27,2% y Giardia lamblia (6,9%, mientras que el helminto mas prevalente fue Ascaris lumbricoides (3,8%. Las variables ambientales analizadas que mostraron asociación (p < 0,05 con la presencia de parásitos en la población fueron: casa de cartón-chapa o de madera con piso de tierra, bomba de agua domiciliaria o comunitaria, canilla fuera de la casa o pública y pozo ciego o letrina. Elementos parasitarios fueron hallados en el 82,3% de las muestras de suelo y en el 84,2% de las muestras de agua. En ambas muestras fueron hallados parásitos que también se encontraron en las personas. En este trabajo hemos hallado deficientes condiciones sanitarias asociadas con la presencia de parásitos en las personas y hemos evidenciado que el suelo y el agua contaminada fueron la fuente de esos parasitos.

  11. Combined enteral and parenteral nutrition.

    Science.gov (United States)

    Wernerman, Jan

    2012-03-01

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

  12. Bases para el manejo integrado del recurso langosta (panulirus rgus) en la zona costera sur de Pinar del Río. I. Factores ambientales

    OpenAIRE

    Piñeiro, R.; Puga, R.; González-Sansón, G.

    2006-01-01

    Se presenta la parte inicial de un estudio sobre manejo integrado de zonas costeras en la porción occidental del Golfo de Batabanó, en la costa Sur de la provincia de Pinar del Río. Son analizadas las características principales de los factores naturales: caudal de agua dulce aportado por los ríos, temperatura, salinidad, oxígeno disuelto, turbidez, pH y nutrientes (amonio, nitrato, nitrito y fósforo inorgánico) y el carbón orgánico y nitrógeno orgánico en sedimento. Además observ...

  13. Features of liver tissue remodeling in intestinal failure during and after weaning off parenteral nutrition.

    Science.gov (United States)

    Mutanen, Annika; Lohi, Jouko; Sorsa, Timo; Jalanko, Hannu; Pakarinen, Mikko P

    2016-09-01

    Intestinal failure is associated frequently with liver injury, which persists after weaning off parenteral nutrition. We compared features of liver remodeling in intestinal failure during and after weaning off parenteral nutrition. Liver biopsies and serum samples were obtained from 25 intestinal failure patients at a median age of 9.7 years (interquartile range: 4.6-18) and from age-matched control patients. Seven patients had been receiving parenteral nutrition for 53 months (22-160), and 18 patients had been weaned off parenteral nutrition 6.3 years (2.4-17) earlier, after having received parenteral nutrition for 10 months (3.3-34). Expression of alpha-smooth muscle actin, collagen 1, proinflammatory cytokines, growth factors, and matrix metalloproteinases (MMPs) was measured. Significant increases in immunohistochemical expression of alpha-smooth muscle actin and collagen 1 were observed predominantly in portal areas and were similar to increases seen in patients currently receiving parenteral nutrition and in patients weaned off parenteral nutrition. Gene and protein expressions of alpha-smooth muscle actin and collagen were interrelated. Gene expression of ACTA2, encoding alpha-smooth muscle actin, was increased only in patients who were receiving parenteral nutrition currently. Comparable upregulation of interleukin-1 (α and ß), epidermal growth factor, integrin-ß6, and MMP9 gene expression was observed in both patient groups, irrespective of whether they were receiving parenteral nutrition currently. Liver expression and serum levels of TIMP1 and MMP7 were increased only in the patients on parenteral nutrition currently but were not increased after weaning off parenteral nutrition. Intestinal failure is characterized by abnormal activation of hepatic myofibroblast and accumulation of collagen both during and after weaning off parenteral nutrition. Persistent transcriptional upregulation of proinflammatory and fibrogenic cytokines after weaning off

  14. Análisis de los factores medio ambientales condicionantes de la inocuidad de hortalizas cultivadas y consumidos en el área rural de Tenjo, Cundinamarca.

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    Sonia Liliana Pertuz Cruz

    2015-01-01

    Full Text Available La seguridad alimentaria y nutricional propende por la garantía de alimentos de calidad para todos. La carencia de inocuidad puede ser la causa de enfermedades transmitidas por alimentos que afectan no sólo la calidad de vida sino el estado nutricional de los consumidores. El estudio de los factores medioambientales que determinan la inocuidad de las hortalizas que se cultivan y se consumen en el municipio de Tenjo, Cundinamarca, se constituye en el objeto del presente trabajo. El trabajo se desarrolló en tres fases: inicialmente se efectuó una revisión, análisis y búsqueda documental sistemática en bases de datos y fuentes documentales impresas; seguidamente se realizó el trabajo de campo dividido en dos tipos de actividades: visitas a cultivos tradicionales y orgánicos de hortalizas en el municipio para poder establecer diferencias entre ellos, y encuestas a los consumidores de las mismas en Tenjo y Bogotá para establecer patrones de compra y consumo de éstos alimentos. Por último, se realizó el análisis de los datos obtenidos y se identificaron los peligros y puntos críticos de control para proponer los correctivos necesarios. Se encontró que los principales factores medioambientes que determinan las condiciones de inocuidad de las hortalizas de Tenjo son el agua que se utiliza en el riego, las sustancias que se emplean para fertilizar el suelo y controlar las plagas, los empaques o embalajes para la distribución y venta del producto y finalmente, la manipulación de las hortalizas por parte de los consumidores.

  15. PANORAMA LATINOAMERICANO DEL PAGO POR SERVICIOS AMBIENTALES

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    González T. Ángela

    2008-07-01

    Full Text Available Este documento busca proveer al lector de algunos elementos para el análisis y reflexión en torno al pago por servicios ambientales. Para ello, en primera instancia, aborda algunos conceptos básicos relacionados con economía ambiental, seguido de temas como la valoración económica de servicios ambientales y la implementación de mecanismos de pago por algunos de ellos. Lo anterior esta enriquecido con experiencias o estudios de caso a nivel latinoamericano y colombiano.

  16. Parenteral nutrition in radiation injuries

    International Nuclear Information System (INIS)

    Glants, R.M.

    1985-01-01

    Basing on the results of experiments on mice and rats and their clinical use in oncological patients treatment recommendations are given on use of parenteral nutrition in treatment of radiation disease

  17. Parenteral nutrition in malnourished patients

    International Nuclear Information System (INIS)

    Lichvarova, I.

    2011-01-01

    Parenteral nutrition became a routine therapeutic option in malnourished patients, if conventional nutritional enteral support is not effective. Cachexia and malnutrition prolong the wound healing, contribute to immunosuppression, increase morbidity and the cost of treatment. Using of a malnutrition protocol as a screening tool is necessary to sort out malnourished patients. Parenteral nutrition is therefore an important part of the multimodal therapy and from the medical and the ethical point of view is a great mistake not to feed a patient. (author)

  18. Plasma trace metals during total parenteral alimentation.

    Science.gov (United States)

    Solomons, N W; Layden, T J; Rosenberg, I H; Vo-Khactu, K; Sandstead, H H

    1976-06-01

    The plasma concentrations of the trace metals zinc and copper were studied prospectively in 13 patients with gastrointestinal diseases treated with parenteral alimentation (TPA) for periods of from 8 days to 7 1/2 weeks. Plasma copper levels fell rapidly and consistently in all patients, with an overall rate of - 11 mug per 100 ml per week. Zinc concentrations declined in 10 of 13 patients at a more gradual rate. Analysis of the standard parenteral alimentation fluids revealed zinc content equivalent to 50% of the daily requirement and a negligible content of copper. From combined analysis of plasma zinc, hair zinc, and taste acuity, there is evidence that increased utilization or redistribution within the body may effect plasma concentrations in some patients. Neither an increase in urinary excretion nor a primary decrease in plasma binding proteins appeared to be a major factor in lowering plasma trace metal concentrations. These findings indicate that a marked decrease in plasma copper is regular and a decline in plasma zinc is common during TPA using fluids unsupplemented with trace metals. Supplementation of parenteral alimentation fluids with the trace metals zinc and copper is recommended.

  19. Preparación de informes contables ambientales

    OpenAIRE

    García Casella, Carlos Luis

    2011-01-01

    Partiendo de la definición de Contabilidad llegamos a la llamada Contabilidad Ambiental como una rama de la disciplina que necesita tratar varios temas principales. Uno de ellos es el establecimiento de Sistemas Contables Ambientales que produzcan informes Contables Ambientales. A la vez hay que establecer Planes Contables Integrados en el tema ambiental y hay que lograr que los informes contables ambientales incluyan los efectos de los mecanismos de desarrollo limpio. Al tratar el tema de la...

  20. Advantages of enteral nutrition over parenteral nutrition

    OpenAIRE

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

    2013-01-01

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

  1. VALORACIÓN DE ACTIVOS AMBIENTALES

    OpenAIRE

    Aznar Bellver, Jerónimo; Estruch Guitart, Arturo Vicente

    2015-01-01

    2ª Edición La importancia del medioambiente y de los activos y recursos naturales cada vez es mayor. La determinación de un Indicador del valor económico de los activos ambientales es un parámetro de gran utilidad para la sensibilización de la sociedad, la conservación de los activos y como instrumento de gestión para la administración. En este libro tras unos capítulos de introducción a la economía ambiental y de repaso de algunos de los métodos clásicos de valoración ambiental, se presen...

  2. Los conflictos ambientales del gas boliviano

    Directory of Open Access Journals (Sweden)

    Gavaldá Palacín, Marc

    2005-01-01

    Full Text Available Los ajustes neoliberales introducidos en la legislación bolivana han facilitado la apropiación de los recursos hidrocarburíferos por parte de las transnacionales petroleras. Estas compañías invaden territorios indígenas y áreas protegidas. En su accionar generan graves conflictos ambientales con las comunidades locales. La costrucción de los gasoductos Bolivia-Brasil, Cuiabá y Gasyrg así como la oposición de la población a exportar gas a Estados Unidos nos reflejan cómo la población se organiza para resistir al expolio de las compañías petroleras. Las movilizaciones populares de ¿La Guerra del gas¿, en octubre 2003 no han terminado, porque el gas sigue en manos extranjeras.

  3. Parenteral nutrition in childhood and consequences for dentition and gingivae.

    Science.gov (United States)

    Olczak-Kowalczyk, D; Danko, M; Banaś, E; Gozdowski, D; Popińska, K; Krasuska-Sławińska, E; Książyk, J

    2017-03-01

    Assessment of dentition in children under parenteral nutrition, risk factors for caries, and dental developmental abnormalities. The study involved 63 patients (aged 2.25-16.6 years), i.e. 32 subjects receiving parenteral nutrition for a mean period of 5.6±2.94 years, and 31 healthy control subjects. Oral hygiene (OHI-S, PL-I), gingival (GI), and dentition status (caries, DMFT/dmft, enamel defects, shape alterations), frequency of oral meals and frequency of cariogenic snacks consumption were evaluated. Medical records provided information on parenteral meals per week, age parenteral nutrition started, birth body mass, Apgar score, weight deficiency, and antibiotic therapy until aged 1 year. The Mann-Whitney test, chi-squared test, and Spearman rank correlation coefficient were used (p≤0.05). Dental developmental abnormalities occurred more often in PN subjects (71.87% vs. 25.80%). The prevalence of caries in PN (56.25% vs. 90.32%) and dmft (2.00±3.30 vs. 4.21±3.33) and DMFT (2.47±4.08 vs. 3.33±3.50) were lower. Positive caries Spearman's rank correlation coefficients: frequency of oral meals and frequency of cariogenic snacks consumption, and GI. Negative correlation coefficients: low birth body mass, antibiotic therapy, and low body mass in the first year of life. Positive dental developmental abnormality Spearman's coefficients: low birth body mass, Apgar score parenteral nutrition duration, low body mass and antibiotic therapy in the first year of life. Beta- lactam, aminoglycoside, glycopeptide and nitroimidazole treatments were related to enamel hypoplasia. Parenteral nutrition in childhood is related to the risk of dental developmental abnormalities, promoted by malnutrition and antibiotic therapy in infancy. Limiting the number of meals and cariogenic snacks, and most probably administration of antibiotics, decreases the risk of caries.

  4. Social and environmental factors associated with the hospitalization of tuberculosis patients Los factores sociales y ambientales asociados a la hospitalización de los pacientes con tuberculosis Fatores sociais e ambientais associados à hospitalização de pacientes com tuberculose

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    Nathália França de Oliveira

    2013-04-01

    Full Text Available OBJECTIVE: to identify social and environmental factors associated with hospitalization of tuberculosis (TB patients in Manaus, Amazonas, during 2010. METHODS: this is a quantitative cross-sectional epidemiological study, with primary data collection and analysis of human immunodeficiency virus (HIV, based on seropositive status. RESULTS: Among social factors for TB-HIV co-infection, the association between alcohol use and dependence was significant for employed workers; among non-co-infections, the association between income less than one minimum wage (U.S. $200 and retired people, Bolsa Família Program [Family Allowance]/other social benefits was significant. Regarding environmental factors, the association was significant for TB-HIV co-infection among those not having their own house, having masonry housing and daily garbage collection; and among non-co-infection, owning their own house, no masonry housing and lack of daily garbage collection was significant. CONCLUSION: The findings indicated that not only social factors, but also environmental ones are associated with hospitalization of tuberculosis patients, and such associations differ according to TB-HIV co-infection. Findings revealed that the non-biological factors associated with hospitalization of tuberculosis patients should be considered when caring patients with this disease. OBJETIVO: identificar los factores sociales y ambientales asociados con la hospitalización de de los pacientes con tuberculosis (TB en Manaus, Amazonas, durante el año 2010. MÉTODOS: se trata de un análisis cuantitativo de corte transversal estudio epidemiológico, con la recolección de datos primarios y el análisis de virus de la inmunodeficiencia humana (VIH, en estado seropositivo. RESULTADOS: Entre los factores sociales para la TB-VIH-SIDA, la asociación entre el consumo de alcohol y la dependencia fue significativa para los trabajadores empleados, entre los no co-infectados, la relación entre

  5. Parenteral nutrition in intestinal failure

    Directory of Open Access Journals (Sweden)

    Kurkchubasche AG

    2015-01-01

    Full Text Available Arlet G Kurkchubasche,1 Thomas J Herron,2 Marion F Winkler31Department of Surgery and Pediatrics, 2Department of Surgery, Alpert Medical School of Brown University, 3Department of Surgery/Nutritional Support Service, Rhode Island Hospital, Providence, RI, USAAbstract: Intestinal failure is a consequence of extensive surgical resection resulting in anatomic loss and/or functional impairment in motility or absorptive capacity. The condition is clinically characterized by the inability to maintain fluid, energy, protein, electrolyte, or micronutrient balance when on a conventionally accepted, normal diet. Parenteral nutrition (PN is the cornerstone of management until intestinal adaptation returns the patient to a PN-independent state. Intestinal length, residual anatomic segments and motility determine the need for and duration of parenteral support. The goals of therapy are to provide sufficient nutrients to enable normal growth and development in children, and support a healthy functional status in adults. This review addresses indications for PN, the formulation of the PN solution, patient monitoring, and considerations for prevention of PN-associated complications. With the ultimate goal of achieving enteral autonomy, the important role of diet, pharmacologic interventions, and surgery is discussed.Keywords: intestinal failure, short-bowel syndrome, parenteral nutrition, home nutrition support, intestinal rehabilitation

  6. Parenteral nutrition in short bowel syndrome patients, regardless of its duration, increases serum proinflammatory cytokines.

    Science.gov (United States)

    Bizari, Letícia; da Silva Santos, Andressa Feijó; Foss, Norma Tiraboschi; Marchini, Júlio Sérgio; Suen, Vivian Marques Miguel

    2016-07-01

    Short bowel syndrome is a severe malabsorption disorder, and prolonged parenteral nutrition is essential for survival in some cases. Among the undesirable effects of long-term parenteral nutrition is an increase in proinflammatory cytokines. The aim of the present study was to measure the serum levels of interleukin-6, interleukin-10, tumor necrosis factor alpha, and transforming growth factor beta, in patients with short bowel syndrome on cyclic parenteral nutrition and patients who had previously received but no longer require parenteral nutrition. The study was cross-sectional and observational. Three groups were studied as follows: Parenteral nutrition group, 9 patients with short bowel syndrome that receive cyclic parenteral nutrition; Oral nutrition group, 10 patients with the same syndrome who had been weaned off parenteral nutrition for at least 1 year prior to the study; Control group, 13 healthy adults, matched for age and sex to parenteral and oral groups. The following data were collected: age, tobacco use, drug therapies, dietary intake, body weight, height, blood collection. All interleukins were significantly higher in the parenteral group compared with the control group as follows: interleukin-6: 22 ± 19 vs 1.5 ± 1.4 pg/mL, P= .0002; transforming growth factor β: 854 ± 204 vs 607 ± 280 pg/mL, P= .04; interleukin-10: 8 ± 37 vs 0.6 ± 4, P= .03; tumor necrosis factor α: 20 ± 8 vs 8 ± 4 pg/mL, Pparenteral nutrition in short bowel syndrome patients, regardless of its duration, increases serum proinflammatory cytokines. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Impacto de la hidatidosis: Influencia de factores ambientales y socioculturales en Tucumán, Argentina Impact of the Hydatidosis: Influence of Environment and Social-Culture Factors. Tucumán - Argentina

    OpenAIRE

    José Antonio Remis; Eduardo Alfredo Guarnera; Alberto Parra

    2009-01-01

    Objetivo: Exponer experiencias de trabajo en terreno sobre la epidemiología y control de hidatidosis en la región de Alta Montaña de Tucumán, su impacto social, económico y sanitario. Material y Métodos: Mediante visitas programadas a la región endémica se estudiaron factores socioculturales establecidos en la población y su contribución para la permanencia de la enfermedad en la región de Alta Montaña de Tucumán. Se consultaron registros para medir el impacto de la patología en el hombre y e...

  8. Hydrogen-Ion Potential of Antibiotics According to the Environment Factors Temperature and Luminosity Potencial hidrogenionico de antimicrobianos, según los factores ambientales de temperatura y luminosidad Potencial hidrogeniônico de antimicrobianos, segundo os fatores ambientais temperatura e luminosidade

    Directory of Open Access Journals (Sweden)

    Renata Maria Coelho Crepaldi

    2010-04-01

    Full Text Available The objective of this experimental study was to measure the pH of antibiotics administered by intravenous infusion - ceftriaxone sodium, vancomycin hydrochloride, metrodinazole, penicillin G potassium and amikacin sulfate - after reconstitution with sterile water and dilution with NaCl 0.9% or dextrose 5% in water, according to temperature and luminosity of the environment. The results showed that variation in the drugs' pH was less than 1.0 value and that some antibiotics remained acidic after dilution and maintained this chemical profile in all situations studied, suggesting that the studied environmental factors did not change the solutions' acid base characteristic. Some pH values measured characterize risk for the development of chemical phlebitis and infiltration, and it is important for clinical practice to emphasize the profile of intravenous solutions of antibiotics, considering method of dilution, and time to infusion.El objetivo de este estudio experimental fue medir el pH de los antibióticos de administración intravenosa ceftriaxona sódica, clorhidrato de vancomicina, metronidazol, penicilina G potásica y sulfato de amikacina, después de reconstitución con agua destilada y dilución con NaCl a 0,9%, o suero glucosado a 5%, considerando la influencia de la temperatura y luminosidad ambientales, así como el tiempo de exposición, en el comportamiento químico de esos fármacos. Los resultados demostraron variaciones que no ultrapasaron 1,0 (valor de pH y que algunos antimicrobianos, eminentemente ácidos después de la dilución, mantuvieron ese comportamiento en todas las situaciones estudiadas, no sugiriendo la influencia de factores ambientales en el comportamiento químico de las soluciones. Considerando que algunos valores de pH encontrados pueden contribuir para el desarrollo de flebitis química e infiltración, es importante enfatizar que para la práctica clínica en salud, existe la necesidad de conocer las caracter

  9. Programmazione del Network di 'Virologia Ambientale': Stato di avanzamento

    OpenAIRE

    Carlesi, Carlo

    2004-01-01

    Presentazione 'Power Point' dell'intervento all'incontro di lavoro 'VIRAMB II incontro del Network di Virologia Ambientale', presso l'Istituto Zooprofilattico Sperimentale delle Regioni Lazio e Toscana. Nell'intervento si presenta lo stato di avanzamento dei lavori riguardo la realizzazione dell'infrastruttura telematica del 'Network di Virologia Ambientale' promosso dal 'Dipartimento di Patologia Sperimentale, Biotecnologie Mediche, Infettivologia ed Epidemiologia' dell'Universit? di Pisa.

  10. ESPEN Guidelines on Parenteral Nutrition: gastroenterology

    DEFF Research Database (Denmark)

    A., Van Gossum; Cabre, E.; Hebuterne, X.

    2009-01-01

    . There is a lack of data supporting specific nutrients in these conditions. Parenteral nutrition is mandatory in case of intestinal failure, at least in the acute period. In patients with short bowel, specific attention should be paid to water and electrolyte supplementation. Currently, the use of growth hormone......-based recommendations for the indications, application and type of parenteral formula to be used in acute and chronic phases of illness. Parenteral nutrition is not recommended as a primary treatment in CD and UC. The use of parenteral nutrition is however reliable when oral/enteral feeding is not possible...

  11. Minimizing systemic infection during complete parenteral alimentation of small infants

    Science.gov (United States)

    Nelson, R.

    1974-01-01

    A regimen of parenteral alimentation for infants was designed to eliminate as many factors responsible for infection as possible. The most important features of the feeding regimen were as follows. (1) Infants were fed via indwelling silastic catheters inserted into the superior vena cava or the right atrium by a cutdown operation. (2) The parenteral feeding was fat free to simplify the administration system. Y connectors and 2- or 3-way taps were avoided. (3) Extreme care was taken of junctions within the infusion system. Only certain members of the hospital staff were allowed to break such junctions, e.g. during the changing of packs of solution or of the giving sets. These junctions were sprayed with antibacterial aerosols. (4) The hypertonic solutions of nutrients were prepared in plastic packs, which do not require ventilation. The infusion system was therefore not contaminated by the entry of unsterile outside air. (5) The infused solutions were passed through 0·22 μm millipore filters before entering the patient's blood stream. There was an infection rate of 9% which was less than the 25 to 45% infection rate previously reported during parenteral feeding through indwelling venous catheters, and is also less than that associated with ventriculoatrial shunts for hydrocephalus. There was no case of systemic candidiasis, which is the most frequent and most serious infection associated with parenteral feeding. PMID:4206445

  12. Efecto de los factores ambientales sobre la diversidad de insectos hemimetábolos y coleópteros acuáticos en la cuenca del Río Xichú, Guanajuato, México

    Directory of Open Access Journals (Sweden)

    Ulises Torres-García

    2014-04-01

    Full Text Available Los sistemas lóticos integrados por cauces temporales representan una alta proporción de las aguas continentales del planeta, no obstante se encuentran entre los sistemas menos estudiados a nivel mundial. En cuanto a diversidad entomológica, el centro de México -donde se ubican estos sistemas- permanece poco estudiado a pesar del alto potencial que presenta la zona de albergar una alta diversidad y de los vínculos importantes que este grupo desempeña en los flujos de energía de los ecosistemas acuáticos. El objetivo del presente trabajo fue analizar las variables ambientales que determinan los cambios en la diversidad y las escalas en que tienen efecto, en las comunidades de insectos acuáticos de un sistema fluvial semiárido del centro de México. Se registraron un total de 89 géneros, con el orden Coleoptera presentando la mayor riqueza. Los valores más altos de diversidad alfa se encontraron sobre sitios permanentes en la temporada de sequía (¹D:10.63, lo que se atribuye a la mayor estabilidad que presentan los sistemas fluviales en esta temporada. Las comunidades establecidas sobre cauces permanentes e intermitentes presentaron baja similitud (Ij <0.45, indicando un alto recambio entre comunidades establecidas sobre cauces con diferente hidroperiodo. Los análisis de distribución (“partición” de la diversidad indican que el mayor aporte a la diversidad regional se da por cambios en la composición de géneros a nivel de ríos (37%, entre temporadas (22% y por el tipo de sistema (21%. De acuerdo con el Análisis de Correlación Canónica las variables de mesohábitat, velocidad de corriente, calidad ecológica y orden del cauce son las que mejor explican la variación en la presencia de los taxones. Los resultados sugieren que los sitios permanentes se encuentran actuando como fuente de especies de los sitios intermitentes y que los esfuerzos de conservación en la región deben implementarse a escala de paisaje.

  13. Parenteral Nutrition in Liver Resection

    Directory of Open Access Journals (Sweden)

    Carlo Chiarla

    2012-01-01

    Full Text Available Albeit a very large number of experiments have assessed the impact of various substrates on liver regeneration after partial hepatectomy, a limited number of clinical studies have evaluated artificial nutrition in liver resection patients. This is a peculiar topic because many patients do not need artificial nutrition, while several patients need it because of malnutrition and/or prolonged inability to feeding caused by complications. The optimal nutritional regimen to support liver regeneration, within other postoperative problems or complications, is not yet exactly defined. This short review addresses relevant aspects and potential developments in the issue of postoperative parenteral nutrition after liver resection.

  14. Parenteral nutrition-associated liver disease and lipid emulsions.

    Science.gov (United States)

    Zugasti Murillo, Ana; Petrina Jáuregui, Estrella; Elizondo Armendáriz, Javier

    2015-01-01

    Parenteral nutrition-associated liver disease (PNALD) is a particularly important problem in patients who need this type of nutritional support for a long time. Prevalence of the condition is highly variable depending on the series, and its clinical presentation is different in adults and children. The etiology of PNALD is not well defined, and participation of several factors at the same time has been suggested. When a bilirubin level >2 mg/dl is detected for a long time, other causes of liver disease should be ruled out and risk factors should be minimized. The composition of lipid emulsions used in parenteral nutrition is one of the factors related to PNALD. This article reviews the different types of lipid emulsions and the potential benefits of emulsions enriched with omega-3 fatty acids. Copyright © 2014 SEEN. Published by Elsevier España, S.L.U. All rights reserved.

  15. Parenteral nutrition in the critically ill.

    Science.gov (United States)

    Gunst, Jan; Van den Berghe, Greet

    2017-04-01

    Feeding guidelines have recommended early, full nutritional support in critically ill patients to prevent hypercatabolism and muscle weakness. Early enteral nutrition was suggested to be superior to early parenteral nutrition. When enteral nutrition fails to meet nutritional target, it was recommended to administer supplemental parenteral nutrition, albeit with a varying starting point. Sufficient amounts of amino acids were recommended, with addition of glutamine in subgroups. Recently, several large randomized controlled trials (RCTs) have yielded important new insights. This review summarizes recent evidence with regard to the indication, timing, and dosing of parenteral nutrition in critically ill patients. One large RCT revealed no difference between early enteral nutrition and early parenteral nutrition. Two large multicenter RCTs showed harm by early supplementation of insufficient enteral nutrition with parenteral nutrition, which could be explained by feeding-induced suppression of autophagy. Several RCTs found either no benefit or harm with a higher amino acid or caloric intake, as well as harm by administration of glutamine. Although unanswered questions remain, current evidence supports accepting low macronutrient intake during the acute phase of critical illness and does not support use of early parenteral nutrition. The timing when parenteral nutrition can be initiated safely and effectively is unclear.

  16. Mass torts e responsabilità per danno ambientale: una analisi economica

    NARCIS (Netherlands)

    Parisi, F.; Dari-Mattiacci, G.

    2009-01-01

    Nel presente studio verranno esaminate alcune delle problematiche giuridiche e delle categorie economiche introdotte dalla nuova normativa europea in tema di danno ambientale. Le nostre argomentazioni tenderanno a dimostrare che le ipotesi di danno ambientale caratterizzabili come mass torts non

  17. 21 CFR 201.323 - Aluminum in large and small volume parenterals used in total parenteral nutrition.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Aluminum in large and small volume parenterals... for Specific Drug Products § 201.323 Aluminum in large and small volume parenterals used in total parenteral nutrition. (a) The aluminum content of large volume parenteral (LVP) drug products used in total...

  18. Pulmonary nodules secondary to total parenteral alimentation

    International Nuclear Information System (INIS)

    Landry, B.A.; Melhem, R.E.

    1989-01-01

    A seven-year-old male, who had a retroperitoneal alveolar rhabdomyosarcoma and was on total parenteral alimentation (TPN) developed muliple pulmonary nodules, indistinguishable from metastases. These proved to be multiple lipid emboli on open biopsy. (orig.)

  19. Prolonged parenteral nutrition after neonatal gastrointestinal surgery

    DEFF Research Database (Denmark)

    Estmann, Anne; Qvist, Niels; Husby, Steffen

    2002-01-01

    to diagnosis and clinical course. METHODOLOGY: This study reviews the clinical course of infants with gastrointestinal disease (gastroschisis, intestinal atresia, omphalocele, volvulus, Hirschsprung's disease and necrotizing enterocolitis) with a prolonged need for parenteral nutrition in the Western part...

  20. Parenteral nutrition in the elderly cancer patient.

    Science.gov (United States)

    Orrevall, Ylva

    2015-04-01

    Parenteral nutrition may be considered when oral intake and/or enteral nutrition are not sufficient to maintain nutritional status and the patient is likely to die sooner from starvation than from the cancer. A detailed assessment should be made prior to the decision about whether parenteral nutrition should be started. A follow up plan should be documented with objective and patient centred treatment goals as well as specific time points for evaluation. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. Aspectos ambientales de algunos ríos camaroneros del Perú

    OpenAIRE

    Llanos Urbina, Jorge

    1980-01-01

    Se presenta un estudio de las condiciories ambientales en cinco ríos camaroneros de la Costa Central y Sur del Perú, considerando la temperatura, la concentración de oxígeno disuelto, la alcalinidad total, el pH, la conductividad y la dureza del agua. Se menciona la existencia de otros factores como el período hidrológico y el tipo de fondo, como elementos importantes en relación con la vida del camarón. Se sugiere que existe una contaminación química potencial de todos los ríos estud...

  2. Inter y transdisciplinariedad en investigaciones ambientales. Una sinopsis

    Directory of Open Access Journals (Sweden)

    Alberto Ramírez-González

    2016-07-01

    Full Text Available El presente artículo de revisión tiene como pretensión realizar un acercamiento al estado actual de conocimiento en torno a la conformación de grupos de investigación y el análisis de la problemática ambiental, bajo enfoques inter y transdisciplinares. Constituye, esencialmente, una investigación teórica soportada en artículos científicos, libros y documentos publicados por entidades y organizaciones reconocidas nacional o internacionalmente. El documento incluye diversos puntos de vista en torno a los marcos conceptuales, teóricos y metodológicos, y expone algunas problemáticas ambientales y sociales que se presume deben ser abordadas desde tales enfoques. Adicionalmente, presenta algunos de los intersticios que ligan lo ambiental con algunas ciencias y disciplinas. La revisión hace acopio de los principales avances y los retos más recurrentes en torno a la formación de profesionales que cumplan con las competencias más pertinentes y adecuadas para la implementación inter y transdisciplinar. Adicionalmente, enuncia algunos de los factores asociados con el éxito y el fracaso de los investigadores, los grupos de investigación y las investigaciones, que han pretendido tales enfoques. Finalmente, expone algunas recomendaciones que podrían potenciar el desempeño de los grupos que realizan investigaciones inter y transdisciplinares, las cuales han emergido, precisamente, del seguimiento a proyectos de esta naturaleza. CC BY-NC-SA Gestión y Ambiente (2016.

  3. Influence of environmental factors on the growth of the juvenile, maturing juvenile, and adult tropical scallop, Euvola ziczac (Pteroida: Pectinidae, in suspended culture conditions Influencia de los factores ambientales en el crecimiento de juveniles, juveniles con capacidad reproductiva y adultos de la vieira tropical Euvola ziczac (Pteroida: Pectinidae en condiciones de cultivo suspendido

    Directory of Open Access Journals (Sweden)

    César Lodeiros

    2012-03-01

    Full Text Available We carried out growth trials on three size groups of the scallop, Euvola ziczac, during two short-term (34-36 days periods at 8, 21, and 34 m depth in Cariaco Gulf, Venezuela, in order to evaluate the effect of environmental factors on growth. Growth was greater in juveniles (initial size: 20-22 mm shell length than in maturing juveniles (30-40 mm and adults (70-75 mm. Somatic tissue growth was more than two-fold greater in juveniles than in maturing individuals. Adult scallops showed losses of tissue mass. The first period (December-January covered the transition from a stratified water column to upwelling conditions, with initial high temperatures and low phytoplankton biomass followed by lower temperatures and greater phytoplankton biomass. The second period (February-March consisted of upwelling, characterized by low temperatures and high phytoplankton production. The greater growth of juvenile and maturing scallops during the second period, particularly at 8 m depth, was associated with the greater availability of phytoplankton, related to coastal upwelling. The first development of gonads in maturing scallops only occurred in the second period, associated with food availability, and the degree of development was correlated with the depth. Our growth trials, which were too short to permit the negative impact of the development of fouling, showed that the growth of E. ziczac was enhanced in the presence of abundant phytoplankton biomass.Se efectuaron ensayos de crecimiento en tres grupos de tallas del pectínido Euvola ziczac, durante dos periodos de corto plazo (34-36 días a 8, 21 y 34 m de profundidad, en el golfo de Cariaco, Venezuela, para evaluar el efecto de factores ambientales en el crecimiento. El crecimiento fue mayor en juveniles (talla inicial 20-22 mm en longitud de concha, que en individuos madurando (30-40 mm y adultos (70-75 mm. El crecimiento del tejido somático fue más del doble en los juveniles que en los organismos en

  4. Parenteral Nutrition and Intestinal Failure.

    Science.gov (United States)

    Bielawska, Barbara; Allard, Johane P

    2017-05-06

    Severe short bowel syndrome (SBS) is a major cause of chronic (Type 3) intestinal failure (IF) where structural and functional changes contribute to malabsorption and risk of micronutrient deficiencies. Chronic IF may be reversible, depending on anatomy and intestinal adaptation, but most patients require long-term nutritional support, generally in the form of parenteral nutrition (PN). SBS management begins with dietary changes and pharmacologic therapies taking into account individual anatomy and physiology, but these are rarely sufficient to avoid PN. New hormonal therapies targeting intestinal adaptation hold promise. Surgical options for SBS including intestinal transplant are available, but have significant limitations. Home PN (HPN) is therefore the mainstay of treatment for severe SBS. HPN involves chronic administration of macronutrients, micronutrients, fluid, and electrolytes via central venous access in the patient's home. HPN requires careful clinical and biochemical monitoring. Main complications of HPN are related to venous access (infection, thrombosis) and metabolic complications including intestinal failure associated liver disease (IFALD). Although HPN significantly impacts quality of life, outcomes are generally good and survival is mostly determined by the underlying disease. As chronic intestinal failure is a rare disease, registries are a promising strategy for studying HPN patients to improve outcomes.

  5. Dificultades en los métodos de estudio de exposiciones ambientales y defectos del tubo neural

    Directory of Open Access Journals (Sweden)

    Borja-Aburto Víctor Hugo

    1999-01-01

    Full Text Available Objetivo. Discutir las actitudes en la evaluación de las exposiciones ambientales como factores de riesgo para defectos de riesgo del tubo neural, al tiempo que se presentan los principales factores estudiados hasta la fecha. Resultados. Las exposiciones ambientales se citan muy a menudo como causa de malformaciones congénitas; sin embargo, ha sido difícil establecer esta asociación en los estudios de poblaciones humanas, debido a problemas en su diseño y conducción. Lo anterior es particularmente marcado en el caso del estudio de los defectos del cierre del tubo neural (DTN, que es una de las principales malformaciones y que incluye anencefalia, espina bífida y encefalocele, y su asociación con exposiciones ambientales. Las dificultades en los métodos surgen de: a la medida de frecuencia para realizar comparaciones espacio-temporales; b la clasificación y heterogeneidad de las malformaciones; c la consideración de los factores relacionados con la madre, el padre y el producto, de manera conjunta, y d la evaluación de las exposiciones ambientales. Conclusiones. Hipotéticamente las exposiciones ambientales tanto del padre como de la madre pueden producir daño genético antes y/o después de la concepción por la acción directa sobre el embrión o sobre el complejo fetoplacentario, de tal manera que en la evaluación de exposiciones ambientales: a deben tomarse en cuenta las exposiciones maternas y paternas; b debe considerarse el periodo crítico de exposición, esto es, tres meses anteriores a la concepción para el padre y un mes alrededor de la concepción para la madre; c en la medida de lo posible, la evaluación de la exposición deberá ser cuantitativa, evitando clasificar a los grupos únicamente como expuestos y no expuestos, y d es recomendable emplear marcadores biológicos de exposición siempre que sea posible, así como utilizar marcadores biológicos que permitan clasificar a la población en grupos con distinta

  6. Influencia de factores socioeconómicos y ambientales sobre la adopción de tecnologías silvopastoriles por productores ganaderos, distrito de Molinopampa, Amazonas, Perú

    OpenAIRE

    Oliva Cruz, Segundo Manuel

    2016-01-01

    Universidad Nacional Agraria La Molina. Escuela de Posgrado. Maestría en Innovación Agraria para el Desarrollo Rural El objetivo general de esta investigación fue analizar el efecto de los factores sociales y culturales en el grado de adopción de cacao entre productores agrícolas del distrito de Santa María de Nieva, en la provincia de Condorcanqui, en la región Amazonas. La investigación se llevó a cabo en cuatro comunidades Awajún (Santa Rosa de Pagkintsa, Tayuntsa, Putuyacat y Najain Pa...

  7. Alteraciones hepáticas inducidas por la nutrición parenteral

    OpenAIRE

    J Salas Salvado; A Recaséns Garica

    1993-01-01

    Liver disorders induced by parenteral nutrition Alteraciones hepáticas inducidas por la nutrición parenteral Liver disorders induced by parenteral nutrition Alteraciones hepáticas inducidas por la nutrición parenteral

  8. Parenteral Opioid Analgesics Utilization Pattern in Amir-al-Momenin Hospital, Zabol-IRAN

    Directory of Open Access Journals (Sweden)

    Hossein Vatanpour

    2016-08-01

    Full Text Available Opioids are the most available medicines to get rid of any general severe pain and avoiding of any deleterious sequential that can worsen patient outcomes. Rational prescription of opioid analgesics with respect to the possibility of abuse is a big concern in the medical care costs. Zabol, where is located in eastern part of Iran and has common border with Afghanistanhas the most opioid traffic in the region. In this study the rational prescription of parenteral opioid in Amir-al-Momenin general hospital was investigated. A retrospective drug utilization review was performed on 509 in-patients who received parenteral opioids including Morphine, Pethidin, Pentazocin, Fentanyl, Alfentanil, Sufentanil and Methadone from March 21sttoSeptember 23rd, 2011. Multivariate conditional regression modeling was used to determine independent predictors for daily parenteral opioid consumption. Total daily parenteral opioid consumption was 38.63 DDDs/100bed-days for Morphine, Pethidine and Pentazocin and 84564.78 PFEQs/100bed-days for Fentanyl, Alfentanil and Sufentanil and 766 mg for Methadone. Pethidine was the most frequently prescribed parenteral opioid. Most patients who were prescribed by the intramuscular routes, ordered PRN. Daily parenteral opioid consumption was the highest in the emergency ward whereas it was considered as the lowest in the intensive care unit[ICU]. According to our findings, total daily parenteral opioid consumption was almost high in Amir-al-Momenin Hospital. Unlike to some relevant factors that can effect on the consumption of analgesic opioids like gender, age, drug-drug interaction and etc, we found no rational prescription and consumption in the mentioned hospital.

  9. CONFLICTOS AMBIENTALES: LA BIODIVERSIDAD COMO ESTRATEGIA ORDENADORA DEL TERRITORIO

    Directory of Open Access Journals (Sweden)

    Helena Pérez Garcés

    2011-12-01

    Full Text Available El interés por la protección de la biodiversidad genera conflictos ambientales inéditos, como el que ocurre con los pobladores de los corregimientos de San Sebastián de Palmitas y San Cristóbal, del municipio de Medellín, a raíz de la declaración de un Distrito de Manejo Integrado. Para abordar adecuadamente su tratamiento, se requiere un enfoque que profundice conceptualmente en la naturaleza de los conflictos ambientales, que considere las características de las comunidades campesinas, que analice las interacciones entre las sociedades y su entorno natural y que busque alternativas para que las decisiones en materia de conservación puedan ser compatibles con la preservación de economías rurales sostenibles

  10. Total parenteral nutrition - Problems in compatibility and stability

    DEFF Research Database (Denmark)

    Schroder, A.M.

    2008-01-01

    Adding calcium, trace elements and vitamins could turn parenteral nutrition into a dangerous product, which could harm the patient. This article focuses on the major pharmaceutical problems of parenteral. nutrition when adding nutritional compounds Udgivelsesdato: 2008...

  11. Estabilidad y funcionalidad de sellantes dentales en altas temperaturas ambientales

    OpenAIRE

    Mishina, Anastasia; Mayelín Guerra, Rosa; Durán Ramos, Ivette; Sabatier, Juan D.

    2000-01-01

    Los sellantes dentales son materiales que se emplean en estomatología para sellar las fosas y fisuras oclusales de los dientes y evitar la adherencia del estreptococus mutans agente que produce la caries dental. Estos materiales se suministran en dos partes que al mezclarse producen el endurecimiento de la resina. Sin embargo, estos productos presentan dificultades para su comercialización en los países tropicales, debido a que las altas temperaturas ambientales traen problemas en...

  12. Veterinarians in environmental protection; Il veterinario nella protezione ambientale

    Energy Technology Data Exchange (ETDEWEB)

    Ioppolo, A; Achene, L; Cappella, M G [eds.; Istituto Superiore di Sanita' , Rome (Italy). Lab. di Medicina Veterinaria

    1999-07-01

    The main contributions of the Fifth and Sixth Courses: Veterinary medicine and environmental contamination, held at the Italian National Institute of Health on October 27-31 1997, and September 28-October 2 1998, are presented. The volume is divided into three sections: general concepts (evolution of environmental protection in the European community, veterinary drugs in Europe, drugs and environmental contamination, aquaculture and environmental contamination); problematic aspects and methodologies applied to the environmental pollution (animal pathologies and environmental quality, toxic algae and aquaculture, aquatic organisms as indicators of environmental contamination, use of arthropods to assess environmental quality); field experiences (monitoring of chemical contaminants by an experimental institute of veterinary services, quality of compost in the light of aspects of management and market). [Italian] Sono riportati alcuni interventi presentati al quinto e al sesto corso di medicina veterinaria ed inquinamento ambientale che si sono svolti rispettivamente il 27-31 ottobre 1997 e il 28 settembre-2 ottobre 1998 presso l'Istituto Superiore di Sanita'. Il volume e' diviso in tre sezioni: contributi generali (evoluzione della tutela ambientale nella Comunita' Europea, i farmaci veterinari in Europa), utilizzo di farmaci e inquinamento (patologie degli animali e inquinamento, alghe tossiche e acquacultura, metodi per la valutazione della qualita' ambientale con organismi acquatici, artropodi terrestri come bioindicatori); esperienze sul campo (compostaggio di qualita'); problematiche gestionali e di mercato, esperienze di un monitoraggio di contaminanti chimici in un istituto zooprofilattico sperimentale.

  13. Veterinarians in environmental protection; Il veterinario nella protezione ambientale

    Energy Technology Data Exchange (ETDEWEB)

    Ioppolo, A.; Achene, L.; Cappella, M.G. [eds.] [Istituto Superiore di Sanita' , Rome (Italy). Lab. di Medicina Veterinaria

    1999-07-01

    The main contributions of the Fifth and Sixth Courses: Veterinary medicine and environmental contamination, held at the Italian National Institute of Health on October 27-31 1997, and September 28-October 2 1998, are presented. The volume is divided into three sections: general concepts (evolution of environmental protection in the European community, veterinary drugs in Europe, drugs and environmental contamination, aquaculture and environmental contamination); problematic aspects and methodologies applied to the environmental pollution (animal pathologies and environmental quality, toxic algae and aquaculture, aquatic organisms as indicators of environmental contamination, use of arthropods to assess environmental quality); field experiences (monitoring of chemical contaminants by an experimental institute of veterinary services, quality of compost in the light of aspects of management and market). [Italian] Sono riportati alcuni interventi presentati al quinto e al sesto corso di medicina veterinaria ed inquinamento ambientale che si sono svolti rispettivamente il 27-31 ottobre 1997 e il 28 settembre-2 ottobre 1998 presso l'Istituto Superiore di Sanita'. Il volume e' diviso in tre sezioni: contributi generali (evoluzione della tutela ambientale nella Comunita' Europea, i farmaci veterinari in Europa), utilizzo di farmaci e inquinamento (patologie degli animali e inquinamento, alghe tossiche e acquacultura, metodi per la valutazione della qualita' ambientale con organismi acquatici, artropodi terrestri come bioindicatori); esperienze sul campo (compostaggio di qualita'); problematiche gestionali e di mercato, esperienze di un monitoraggio di contaminanti chimici in un istituto zooprofilattico sperimentale.

  14. Use of parenteral testosterone in hypospadias cases

    Directory of Open Access Journals (Sweden)

    Vikram Satav

    2015-01-01

    Full Text Available Objectives: The aim was to evaluate the effect of parenteral testosterone on penile length, preputial hood, vascularity of dartos pedicle in patients with hypospadias. Materials and Methods: A total of 42 patients with hypospadias were included in this study. Injection aquaviron (oily solution each ml containing testosterone propionate 25 mg was given deep intramuscularly in three doses with an interval of 3 weeks before reconstructive surgery at the dose of 2 mg/kg body weight. Preoperatively penile length, transverse preputial width and diameter at the base of the penis were measured. Basal testosterone levels were obtained before the institution of therapy and on the day of operation. Results: Following parenteral testosterone administration, the mean increase in penile length, transverse preputial width and diameter at the base of penis was 1.01 ± 0.25 cm (P < 0.001, 1.250 ± 0.52 cm and 0.61 ± 0.35 cm, respectively, (P < 0.001. Serum testosterone level after injection was well within normal range for that age. Conclusion: Parenteral testosterone increased phallus size, diameter and prepuce hypertrophy without any adverse effects. However, due to lack of a control group we cannot make any inferences. Controlled studies are required to establish the benefits of parenteral testosterone.

  15. Solid lipid nanoparticles for parenteral drug delivery

    NARCIS (Netherlands)

    Wissing, S.A.; Kayser, Oliver; Muller, R.H.

    2004-01-01

    This review describes the use of nanoparticles based on solid lipids for the parenteral application of drugs. Firstly, different types of nanoparticles based on solid lipids such as "solid lipid nanoparticles" (SLN), "nanostructured lipid carriers" (NLC) and "lipid drug conjugate" (LDC)

  16. Pharmaceutical Point of View on Parenteral Nutrition

    Directory of Open Access Journals (Sweden)

    M. Stawny

    2013-01-01

    Full Text Available Parenteral nutrition—a form of administering nutrients, electrolytes, trace elements, vitamins, and water—is a widely used mode of therapy applied in many diseases, in patients of different ages both at home and in hospital. The success of nutritional therapy depends chiefly on proper determination of the patient’s energetic and electrolytic needs as well as preparation and administration of a safe nutritional mixture. As a parenterally administered drug, it is expected to be microbiologically and physicochemically stable, with all of the components compatible with each other. It is very difficult to obtain a stable nutritional mixture due to the fact that it is a complex, two-phase drug. Also, the risk of incompatibility between mixture components and packaging should be taken into consideration and possibly eliminated. Since parenteral nutrition is a part of therapy, simultaneous use of drugs may cause pharmacokinetic and pharmacodynamic interactions as well as those with the pharmaceutical phase. The aim of this paper is to discuss such aspects of parenteral nutrition as mixture stability, methodology, and methods for determining the stability of nutritional mixtures and drugs added to them.

  17. Pharmaceutical Point of View on Parenteral Nutrition

    Science.gov (United States)

    Stawny, M.; Olijarczyk, R.; Jaroszkiewicz, E.; Jelińska, A.

    2013-01-01

    Parenteral nutrition—a form of administering nutrients, electrolytes, trace elements, vitamins, and water—is a widely used mode of therapy applied in many diseases, in patients of different ages both at home and in hospital. The success of nutritional therapy depends chiefly on proper determination of the patient's energetic and electrolytic needs as well as preparation and administration of a safe nutritional mixture. As a parenterally administered drug, it is expected to be microbiologically and physicochemically stable, with all of the components compatible with each other. It is very difficult to obtain a stable nutritional mixture due to the fact that it is a complex, two-phase drug. Also, the risk of incompatibility between mixture components and packaging should be taken into consideration and possibly eliminated. Since parenteral nutrition is a part of therapy, simultaneous use of drugs may cause pharmacokinetic and pharmacodynamic interactions as well as those with the pharmaceutical phase. The aim of this paper is to discuss such aspects of parenteral nutrition as mixture stability, methodology, and methods for determining the stability of nutritional mixtures and drugs added to them. PMID:24453847

  18. Chemical Incompatibility of Parenteral Drug Admixtures

    African Journals Online (AJOL)

    1974-09-21

    Sep 21, 1974 ... made of a single drug injection at a separate locus. S. Afr. Med. J., 48, 1951 ... and nursing staff with the difficulties of administering safe parenteral ... needle and infusion bottle, but this practice is not common in South Africa.

  19. Early versus Late Parenteral Nutrition in Critically Ill Children.

    Science.gov (United States)

    Fivez, Tom; Kerklaan, Dorian; Mesotten, Dieter; Verbruggen, Sascha; Wouters, Pieter J; Vanhorebeek, Ilse; Debaveye, Yves; Vlasselaers, Dirk; Desmet, Lars; Casaer, Michael P; Garcia Guerra, Gonzalo; Hanot, Jan; Joffe, Ari; Tibboel, Dick; Joosten, Koen; Van den Berghe, Greet

    2016-03-24

    Recent trials have questioned the benefit of early parenteral nutrition in adults. The effect of early parenteral nutrition on clinical outcomes in critically ill children is unclear. We conducted a multicenter, randomized, controlled trial involving 1440 critically ill children to investigate whether withholding parenteral nutrition for 1 week (i.e., providing late parenteral nutrition) in the pediatric intensive care unit (ICU) is clinically superior to providing early parenteral nutrition. Fluid loading was similar in the two groups. The two primary end points were new infection acquired during the ICU stay and the adjusted duration of ICU dependency, as assessed by the number of days in the ICU and as time to discharge alive from ICU. For the 723 patients receiving early parenteral nutrition, parenteral nutrition was initiated within 24 hours after ICU admission, whereas for the 717 patients receiving late parenteral nutrition, parenteral nutrition was not provided until the morning of the 8th day in the ICU. In both groups, enteral nutrition was attempted early and intravenous micronutrients were provided. Although mortality was similar in the two groups, the percentage of patients with a new infection was 10.7% in the group receiving late parenteral nutrition, as compared with 18.5% in the group receiving early parenteral nutrition (adjusted odds ratio, 0.48; 95% confidence interval [CI], 0.35 to 0.66). The mean (±SE) duration of ICU stay was 6.5±0.4 days in the group receiving late parenteral nutrition, as compared with 9.2±0.8 days in the group receiving early parenteral nutrition; there was also a higher likelihood of an earlier live discharge from the ICU at any time in the late-parenteral-nutrition group (adjusted hazard ratio, 1.23; 95% CI, 1.11 to 1.37). Late parenteral nutrition was associated with a shorter duration of mechanical ventilatory support than was early parenteral nutrition (P=0.001), as well as a smaller proportion of patients

  20. Factores sociodemográficos y ambientales asociados con la actividad física deportiva en la población urbana del Perú Sociodemographic and environmental factors associated with sports physical activity in the urban population of Peru

    Directory of Open Access Journals (Sweden)

    Juan A. Seclén-Palacín

    2003-10-01

    Full Text Available OBJETIVOS: Determinar la frecuencia de la actividad deportiva en la población urbana del Perú e identificar los factores sociodemográficos, económicos y ambientales asociados con ella. MÉTODOS: Se utilizó la información recogida por la Encuesta Nacional de Hogares del segundo trimestre del año 1997, Perú (ENAHO 97-II, a cargo del Instituto Nacional de Estadística e Informática del Perú. ENAHO-97 se basó en un muestreo probabilístico, multietápico y estratificado de todo el territorio nacional urbano dividido en ocho regiones geográficas: Lima metropolitana, costa norte, costa centro, costa sur, sierra norte, sierra centro, sierra sur y selva. En total se visitaron 14 913 hogares y fueron entrevistadas 45 319 personas de 15 años o mayores. La información sobre la frecuencia de la práctica deportiva fue clasificada en diaria, interdiaria (en días alternos, semanal u ocasional. La actividad deportiva regular (ADR se definió como la práctica de cualquier deporte con una frecuencia diaria o interdiaria. Además se examinaron las preferencias y obstáculos para la práctica deportiva. Se realizó un análisis descriptivo de los niveles de ADR según el sexo mediante la prueba de ji al cuadrado. Se analizaron los factores asociados con la ADR mediante regresión logística múltiple condicional y análisis de residuos, multicolinearidad e interacciones. El nivel de significación utilizado fue de 0,05. RESULTADOS: La práctica de deportes al menos una vez a la semana y de ADR fue mayor entre los hombres (44,5 y 12,8%, respectivamente que ente las mujeres (32,4 y 10,5%. El grupo de edad en que hubo una mayor práctica de ADR fue el de 50­55 años en los hombres (20% y el de 40­45 años en las mujeres (18%. Se encontró que en la zona de la selva, sierra centro y costa centro se practica más deporte (15,3, 12,8 y 12,1%, respectivamente, mientras que en Lima metropolitana y sierra sur se observan los valores más bajos (10,6 y 9

  1. The prognosis of incurable cachectic cancer patients on home parenteral nutrition

    DEFF Research Database (Denmark)

    Bozzetti, F; Santarpia, L; Pironi, L

    2014-01-01

    BACKGROUND: The role of home parenteral nutrition (HPN) in incurable cachectic cancer patients unable to eat is extremely controversial. The aim of this study is to analyse which factors can influence the outcome. PATIENTS AND METHODS: We studied prospectively 414 incurable cachectic (sub)obstruc...

  2. Los pasivos mineros ambientales y los conflictos sociales en Hualgayoc

    OpenAIRE

    Pinto Herrera, Honori

    2014-01-01

    El trabajo trata sobre los pasivos ambientales mineros (PAM) y los conflictos sociales de Hualgayoc (Cajamarca), cuya atención ha sido considerada prioritaria por el Ministerio de Energía y Minas (MEM). Contiene número de PAM, una descripción histórica de este centro minero, una breve cronología que presenta los esfuerzos del MEM y FONAM para lograr la remediación de los PAM, finalmente se exponen los hechos estructurales y coyunturales que impiden la remediación cabal de los PAM en Hualgayoc...

  3. MRI in children receiving total parenteral nutrition

    International Nuclear Information System (INIS)

    Quaghebeur, G.; Taylor, W.J.; Kingsley, D.P.E.; Fell, J.M.E.; Reynolds, A.P.; Milla, P.J.

    1996-01-01

    Cranial MRI was obtained in 13 of a group of 57 children receiving long-term parenteral nutrition, who were being investigated for hypermanganasaemia. Increased signal intensity on T1-weighted images has been reported in adult patients on long-term parenteral nutrition and with encephalopathy following chronic manganese exposure in arc welding. It has been postulated that these changes are due to deposition of the paramagnetic trace element manganese. In excess manganese is hepato- and neurotoxic and we present the correlation of whole blood manganese levels with imaging findings. The age range of our patients was 6 months to 10 years, and the duration of therapy 3 months to 10 years. In 7 children we found characteristic increased signal intensity on T1-weighted images, with no abnormality on T2-weighted images. All patients had elevated whole blood manganese levels, suggesting that the basis for this abnormality is indeed deposition of manganese within the tissues. (orig.). With 3 figs

  4. PROBLEMÁTICA DE LOS PASIVOS AMBIENTALES MINEROS EN COLOMBIA

    Directory of Open Access Journals (Sweden)

    ARANGO ARAMBURO MARCELA

    2012-12-01

    Full Text Available Los pasivos ambientales mineros (PAM se refieren a "un área donde existe la necesidad de restauración, mitigación o compensación por un daño ambiental o impacto no gestionado, producido por actividades mineras inactivas o abandonadas que pone en riesgo la salud, calidad de vida o bienes públicos o privados" . En Colombia no se han reglamentado los PAM, pero dada la antigüedad y la prevalencia de la informalidad en la explotación minera, el interés en definir, reglamentar y gestionar estas obligaciones es creciente. En este artículo nos aproximamos a la problemática de la valoración de pasivos ambientales en Colombia, basándonos en la revisión de la gestión de PAM mineros en el mundo e identificamos los requerimientos de información clave para realizar dicha gestión en Colombia.

  5. Taurolidine in Pediatric Home Parenteral Nutrition Patients.

    Science.gov (United States)

    Hulshof, Emma Claire; Hanff, Lidwien Marieke; Olieman, Joanne; de Vette, Susanna; Driessen, Gert-Jan; Meeussen, Conny; Escher, Johanna Caroline

    2017-02-01

    To reduce the incidence of catheter-related bloodstream infections in home parenteral nutrition patients, the use of taurolidine was introduced in the Sophia Children's Hospital in 2011. This introduction led to a reduction in catheter-related bloodstream infections: 12.7/1000 catheter days before the use of taurolidine, compared with 4.3/1000 catheter days afterwards (n = 7) [relative risk = 0.36, 95% confidence interval: 0.20-0.65 (P = 0.018)].

  6. Steroidal Compounds in Commercial Parenteral Lipid Emulsions

    Science.gov (United States)

    Xu, Zhidong; Harvey, Kevin A.; Pavlina, Thomas; Dutot, Guy; Hise, Mary; Zaloga, Gary P.; Siddiqui, Rafat A.

    2012-01-01

    Parenteral nutrition lipid emulsions made from various plant oils contain steroidal compounds, called phytosterols. During parenteral administration of lipid emulsions, phytosterols can reach levels in the blood that are many fold higher than during enteral administration. The elevated phytosterol levels have been associated with the development of liver dysfunction and the rare development of liver failure. There is limited information available in the literature related to phytosterol concentrations in lipid emulsions. The objective of the current study was to validate an assay for steroidal compounds found in lipid emulsions and to compare their concentrations in the most commonly used parenteral nutrition lipid emulsions: Liposyn® II, Liposyn® III, Lipofundin® MCT, Lipofundin® N, Structolipid®, Intralipid®, Ivelip® and ClinOleic®. Our data demonstrates that concentrations of the various steroidal compounds varied greatly between the eight lipid emulsions, with the olive oil-based lipid emulsion containing the lowest levels of phytosterols and cholesterol, and the highest concentration of squalene. The clinical impression of greater incidences of liver dysfunction with soybean versus MCT/LCT and olive/soy lipid emulsions may be reflective of the levels of phytosterols in these emulsions. This information may help guide future studies and clinical care of patients with lipid emulsion-associated liver dysfunction. PMID:23016123

  7. Steroidal compounds in commercial parenteral lipid emulsions.

    Science.gov (United States)

    Xu, Zhidong; Harvey, Kevin A; Pavlina, Thomas; Dutot, Guy; Hise, Mary; Zaloga, Gary P; Siddiqui, Rafat A

    2012-08-01

    Parenteral nutrition lipid emulsions made from various plant oils contain steroidal compounds, called phytosterols. During parenteral administration of lipid emulsions, phytosterols can reach levels in the blood that are many fold higher than during enteral administration. The elevated phytosterol levels have been associated with the development of liver dysfunction and the rare development of liver failure. There is limited information available in the literature related to phytosterol concentrations in lipid emulsions. The objective of the current study was to validate an assay for steroidal compounds found in lipid emulsions and to compare their concentrations in the most commonly used parenteral nutrition lipid emulsions: Liposyn(®) II, Liposyn(®) III, Lipofundin(®) MCT, Lipofundin(®) N, Structolipid(®), Intralipid(®), Ivelip(®) and ClinOleic(®). Our data demonstrates that concentrations of the various steroidal compounds varied greatly between the eight lipid emulsions, with the olive oil-based lipid emulsion containing the lowest levels of phytosterols and cholesterol, and the highest concentration of squalene. The clinical impression of greater incidences of liver dysfunction with soybean versus MCT/LCT and olive/soy lipid emulsions may be reflective of the levels of phytosterols in these emulsions. This information may help guide future studies and clinical care of patients with lipid emulsion-associated liver dysfunction.

  8. Steroidal Compounds in Commercial Parenteral Lipid Emulsions

    Directory of Open Access Journals (Sweden)

    Rafat A. Siddiqui

    2012-08-01

    Full Text Available Parenteral nutrition lipid emulsions made from various plant oils contain steroidal compounds, called phytosterols. During parenteral administration of lipid emulsions, phytosterols can reach levels in the blood that are many fold higher than during enteral administration. The elevated phytosterol levels have been associated with the development of liver dysfunction and the rare development of liver failure. There is limited information available in the literature related to phytosterol concentrations in lipid emulsions. The objective of the current study was to validate an assay for steroidal compounds found in lipid emulsions and to compare their concentrations in the most commonly used parenteral nutrition lipid emulsions: Liposyn® II, Liposyn® III, Lipofundin® MCT, Lipofundin® N, Structolipid®, Intralipid®, Ivelip® and ClinOleic®. Our data demonstrates that concentrations of the various steroidal compounds varied greatly between the eight lipid emulsions, with the olive oil-based lipid emulsion containing the lowest levels of phytosterols and cholesterol, and the highest concentration of squalene. The clinical impression of greater incidences of liver dysfunction with soybean versus MCT/LCT and olive/soy lipid emulsions may be reflective of the levels of phytosterols in these emulsions. This information may help guide future studies and clinical care of patients with lipid emulsion-associated liver dysfunction.

  9. Total parenteral nutrition in diabetic rats

    International Nuclear Information System (INIS)

    Norcross, E.D.; Stein, T.P.

    1986-01-01

    Parenteral Nutrition with hypertonic glucose is frequently given to diabetic patients. Large amounts of insulin can be required. The purpose of this investigation was to develop a totally parenterally nourished diabetic rat model. 200 g Female Sprague Dawley rats were made diabetic by i.v. injection of streptozotocin (50 mg/kg). Rats were then allowed to recover for at least 1 week before undergoing surgical insertion of a central venous catheter for parenteral feeding. TPN was begun 3 days after surgery. Prior to this they were allowed unlimited access to food and water. Control (non-streptozotocin treated) rats were run at the same time. Protein turnover was investigated by using 15 N glycine. Preliminary results: diabetic rats given mostly fat as a calorie source survived well in the absence of exogenous insulin whereas those that were given glucose only as their non-protein calorie source showed poor survival even with exogenous insulin. N balance and protein turnover in the lipid treated diabetic rats were comparable to the non-diabetic control rats

  10. Standardized Competencies for Parenteral Nutrition Prescribing: The American Society for Parenteral and Enteral Nutrition Model.

    Science.gov (United States)

    Guenter, Peggi; Boullata, Joseph I; Ayers, Phil; Gervasio, Jane; Malone, Ainsley; Raymond, Erica; Holcombe, Beverly; Kraft, Michael; Sacks, Gordon; Seres, David

    2015-08-01

    Parenteral nutrition (PN) provision is complex, as it is a high-alert medication and prone to a variety of potential errors. With changes in clinical practice models and recent federal rulings, the number of PN prescribers may be increasing. Safe prescribing of this therapy requires that competency for prescribers from all disciplines be demonstrated using a standardized process. A standardized model for PN prescribing competency is proposed based on a competency framework, the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.)-published interdisciplinary core competencies, safe practice recommendations, and clinical guidelines. This framework will guide institutions and agencies in developing and maintaining competency for safe PN prescription by their staff. © 2015 American Society for Parenteral and Enteral Nutrition.

  11. Standardized Competencies for Parenteral Nutrition Order Review and Parenteral Nutrition Preparation, Including Compounding: The ASPEN Model.

    Science.gov (United States)

    Boullata, Joseph I; Holcombe, Beverly; Sacks, Gordon; Gervasio, Jane; Adams, Stephen C; Christensen, Michael; Durfee, Sharon; Ayers, Phil; Marshall, Neil; Guenter, Peggi

    2016-08-01

    Parenteral nutrition (PN) is a high-alert medication with a complex drug use process. Key steps in the process include the review of each PN prescription followed by the preparation of the formulation. The preparation step includes compounding the PN or activating a standardized commercially available PN product. The verification and review, as well as preparation of this complex therapy, require competency that may be determined by using a standardized process for pharmacists and for pharmacy technicians involved with PN. An American Society for Parenteral and Enteral Nutrition (ASPEN) standardized model for PN order review and PN preparation competencies is proposed based on a competency framework, the ASPEN-published interdisciplinary core competencies, safe practice recommendations, and clinical guidelines, and is intended for institutions and agencies to use with their staff. © 2016 American Society for Parenteral and Enteral Nutrition.

  12. Impact of Early Parenteral Nutrition on Metabolism and Kidney Injury

    OpenAIRE

    Gunst, Jan; Vanhorebeek, Ilse; Casaer, Michaël P.; Hermans, Greet; Wouters, Pieter J.; Dubois, Jasperina; Claes, Kathleen; Schetz, Miet; Van den Berghe, Greet

    2013-01-01

    A poor nutritional state and a caloric deficit associate with increased morbidity and mortality, but a recent multicenter, randomized controlled trial found that early parenteral nutrition to supplement insufficient enteral nutrition increases morbidity in the intensive care unit, including prolonging the duration of renal replacement therapy, compared with withholding parenteral nutrition for 1 week. Whether early versus late parenteral nutrition impacts the incidence and recovery of AKI is ...

  13. Amino acid composition in parenteral nutrition: what is the evidence?

    Science.gov (United States)

    Yarandi, Shadi S.; Zhao, Vivian M.; Hebbar, Gautam; Ziegler, Thomas R.

    2011-01-01

    Purpose of review Complete parenteral nutrition solutions contain mixed amino acid products providing all nine essential amino acids and a varying composition of nonessential amino acids. Relatively little rigorous comparative efficacy research on altered parenteral nutrition amino acid composition has been published in recent years. Recent findings Limited data from randomized, double-blind, adequately powered clinical trials to define optimal doses of total or individual amino acids in parenteral nutrition are available. An exception is the growing number of studies on the efficacy of glutamine supplementation of parenteral nutrition or given as a single parenteral agent. Parenteral glutamine appears to confer benefit in selected patients; however, additional data to define optimal glutamine dosing and the patient subgroups who may most benefit from this amino acid are needed. Although some promising studies have been published, little data are available in the current era of nutrition support on the clinical efficacy of altered doses of arginine, branched chain amino acids, cysteine, or taurine supplementation of parenteral nutrition. Summary Despite routine use of parenteral nutrition, surprisingly little clinical efficacy data are available to guide total or specific amino acid dosing in adult and pediatric patients requiring this therapy. This warrants increased attention by the research community and funding agencies to better define optimal amino acid administration strategies in patient subgroups requiring parenteral nutrition. PMID:21076291

  14. Severe Hypothyroidism From Iodine Deficiency Associated With Parenteral Nutrition.

    Science.gov (United States)

    Golekoh, Marjorie C; Cole, Conrad R; Jones, Nana-Hawa Yayah

    2016-11-01

    Parenteral nutrition is crucial for supply of nutrients in children who cannot tolerate a full enteral diet. In the United States, it is not standard of care to give iodine to children dependent on parenteral nutrition, hence iodine is not routinely included in the micronutrient package. Herein, we present a case of a boy with hypothyroidism secondary to iodine deficiency after prolonged exclusive use of parenteral nutrition. Our case highlights the importance of screening for iodine deficiency and administering timely iodine supplementation in these at-risk children to prevent iatrogenic hypothyroidism. © 2015 American Society for Parenteral and Enteral Nutrition.

  15. Determinacion de periodos fundamentales del suelo mediante vibraciones ambientales en el municipio de Humacao, Puerto Rico

    Science.gov (United States)

    Cintron Aponte, Rommel

    La tecnica de Nakamura ha sido utilizada a nivel mundial para determinar periodos fundamentales del suelo. La tecnica consiste en calcular y graficar cocientes espectrales H/V de vibraciones ambientales registradas sobre el suelo. Mediciones de vibraciones ambientales fueron tomadas en 151 lugares dentro del municipio de Humacao, localizado al este de Puerto Rico. Los datos se procesaron utilizando espectros de Fourier y espectros de potencia. La tecnica fue validada al compararla con los resultados de cocientes espectrales H/V de registros de sismos debiles y tambien con una modelacion numerica realizada con datos de un ensayo "downhole". Las graficas de los cocientes espectrales H/V fueron divididas en casos y grupos, los cuales dependen de la facilidad para identificar el periodo fundamental pico y amplitudes en frecuencias menores de 1 Hz, respectivamente. Los resultados obtenidos con ambos espectros fueron comparados y se concluye que los mismos se complementan para proveer resultados mas confiables. Se crearon mapas de periodos fundamentales, factores de amplitud, isoperiodos y clasificacion sismica de sitio. Los mapas de isoperiodos fueron realizados en las zonas mas pobladas sobre depositos de suelo. El mapa de periodos fundamentales del suelo mostro buena correlacion con la geologia local. El mapa de clasificacion sismica derivado de periodos de sitio fue comparado con el mapa de clasificacion sismica derivado de barrenos geotecnicos. El mapa de clasificacion obtenido de periodos puede sobreestimar un poco algunas clasificaciones del suelo. Sin embargo, este mapa puede proveer un estimado aproximado de la velocidad de onda de corte promedio del suelo hasta una profundidad de 100 pies (30 metros).

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

    Science.gov (United States)

    Akbulut, Gamze

    2011-07-01

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

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

    Science.gov (United States)

    AKBULUT, GAMZE

    2011-01-01

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

  18. Environmental factors associated with fish assemblage patterns in a high gradient river of the Gulf of Mexico slope Factores ambientales asociados a los patrones en las comunidades de peces en un río de alta pendiente en la vertiente del golfo de México

    Directory of Open Access Journals (Sweden)

    Norman Mercado-Silva

    2012-03-01

    Full Text Available Using multivariate analyses of fish community and environmental data, we explored associations among 13 fish species and 9 ecological guilds and identified ecological gradients that explain patterns in the fish community of the La Antigua River (Veracruz, Mexico. Altitude, distance to ocean, stream width, and water temperature were the most important variables explaining community composition. Sites with high altitudes (> 1 393 m, cold water ( 100 km and less than 5 m wide were dominated by non-native Onchorhynchus mykiss. Many sites exclusively inhabited by native poeciliids were also narrow ( 80 km, 20°C. Because 7 guilds were exclusive to a single species, results from the guild analysis were very similar to species-specific analyses. Higher species and guild diversity were found in wider sites (> 5 m, sites with lower altitudes (Utilizamos datos de la comunidad de peces y de variables ambientales y análisis multivariados para explorar asociaciones entre 13 especies y 9 gremios ecológicos en el río La Antigua (Veracruz, México. Además, identificamos gradientes ecológicos que explicaron los patrones en las comunidades de peces. Las variables más importantes en la determinación de la composición de la comunidad fueron altitud, distancia al océano, ancho de río y temperatura del agua. Los sitios ubicados a gran altitud (> 1 393 m, con aguas frías ( 100 km y menos de 5 m de ancho estuvieron dominados por la especie no nativa Onchorhynchus mykiss. Muchos sitios habitados exclusivamente por poecílidos nativos también fueron angostos ( 20°C y estuvieron a distancias intermedias al océano (> 80 km, 5 m, con menor altitud (< 600 m y más cercanos al océano (< 71 km. Las variables relacionadas con la influencia antropogénica no tuvieron relevancia en la explicación de las tendencias encontradas.

  19. Biological and environmental factors associated with risk of schistosomiasis mansoni transmission in Porto de Galinhas, Pernambuco State, Brazil Factores biológicos y ambientales asociados al riesgo de transmisión de la esquistosomiasis mansoni en la localidad de Porto de Galinhas, Pernambuco, Brasil Fatores biológicos e ambientais associados ao risco de transmissão da esquistossomose mansoni na localidade de Porto de Galinhas, Pernambuco, Brasil

    Directory of Open Access Journals (Sweden)

    Onicio Batista Leal Neto

    2013-02-01

    Full Text Available Schistosomiasis has expanded to the coast of Pernambuco State, Brazil, where there are frequent reports of Biomphalaria glabrata snails and human cases of the disease. This study analyzes factors related to schistosomiasis transmission risk in Porto de Galinhas. A one-year malacological survey was conducted to identify biological, abiotic, and environmental factors related to the host snail breeding sites. Data analysis used Excel 2010, GTM Pro, and ArcGis 10. A total of 11,012 B. glabrata snails were captured in 36 breeding sites, and 11 schistosomiasis transmission foci were identified. A negative correlation was found between breeding site temperature and snail density and infection rate, and a positive correlation with pH and salinity. The rainy season showed a positive correlation with snail density and infection rate. The study emphasizes the factors involved in the maintenance of schistosomiasis breeding sites, in light of persistence of this disease in Porto de Galinhas for more than 10 years.La esquistosomiasis se expande hacia el litoral de Pernambuco, Brasil, donde han sido frecuentes los registros de caracoles Biomphalaria glabrata y casos humanos de la enfermedad. Este estudio presenta factores relacionados con el riesgo de transmisión de la esquistosomiasis en la localidad Porto de Galinhas. Durante un año se llevó a cabo una investigación malacológica para identificar factores biológicos, abióticos y ambientales, relacionados con los criaderos de los moluscos huéspedes. Para el análisis de los datos se utilizaron los softwares Excel 2010, GTM Pro y ArcGis 10. Se recogieron 11.012 caracoles B. glabrata en los 36 criaderos identificados, siendo diagnosticados 11 focos de transmisión de la esquistosomiasis. Se verificó la correlación negativa entre la temperatura de los criaderos, densidad y tasa de infección de los caracoles, y la correlación positiva entre el pH y salinidad. El período de lluvia presentó una

  20. Determinación de restricciones y posibilidades ambientales para la expansion del transporte de gas natural en Colombia

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    Ángel Sanint Enrique

    2011-11-01

    Full Text Available En la línea de la Evaluación Ambiental Estratégica, EAE, se desarrolló un método para la determinación de restricciones y posibilidades ambientales en proyectos de transporte de gas natural por ductos, basado en el uso de herramientas de análisis territorial aplicadas sobre la plataforma SIG (Sistema de Información Geográfica, incorporando criterios ambientales que a escala 1:500.000 apoyarán la toma de decisiones en el nivel de planeación y propiciarán la elaboración del plan de expansión para el transporte de gas natural en Colombia. Para esto, se definió el concepto de ambiente a partir de un Modelo Analítico preexistente; se delimitó un área con posibilidades para la expansión de la red de transporte de gas natural incorporando nuevos trazados; se seleccionaron las variables y factores que complementaban el Modelo Analítico; se definió la estructura de preferencias a partir de una encuesta a expertos; se determinaron las restricciones nacionales y se construyeron superficies numéricas síntesis de critici dad ambiental para cada dimensión. Como resultado, se obtuvieron 5 superficies síntesis, una por cada dimensión, y una superficie final para Colombia, con restricciones y posibilidades ambientales. Además se propusieron análisis complementarios para establecer prioridades en la gestión ambiental.

  1. Zinc: physiology, deficiency, and parenteral nutrition.

    Science.gov (United States)

    Livingstone, Callum

    2015-06-01

    The essential trace element zinc (Zn) has a large number of physiologic roles, in particular being required for growth and functioning of the immune system. Adaptive mechanisms enable the body to maintain normal total body Zn status over a wide range of intakes, but deficiency can occur because of reduced absorption or increased gastrointestinal losses. Deficiency impairs physiologic processes, leading to clinical consequences that include failure to thrive, skin rash, and impaired wound healing. Mild deficiency that is not clinically overt may still cause nonspecific consequences, such as susceptibility to infection and poor growth. The plasma Zn concentration has poor sensitivity and specificity as a test of deficiency. Consequently, diagnosis of deficiency requires a combination of clinical assessment and biochemical tests. Patients receiving parenteral nutrition (PN) are susceptible to Zn deficiency and its consequences. Nutrition support teams should have a strategy for assessing Zn status and optimizing this by appropriate supplementation. Nutrition guidelines recommend generous Zn provision from the start of PN. This review covers the physiology of Zn, the consequences of its deficiency, and the assessment of its status, before discussing its role in PN. © 2015 American Society for Parenteral and Enteral Nutrition.

  2. Home parenteral nutrition in children: the Polish experience.

    Science.gov (United States)

    Ksiazyk, J; Lyszkowska, M; Kierkus, J; Bogucki, K; Ratyńska, A; Tondys, B; Socha, J

    1999-02-01

    Home parenteral nutrition has become routine for management of intestinal failure in patients. In Poland the main obstacle to widespread use of home parenteral nutrition is the lack of interest of commercial companies in delivering feedings and ancillaries to patients. Twenty-five home parenteral nutrition patients aged from 4 months to more than 13 years were reviewed. The mother or both parents were trained in home parenteral nutrition techniques for 4 to 6 weeks and compounded the nutrients themselves at home. The mean duration of home parenteral nutrition was 10,117 patient days. Hospital stays of patients receiving parenteral feedings were significantly shorter than the duration of administration of home parenteral nutrition (p rate of catheter occlusion decreased within the observation period, and in 1997 not one case of occlusion was observed. In 1997 only three catheters were removed during 7.8 patient years, and the overall incidence of catheter-related complications was 0.38 per patient year. The overall occurrence of septicemia was one case in 516 days and of catheter infection was one in 459 days. In 1997 a catheter was infected on average of once every 1419 days. There was significant improvement in the z score for weight during therapy. The average monthly cost of nutrients and ancillary items was approximately $1200 (4200 Polish zlotys [PLN]). These costs are 1.6 to 3 times lower than those recorded in other studies. Home parenteral nutrition in children with nutrients mixed by caregivers in the home setting is a safe and appropriate method of treatment that can be used in countries where home parenteral nutrition solutions are not manufactured or where commercial home parenteral nutrition is not economically feasible.

  3. Central venous catheter infections in home parenteral nutrition patients: Outcomes from Sustain: American Society for Parenteral and Enteral Nutrition's National Patient Registry for Nutrition Care.

    Science.gov (United States)

    Ross, Vicki M; Guenter, Peggi; Corrigan, Mandy L; Kovacevich, Debra; Winkler, Marion F; Resnick, Helaine E; Norris, Tina L; Robinson, Lawrence; Steiger, Ezra

    2016-12-01

    Home parenteral nutrition (HPN) is a high-cost, complex nutrition support therapy that requires the use of central venous catheters. Central line-associated bloodstream infections (CLABSIs) are among the most serious risks of this therapy. Sustain: American Society for Parenteral and Enteral Nutrition's National Patient Registry for Nutrition Care (Sustain registry) provides the most current and comprehensive data for studying CLABSI among a national cohort of HPN patients in the United States. This is the first Sustain registry report detailing longitudinal data on CLABSI among HPN patients. To describe CLABSI rates for HPN patients followed in the Sustain registry from 2011-2014. Descriptive, χ 2 , and t tests were used to analyze data from the Sustain registry. Of the 1,046 HPN patients from 29 sites across the United States, 112 (10.7%) experienced 194 CLABSI events during 223,493 days of HPN exposure, for an overall CLABSI rate of 0.87 episodes/1,000 parenteral nutrition-days. Although the majority of patients were female (59%), adult (87%), white (75%), and with private insurance or Medicare (69%), CLABSI episodes per 1,000 parenteral nutrition-days were higher for men (0.69 vs 0.38), children (1.17 vs 0.35), blacks (0.91 vs 0.41), and Medicaid recipients (1.0 vs 0.38 or 0.39). Patients with implanted ports or double-lumen catheters also had more CLABSIs than those with peripherally inserted or central catheters or single-lumen catheters. Staphylococci were the most commonly reported pathogens. These data support findings of smaller studies about CLABSI risk for children and by catheter type and identify new potential risk factors, including gender, race, and insurance type. Additional studies are needed to determine effective interventions that will reduce HPN-associated CLABSI. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  4. DIAGNOSTICO DE LA GESTIÓN TECNOLÓGICA Y SUS IMPLICANCIAS AMBIENTALES Y LABORALES EN ASERRADEROS PYMES – ESTUDIO DE UN CASO

    Directory of Open Access Journals (Sweden)

    Mario J. Mantulak

    2012-06-01

    Full Text Available El trabajo se llevó a cabo en un establecimiento maderero PyMEs (Pequeña y Mediana Empresa de la provincia de Misiones, Argentina. Como objetivo se planteó el desarrollo de un método de diagnóstico de la gestión tecnológica que permitiera abordar transversalmente las relaciones existentes entre los factores tecnológicos, los laborales y los ambientales. Las tareas realizadas posibilitaron un análisis integral de los aspectos ambientales y laborales desde la perspectiva de la gestión tecnológica. Como resultados se obtuvieron, por una parte, la valorización de los niveles de factores tecnológicos y de significación de aspectos ambientales y laborales para los sectores de aserrado, secado y remanufactura; y por otra parte, a través de la herramienta estadística de análisis de correspondencias, se estudiaron las asociaciones existentes entre los factores tecnológicos de las diferentes estaciones de trabajo, y las implicancias devenidas de los impactos ambientales y laborales. El trabajo desarrollado permitió realizar un adecuado diagnóstico tecnológico, posibilitando la detección de puntos críticos relacionados con recursos tecnológicos factibles de mejorar; contribuyendo además, al proceso de toma de decisiones vinculadas a la gestión tecnológica.

  5. Cuentas ambientales: un plan de cuentas integrado, ¿si o no?

    OpenAIRE

    Panario Centeno, María Marta

    2011-01-01

    Se aborda el tema de las "cuentas ambientales" y el "plan de cuentas". Dicho tema es sumamente interesante, ya que las cuentas ambientales son elementos fundamentales de registro e evidencia de hechos contables, o sea, sin las cuentas nada podría ser contabilizado y expuesto contablemente; y el plan de cuentas es uno de los aspectos más importantes del sistema contable, destinado a orientar el registro de las operaciones, ofreciendo la ventaja de uniformidad de las cuentas utilizada...

  6. 21 CFR 310.509 - Parenteral drug products in plastic containers.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 5 2010-04-01 2010-04-01 false Parenteral drug products in plastic containers... Parenteral drug products in plastic containers. (a) Any parenteral drug product packaged in a plastic... parenteral drug product for intravenous use in humans that is packaged in a plastic immediate container on or...

  7. Gluconeogenesis is not regulated by either glucose or insulin in extremely low birth weight infants receiving total parenteral nutrition

    Science.gov (United States)

    The objective was to determine potential factors regulating gluconeogenesis (GNG) in extremely low birth weight infants receiving total parenteral nutrition. Seven infants (birth weight, 0.824 +/- 0.068 kg; gestational age, 25.4 +/- 0.5 weeks; postnatal age, 3.3 +/- 0.2 days) were studied for 11 hou...

  8. Procedimiento para la gestión de los impactos ambientales negativos asociados a la recuperación de materias primas en Cienfuegos, Cuba.

    Directory of Open Access Journals (Sweden)

    David Javier Castro Rodríguez

    2016-04-01

    Full Text Available El reciclaje constituye una actividad priorizada en Cuba. El objetivo fue implementar un procedimiento para la gestión de los impactos ambientales negativos asociados a los procesos operativos de la Empresa de Recuperación de Materias Primas de Cienfuegos. El procedimiento se construyó utilizando la propuesta del Instituto Andaluz de Tecnología para la gestión por procesos y los ocho pasos en la solución de problemas. Se combinaron herramientas de gestión bajo el principio de convergencia metodológica. Los impactos ambientales fueron evaluados mediante el software GAIA versión 1.0, utilizando los criterios propuestos por la Guía Metodológica de Evaluación de Impacto Ambiental de Conesa. Se identificaron 97 impactos ambientales negativos, entre severos y moderados integraron el 80.41 % de ellos. El factor ambiental más impactado fue el físico-químico con el 50.52 %. El subproceso no metálico resultó el más impactante, con el 50 % de los impactos severos negativos totales y el 34 % de los moderados. Se identificaron las principales causas asociadas y se diseñó un plan de intervención de 35 medidas con base en los principios de Producción Más Limpia. Los resultados contribuyen a lograr la gestión de los impactos ambientales negativos de la entidad y a la sostenibilidad del reciclaje.

  9. Servicios ambientales, agua y economía

    Directory of Open Access Journals (Sweden)

    Juan Pablo Ruiz Soto

    2007-11-01

    Full Text Available Los servicios ambientales (SA asociados a los ecosistemas naturales están seriamente amenazados por acciones locales y por el calentamiento global. El SA asociado al agua y su efecto sobre calidad y cantidad en cuencas hidrográficas aportantes a acueductos y sistemas de riego, son de gran importancia económica y social. Para Bogotá-Colombia el SA de los páramos y bosque nublado en la cuenca de Chingaza representa US$18,2 millones anuales. Para el abastecimiento de agua a la ciudad de Quito-Ecuador, el efecto negativo del cambio climático (CC asociado a la contracción de los glaciares representa un incremento en la inversión de un 31% versus el escenario sin CC. Se deben tomar medidas para asegurar la permanencia de los SA y mitigar los efectos del CC./ Environmental services (ES related to natural ecosystems are seriously threatened by local activities and global warming. The ES related to water and its effect on quality and quantity in watersheds that supply aqueducts and irrigation systems has great social and economic importance. For Bogotá-Colombia the ES of páramos and cloudy forest in the Chingaza basin represents US$18.2 million per year. For water supply in the city of Quito-Ecuador, the negative effect of climate change (CC related to the contraction of glaciers represents a 31% increase in investments versus the scenario without CC. Measures must be taken to ensure the permanence of ES and mitigate the effects of CC.

  10. Parenteral nutrition in malnourished patients; Parenteralna vyziva u malnutricnych pacientov

    Energy Technology Data Exchange (ETDEWEB)

    Lichvarova, I. [OAIM, Narodny onkologicky ustav, Bratislava (Slovakia)

    2011-07-01

    Parenteral nutrition became a routine therapeutic option in malnourished patients, if conventional nutritional enteral support is not effective. Cachexia and malnutrition prolong the wound healing, contribute to immunosuppression, increase morbidity and the cost of treatment. Using of a malnutrition protocol as a screening tool is necessary to sort out malnourished patients. Parenteral nutrition is therefore an important part of the multimodal therapy and from the medical and the ethical point of view is a great mistake not to feed a patient. (author)

  11. Hypercalcemia and hypophosphatemia among preterm infants receiving aggressive parenteral nutrition.

    Science.gov (United States)

    Brener Dik, Pablo H; Galletti, María F; Bacigalupo, Leticia T; Fernández Jonusas, Silvia; L Mariani, Gonzalo

    2018-06-01

    Aggressive parenteral nutrition is the standard of care among very-low-birth weight preterm infants. However, in recent studies, its impact on short-term outcomes, has been evaluated. The objective was to compare the prevalence of hypercalcemia and hypophosphatemia among preterm infants receiving aggressive or standard parenteral nutrition. Observational, retrospective study comparing a group of preterm infants weighing less than 1250 grams who received aggressive parenteral nutrition with a historical control group. The prevalence of hypercalcemia was estimated and its association with aggressive parenteral nutrition was searched adjusting by confounders. The mean phosphate level was estimated for the control group by linear regression and was compared to the value in the other group. Forty patients per group were included. The prevalence of hypercalcemia was higher in the group who received aggressive parenteral nutrition (87.5% versus 35%, p= 0.001). Aggressive parenteral nutrition was associated with hypercalcemia when adjusting by birth weight, intrauterine growth restriction, amino acid, and calorie intake (adjusted odds ratio: 21.8, 95% confidence interval [CI]: 3.7-128). The mean calcium level was different between both groups (p= 0.002). Infants who received aggressive parenteral nutrition had more sepsis without reaching statistical significance and the mean phosphate level was lower than that estimated for the control group (p= 0.04). The prevalence of hypophosphatemia in this group was 90% (95% CI: 76-97%). Our data show an association between hypercalcemia/hypophosphatemia and aggressive parenteral nutrition. It is recommended to frequently monitor calcium and phosphate levels since they might be associated with adverse clinical outcomes. Sociedad Argentina de Pediatría.

  12. Copper and Zinc Deficiency in a Patient Receiving Long-Term Parenteral Nutrition During a Shortage of Parenteral Trace Element Products.

    Science.gov (United States)

    Palm, Eric; Dotson, Bryan

    2015-11-01

    Drug shortages in the United States, including parenteral nutrition (PN) components, have been common in recent years and can adversely affect patient care. Here we report a case of copper and zinc deficiency in a patient receiving PN during a shortage of parenteral trace element products. The management of the patient's deficiencies, including the use of an imported parenteral multi-trace element product, is described. © 2014 American Society for Parenteral and Enteral Nutrition.

  13. Parenteral Nutrition-Associated Liver Disease: The Role of the Gut Microbiota.

    Science.gov (United States)

    Cahova, Monika; Bratova, Miriam; Wohl, Petr

    2017-09-07

    Parenteral nutrition (PN) provides life-saving nutritional support in situations where caloric supply via the enteral route cannot cover the necessary needs of the organism. However, it does have serious adverse effects, including parenteral nutrition-associated liver disease (PNALD). The development of liver injury associated with PN is multifactorial, including non-specific intestine inflammation, compromised intestinal permeability, and barrier function associated with increased bacterial translocation, primary and secondary cholangitis, cholelithiasis, short bowel syndrome, disturbance of hepatobiliary circulation, lack of enteral nutrition, shortage of some nutrients (proteins, essential fatty acids, choline, glycine, taurine, carnitine, etc.), and toxicity of components within the nutrition mixture itself (glucose, phytosterols, manganese, aluminium, etc.). Recently, an increasing number of studies have provided evidence that some of these factors are directly or indirectly associated with microbial dysbiosis in the intestine. In this review, we focus on PN-induced changes in the taxonomic and functional composition of the microbiome. We also discuss immune cell and microbial crosstalk during parenteral nutrition, and the implications for the onset and progression of PNALD. Finally, we provide an overview of recent advances in the therapeutic utilisation of pro- and prebiotics for the mitigation of PN-associated liver complications.

  14. Diazepam parenteral no tratamento de epilepsias graves Treatment of severe epilepsies with parenteral diazepam

    Directory of Open Access Journals (Sweden)

    José Geraldo Speciali

    1971-09-01

    Full Text Available As modificações dos quadros clínico e EEG foram estudadas em 9 pacientes com manifestações epilépticas rebeldes às medicações anticonvulsivantes habituais, quando submetidos à administração parenteral diária de diazepam (Valium e após sua interrupção. Houve diminuição do número e da duração das crises, superior a 75%, em três pacientes. Esses resultados são satisfatórios, considerando a gravidade dos quadros epilépticos e foram obtidos em pacientes com predomínio de alterações EEG lentas antes de iniciar o esquema terapêutico. Não se verificaram efeitos colaterais relevantes na época da administração parenteral. Em dois pacientes foi observado o aparecimento de crises tônicas coincidindo com o aumento de elementos EEG paroxísticos rápidos, localizados ou difusos.Changes of the clinical pictures and electroencephalographic patterns were studied in 9 patients suffering from epileptic seizures non responsive to common anticonvulsivants, when submitted to daily parenteral administration of diazepam (Valium and after its interruption. There was decrease of the number and duration of seizures, over to 75%, in 3 patients. These results can be considered as satisfatory, considering the intensity of the seizures. The best results were obtained in those patients which showed predominance of slow waves in the EEGs prior to the begin of the treatment. No side effects were observed during the treatment. Two patients developed tonic seizures coincident with the increasing of fast paroxistic EEG patterns, of localized or diffuse type.

  15. ESPEN Guidelines on Parenteral Nutrition: home parenteral nutrition (HPN) in adult patients

    DEFF Research Database (Denmark)

    Staun, M.; Pironi, L.; Bozzetti, F.

    2009-01-01

    Home parenteral nutrition (HPN) was introduced as a treatment modality in the early 1970s primarily for the treatment of chronic intestinal failure in patients with benign disease. The relatively low morbidity and mortality associated with HPN has encouraged its widespread use in western countries....... Thus there is huge clinical experience, but there are still few controlled clinical studies of treatment effects and management of complications. The purpose of these guidelines is to highlight areas of good practice and promote the use of standardized treatment protocols between centers...

  16. A new glass option for parenteral packaging.

    Science.gov (United States)

    Schaut, Robert A; Peanasky, John S; DeMartino, Steven E; Schiefelbein, Susan L

    2014-01-01

    Glass is the ideal material for parenteral packaging because of its chemical durability, hermeticity, strength, cleanliness, and transparency. Alkali borosilicate glasses have been used successfully for a long time, but they do have some issues relating to breakage, delamination, and variation in hydrolytic performance. In this paper, alkali aluminosilicate glasses are introduced as a possible alternative to alkali borosilicate glasses. An example alkali aluminosilicate glass is shown to meet the compendial requirements, and to have similar thermal, optical, and mechanical attributes as the current alkali borosilicate glasses. In addition, the alkali aluminosilicate performed as well or better than the current alkali borosilicates in extractables tests and stability studies, which suggests that it would be suitable for use with the studied liquid product formulation. The physical, mechanical, and optical properties of glass make it an ideal material for packaging injectable drugs and biologics. Alkali borosilicate glasses have been used successfully for a long time for these applications, but there are some issues. In this paper, alkali aluminosilicate glasses are introduced as a possible alternative to alkali borosilicate glasses. An example alkali aluminosilicate glass is shown to meet the requirements for packaging injectable drugs and biologics, and to be suitable for use with a particular liquid drug. © PDA, Inc. 2014.

  17. [Should pediatric parenteral nutrition be individualized?].

    Science.gov (United States)

    Freitas, Renata Germano Borges de Oliveira Nascimento; Nogueira, Roberto José Negrão; Saron, Margareth Lopes Galvão; Lima, Alexandre Esteves Souza; Hessel, Gabriel

    2014-12-01

    Parenteral nutrition (PN) formulations are commonly individualized, since their standardization seem inadequate for the pediatric population. This study aimed to evaluate the nutritional state and the reasons for PN individualization in pediatric patients using PN hospitalized in a tertiary hospital in Campinas, São Paulo. This longitudinal study comprised patients using PN followed by up to 67 days. Nutritional status was classified according to the criteria established by the World Health Organization (WHO) (2006) and WHO (2007). The levels of the following elements on blood were analyzed: sodium, potassium, ionized calcium, chloride, magnesium, inorganic phosphorus and triglycerides (TGL). Among the criteria for individualization, were considered undeniable: significant reduction in blood levels of potassium (nutritional state of patients was considered critical in most cases. Thus, the individualization performed in the beginning of PN for energy protein adequacy was indispensable. In addition, the individualized PN was indispensable in at least 29.2% of PN for correction of alterations found in biochemical parameters. Copyright © 2014 Associação de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.

  18. Federalismo y políticas ambientales en la Región Metropolitana de Buenos Aires, Argentina

    Directory of Open Access Journals (Sweden)

    Ricardo A Gutiérrez

    2012-05-01

    Full Text Available La articulación entre la escala metropolitana de los problemas y la multiplicidad de jurisdicciones gubernamentales constituye un desafío para cualquier política ambiental. Centrado en la Región Metropolitana de Buenos Aires, este trabajo aborda la coordinación de políticas ambientales metropolitanas en un contexto federal. La primera parte describe la región metropolitana, el modo en que el federalismo argentino distribuye competencias ambientales entre niveles de gobierno, los mecanismos institucionales para la gestión metropolitana y las características y principales deficiencias de las organizaciones interjurisdiccionales que operan en la región metropolitana. La segunda parte discute los factores que explican esas deficiencias. Se argumenta que las fallas de coordinación metropolitana de políticas ambientales se explican por la interacción entre las instituciones federales y otras variables del sistema político, como la lógica de acumulación partidaria, la configuración de las agendas de gobierno, el papel de las burocracias estatales y el impacto del activismo ambiental.In any metropolitan region, the articulation between metropolitan scale of issues and the multiplicity of government jurisdictions poses a challenge for the implementation of environmental policies. Focused on the Buenos Aires Metropolitan Region, this article examines the coordination of metropolitan environmental policies in a federal context. The first part describes the metropolitan region and its main environmental problems, the way in which Argentine federalism assigns environmental competences to the different government levels and the mechanisms it sets for metropolitan governance, and the characteristics and flaws of the inter-jurisdictional organizations at work in the metropolitan region. The second part discusses the factors explaining those flaws. It argues that the shortcomings of the metropolitan coordination of environmental policies are

  19. Conflictos ambientales y redes transnacionales de defensa en el Chile Postdictadura

    Directory of Open Access Journals (Sweden)

    Claudio Rivera

    2011-01-01

    Full Text Available Los conflictos ambientales reflejan y reproducen configuraciones de poder. El artículo analiza tres conflictos ambientales en Chile postdictadura en los que diferentes actores tales como empresas, agencias estatales, comunidades de base y ONGs ambientalistas se enfrentan por el uso de recursos naturales. Usando la literatura en redes transnacionales de apoyo como marco analítico, el trabajo analiza las condiciones bajo las cuales conflictos ambientales locales alcanzan visibilidad internacional. Se discuten dos campos de investigación interdisciplinarios como son la justicia ambiental y la ecología política podrían avanzar el un mejor entendimiento de la afectividad de estas redes en los niveles a escala internacional, nacional y local.

  20. Sorveglianza della circolazione ambientale dei poliovirus nel Lazio

    Directory of Open Access Journals (Sweden)

    A.M. Patti

    2003-05-01

    importanza della sorveglianza della circolazione ambientale dei poliovirus vaccinali e dei virus derivati e in particolare nell’immediato futuro, dopo l’eliminazione della vaccinazione OPV.

  1. Environmental risk factors associated with tooth decay in children: a review of four studies in Indonesia Riesgos ambientales asociados con la caries dental en niños: una revisión de cuatro estudios en Indonesia Fatores de risco ambientais associados à cárie dentária nas crianças: uma revisão de quatro estudos na Indonésia

    Directory of Open Access Journals (Sweden)

    Sri S. Winanto

    2013-06-01

    Full Text Available There is growing concern over studying the environmental impacts on human health. Among the world’s population, children are particularly vulnerable to environmental threats.Currently, in certain areas of Indonesia, there are significant problems with water quality, especially as many consume surface water for drinking. There is evidence that this contributes to tooth decay – the process of dental caries. Furthermore, teeth provide an excellent chronological record of nutritional status and trace metal exposure during human development.This paper provides an overview of risk factors for dental caries and reviews four epidemiological and laboratory studies that have addressed these issues in Indonesia. First, Winanto in 1993 showed that acidity and high tin (Sn concentrations in drinking water are associated with the erosion of permanent teeth in children living close to a tin mining area. Second, Wulandari in 2009, using Graphite Furnace Atomic Absorption Spectrometry (GFAAS, showed that deciduous teeth containing high concentration of lead (Pb have 3 times higher risks of contracting caries. Third, Satrio in 2010 compared the dental status of children who consumed rain water with those using other sources of drinking water: this revealed that low concentration of Fluoride in drinking water contributes 19 times higher risk of dental caries and low pH 22 times the risk compared to water of neutral pH. Fourth, Musadad in 2009 undertook an ecological study on the effect of drinking water quality in relation to dental caries and revealed significant associations with acidity, total water consumption, household expenditure and the distance from a subject’s residence to the nearest dental health provider.Thus, in Indonesia, tooth decay is not only associated with poor diet and poor oral hygiene; it also reflects poor environment.Existe una creciente preocupación por el estudio de los impactos ambientales en la salud humana. Los niños son

  2. Prediction of parenteral nutrition osmolarity by digital refractometry.

    Science.gov (United States)

    Chang, Wei-Kuo; Yeh, Ming-Kung

    2011-05-01

    Infusion of high-osmolarity parenteral nutrition (PN) formulations into a peripheral vein will damage the vessel. In this study, the authors developed a refractometric method to predict PN formulation osmolarity for patients receiving PN. Nutrients in PN formulations were prepared for Brix value and osmolality measurement. Brix value and osmolality measurement of the dextrose, amino acids, and electrolytes were used to evaluate the limiting factor of PN osmolarity prediction. A best-fit equation was generated to predict PN osmolarity (mOsm/L): 81.05 × Brix value--116.33 (R(2) > 0.99). To validate the PN osmolarity prediction by these 4 equations, a total of 500 PN admixtures were tested. The authors found strong linear relationships between the Brix values and the osmolality measurement of dextrose (R(2) = 0.97), amino acids (R(2) = 0.99), and electrolytes (R(2) > 0.96). When PN-measured osmolality was between 600 and 900 mOsm/kg, approximately 43%, 29%, 43%, and 0% of the predicted osmolarity obtained by equations 1, 2, 3, and 4 were outside the acceptable 90% to 110% confidence interval range, respectively. When measured osmolality was between 900 and 1,500 mOsm/kg, 31%, 100%, 85%, and 15% of the predicted osmolarity by equations 1, 2, 3, and 4 were outside the acceptable 90% to 110% confidence interval range, respectively. The refractive method permits accurate PN osmolarity prediction and reasonable quality assurance before PN formulation administration.

  3. Comparison Between Premixed and Compounded Parenteral Nutrition Solutions in Hospitalized Patients Requiring Parenteral Nutrition.

    Science.gov (United States)

    Beattie, Colleen; Allard, Johane; Raman, Maitreyi

    2016-04-01

    Parenteral nutrition (PN) may be provided through compounded or premixed solutions. To determine the proportion of stable custom-compounded PN prescriptions that would fit within a 20% deviance of an existing premixed PN solution. A retrospective study design was used. Inpatients who received PN in non-critical care units in the preceding year were screened for eligibility. Results are reported descriptively as means (95% confidence intervals) and proportions. We reviewed 97 PN prescriptions that met inclusion criteria. Stable hospital PN prescriptions compared with the reference premixed prescription provided 1838 (1777-1898) vs 1843 (1781-1905) kcal/d, P = .43; dextrose, 266 (254-277) vs 225 (216-234) g/d, P magnesium, 5.4 (4.8-5.4) vs 7.6 (7.4-7.9) mmol/L. Calories and protein were remarkably similar, but dextrose, lipid, and electrolytes differed between hospital PN and the reference premixed prescription. We believe that there may be a role for premixed solutions in quaternary centers in stable non-critically ill patients. © 2016 American Society for Parenteral and Enteral Nutrition.

  4. PROYECTOS AMBIENTALES ESCOLARES Y CULTURA AMBIENTAL EN LA COMUNIDAD ESTUDIANTIL DE LAS INSTITUCIONES EDUCATIVAS DE SINCELEJO, COLOMBIA

    Directory of Open Access Journals (Sweden)

    Nurys Del Carmen Bustamante Gazabon

    2017-07-01

    Full Text Available La investigación fue realizada en las Instituciones Educativas del municipio de Sincelejo - Sucre, donde se hizo la caracterización de los proyectos Ambientales Escolares (PRAES y la cultura ambiental de los estudiantes, con el propósito de ofrecer alternativas de mejoramiento. La investigación es descriptiva y exploratoria. Es de tipo Cualitativo-cuantitativo. Se aplicaron 2 cuestionarios a docentes, directivos docentes, líderes de los PRAES, estudiantes y padres de Familia. Los hallazgos indican la existencia de varios factores que limitan el desarrollo de los PRAE como la falta de recursos financieros, tiempo y talento humano. Además, de la escasa participación de la comunidad educativa en el diagnóstico, desarrollo y evaluación de los PRAES. Se propuso fortalecer los PRAES, como un compromiso institucional.

  5. Las normas internacionales de información financiera y las cuestiones ambientales

    OpenAIRE

    García Fronti, Inés Mercedes

    2011-01-01

    Se analiza la normativa contable existente en la actualidad y las propuestas en curso elaboradas o recibidas por el International Accounting Standards Board (IASB) sobre cuestiones ambientales, a la vez que recomienda la inclusión de pasivos y activos ambientales en la información financiera de las empresas, así como contingencias, costos y estados financieros referidos al medio ambiente. Finalmente, se apuntan también los pasos de una evolución lógica recomendable de la normativa contable fi...

  6. Los alumnos de ciencias ambientales ¿disponen de habilidades para la investigación?

    OpenAIRE

    Cobos López, Juan

    2015-01-01

    La investigación en Ciencias Ambientales, requiere de conocimientos de Estadística y epidemiología. En la Universidad de Alcalá, la estadística y epidemiología (incluido en la asignatura: toxicología Ambiental y salud Pública), disponen de 6 créditos. El objetivo del estudio, es conocer habilidades para elaborar un proyecto de investigación en Ciencias Ambientales, en alumnos de 2º Curso .Universidad de Alcalá durante 2014-2015. Se diseña una encuesta, con 15 preguntas abiertas, con carácter ...

  7. Metabolismo socio-natural y conflictos ambientales en Costa Rica y El Salvador 1992-2007

    OpenAIRE

    Cartagena Cruz, Rafael Ernesto

    2009-01-01

    La investigación, realizada en Costa Rica y El Salvador, se interroga por la relación entre dinámicas ambientales y conflictividad social. Las dinámicas ambientales han sido analizadas mediante el concepto de metabolismo socio-natural, es decir, como resultado del nexo físico de una sociedad y su entorno. Tres elementos que definen el metabolismo socio-natural en una sociedad dada son las formas de ocupación del espacio, las actividades económicas desarrolladas y los desechos y emisiones que ...

  8. Composicion de redes ambientales a partir de la calidad de servicio

    OpenAIRE

    Palleja Muñoz, Angel; Barba Martí, Antonio

    2009-01-01

    Las redes ambientales definen una iniciativa europea para la cuarta generación de omunicaciones móviles. En esos entornos, la composición de redes heterogéneas para posibilitar comunicaciones con calidad de servicio es un tema fundamental. En este artículo se presenta una propuesta para el diseño de composiciones basándose en el uso de técnicas de inteligencia artificial. Esta ubicuidad se proporciona mediante la omposición de redes ambientales se realiza mediante redes neuronales, algoritm...

  9. PROPUESTA METODOLÓGICA PARA UN SISTEMA DE PAGO POR SERVICIOS AMBIENTALES EN EL ESTADO DE MÉXICO

    Directory of Open Access Journals (Sweden)

    Ángeles Alberto Villavicencio

    2009-01-01

    Full Text Available Este artículo propone una metodología para un Sistema de Pago por Servicios Ambientales en el Estado de México, fundamentado en principios de sustentabilidad ambiental, manejo novedoso de recursos naturales y políticas ambientales dirigidas a proteger los ecosistemas y contribuir al crecimiento económico local.

  10. Safety of home parenteral nutrition during pregnancy.

    Science.gov (United States)

    Theilla, Miriam; Ławiński, Michał; Cohen, Jonathan; Hadar, Eran; Kagan, Ilya; Perkewick, Marek; Singer, Pierre

    2017-02-01

    Few studies have examined the effect of total parenteral nutrition which is lipid-based given throughout pregnancy to patients unable to obtain adequate nutrition by the oral route. In this study we examined the use of lipid-based home parenteral nutrition (HPN) in 7 pregnant women, commenced either before or during pregnancy, and their intra-pregnant course as well as a 2-year follow-up of their offspring is described. HPN was formulated on an individual basis and protein administered in a dose of 0.8-1.1 g/kg during the three trimesters. Lipid emulsions included long chain triglycerides or olive-oil based formulae and all patients received trace elements. Data were collected during the course of pregnancy and at birth while infants were followed for a period of between 6 months and 2 years using medical records and questionnaires. In total, we studied 9 pregnancies (in 7 women). HPN was administered for a median of 9 months (range 3-9 months). The mean energy provided during the 1st, 2nd and 3rd trimester was 9297 ± 2797 kcal/week, 9148 ± 2629 kcal/week and 8564 ± 4059 kcal/week resp. The mean increase in weight during the pregnancy was 9 ± 5 Kg. The only complications noted during the pregnancy consisted of 3 episodes of catheter-related infections which were successfully treated by antibiotics. The infants were born after a mean of 38.00 ± 1.55 weeks of gestation, with a mean first minute Apgar score of 8.7 ± 1.8 which increased to 9.8 ± 0.4 after 10 min. The mean infant birth weight was 2.45 ± 0.37 kg. No complications were noted at birth apart from one infant who suffered from torticollis which resolved spontaneously. During follow up, a decrease in hemoglobin related to low iron levels was noted in 1 infant, 2 infants were noted to be allergic to pollen and one underwent a scrotal hernia reduction. No developmental problems have been observed, neither physiological nor psychomotor, over the 2-year follow-up period. The authors

  11. Phytosterols, Lipid Administration, and Liver Disease During Parenteral Nutrition.

    Science.gov (United States)

    Zaloga, Gary P

    2015-09-01

    Phytosterols are plant-derived sterols that are structurally and functionally analogous to cholesterol in vertebrate animals. Phytosterols are found in many foods and are part of the normal human diet. However, absorption of phytosterols from the diet is minimal. Most lipid emulsions used for parenteral nutrition are based on vegetable oils. As a result, phytosterol administration occurs during intravenous administration of lipid. Levels of phytosterols in the blood and tissues may reach high levels during parenteral lipid administration and may be toxic to cells. Phytosterols are not fully metabolized by the human body and must be excreted through the hepatobiliary system. Accumulating scientific evidence suggests that administration of high doses of intravenous lipids that are high in phytosterols contributes to the development of parenteral nutrition-associated liver disease. In this review, mechanisms by which lipids and phytosterols may cause cholestasis are discussed. Human studies of the association of phytosterols with liver disease are reviewed. In addition, clinical studies of lipid/phytosterol reduction for reversing and/or preventing parenteral nutrition associated liver disease are discussed. © 2015 American Society for Parenteral and Enteral Nutrition.

  12. Dificultades en los métodos de estudio de exposiciones ambientales y defectos del tubo neural Methodological challenges to assess environmental exposures related to neural tube defects

    Directory of Open Access Journals (Sweden)

    Víctor Hugo Borja-Aburto

    1999-11-01

    Full Text Available Objetivo. Discutir las actitudes en la evaluación de las exposiciones ambientales como factores de riesgo para defectos de riesgo del tubo neural, al tiempo que se presentan los principales factores estudiados hasta la fecha. Resultados. Las exposiciones ambientales se citan muy a menudo como causa de malformaciones congénitas; sin embargo, ha sido difícil establecer esta asociación en los estudios de poblaciones humanas, debido a problemas en su diseño y conducción. Lo anterior es particularmente marcado en el caso del estudio de los defectos del cierre del tubo neural (DTN, que es una de las principales malformaciones y que incluye anencefalia, espina bífida y encefalocele, y su asociación con exposiciones ambientales. Las dificultades en los métodos surgen de: a la medida de frecuencia para realizar comparaciones espacio-temporales; b la clasificación y heterogeneidad de las malformaciones; c la consideración de los factores relacionados con la madre, el padre y el producto, de manera conjunta, y d la evaluación de las exposiciones ambientales. Conclusiones. Hipotéticamente las exposiciones ambientales tanto del padre como de la madre pueden producir daño genético antes y/o después de la concepción por la acción directa sobre el embrión o sobre el complejo fetoplacentario, de tal manera que en la evaluación de exposiciones ambientales: a deben tomarse en cuenta las exposiciones maternas y paternas; b debe considerarse el periodo crítico de exposición, esto es, tres meses anteriores a la concepción para el padre y un mes alrededor de la concepción para la madre; c en la medida de lo posible, la evaluación de la exposición deberá ser cuantitativa, evitando clasificar a los grupos únicamente como expuestos y no expuestos, y d es recomendable emplear marcadores biológicos de exposición siempre que sea posible, así como utilizar marcadores biológicos que permitan clasificar a la población en grupos con distinta

  13. Caracterización del estado nutricional en relación con factores socio-ambientales de la población escolar del partido de Punta Indio (Provincia de Buenos Aires, Argentina / Characterization of nutritional status in relation to social and envi

    Directory of Open Access Journals (Sweden)

    María Laura Bergel Sanchís

    2015-12-01

    Full Text Available El objetivo es evaluar el estado nutricional, la composición y proporción corporal con relación a las condiciones socio-ambientales de residencia de la población infanto-juvenil de las localidades de Verónica, Pipinas y La Viruta (partido de Punta Indio, provincia de Buenos Aires. Se realizó un estudio antropométrico transversal en 845 niños (47.5% varones y 52.5% mujeres de 3 a 15 años. Se relevaron peso, talla, estatura sentado, perímetro braquial y pliegues tricipital y subescapular, y se calcularon indicadores nutricionales, de proporción y composición corporal, utilizando la referencia Third National Health and Nutrition Examination Survey. La información socio-ambiental se obtuvo aplicando encuestas estructuradas y fue procesada mediante Análisis de Componentes Principales Categórico. Esto permitió diferenciar cuatro grupos: I “urbano favorecido”; II “urbano intermedio”; III “urbano desfavorable” y IV “rural”. Para cada grupo se calcularon prevalencias de estado nutricional que fueron comparadas mediante la prueba exacta de Fisher. Los resultados indicaron 3.8% de desnutrición, 13.1% de sobrepeso y 10.9% de obesidad. La malnutrición por déficit y por exceso se vio acompañada por modificaciones en la composición corporal. El grupo “rural” se diferenció de los otros grupos por no presentar casos de desnutrición crónica. Estos resultados permiten concluir que la población estudiada experimenta una transición nutricional avanzada, dada por bajas prevalencias de desnutrición y altas prevalencias de sobrepeso y obesidad. Esta situación puede interpretarse en el marco de las transformaciones económicas intensas ocurridas recientemente en el partido de Punta Indio, las cuales no han conducido a erradicar la malnutrición, sino a cambiar su polaridad hacia el exceso de peso. PALABRAS CLAVE malnutrición; proporción y composición corporal; variables socio-ambientales; antropología biológica The

  14. Clinical significance of changes of serum TBA, CG, HA levels in neonate with parenteral nutrition

    International Nuclear Information System (INIS)

    Huang Weiliang; Zhou Jiongying; Zhang Xiaoyi; Lv Weihua; Ma Yunbao; He Qizhi

    2010-01-01

    Objective: To study the clinical significance of changes of serum levels of TBA, CG, HA in neonate with parenteral nutrition. Methods: Serum total bile acid (TBA, with biochemistry) and CG, HA (with RIA) contents were measured in 52 neonates (full-term 32, preterm 20) with parenteral nutrition and 28 neonates (full-term 16, preterm 12) without parenteral nutrition (as controls). Results: Before parenteral nutrition,the serum TBA, CG and HA levels in full-term neonates were not significantly different from those in the controls (P>0.05). After parenteral nutrition,serum levels were significantly higher than those before parenteral nutrition (P<0.01). The levels in pre-term neonates were significantly higher after parenteral nutrition than those in full-term neonates (P<0.05). Conclusion: Long term parenteral nutrition might be harmful to hepatic and gall bladder function in neonates especially in premature ones. (authors)

  15. Management of Hyperglycemia During Enteral and Parenteral Nutrition Therapy

    Science.gov (United States)

    Umpierrez, Guillermo E.

    2013-01-01

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

  16. Iron deficiency anaemia in pregnancy: The role of parenteral iron.

    Science.gov (United States)

    Esen, Umo I

    2017-01-01

    Maternal and perinatal morbidity and mortality remain major challenges in the delivery of safe maternity care worldwide. Anaemia in pregnancy is an important contributor to this dismal picture, especially where blood transfusion services are poorly developed. An early diagnosis and treatment of iron deficiency anaemia in pregnancy using the new generation dextran-free parenteral iron preparations can save lives and reduce morbidity in selected pregnancies. It is time to cast aside the fears associated with the use of the old parenteral iron preparations which were associated a high incidence of anaphylaxis, and embrace the use of new parenteral iron products which have better side effect profiles and can deliver total dose infusions without the need for test dosing. In selected women, the benefits of this treatment far outweigh any disadvantages.

  17. LICENCIAS AMBIENTALES: APROXIMACIÓN Y VALORACIÓN DESDE EL ORIGEN DEL CONFLICTO AMBIENTAL

    Directory of Open Access Journals (Sweden)

    Claudia Alexandra Munévar Quintero

    2014-08-01

    Full Text Available El siguiente artículo presenta los avances de investigación del proyecto titulado: “Minería, Derechos Humanos y Conflicto: Estado, avances y prospectiva de la explotación minera y su incidencia sobre los Derechos Humanos”. En primer lugar, se presenta una contextualización y definición de las Licencias Ambientales en Colombia. En segundo lugar, se establece una relación entre el origen del conflicto ambiental a partir del otorgamiento de una licencia ambiental. Por último, se analizan los criterios de valoración de las licencias ambientales como normas jurídicas. De igual forma, se presenta una relación sobre la metodología y tipos de investigación del proyecto. Finalmente, se realizan las primeras conclusiones de la fase descriptiva del proyecto de investigación con relación a las Licencias Ambientales como originadoras de conflictos ambientales.

  18. Valoración económica de bienes ambientales.

    OpenAIRE

    Orrego Suaza, Sergio Alonso; Cerda Urrutia, Arcadio; Vásquez Lavín, Felipe

    2011-01-01

    El trabajo describe los distintos métodos de valoración económica de bienes ambientales y su utilización en estudios de impacto sobre el entorno para obtener estimaciones monetarias de los efectos negativos sobre la calidad ambiental de recursos naturales específicos.

  19. Reflexiones jurídicas sobre los costos ambientales Aumento de exploración de hidrocarburos no convencionales

    Directory of Open Access Journals (Sweden)

    Danielle Mendes Thame Denny

    2016-06-01

    Full Text Available El abaratamiento de la producción de energía a partir de la extracción de hidrocar- buros no convencionales, mediante el fracking, está creciendo de manera exponencial en los Estados Unidos y Canadá, con esto baja el precio de los hidrocarburos, que se vuelve más ventajoso en términos económicos y dificultando aún más la competitividad de las fuentes de energía renovables. Sus impactos son de interés comercial, pero también son de gran importancia para el medio ambiente, dado que la exploración de la forma en que se ha hecho, parece ser la causa de varios factores externos negativos, como el metano liberado durante la extracción y el posible deterioro de la calidad de los recursos hídricos, entre otros impactos ambientales. La investigación que apoya este artículo indica, hasta el momento, que el bajo precio de la energía de la fracturación hidráulica de esquisto solo se logra mediante el uso insostenible de los recursos naturales. En este sentido es oportuna la investigación legal de los costos ambientales de esa explotación, con la consideración de un posible “dumping ambiental” y, como tal susceptible de apreciación por el Sistema de Solución de Diferencias de la Organización Mundial del Comercio

  20. Glycemic Variation in Tumor Patients with Total Parenteral Nutrition

    Directory of Open Access Journals (Sweden)

    Jin-Cheng Yang

    2015-01-01

    Full Text Available Background: Hyperglycemia is associated with poor clinical outcomes and mortality in several patients. However, studies evaluating hyperglycemia variation in tumor patients receiving total parenteral nutrition (TPN are scarce. The aim of this study was to assess the relationship between glycemia and tumor kinds with TPN by monitoring glycemic variation in tumor patients. Methods: This retrospective clinical trial selected 312 patients with various cancer types, whose unique nutrition treatment was TPN during the monitoring period. All patients had blood glucose (BG values assessed at least six times daily during the TPN infusion. The glycemic variation before and after TPN was set as the indicator to evaluate the factors influencing BG. Results: The clinical trial lasted 7.5 ± 3.0 days adjusted for age, gender, family cancer history and blood types. There were six cancer types: Hepatic carcinoma (HC, 21.8%, rectal carcinoma (17.3%, colon carcinoma (CC, 14.7%, gastric carcinoma (29.8%, pancreatic carcinoma (11.5%, and duodenal carcinoma (DC, 4.8%. The patients were divided into diabetes and nondiabetes groups. No statistical differences in TPN glucose content between diabetes and nondiabetes groups were found; however, the tumor types affected by BG values were obvious. With increasing BG values, DC, HC and CC were more represented than other tumor types in this sequence in diabetic individuals, as well as in the nondiabetic group. BG was inclined to be more easily influenced in the nondiabetes group. Other factors did not impact BG values, including gender, body mass index, and TPN infusion duration time. Conclusions: When tumor patients are treated with TPN, BG levels should be monitored according to different types of tumors, besides differentiating diabetes or nondiabetes patients. Special BG control is needed for DC, HC and CC in both diabetic and nondiabetic patients. If BG overtly increases, positive measurements are needed to control BG

  1. Sterilization of solutions for parenterals products. Problem analysis

    Directory of Open Access Journals (Sweden)

    Yanelys Montes-González

    2017-09-01

    Full Text Available The solutions for the formulation of parenteral products must be sterile before the aseptic formulation process. For this reason, different methods of sterilization referred in the literature are analyzed. Thermodynamic criteria that rule the sterilization are presented. Furthermore, previous experiences in the sterilization of solutions for the formulation of parental products in an autoclave are analyzed, that take large time of processing and only low volumes of solution can be handled. Using jacketed stirred tanks for the sterilization may solve the problem and, therefore, criteria for the design of the later that allow to process high volumes of solution for the formulation of parenteral products are shown.

  2. Home parenteral nutrition in treatment of severe radiation enteritis

    International Nuclear Information System (INIS)

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

    1979-01-01

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

  3. Serum immunoglobulin and complement levels in prematures with parenteral feeding--preliminary results.

    Science.gov (United States)

    Tamaro, G; Morena, C; Uxa, F; Candusso, M; Trappan, A; de Vonderweid, U

    1993-01-01

    Immunoglobulins IgA, IgG and IgM and complement factors C3 and C4 have been measured in a population of premature infants to evaluate their degree of immunological maturity. All the infants were receiving complete parenteral nutrition. In parallel, the same parameters were measured in twenty two full term, healthy neonates. To explore maturation and liver function, the authors used other proteins as nutritional markers. Differences in the immunoglobulins, but not in the complement fractions were seen between the two groups. Two applications are suggested: incidence of infections and post partum maturation.

  4. Nutritional requirements and parenteral nutrition in preterm infants ...

    African Journals Online (AJOL)

    Provision of appropriate nutritional requirements soon after birth is critical for normal development and growth of preterm infants. Preterm infants are often not able to tolerate volumes of oral feeds that will provide adequate daily requirements for growth within the first week or two of life, therefore parenteral nutrition is often ...

  5. Lipid emulsions in parenteral nutrition: does one size fits all ...

    African Journals Online (AJOL)

    Dietary lipids significantly contribute to preserve the efficiency of human metabolism and restore it during disease. Therefore, in the absence of absolute contraindications, it would not appear reasonable to exclude lipid emulsions when prescribing parenteral nutrition (PN). The metabolic role of lipids has been elucidated, ...

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

    African Journals Online (AJOL)

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

  7. Home Parenteral Nutrition in Adult Patients With Chronic Intestinal Failure

    DEFF Research Database (Denmark)

    Brandt, Christopher Filtenborg; Tribler, Siri; Hvistendahl, Mark

    2018-01-01

    BACKGROUND/AIMS: Catheter-related complications (CRCs) cause mortality and morbidity in patients dependent on parenteral support at home (HPN) due to intestinal failure (IF). This study describes the incidences of CRCs in an adult IF cohort over 40 years. It illustrates the evolution and conseque...

  8. Gluconeogenesis continues in premature infants receiving total parenteral nutrition

    Science.gov (United States)

    To determine the contribution of total gluconeogenesis, to glucose production in preterm infants receiving total parenteral nutrition (TPN) providing glucose exceeding normal infant glucose turnover rate, eight infants (0.955 +/- 0.066 kg, 26.5 - 0.5 wks, 4-1 d) were studied while receiving routine ...

  9. Managing an outpatient parenteral antibiotic therapy team: challenges and solutions.

    Science.gov (United States)

    Halilovic, Jenana; Christensen, Cinda L; Nguyen, Hien H

    2014-01-01

    Outpatient parenteral antimicrobial therapy (OPAT) programs should strive to deliver safe, cost effective, and high quality care. One of the keys to developing and sustaining a high quality OPAT program is to understand the common challenges or barriers to OPAT delivery. We review the most common challenges to starting and managing an OPAT program and give practical advice on addressing these issues.

  10. Condiciones ambientales riesgosas para las infecciones respiratorias agudas en escolares de primaria Risky environmental conditions for acute respiratory infections in primary school students

    Directory of Open Access Journals (Sweden)

    Alina Mezquía Valera

    2011-06-01

    Full Text Available Introducción: el deterioro de las condiciones ambientales contribuye de forma importante a los procesos de la enfermedad, porque expone a la población urbana a enfermedades y riesgos muy bien identificados y conocidos. Objetivos: identificar las condiciones ambientales riesgosas en los hogares, las escuelas y sus entornos para la prevalencia de las infecciones respiratorias en educandos, en el curso escolar 2006-2007. Métodos: se realizó un estudio descriptivo transversal en los educandos de 1ro. a 6to. grado del universo de las escuelas primarias del consejo popular Cayo Hueso, del municipio Centro Habana. Se aplicó a las madres un cuestionario con preguntas al respecto, y se realizó la evaluación de las condiciones ambientales de las escuelas y sus entornos, según las orientaciones de guías preelaboradas. Resultados: la prevalencia de infecciones respiratorias agudas fueron obtenidas de los educandos que asisten a las escuelas "Pedro Carbó Serviá", "Salvador Cisneros Betancourt", "Fernández Roig" y "República de Bolivia", y coincidió con que son las que tienen más factores de riesgo del ambiente y/o las que tienen mayores frecuencias de educandos con condiciones ambientales riesgosas de sus hogares, escuelas o entorno.Introduction: deterioration of environmental conditions contributes in a very important way to disease processes because of to expose to urban population to diseases and risks very well identified and well known. Objective: to identify the risky environmental conditions at homes, schools and its surroundings for prevalence of respiratory infections in the students during 2006-1007 courses. Methods: a cross-sectional and descriptive study was conducted in students from 1st to sixth degrees from the universe of primary schools of "Cayo Hueso" popular council of the Centro Habana municipality. In mothers a questionnaire was distributed with related questions and the environmental conditions of schools and its

  11. Discursos ambientales: una mirada histórica a la configuración del territorio del PNN Katíos en Colombia y su zona de amortiguación

    Directory of Open Access Journals (Sweden)

    Mónica Pérez Marín

    2012-01-01

    Full Text Available Este artículo intenta identificar y caracterizar desde una perspectiva histórica "los discursos ambientales" que se han construido y han circulado alrededor de lo que actualmente conocemos como Parque Nacional Natural en Colombia, particularmente sobre el PNN Katíos. Se defiende la idea de que dichos discursos se han construido, propagado, institucionalizado y legitimado como medio y factor dinamizador de un discurso más amplio que hemos denominado "discurso del desarrollo".

  12. IODINE CONTENT OF ENTERAL AND PARENTERAL NUTRITION SOLUTIONS.

    Science.gov (United States)

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

    2017-07-01

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

  13. Temporal Trends in the Use of Parenteral Nutrition in Critically Ill Patients

    Science.gov (United States)

    Kahn, Jeremy M.; Wunsch, Hannah

    2014-01-01

    Background: Clinical practice guidelines recommend enteral over parenteral nutrition in critical illness and do not recommend early initiation. Few data are available on parenteral nutrition use or timing of initiation in the ICU or how this use may have changed over time. Methods: We used the Project IMPACT database to evaluate temporal trends in parenteral nutrition use (total and partial parenteral nutrition and lipid supplementation) and timing of initiation in adult ICU admissions from 2001 to 2008. We used χ2 tests and analysis of variance to examine characteristics of patients receiving parenteral nutrition and multilevel multivariate logistic regression models to assess parenteral nutrition use over time, in all patients and in specific subgroups. Results: Of 337,442 patients, 20,913 (6.2%) received parenteral nutrition. Adjusting for patient characteristics, the use of parenteral nutrition decreased modestly over time (adjusted probability, 7.2% in 2001-2002 vs 5.5% in 2007-2008, P nutrition use increased simultaneously (adjusted probability, 11.5% in 2001-2002 vs 15.3% in 2007-2008, P parenteral nutrition declined most rapidly in emergent surgical patients, patients with moderate illness severity, patients in the surgical ICU, and patients admitted to an academic facility (P ≤ .01 for all interactions with year). When used, parenteral nutrition was initiated a median of 2 days (interquartile range, 1-3), after ICU admission and > 90% of patients had parenteral nutrition initiated within 7 days; timing of initiation of parenteral nutrition did not change from 2001 to 2008. Conclusions: Use of parenteral nutrition in US ICUs declined from 2001 through 2008 in all patients and in all examined subgroups, with the majority of parenteral nutrition initiated within the first 7 days in ICU; enteral nutrition use coincidently increased over the same time period. PMID:24233390

  14. The prognosis of incurable cachectic cancer patients on home parenteral nutrition: a multi-centre observational study with prospective follow-up of 414 patients

    NARCIS (Netherlands)

    Bozzetti, F.; Santarpia, L.; Pironi, L.; Thul, P.; Klek, S.; Gavazzi, C.; Tinivella, M.; Joly, F.; Jonkers, C.; Baxter, J.; Gramlich, L.; Chicharro, L.; Staun, M.; van Gossum, A.; Lo Vullo, S.; Mariani, L.

    2014-01-01

    The role of home parenteral nutrition (HPN) in incurable cachectic cancer patients unable to eat is extremely controversial. The aim of this study is to analyse which factors can influence the outcome. We studied prospectively 414 incurable cachectic (sub)obstructed cancer patients receiving HPN and

  15. Parenteral lipids and partial enteral nutrition affect hepatic lipid composition but have limited short term effects on formula-induced necrotizing enterocolitis in preterm piglets

    DEFF Research Database (Denmark)

    Vegge, Andreas; Thymann, Thomas; Lauritzen, Lotte

    2015-01-01

    Rapid transition from total parenteral nutrition (TPN) to enteral feeding is a risk factor for necrotizing enterocolitis (NEC) in preterm infants. We hypothesized that partial enteral nutrition with colostrum, increased proportion of n-3 polyunsaturated fatty acids (PUFA), or exclusion of lipid...

  16. Access technique and its problems in parenteral nutrition – Guidelines on Parenteral Nutrition, Chapter 9

    Directory of Open Access Journals (Sweden)

    Bischoff, S. C.

    2009-11-01

    Full Text Available Catheter type, access technique, and the catheter position should be selected considering to the anticipated duration of PN aiming at the lowest complication risks (infectious and non-infectious. Long-term (>7–10 days parenteral nutrition (PN requires central venous access whereas for PN 3 weeks subcutaneous tunnelled catheters or port systems are appropriate. CVC (central venous catheter should be flushed with isotonic NaCl solution before and after PN application and during CVC occlusions. Strict indications are required for central venous access placement and the catheter should be removed as soon as possible if not required any more. Blood samples should not to be taken from the CVC. If catheter infection is suspected, peripheral blood-culture samples and culture samples from each catheter lumen should be taken simultaneously. Removal of the CVC should be carried out immediately if there are pronounced signs of local infection at the insertion site and/or clinical suspicion of catheter-induced sepsis. In case PN is indicated for a short period (max. 7–10 days, a peripheral venous access can be used if no hyperosmolar solutions (>800 mosm/L or solutions with a high titration acidity or alkalinity are used. A peripheral venous catheter (PVC can remain in situ for as long as it is clinically required unless there are signs of inflammation at the insertion site.

  17. Access technique and its problems in parenteral nutrition - Guidelines on Parenteral Nutrition, Chapter 9.

    Science.gov (United States)

    Jauch, K W; Schregel, W; Stanga, Z; Bischoff, S C; Brass, P; Hartl, W; Muehlebach, S; Pscheidl, E; Thul, P; Volk, O

    2009-11-18

    Catheter type, access technique, and the catheter position should be selected considering to the anticipated duration of PN aiming at the lowest complication risks (infectious and non-infectious). Long-term (>7-10 days) parenteral nutrition (PN) requires central venous access whereas for PN 3 weeks subcutaneous tunnelled catheters or port systems are appropriate. CVC (central venous catheter) should be flushed with isotonic NaCl solution before and after PN application and during CVC occlusions. Strict indications are required for central venous access placement and the catheter should be removed as soon as possible if not required any more. Blood samples should not to be taken from the CVC. If catheter infection is suspected, peripheral blood-culture samples and culture samples from each catheter lumen should be taken simultaneously. Removal of the CVC should be carried out immediately if there are pronounced signs of local infection at the insertion site and/or clinical suspicion of catheter-induced sepsis. In case PN is indicated for a short period (max. 7-10 days), a peripheral venous access can be used if no hyperosmolar solutions (>800 mosm/L) or solutions with a high titration acidity or alkalinity are used. A peripheral venous catheter (PVC) can remain in situ for as long as it is clinically required unless there are signs of inflammation at the insertion site.

  18. Ethical and legal points of view in parenteral nutrition – Guidelines on Parenteral Nutrition, Chapter 12

    Directory of Open Access Journals (Sweden)

    Rothaermel, S.

    2009-11-01

    Full Text Available Adequate nutrition is a part of medical treatment and is influenced by ethical and legal considerations. Patients, who cannot be sufficiently fed via the gastrointestinal tract, have the fundamental right to receive PN (parenteral nutrition even so patients who are unable to give their consent. General objectives in nutrition support are to supply adequate nutrition with regards to the prevention of malnutrition and its consequences (increased morbidity and mortality, and thereby promoting improved outcome and/or quality of life for the patient considering always the patient’s needs and wishes. The requests of the patient to renounce PN should be respected where a signed living will is helpful. During the course of a terminal illness the nutrition has to be adapted individually according to the needs and wishes of a patient in the corresponding phase. Capability of consent should be checked in each individual case and for each measure on an individual basis. Consent should only be accepted if the patient is capable of recognizing the nature, meaning and importance of the intervention as well as the consequences of relinquishment of such an intervention, and is capable to make a self-determined decision. If the patient is not capable of consenting, the patient’s living will is the most important document when determining their assumed will and legally binding. Otherwise a guardian appointed by the patient, or the representative appointed by the court (if the patient has made no provisions can make the decision.

  19. Parenteral nutrition in patients with renal failure – Guidelines on Parenteral Nutrition, Chapter 17

    Directory of Open Access Journals (Sweden)

    Druml, W.

    2009-11-01

    Full Text Available Partial EN (enteral nutrition should always be aimed for in patients with renal failure that require nutritional support. Nevertheless PN (parenteral nutrition may be necessary in renal failure in patient groups with acute or chronic renal failure (ARF or CRF and additional acute diseases but without extracorporeal renal replacement therapy, or in patients with ARF or CRF with additional acute diseases on extracorporeal renal replacement therapy, haemodialysis therapy (HD, peritoneal dialysis (PD or continuous renal replacement therapy (CRRT, or in patients on HD therapy with intradialytic PN. Patients with renal failure who show marked metabolic derangements and changes in nutritional requirements require the use of specifically adapted nutrient solutions. The substrate requirements of acutely ill, non-hypercatabolic patients with CRF correspond to those of patients with ARF who are not receiving any renal replacement patients therapy (utilisation of the administered nutrients has to be monitored carefully. In ARF patients and acutely ill CRF patients on renal replacement therapy, substrate requirements depend on disease severity, type and extent/frequency of extracorporeal renal replacement therapy, nutritional status, underlying disease and complications occurring during the course of the disease. Patients under HD have a higher risk of developing malnutrition. Intradialytic PN (IDPN should be used if causes of malnutrition cannot be eliminated and other interventions fail. IDPN should only be carried out when modifiable causes of malnutrition are excluded and enhanced oral (like i.e. additional energy drinks or enteral supply is unsuccessful or cannot be carried out.

  20. Ethical and legal points of view in parenteral nutrition - Guidelines on Parenteral Nutrition, Chapter 12.

    Science.gov (United States)

    Rothaermel, S; Bischoff, S C; Bockenheimer-Lucius, G; Frewer, A; Wehkamp, K H; Zuercher, G

    2009-11-18

    Adequate nutrition is a part of medical treatment and is influenced by ethical and legal considerations. Patients, who cannot be sufficiently fed via the gastrointestinal tract, have the fundamental right to receive PN (parenteral nutrition) even so patients who are unable to give their consent. General objectives in nutrition support are to supply adequate nutrition with regards to the prevention of malnutrition and its consequences (increased morbidity and mortality), and thereby promoting improved outcome and/or quality of life for the patient considering always the patient's needs and wishes. The requests of the patient to renounce PN should be respected where a signed living will is helpful. During the course of a terminal illness the nutrition has to be adapted individually according to the needs and wishes of a patient in the corresponding phase. Capability of consent should be checked in each individual case and for each measure on an individual basis. Consent should only be accepted if the patient is capable of recognizing the nature, meaning and importance of the intervention as well as the consequences of relinquishment of such an intervention, and is capable to make a self-determined decision. If the patient is not capable of consenting, the patient's living will is the most important document when determining their assumed will and legally binding. Otherwise a guardian appointed by the patient, or the representative appointed by the court (if the patient has made no provisions) can make the decision.

  1. Enteral bile acid treatment improves parenteral nutrition-related liver disease and intestinal mucosal atrophy in neonatal pigs

    DEFF Research Database (Denmark)

    Jain, Ajay Kumar; Stoll, Barbara; Burrin, Douglas G

    2012-01-01

    Total parenteral nutrition (TPN) is essential for patients with impaired gut function but leads to parenteral nutrition-associated liver disease (PNALD). TPN disrupts the normal enterohepatic circulation of bile acids, and we hypothesized that it would decrease intestinal expression of the newly...... described metabolic hormone fibroblast growth factor-19 (FGF19) and also glucagon-like peptides-1 and -2 (GLP-1 and GLP-2). We tested the effects of restoring bile acids by treating a neonatal piglet PNALD model with chenodeoxycholic acid (CDCA). Neonatal pigs received enteral feeding (EN), TPN, or TPN...... + CDCA for 14 days, and responses were assessed by serum markers, histology, and levels of key regulatory peptides. Cholestasis and steatosis were demonstrated in the TPN group relative to EN controls by elevated levels of serum total and direct bilirubin and also bile acids and liver triglyceride (TG...

  2. New products. The environmental quality increases; Nuovi prodotti: cresce la qualita' ambientale

    Energy Technology Data Exchange (ETDEWEB)

    Chiapponi, M. [Milan Politecnico, Milan (Italy)

    1999-10-01

    The paper discusses the efforts to prevent and reduce the environmental impacts focused on industrial processes and on improving the environmental compatibility of products. The redesign of large consumption products with the purpose of making them more environmentally sustainable is today a tangible reality which is in constant evolution and needs support both from demand and supply side. [Italian] L'articolo discute il problema della riduzione degli impatti ambientali sui processi industriali del miglioramento della compatibilita' ambientale dei prodotti. Il redesign dei prodotti di largo consumo in funzione di una loro maggiore sostenibilita' ambientale e' infatti oggi una realta' in continua evoluzione e un impegno sul fronte dell'innovazione, che deve essere sostenuto sia sul fronte della domanda che su quello dell'offerta.

  3. Considerazioni sul problema dei rigassificatori tra aggregazione del consenso e conflitto ambientale

    OpenAIRE

    Lodoli, Flavio

    2011-01-01

    2009/2010 Considerazioni sul problema dei Rigassificatori tra Aggregazione del Consenso e Conflitto Ambientale 1. Il nostro Paese, per scelta politica e per una sostanziale limitata capacità di innovazione del mondo industriale, ha una quota attuale di produzione di energia da fonti rinnovabili poco significativa nonostante gli investimenti, i contributi e le agevolazioni fiscali che dovrebbero incentivare opportunamente ad esempio, l’utilizzo dell’energia solare che rappresenta una...

  4. ¿PUEDE LA ÉTICA RESPONDER A LA NOVEDAD DE LOS PROBLEMAS AMBIENTALES?

    Directory of Open Access Journals (Sweden)

    RAMÍREZ RESTREPO RUBIEL

    2012-11-01

    Full Text Available El ser humano tiene una indiscutible especificidad biológica y cultural; sin embargo, de manera inevitable se relaciona con las cosas de su entorno, las utiliza y, con frecuencia, las agota más allá de la capacidad misma de recuperación de ese entorno. Surgen entonces los novedosos y graves problemas ambientales que terminan comprometiendo las posibilidades mismas de sobrevivencia de nuestra especie, así como de toda posible forma de vida. Esta situación exige actitudes y comportamientos por parte de ese ser humano que respondan, respecto de sí mismo y de las cosas de ese entorno, de manera coherente con la índole y gravedad de sus actos. Dar cuenta de los propios actos y generar normas que orienten al respecto, corresponden a lo que históricamente se conoce como moral, cuyo estudio filosófico es la ética. Pero una mirada a las éticas históricamente constituidas indica que ellas, debido a su excluyente antropocentrismo, son incapaces de responder a la novedad de los problemas ambientales. Por eso es necesario y urgente pensar en una alternativa ética, tanto con relación a sus principios como a sus temas, que responda a la particularidad y gravedad de los temas ambientales.

  5. Educar con ética y valores ambientales para conservar la naturaleza

    Directory of Open Access Journals (Sweden)

    Adriana de Castro Cuéllar

    2009-01-01

    Full Text Available Pese a los esfuerzos por conservar los recursos naturales no se ha podido frenar el deterioro ambiental, debido, posiblemente, a que no logramos tener conciencia y actitud de respeto hacia la naturaleza. La enseñanza de valores ambientales desde la infancia es una forma de generar cambios de visión y de apreciación de la naturaleza. En este trabajo se analiza el contenido del libro de texto de Ciencias Naturales de quinto grado de primaria y realizamos observaciones sobre la conducta de alumnos de este grado en dos escuelas de San Cristóbal de las Casas, Chiapas. Se les entrevistó y pidió que respondieran un cuestionario para identificar si los contenidos del libro de texto ofrecen una enseñanza de valores éticos-ambientales, y verificar si el niño expresa dichos valores. El contenido del programa oficial y sus ejecuciones aportan información valiosa sobre la problemática ambiental; sin embargo, es ineficiente para promover valores ambientales en los niños como el respeto a la flora y fauna, y el manejo responsable del agua y desechos.

  6. Effectiveness and tolerability of parenteral testosterone undecanoate: a post-marketing surveillance study.

    Science.gov (United States)

    Wolf, Jan; Keipert, Dieter; Motazedi, Heiko; Ernst, Michael; Nettleship, Joanne; Gooren, Louis

    2017-12-01

    This observational post-marketing study of parenteral testosterone undecanoate (TU) in a non-selected population aimed to: examine the effectiveness of TU as treatment of hypogonadism; record adverse drug reactions (ADR) quantitatively particularly regarding polycythemia, prostate safety and cardiovascular-related metabolic risk factors; and verify whether recommended injection intervals apply to routine clinical practice. Eight hundred and seventy subjects from 259 outpatient units scheduled to visit the clinic six times were included. Effectiveness and tolerability of TU administration were assessed on a 4-point scale. Body weight, waist girth, blood pressure, hemoglobin levels, hematocrit, prostate-specific antigen (PSA), and digital rectal prostate examination were assessed. Over 90% of subjects completed the observational duration of 52.8 ± 9.7 weeks (mean ± SD) and 56% judged effectiveness as very good, 30.8% as good. 63.1% judged tolerability as very good, and 24.4% as good. No adverse effects on indicators of cardiovascular risk were observed. Polycythemia occurred in one subject and a supranormal hematocrit in one subject. Four subjects developed supranormal PSA levels. Prostate carcinoma was found in one subject, one subject had recurrence of a previously surgically treated prostate carcinoma, and the other two showed no indication of malignancy. Parenteral TU is safe, effective, and well-tolerated in clinical practice proving a good therapeutic option for hypogonadism.

  7. Parenteral Antibiotics Reduce Bifidobacteria Colonization and Diversity in Neonates

    Directory of Open Access Journals (Sweden)

    Séamus Hussey

    2011-01-01

    Full Text Available We investigated the impact of parenteral antibiotic treatment in the early neonatal period on the evolution of bifidobacteria in the newborn. Nine babies treated with intravenous ampicillin/gentamicin in the first week of life and nine controls (no antibiotic treatment were studied. Denaturing gradient gel electrophoresis was used to investigate the composition of Bifidobacterium in stool samples taken at four and eight weeks. Bifidobacteria were detected in all control infants at both four and eight weeks, while only six of nine antibiotic-treated infants had detectable bifidobacteria at four weeks and eight of nine at eight weeks. Moreover, stool samples of controls showed greater diversity of Bifidobacterium spp. compared with antibiotic-treated infants. In conclusion, short-term parenteral antibiotic treatment of neonates causes a disturbance in the expected colonization pattern of bifidobacteria in the first months of life. Further studies are required to probiotic determine if supplementation is necessary in this patient group.

  8. Introduction and methodology – Guidelines on Parenteral Nutrition, Chapter 1

    Directory of Open Access Journals (Sweden)

    Jauch, K. W.

    2009-11-01

    Full Text Available Guidelines for Parenteral Nutrition were prepared by the German Society for Nutritional Medicine (http://www.dgem.de/, in collaboration with other medical associations to provide guidance for quality assurance for parenteral nutrition (PN practice, and to promoting health and quality of life of patients concerned. A coordination team proposed topics, working group leaders who along with working group members performed systematic literatur searches and drafted recommendations in a nominal group process. Recommendations were discussed and agreed upon in a structured consensus conference process, followed by a Delphi consensus. The current English version of the guidelines was written and updated during the period between the last quarter of 2007 and the first quarter of 2009. The recommendations of the guidelines should be reviewed, and if necessary updated five years after publication.

  9. Nutrición parenteral precoz en el neonato grave

    Directory of Open Access Journals (Sweden)

    Alina González Mustelier

    2004-06-01

    Full Text Available Se realizó un estudio descriptivo en el Servicio de Terapia Intensiva Neonatal del Hospital Ginecoobstétrico "Ramón González Coro" de Ciudad de La Habana, desde enero del 2000 hasta enero del 2002, con el objetivo de valorar las ventajas del uso de nutrición parenteral (NP precoz en los neonatos críticamente enfermos, durante la primera semana de vida. Se compararon 2 grupos de 23 recién nacidos críticos, uno de ellos recibió alimentación parenteral (grupo I y el otro no (grupo II. Se encontró homogeneidad en ambos grupos en cuanto a peso, edad gestacional, valoración nutricional al nacer, sexo y morbilidad inicial. La nutrición parenteral se caracterizó por su uso precoz (menos de 72 horas, conjuntamente con alimentación enteral mínima. La media del aporte máximo de macronutrientes fue de 16 g/kg/d de dextrosa, 1,2 g/kg/d de lípidos y 2 g/kg/d de proteínas. El desarrollo nutricional fue más favorable en el grupo con NP, porque le disminuyó a la mitad el tanto por ciento de peso perdido en la primera semana de vida, le sostuvo mayor aporte energético durante ese período y recupó 7 días antes su peso del nacimiento en relación con el grupo II. Las complicaciones fueron similares en ambos grupos, para concluir en que estas no estuvieron relacionadas con el uso de NP.A descriptive study was conducted at the Neonatal Intensive Therapy Service of "Ramón Gonzalez Coro" Gynecoobstetric Hospital, in Havana City, from January 2000, to January 2002, aimed at assessing the advantages of the use of early parenteral nutrition in the critically ill neonates during the first week of life. 2 groups of 23 critical newborn infants each were compared. One of them recieved parenteral nutrition (group 1 and the other one did not (group II. Homogeneity was found in both groups as regards weight, gestational age, nutritional assessment at birth and initial morbidity. The parenteral nutrition was characterized by its early use (less than 72

  10. [Routine comparison of trace element deficiencies during parenteral alimentation].

    Science.gov (United States)

    du Cailar, J; Mathieu-Daudé, J C; Kienlen, J; Béssou, D; Griffe, O; Bélé-Binda

    1977-01-01

    In 50 patients aged between 3 and 84 years treated in a multidisciplinary Intensive Care Unit and receiving parenteral alimentation, deficiency in certain trace elements or electrolytes (Cu++, Zn++, Mn++, Co++, PO-4, Mg++) was prevented or treated by the administration of a glucose solution (MB 147 G) enriched in trace elements. The aim of the present study was to demonstrate, on the basis of assay of serum levels of the trace elements involved, with the exception of Mn and Co, the effectiveness of treatment. Reference values were determined on the one hand in healthy individuals for normal figures and secondly on subjects included in the study, already on parenteral alimentation for several days, before treatment with MB 147 G, in order to demonstrate the existence of a deficiency (patient control values). In the case of PO--4, however, the patient control values concerned at one and the same time subjects in the study before treatment with MB 147 G and other patients receiving parenteral alimentation who were not part of the trial. MB 147 G solution was presented in units of 500 ml associated with glucose of varying concentrations (15 p. 100, 30 p. 100, 50 p. 100). The average daily amount administered, over a period of 236 days, was 3 unites per 24 hours, corresponding to an intake of copper of 3.78 mg, 3.90 mg of zinc, 0.20 mg of manganese, 0.24 mg of cobalt, 363 mg of magnesium, 240 mg of calcium and 15 mEz of phosphates. The results show that levels of copper, zinc, magnesium and phosphates were low during parenteral alimentation. The administration of MB 147 G resulted in a significant increase in these values, without there being any evidence of accumulation.

  11. Parenteral nutrition including polyamine under experimental irradiation of the abdomen

    International Nuclear Information System (INIS)

    Moroz, B.B.; Fedorovskij, L.L.; Lyashchenko, Yu.N.

    1982-01-01

    White rats-males were used in experiments. Irradiation dose of abdomen area is 13.5 Gy (1400 R). Parenteral nutrition using aminoacid preparation of polyamine affects favourably during radiation damage resulted from local irradiation of abdomen area. This was manifested in weakening of gastroenteric syndrom, reduction of 3.5 day death of animals and increase of their 30 day survival rate, intensification of recovery processes in small intestine, decrease of cell devastation in bone marrow

  12. Characteristics of medication errors with parenteral cytotoxic drugs

    OpenAIRE

    Fyhr, A; Akselsson, R

    2012-01-01

    Errors involving cytotoxic drugs have the potential of being fatal and should therefore be prevented. The objective of this article is to identify the characteristics of medication errors involving parenteral cytotoxic drugs in Sweden. A total of 60 cases reported to the national error reporting systems from 1996 to 2008 were reviewed. Classification was made to identify cytotoxic drugs involved, type of error, where the error occurred, error detection mechanism, and consequences for the pati...

  13. Managing an outpatient parenteral antibiotic therapy team: challenges and solutions

    OpenAIRE

    Nguyen, Hien; Halilovic,Jenana; Christensen,Cinda

    2014-01-01

    Jenana Halilovic,1 Cinda L Christensen,2 Hien H Nguyen31University of the Pacific Thomas J Long School of Pharmacy, Stockton, CA, USA; 2Department of Pharmaceutical Services, University of California, Davis Health System, Sacramento, CA, USA; 3Division of Infectious Diseases, Section of Hospital Medicine, University of California, Davis Health System, Sacramento, CA, USAAbstract: Outpatient parenteral antimicrobial therapy (OPAT) programs should strive to deliver safe, cost effective, and hig...

  14. Product quality of parenteral vancomycin products in the United States.

    Science.gov (United States)

    Nambiar, S; Madurawe, R D; Zuk, S M; Khan, S R; Ellison, C D; Faustino, P J; Mans, D J; Trehy, M L; Hadwiger, M E; Boyne, M T; Biswas, K; Cox, E M

    2012-06-01

    In response to concerns raised about the quality of parenteral vancomycin products, the U.S. Food and Drug Administration (FDA) is investigating the product quality of all FDA-approved parenteral vancomycin products available in the United States. Product quality was evaluated independently at two FDA Office of Testing and Research (FDA-OTR) sites. In the next phase of the investigation, being done in collaboration with the National Institute of Allergy and Infectious Diseases, the in vivo activity of these products will be evaluated in an appropriate animal model. This paper summarizes results of the FDA investigation completed thus far. One site used a validated ultrahigh-pressure liquid chromatography method (OTR-UPLC), and the second site used the high-performance liquid chromatography (HPLC) method for related substances provided in the British Pharmacopeia (BP) monograph for vancomycin intravenous infusion. Similar results were obtained by the two FDA-OTR laboratories using two different analytical methods. The products tested had 90 to 95% vancomycin B (active component of vancomycin) by the BP-HPLC method and 89 to 94% vancomycin by OTR-UPLC methods. Total impurities were 5 to 10% by BP-HPLC and 6 to 11% by OTR-UPLC methods. No single impurity was >2.0%, and the CDP-1 level was ≤ 2.0% across all products. Some variability in impurity profiles of the various products was observed. No adverse product quality issues were identified with the six U.S. vancomycin parenteral products. The quality parameters of all parenteral vancomycin products tested surpassed the United States Pharmacopeia acceptance criteria. Additional testing will characterize in vivo performance characteristics of these products.

  15. Delivery of vitamins E and C from parenteral alimentation solution.

    Science.gov (United States)

    Shenai, J P; Borum, P R; Duke, E A

    1982-01-01

    We have previously shown that substantial losses of fat-soluble (FS) vitamin A from parenteral alimentation solution occur due to adsorption in the intravenous tubing and photodegradation in the bottle. This study assessed the delivery of other vitamins, viz, FS vitamin E and water-soluble (WS) vitamin C, from parenteral alimentation solution. The solution containing 2.0 ml/L of an aqueous multivitamin infusion was infused at a constant rate of 10 ml/h using a standard intravenous administration set. Multiple aliquots of the solution from the bottle and the effluent obtained sequentially in a 24-h period were analyzed for concentrations of vitamins E and C. Both vitamins remained relatively stable in the bottle. A significant amount (12%) of vitamin E was lost in the intravenous tubing. No losses of vitamin C were incurred in the intravenous tubing. The data suggest that delivery of FS vitamin E from parenteral alimentation solutions is less than optimum because of adsorptive losses. Similar losses are not encountered with WS vitamin C.

  16. Compatibility of 5-fluorouracil and total parenteral nutrition solutions.

    Science.gov (United States)

    Hardin, T C; Clibon, U; Page, C P; Cruz, A B

    1982-01-01

    The physicochemical stability and availability of 0.1% 5-fluorouracil solutions in D5W and a typical total parenteral nutrition solution (hypertonic dextrose and crystalline amino acids) were studied in both glass and Viaflex delivery systems. Serial samples collected over a 48-hour period were assayed for 5-fluorouracil concentration using a high performance liquid chromatographic technique. Changes in the pH as well as precipitate formation were also investigated. There was no reduction in the amount of 5-fluorouracil at 48 hours in either the glass or plastic system, regardless of whether the drug was added to D5W or to the total parenteral nutrition solution. No pH changes or precipitates were observed. These findings indicate that 5-fluorouracil is compatible with and available from total parenteral solutions of hypertonic dextrose and amino acid in both plastic and glass containers. Use of such a system would allow for (1) a reduction in vascular access in patients receiving both treatments and (2) continued administration of nutritional support without the requirement for additional fluid volume.

  17. Intensive medicine - Guidelines on Parenteral Nutrition, Chapter 14.

    Science.gov (United States)

    Kreymann, G; Adolph, M; Druml, W; Jauch, K W

    2009-11-18

    In intensive care patients parenteral nutrition (PN) should not be carried out when adequate oral or enteral nutrition is possible. Critically ill patients without symptoms of malnutrition, who probably cannot be adequately nourished enterally for a period of <5 days, do not require full PN but should be given at least a basal supply of glucose. Critically ill patients should be nourished parenterally from the beginning of intensive care if they are unlikely to be adequately nourished orally or enterally even after 5-7 days. Critically ill and malnourished patients should, in addition to a possible partial enteral nutrition, be nourished parenterally. Energy supply should not be constant, but should be adapted to the stage, the disease has reached. Hyperalimentation should be avoided at an acute stage of disease in any case. Critically ill patients should be given, as PN, a mixture consisting of amino acids (between 0.8 and 1.5 g/kg/day), carbohydrates (around 60% of the non-protein energy) and fat (around 40% of the non-protein energy) as well as electrolytes and micronutrients.

  18. Surgery and transplantation – Guidelines on Parenteral Nutrition, Chapter 18

    Directory of Open Access Journals (Sweden)

    Holland-Cunz, S.

    2009-11-01

    Full Text Available In surgery, indications for artificial nutrition comprise prevention and treatment of catabolism and malnutrition. Thus in general, food intake should not be interrupted postoperatively and the re-establishing of oral (e.g. after anastomosis of the colon and rectum, kidney transplantation or enteral food intake (e.g. after an anastomosis in the upper gastrointestinal tract, liver transplantation is recommended within 24 h post surgery. To avoid increased mortality an indication for an immediate postoperatively artificial nutrition (enteral or parenteral nutrition (PN also exists in patients with no signs of malnutrition, but who will not receive oral food intake for more than 7 days perioperatively or whose oral food intake does not meet their needs (e.g. less than 60–80% for more than 14 days. In cases of absolute contraindication for enteral nutrition, there is an indication for total PN (TPN such as in chronic intestinal obstruction with a relevant passage obstruction e.g. a peritoneal carcinoma. If energy and nutrient requirements cannot be met by oral and enteral intake alone, a combination of enteral and parenteral nutrition is indicated. Delaying surgery for a systematic nutrition therapy (enteral and parenteral is only indicated if severe malnutrition is present. Preoperative nutrition therapy should preferably be conducted prior to hospital admission to lower the risk of nosocomial infections. The recommendations of early postoperative re-establishing oral feeding, generally apply also to paediatric patients. Standardised operative procedures should be established in order to guarantee an effective nutrition therapy.

  19. Intensive medicine – Guidelines on Parenteral Nutrition, Chapter 14

    Directory of Open Access Journals (Sweden)

    Kreymann, G.

    2009-11-01

    Full Text Available In intensive care patients parenteral nutrition (PN should not be carried out when adequate oral or enteral nutrition is possible. Critically ill patients without symptoms of malnutrition, who probably cannot be adequately nourished enterally for a period of <5 days, do not require full PN but should be given at least a basal supply of glucose. Critically ill patients should be nourished parenterally from the beginning of intensive care if they are unlikely to be adequately nourished orally or enterally even after 5–7 days. Critically ill and malnourished patients should, in addition to a possible partial enteral nutrition, be nourished parenterally. Energy supply should not be constant, but should be adapted to the stage, the disease has reached. Hyperalimentation should be avoided at an acute stage of disease in any case. Critically ill patients should be given, as PN, a mixture consisting of amino acids (between 0.8 and 1.5 g/kg/day, carbohydrates (around 60% of the non-protein energy and fat (around 40% of the non-protein energy as well as electrolytes and micronutrients.

  20. [Staff accreditation in parenteral nutrition production in hospital pharmacy].

    Science.gov (United States)

    Vrignaud, S; Le Pêcheur, V; Jouan, G; Valy, S; Clerc, M-A

    2016-09-01

    This work aims to provide staff accreditation methodology to harmonize and secure practices for parenteral nutrition bags preparation. The methodology used in the present study is inspired from project management and quality approach. Existing training supports were used to produce accreditation procedure and evaluation supports. We first defined abilities levels, from level 1, corresponding to accredited learning agent to level 3, corresponding to expert accredited agent. Elements assessed for accreditation are: clothing assessment either by practices audit or by microbiologic test, test bags preparation and handling assessment, bag production to assess aseptic filling for both manual or automatized method, practices audit, number of days of production, and non-conformity following. At Angers Hospital, in 2014, production staff is composed of 12 agents. Staff accreditation reveals that 2 agents achieve level 3, 8 agents achieve level 2 and 2 agents are level 1. We noted that non-conformity decreased as accreditation took place from 81 in 2009 to 0 in 2014. To date, there is no incident due to parenteral bag produced by Angers hospital for neonatal resuscitation children. Such a consistent study is essential to insure a secured nutrition parenteral production. This also provides a satisfying quality care for patients. Copyright © 2016 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

  1. Iron Deficiency in Long-Term Parenteral Nutrition Therapy.

    Science.gov (United States)

    Hwa, Yi L; Rashtak, Shahrooz; Kelly, Darlene G; Murray, Joseph A

    2016-08-01

    Iron is not routinely added to parenteral nutrition (PN) formulations in the United States because of the risk of anaphylaxis and concerns about incompatibilities. Studies have shown that iron dextran in non-lipid-containing PN solutions is safe. Data are limited on iron status, prevalence of iron deficiency anemia (IDA), and efficacy of intravenous iron infusion in long-term home PN (HPN). We aimed to determine the incidence of IDA and to examine the effectiveness of parenteral iron replacement in patients receiving HPN. Medical records of patients receiving HPN at the Mayo Clinic from 1977 to 2010 were reviewed. Diagnoses, time to IDA development, and hemoglobin, ferritin, and mean corpuscular volume (MCV) values were extracted. Response of iron indices to intravenous iron replacement was investigated. Of 185 patients (122 women), 60 (32.4%) were iron deficient. Five patients were iron deficient, and 18 had unknown iron status before HPN. Of 93 patients who had sufficient iron storage, 37 had IDA development after a mean of 27.2 months (range, 2-149 months) of therapy. Iron was replaced by adding maintenance iron dextran to PN or by therapeutic iron infusion. Patients with both replacement methods had significant improvement in iron status. With intravenous iron replacement, mean ferritin increased from 10.9 to 107.6 mcg/L (P Parenteral and Enteral Nutrition.

  2. Tratamento da endometrite puerperal com antibioticoterapia parenteral exclusiva Treatment of puerperal endometritis using a regimen with exclusive parenteral antibiotics

    Directory of Open Access Journals (Sweden)

    Geraldo Duarte

    2005-08-01

    Full Text Available OBJETIVO: analisar a efetividade e segurança da antibioticoterapia parenteral hospitalar exclusiva para tratamento da endometrite puerperal, em população de baixo nível socioeconômico. MÉTODOS: estudo clínico prospectivo, que avaliou 21 puérperas com diagnóstico de endometrite puerperal, cujas gestações foram resolvidas em hospital universitário por cesárea (52,4% ou parto normal (47,6. A amostra caracterizou-se por baixo nível socioeconômico e de escolaridade. Foram submetidas ao regime de antibioticoterapia parenteral exclusiva, apenas durante o período de internação (grupo ATP-EX. Os resultados foram comparados com aqueles obtidos de série histórica do mesmo serviço (20 casos submetidas a antibioticoterapia parenteral hospitalar, complementada por terapia via oral ambulatorial (grupo ATP+VO. As pacientes foram avaliadas clinicamente em retornos periódicos visando identificar casos de recidivas e complicações infecciosas. RESULTADOS: uma paciente do grupo ATP+VO necessitou de reinternação no 6º dia após a alta por recrudescência da endometrite. Não foi observada nenhuma complicação entre as pacientes do grupo ATP-EX. CONCLUSÃO: para o tratamento de endometrite puerperal, não foi observado benefício adicional com a adição da antibioticoterapia oral complementar após a alta. Os resultados com o uso da antibioticoterapia parenteral exclusiva durante a internação indicam que esse esquema pode ser utilizado com segurança em população de baixo nível socioeconômico.PURPOSE: to analyze the effectiveness and safety of exclusive hospital parenteral antibiotic therapy to treat puerperal endometritis in a population of low socioeconomic level. METHODS: a prospective clinical trial evaluated 21 puerperae with a diagnosis of postpartum endometritis, whose deliveries occurred at a university hospital by cesarean section (52.4% or normal delivery (47.6%. The sample was characterized by low socioeconomic and

  3. Peripheral parenteral nutrition: an option for patients with an indication for short-term parenteral nutrition La nutrición parenteral periférica, alternativa para los pacientes con indicación de nutrición parenteral durante poco tiempo

    OpenAIRE

    M. I. T. D. Correia; J. Guimarâes; L. Cirino de Mattos; K. C. Araújo Gurgel; E. B. Cabral

    2004-01-01

    Objective: The aim of this study was to examine and describe our experience with the use of peripheral parenteral nutrition (PPN). Methods: Patients with an indication for parenteral nutrition for less than 15 days received it via a peripheral vein via a short, 20 or 22 gauge French polyurethane catheter. Parenteral nutrition had a final osmolality of 993 mOsm/l and was administered by infusion pump. The nutritional status of patients was assessed by the Subjective Global Assessment (SGA) tec...

  4. Timing of the initiation of parenteral nutrition in critically ill children.

    Science.gov (United States)

    Jimenez, Lissette; Mehta, Nilesh M; Duggan, Christopher P

    2017-05-01

    To review the current literature evaluating clinical outcomes of early and delayed parenteral nutrition initiation among critically ill children. Nutritional management remains an important aspect of care among the critically ill, with enteral nutrition generally preferred. However, inability to advance enteral feeds to caloric goals and contraindications to enteral nutrition often leads to reliance on parenteral nutrition. The timing of parenteral nutrition initiation is varied among critically ill children, and derives from an assessment of nutritional status, energy requirements, and physiologic differences between adults and children, including higher nutrient needs and lower body reserves. A recent randomized control study among critically ill children suggests improved clinical outcomes with avoiding initiation of parenteral nutrition on day 1 of admission to the pediatric ICU. Although there is no consensus on the optimal timing of parenteral nutrition initiation among critically ill children, recent literature does not support the immediate initiation of parenteral nutrition on pediatric ICU admission. A common theme in the reviewed literature highlights the importance of accurate assessment of nutritional status and energy expenditure in deciding when to initiate parenteral nutrition. As with all medical interventions, the initiation of parenteral nutrition should be considered in light of the known benefits of judiciously provided nutritional support with the known risks of artificial, parenteral feeding.

  5. GEOPOLÍTICA Y MEDIO AMBIENTE: UNA MIRADA A LA PROBLEMÁTICA DE LOS DESPLAZADOS AMBIENTALES

    Directory of Open Access Journals (Sweden)

    William Rodrigo Avendaño Castro

    2014-01-01

    Full Text Available Este artículo pretende brindar una noción de la condición de desplazado desde el punto de vista medio-ambiental, involucrando factores antropogénicos que ocasionan daños y perjuicios. Para tal fin, se realizó una revisión conceptual que abarca al desplazado ambiental como un problema global, destacando el régimen jurídico internacional que lo integra, y se acentúan como base los derechos humanos internacionales con el fin de entender el marco de la geopolítica ambiental en los aspectos económicos, culturales y ambientales como resultado de esta situación. Con esto, es comprensible que el deterioro ambiental es una de las principales causas del desplazamiento de las poblaciones que procuran asegurar su subsistencia, por ende, la ampliación del régimen jurídico podría garantizar la eficacia, en cuanto a la cooperación internacional se refiere, para acceder a medidas de acción ante los desastres de todo tipo, y se extendería el marco de la geopolítica ambiental en beneficio de las poblaciones desplazadas.

  6. Prevalencia de insomnio y condicionantes ambientales en mayores de 65 años en atención primaria

    Directory of Open Access Journals (Sweden)

    Clara Pardo Crego

    Full Text Available RESUMEN Objetivo: Describir la prevalencia de insomnio y los condicionantes ambientales que se presentan como factores de riesgo en su aparición en los pacientes de edad igual o superior a 65 años adscritos a dos consultas de enfermería de los centros de salud Ciudad Jardín y Los Ángeles de la Comunidad de Madrid. Método: Estudio descriptivo observacional transversal. Se consideró una proporción esperada de ancianos con insomnio del 25%, un intervalo de confianza (IC del 95% y una precisión de ±7%, resultando un tamaño muestral aleatorizado de 168 pacientes. Resultados: Prevalencia de insomnio del 46%, destacando entre ellos el de mantenimiento. Predominio en el sexo femenino, la diabetes, el consumo de fármacos antihipertensivos y la somnolencia diurna. Conclusión: Resulta recomendable el incremento de las actividades de educación para la salud en relación con este problema y la promoción de cursos para la actualización de los conocimientos de los profesionales para facilitar la correcta detección de los casos.

  7. Suministro de alimentos e indicadores ambientales en el Magreb Central

    Directory of Open Access Journals (Sweden)

    José Soler

    2013-01-01

    Full Text Available El suministro de alimentos básicos en Argelia, Marruecos y Túnez se basa en una gran proporción en las importaciones desde el exterior, que presentan una balanza comercial agrícola negativa y un flujo de biomasa, energía, proteína y agua virtual hacia el interior del metabolismo de su economía. Aparece también una dualidad entre los sistemas cerealísticos extensivos para consumo interno y los hortofrutícolas intensivos para la exportación. El rendimiento es el factor agronómico que explica la producción de los cereales, aunque la superficie dedicada a su cultivo puede ser también limitante. El uso de insumos y maquinaria es bajo en el Magreb Central, propio de agriculturas con un bajo índice de tecnificación que limitaría el rendimiento, aunque esto se compensa en parte con una elevada productividad de la mano de obra agrícola.

  8. Calidad de vida y necesidades percibidas en niños con Parálisis Cerebral: Análisis de los factores ambientales como prevención de la dependencia y promoción de la autonomía personal

    OpenAIRE

    Badia Corbella, Marta; Arias Martínez, Benito; Verdugo Alonso, Miguel Ángel; Gómez, María; González, Francisca

    2012-01-01

    Con el desarrollo de este proyecto se ha llevando a cabo un análisis del efecto del ambiente y de la calidad de vida de los niños y adolescentes con Parálisis Cerebral (PC) que viven en Castilla y León. Se han investigado, en concreto, dos aspectos de fundamental importancia para planificar los servicios de gestión y apoyo a los niños con discapacidad y sus familias: (1) identificar cuáles son los factores del ambiente físico, social y actitudinal que, si fueran mejorados, influirían positiva...

  9. Efectos de las Políticas Medio Ambientales en el Comercio Internacional

    OpenAIRE

    Gómez Llorente, Elena

    2014-01-01

    El estudio comienza con una explicación de las diferentes teorías sobre el comercio internacional, las cuales han sido ideadas a lo largo de la historia por los diferentes economistas. También se recogen las políticas medio ambientales llevadas a cabo por los gobiernos para proteger al medio ambiente de la contaminación. A continuación, se abordan las consecuencias de las emisiones de gases contaminantes y se procede a la realización de un análisis económico del medio ambiente y el cambio cli...

  10. Evaluacion de la deforestacion y sus impactos ambientales: provincia de Padre Abad

    OpenAIRE

    Meza Arquiñigo, Carlos; Diaz Encinas, Alida Isidora

    2014-01-01

    El estudio está orientado a evaluar los problemas de la deforestación, mediante la aplicación del Sistema de Información Geográfica (SIG), que viene impactando en el medio ambiente, con el propósito de mostrar las áreas críticas para un mejor ordenamiento espacial y manejo de los recursos; en tal sentido, nos trazamos los siguientes objetivos: estudiar y analizar la deforestacion y el cambio en el medio con la finalidad de interpretar los impactos ambientales que está ocasionando en la provin...

  11. Problemática de los pasivos ambientales mineros en colombia

    OpenAIRE

    ARANGO ARAMBURO, MARCELA; OLAYA, YRIS

    2012-01-01

    Los pasivos ambientales mineros (PAM) se refieren a "un área donde existe la necesidad de restauración, mitigación o compensación por un daño ambiental o impacto no gestionado, producido por actividades mineras inactivas o abandonadas que pone en riesgo la salud, calidad de vida o bienes públicos o privados" . En Colombia no se han reglamentado los PAM, pero dada la antigüedad y la prevalencia de la informalidad en la explotación minera, el interés en definir, reglamentar y gestionar estas ob...

  12. Cuestiones Ambientales y Seguridad Alimentaria en el Cantón Guano, Ecuador

    OpenAIRE

    Andrade, Claudia M; Ayaviri, Víctor D

    2017-01-01

    La presente investigación tiene como objetivo estudiar las cuestiones ambientales que afectan la producción del cultivo de papa (solanum tuberosum) y su relación con la seguridad alimentaria del cantón Guano, Ecuador. Para ello, se aplicó una encuesta dirigida a la población rural para construir un modelo de regresión lineal simple, que se complementa con observación de campo y entrevistas. Los principales hallazgos son destrucción de páramos, incremento de plagas y enfermedades en los cultiv...

  13. LAS MEDIDAS PREVENTIVAS AMBIENTALES, UNA APROXIMACIÓN DESDE EL DERECHO ADMINISTRATIVO.

    Directory of Open Access Journals (Sweden)

    Iván Andrés Páez Páez

    2013-05-01

    Full Text Available Las medidas preventivas previstas en el régimen sancionatorio ambiental sonuna especie de las medidas cautelares consagradas en el ordenamiento jurídicocolombiano, aunque con algunas particularidades propias de su ámbito deaplicación, que es el derecho ambiental. El artículo realiza una aproximaciónrespecto al contenido, alcance, antecedentes y justificación de las medidaspreventivas ambientales desde la óptica del derecho administrativo y comomanifestación de una de las funciones del ejecutivo, cual es el mantenimientodel orden público.

  14. Evolución en la reglamentación de las licencias ambientales en Colombia

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    Carlos A. Zárate Yepes

    2016-07-01

    Full Text Available El presente artículo, pretende evidenciar los cambios que han sido efectuados sobre la legislación colombiana referida a la reglamentación de las licencias ambientales, mediante la realización de una análisis crítico y comparativo de los aspectos tanto positivos como negativos en cada una de las reformas que se han desarrollado desde la aparición del Código de recursos naturales renovables y del Medio Ambiente-Decreto 2811 de 1974, hasta el decreto 2041 de 2014.

  15. Sistemas de vigilancia de riesgos ambientales para la salud. Sistemas de toxicovigilancia

    Directory of Open Access Journals (Sweden)

    Ana Ferrer Dufol

    2004-12-01

    Full Text Available Se presenta el estudio de la Sección de Toxicología Clínica, sobre vigilancia epidemiológica en los Servicios de Urgencias, que tienen como causa intoxicaciones por productos químicos en el periodo de 1999-2003 y dentro del convenio de Asociación Española de Toxicología (AETOX con el Ministerio de Sanidad y Consumo; trabajo presentado en el Congreso Nacional de Medio Ambiente (CONAMA en el Grupo de trabajo “Sistemas de Vigilancia de Riesgos Ambientales para la Salud”.

  16. La gestión de riesgos ambientales en situaciones de incertidumbre científica

    OpenAIRE

    Morales Muñoz, Sergio

    2013-01-01

    El Derecho Medioambiental debe inexcusablemente hacer frente a situaciones de incertidumbre científica en lo que versa sobre la gestión de riesgos ambientales. Para ello es preciso contar con unas herramientas que faciliten la toma decisión sobre los mismos y acerquen a las Administraciones Públicas a la decisión más acertada sobre un riesgo concreto, dado por otro lado el inexcusable deber de decidir que ostentan. Por ello han surgido técnicas tales como la Licencia Ambiental, la Autorizació...

  17. Las cumbres ambientales internacionales y la educación ambiental

    OpenAIRE

    María Luisa Eschenhagen

    2007-01-01

    Las grandes cumbres ambientales son referencias importantes, tanto para la generación de políticas nacionales específicas como para lineamientos teóricos como p.ej., en la educación ambiental. Pero no siempre se encuentran análisis minuciosos sobre los contenidos y los contextos teóricos e históricos de las cumbres. El presente artículo pretende realizar una aproximación a este reto, especialmente para poder identificar mejor el surgimiento y los intereses que giran alrededor de la educación ...

  18. Conjugated hyperbilirubinemia in infancy associated with parenteral alimentation.

    Science.gov (United States)

    Bernstein, J; Chang, C H; Brough, A J; Heidelberger, K P

    1977-03-01

    Liver biopsy was performed to exclude anatomic obstruction of the biliary tract in five prematurely born infants who had developed conjugated hyperbilirubinemia during intravenous alimentation with a protein hydrolysate. Each was being treated after having undergone a segmental intestinal resection for necrotizing enterocolitis. Bacterial and viral infections, metabolic disorders, and isoimmune hemolytic disease were excluded as possible causes of jaundice. Light microscopic and ultrastructural analysis disclosed cholestasis and hepatocellular injury without significant inflammatory reaction. Jaundice abated following permanent discontinuation of parenteral alimentation. The jaundice and cholestasis are interpreted to be hepatotoxic effects because of (1) their temporal relationship to the treatment and (2) the presence of hepatocellular damage.

  19. Home Parenteral Nutrition in Adult Patients with Chronic Intestinal Failure

    DEFF Research Database (Denmark)

    Brandt, Christopher Filtenborg; Hvistendahl, Mark; Naimi, Rahim M.

    2017-01-01

    in treating IF with home parenteral nutrition (HPN), this study documents the HPN evolution and describes the demographics and outcome in one of the world's largest single-center cohorts. Methods: We included patients with IF discharged with HPN from 1970-2010. Data were extracted according to European...... Society for Clinical Nutrition and Metabolism classifications from the Copenhagen IF database. Results: Over the decades, we observed an exponential increase in the number of HPN patients. The 508 patients with IF collectively received HPN for 1751 years. While receiving HPN, 211 patients with IF (42...

  20. Choline Alleviates Parenteral Nutrition-Associated Duodenal Motility Disorder in Infant Rats.

    Science.gov (United States)

    Zhu, Jie; Wu, Yang; Guo, Yonggao; Tang, Qingya; Lu, Ting; Cai, Wei; Huang, Haiyan

    2016-09-01

    Parenteral nutrition (PN) has been found to influence duodenal motility in animals. Choline is an essential nutrient, and its deficiency is related to PN-associated organ diseases. Therefore, this study was aimed to investigate the role of choline supplementation in an infant rat model of PN-associated duodenal motility disorder. Three-week-old Sprague-Dawley male rats were fed chow and water (controls), PN solution (PN), or PN plus intravenous choline (600 mg/kg) (PN + choline). Rats underwent jugular vein cannulation for infusion of PN solution or 0.9% saline (controls) for 7 days. Duodenal oxidative stress status, concentrations of plasma choline, phosphocholine, and betaine and serum tumor necrosis factor (TNF)-α were assayed. The messenger RNA (mRNA) and protein expression of c-Kit proto-oncogene protein (c-Kit) and membrane-bound stem cell factor (mSCF) together with the electrophysiological features of slow waves in the duodenum were also evaluated. Rats on PN showed increased reactive oxygen species; decreased total antioxidant capacity in the duodenum; reduced plasma choline, phosphocholine, and betaine; and enhanced serum TNF-α concentrations, which were reversed by choline intervention. In addition, PN reduced mRNA and protein expression of mSCF and c-Kit, which were inversed under choline administration. Moreover, choline attenuated depolarized resting membrane potential and declined the frequency and amplitude of slow waves in duodenal smooth muscles of infant rats induced by PN, respectively. The addition of choline to PN may alleviate the progression of duodenal motor disorder through protecting smooth muscle cells from injury, promoting mSCF/c-Kit signaling, and attenuating impairment of interstitial cells of Cajal in the duodenum during PN feeding. © 2015 American Society for Parenteral and Enteral Nutrition.

  1. Preventing errors in administration of parenteral drugs: the results of a four-year national patient safety program.

    NARCIS (Netherlands)

    Blok, C. de; Schilp, J.; Wagner, C.

    2013-01-01

    Objectives: To evaluate the implementation of a four-year national patient safety program concerning the parenteral drug administration process in the Netherlands. Methods: Structuring the preparation and administration process of parenteral drugs reduces the number of medication errors. A

  2. Los impactos ambientales y medidas de remediación en las cuencas auríferas de caychive y huaypetue madre de dios

    OpenAIRE

    Gutierrez Orozco, Niverción Hugo; Gutierrez Orozco, Niverción Hugo

    2002-01-01

    Las microcuencas auríferas de los ríos Caychive y Huaypetue - Madre de Dios, constituyen una zona donde la minería aurífera aluvial, a partir de la última década, se ha desarrollado intensa y desordenadamente a nivel de la pequeña minería, sin el adecuado uso de técnicas mineras que conduzcan a preservar el medio ambiente. Las operaciones de explotación y concentración de gravas auríferas han dado lugar a la degradación y contaminación de los principales factores ambientales, bajo la forma...

  3. Problemas ambientales

    Directory of Open Access Journals (Sweden)

    Fernando Ortiz Crespo

    2015-01-01

    Full Text Available Todos somos culpables y causantes del efecto invernadero, el aumento del gas carbónico en la atmósfera, el calentamiento del clima, los violentos cambios en la capa de ozono, la destrucción de la amazonia incluida sus etnias y la extinción de centenares de especies de todo tipo.Todas en espera de soluciones. Aquí radica el rol de los comunicadores cuya responsabilidad radica en crear conciencia de los daños que estamos ocasionando todos y el deber que se impone de poner soluciones a tiempo y apostar al desarrollo de nuestros pueblos

  4. Early optimal parenteral nutrition and metabolic acidosis in very preterm infants.

    Directory of Open Access Journals (Sweden)

    Francesco Bonsante

    Full Text Available It is currently recognized that an optimized nutritional approach, consisting of an early and substantial supply of protein and energy by parenteral route, may be beneficial for very low birth weight infants and recent guidelines endorse this strategy. However, the impact of the enhanced parenteral nutrition (PN on acid-basic balance has never been investigated. The aim of the present study is to assess the effect of nutrient intake on acid-base homeostasis in a large population of preterm infants on PN.This observational study described the acid-base profile of very preterm infants (≤29 week's gestation receiving PN during the first week of life. For this purpose three different cohorts of infants who received increasing (group 1 to group 3 nutritional intakes were considered. Nutrition data were recorded daily and correlated to acid-base data (pH, base excess, and lactate. The outcome measure to assess metabolic acidosis was the base excess (BE.161 infants were included. 1127 daily nutritional records and 795 blood gas data were analyzed. The three groups were different with regard to nutritional intravenous intakes. Group 3 in particular had a higher mean intake of both amino acids (3.3 ± 0.8 g/kg/d and lipids (2.8 ± 1.4 g/kg/d during the first week of life. Metabolic acidosis was more severe in the group with the highest parenteral intake of amino acids and lipids: mean BE = -8.7 ± 3.4 (group 3; -6.4 ± 3.4 (group 2; -5.1 ± 3.0 (group 1]. At the multivariate analysis the significant risk factors for metabolic acidosis were: gestational age, initial base excess, amino acid and lipid intravenous intakes.Acid-base homeostasis was influenced by the nutritional intake. Earlier and higher intravenous amino acid and lipid intakes particularly increased the risk of metabolic acidosis. The nutritional tolerance was different depending on gestational age, and the smaller infants (24-26 week's gestation displayed greater acidotic disequilibrium

  5. Aproximación a las autoridades ambientales regionales en Colombia

    Directory of Open Access Journals (Sweden)

    Hugues Manuel Lacouture Daníes

    2006-01-01

    Full Text Available Colombia es un país conformado política y administrativamente por departamentos, distritos y municipios, sin embargo, las condiciones físicas, de clima, vegetación, recursos naturales, problemáticas ambientales, e incluso la idiosincrasia de sus habitantes, lo convierten en un país de regiones. Por tal motivo, la administración de los recursos naturales renovables, la planificación del crecimiento poblacional, problemas como la diversificación y aumento de los residuos generados, y el manejo, uso y aprovechamiento de los recursos naturales, son fenómenos que exigen autoridades ambientales regionalizadas con autonomía política y administrativa, personería jurídica propia, poderes coercitivos y sancionadores, capacidad de inversión, entre otras características. Este es un trabajo descriptivo, de interpretación y aplicación normativa, y es un aporte para la comprensión de la problemática ambiental regional en Colombia y una herramienta para el conocimiento de las Corporaciones Autónomas Regionales vistas dentro del Sistema Nacional Ambiental (SINA.

  6. Impactos ambientales en la microcuenca del río Parafuso, Amazonas oriental, Brasil

    Directory of Open Access Journals (Sweden)

    Claudia Miranda

    2016-01-01

    Full Text Available La investigación analizó los impactos ambientales causados por las actividades humanas en la microcuenca del río Parafuso en el municipio de Moju en el Estado de Pará (Brasil. Los datos fueron obtenidos mediante herramientas de geoprocesamiento, investigación documental, cuestionarios, entrevistas semi estructuradas, observación directa y la cartografía participativa. Los resultados mostraron que las actividades antropogénicas y de crecimiento de la población sin planificación, combinada con el uso excesivo de los recursos naturales, causan un deterioro grave en los medios físico, biótico y antrópico en la cuenca del río Parafuso. Las fuentes identificadas en esta cuenca son difusas, temporales y han cambiado. La jerarquía del río en el sistema de drenaje es de segundo orden. La mayoría de los impactos ambientales identificados son de de carácter adverso, de gran importancia, de alta magnitude y de duración larga. El medio fisico es el más afectado. En orden de magnitud e importancia, la agricultura es la actividad que hace los principales impactos adversos y duraderos sobre el ambiente físico y el ambiente biológico.

  7. Hidrotórax secundário à nutrição parenteral: relato de caso Hydrothorax due to parenteral nutrition: a case report

    Directory of Open Access Journals (Sweden)

    José Henrique Silvah

    2011-09-01

    Full Text Available Hidrotórax secundário à infusão de nutrição parenteral é uma condição rara, embora se apresente cada vez mais comum. Neste relato de caso, uma paciente com síndrome do intestino curto desenvolveu instabilidade hemodinâmica e insuficiência respiratória algumas horas após o início da infusão de nutrição parenteral. Ressaltamos também as manobras para evitar e tratar tal complicação.Hydrothorax due to parenteral nutrition infusion is a rare, although increasingly common event. This report shows a short bowel patient who developed hemodynamic instability and respiratory failure few hours after parenteral nutrition infusion's start. We also emphasize the maneuvers to avoid and treat such complication.

  8. 76 FR 50741 - 2011 Parenteral Drug Association/Food and Drug Administration Joint Public Conference; Quality...

    Science.gov (United States)

    2011-08-16

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2011-N-0002] 2011 Parenteral Drug Association/Food and Drug Administration Joint Public Conference; Quality and...: Notice of public conference. The Food and Drug Administration (FDA), in cosponsorship with Parenteral...

  9. Parenteral nutrition facilitates activation of coagulation but not of fibrinolysis during human endotoxemia

    NARCIS (Netherlands)

    van der Poll, T.; Levi, M. [=Marcel M.; Braxton, C. C.; Coyle, S. M.; Roth, M.; ten Cate, J. W.; Lowry, S. F.

    1998-01-01

    Venous thrombosis and bacterial infections are common complications of parenteral nutrition. To test the hypothesis that infection facilitates activation of coagulation during parenteral nutrition, healthy subjects were intravenously injected with endotoxin (2 ng/kg) after they had received either 1

  10. Ceramide in lipid emulsions used in parenteral nutrition: an innocent bystander?

    NARCIS (Netherlands)

    Groener, Johanna E.; Serlie, Mireille J.; Poppema, Aldi; Mirzaian, Mina; Aerts, Johannes M.

    2011-01-01

    Parenteral nutrition-associated liver disease is a prevalent and severe complication of long term parenteral nutrition. We present here for the first time data on the presence of ceramide, a bioactive compound involved in a variety of metabolic processes, in different lipid emulsions used in

  11. Antibioticoterapia parenteral en la infección urinaria neonatal Parenteral antibiotic therapy in neonatal urinary infection

    Directory of Open Access Journals (Sweden)

    Manuel Díaz Álvarez

    2006-03-01

    Full Text Available Se realizó un estudio analítico, retrospectivo, en el que se conformaron dos grupos según el régimen de tratamiento antibiótico parenteral (TAP: corto y largo. Éste fue seguido de antibioticoterapia oral, lo cual generó un ciclo de tratamiento parenteral-oral secuencial al menos de 10 días de duración. Se determinó la tasa de curación de la infección del tracto urinario, las reinfecciones en los primeros 3 meses de edad y la presencia de cicatrices renales. El objetivo fue evaluar la efectividad de un régimen de tratamiento antibiótico parenteral de corta duración (3 días en recién nacidos con infección del tracto urinario alta, de evolución inicial favorable. La tasa de curación de la infección con el TAP corto fue de 93,9 % y con el largo de 97,0 % (p = 0,32. En 5 pacientes del grupo de TAP corto ocurrió reinfección dentro de los 3 meses de edad, mientras que sólo ocurrió en 3 de los que llevaron TAP largo (p = 0,49. En los casos estudiados con gammagrafía con DMSA renal, se constató la presencia de cicatrices renales en 3 de 32 (9,4 % del grupo de TAP corto y en 7 de 33 (21,2 % en los pacientes de TAP largo (p = 0,30. Ambos regímenes de TAP tuvieron similar efectividad.

  12. Interdependency of EGF and GLP-2 Signaling in Attenuating Mucosal Atrophy in a Mouse Model of Parenteral Nutrition

    DEFF Research Database (Denmark)

    Feng, Yongjia; Demehri, Farok R; Xiao, Weidong

    2017-01-01

    BACKGROUND & AIMS: Total parenteral nutrition (TPN), a crucial treatment for patients who cannot receive enteral nutrition, is associated with mucosal atrophy, barrier dysfunction, and infectious complications. Glucagon-like peptide-2 (GLP-2) and epidermal growth factor (EGF) improve intestinal...... deprived of enteral nutrition. METHODS: Adult C57BL/6J, IEC-Egfr(knock out (KO)) and IEC-pik3r1(KO) mice receiving TPN or enteral nutrition were treated with EGF or GLP-2 alone or in combination with reciprocal receptor inhibitors, GLP-2(3-33) or gefitinib. Jejunum was collected and mucosal atrophy and IEC...

  13. Recent developments in protein and peptide parenteral delivery approaches

    Science.gov (United States)

    Patel, Ashaben; Cholkar, Kishore; Mitra, Ashim K

    2014-01-01

    Discovery of insulin in the early 1900s initiated the research and development to improve the means of therapeutic protein delivery in patients. In the past decade, great emphasis has been placed on bringing protein and peptide therapeutics to market. Despite tremendous efforts, parenteral delivery still remains the major mode of administration for protein and peptide therapeutics. Other routes such as oral, nasal, pulmonary and buccal are considered more opportunistic rather than routine application. Improving biological half-life, stability and therapeutic efficacy is central to protein and peptide delivery. Several approaches have been tried in the past to improve protein and peptide in vitro/in vivo stability and performance. Approaches may be broadly categorized as chemical modification and colloidal delivery systems. In this review we have discussed various chemical approaches such as PEGylation, hyperglycosylation, mannosylation, and colloidal carriers including microparticles, nanoparticles, liposomes, carbon nanotubes and micelles for improving protein and peptide delivery. Recent developments on in situ thermosensitive gel-based protein and peptide delivery have also been described. This review summarizes recent developments on some currently existing approaches to improve stability, bioavailability and bioactivity of peptide and protein therapeutics following parenteral administration. PMID:24592957

  14. [Role of parenteral cephalosporins for outpatients treatment of infections].

    Science.gov (United States)

    Esposito, S; Mazzei, T; Novelli, A

    2001-12-01

    OPAT (Outpatient Parenteral Antibiotic Therapy) arose in the early 1980s in the USA and later in many other countries from the primary consideration that outpatient treatment is more cost-effective than hospitalisation. Currently, several thousand patients undergo OPAT programmes all over the world and several different bacterial infections are included in the list of treatable diseases, especially those requiring long-term parenteral treatment such as osteomyelitis and soft tissue infections. All injectable antibiotics are suitable for OPAT according to their microbiological spectrum, although clearly some pharmacological properties make one antibiotic more preferable than another. Beta-lactams represent more than half of the antibiotic world market and two-thirds of them are cephalosporins. Such a widespread use of cephalosporins is certainly due to their wide antibacterial spectrum and good tolerability. Among third-generation cephalosporins, covering the majority of micro-organisms responsible for community-acquired infections, ceftriaxone is the only one with an 8-hour half-life, thereby permitting a single daily dose, which represents a great advantage when undertaking an OPAT programme. Analysis of antibiotic consumption used for OPAT therapies, based on data collected from the International OPAT Registry project, with the participation of many countries (USA, Canada, Britain, Argentina, etc.) including Italy, shows that ceftriaxone is the most widely used antibiotic for home therapy, clearly due to the above-mentioned properties.

  15. Femoral venous catheters: a safe alternative for delivering parenteral alimentation.

    Science.gov (United States)

    Friedman, B; Kanter, G; Titus, D

    1994-04-01

    Femoral vein catheterization is an alternative method of obtaining central venous access. Placement of femoral venous catheters (FVCs) is possible in the majority of patients, suitable for most indications, and associated with a low complication rate during insertion. We wished to determine the incidence of infections or other complications resulting when parenteral nutrition was delivered through FVCs. Fifty-two patients were followed from a hospital-wide population including patients in the critical care units. Triple-lumen catheters were placed by using the sterile Seldinger technique, and sites were examined daily for inflammation. Bacteriologic surveillance was accomplished by submitting the catheter tip for semiquantitative cultures. If catheter line sepsis was suspected, blood samples for cultures were drawn through the catheter and peripherally. The rate of occurrence of colonized catheters was 9.6% (five of 52), and catheter sepsis was found in one case (1.9%). Other than inflammation at six (11.5%) of 52 catheter sites, noninfectious complications of FVCs were not found. On the basis of these findings, we consider FVC-delivered parenteral alimentation a safe and effective alternative to other forms of central venous access.

  16. Studies with a safflower oil emulsion in total parenteral nutrition.

    Science.gov (United States)

    Wong, K. H.; Deitel, M.

    1981-01-01

    The prevention of essential fatty acid deficiency and the provision of adequate amounts of energy are two major concerns in total parenteral nutrition. Since earlier preparations of fat emulsion used to supplement the usual regimen of hypertonic glucose and amino acids have widely varying clinical acceptability, a new product, a safflower oil emulsion available in two concentrations (Liposyn), was evaluated. In four clinical trials the emulsion was used as a supplement to total parenteral nutrition. In five surgical patients 500 ml of the 10% emulsion infused every third day prevented or corrected essential fatty acid deficiency; however, in some cases in infusion every other day may be necessary. In 40 patients in severe catabolic states the emulsion provided 30% to 50% of the energy required daily: 10 patients received the 10% emulsion for 14 to 42 days, 9 patients received each emulsion in turn for 7 days, and 21 patient received the 20% emulsion for 14 to 28 days. All the patients survived and tolerated the lipid well; no adverse clinical effects were attributable to the lipid infusions. Transient mild, apparently clinically insignificant abnormalities in the results of one or more liver function tests and eosinophilia were observed in some patients. Thus, the safflower oil emulsion, at both concentrations, was safe and effective as a source of 30% to 50% of the energy required daily by seriously ill patients. PMID:6799182

  17. Hepatology – Guidelines on Parenteral Nutrition, Chapter 16

    Directory of Open Access Journals (Sweden)

    Plauth, M.

    2009-11-01

    Full Text Available Parenteral nutrition (PN is indicated in alcoholic steatohepatitis (ASH and in cirrhotic patients with moderate or severe malnutrition. PN should be started immediately when sufficientl oral or enteral feeding is not possible. ASH and cirrhosis patients who can be sufficiently fed either orally or enterally, but who have to abstain from food over a period of more than 12 hours (including nocturnal fasting should receive basal glucose infusion (2–3 g/kg/d. Total PN is required if such fasting periods last longer than 72 h. PN in patients with higher-grade hepatic encephalopathy (HE; particularly in HE IV° with malfunction of swallowing and cough reflexes, and unprotected airways. Cirrhotic patients or patients after liver transplantation should receive early postoperative PN after surgery if they cannot be sufficiently rally or enterally nourished. No recommendation can be made on donor or organ conditioning by parenteral administration of glutamine and arginine, aiming at minimising ischemia/reperfusion damage. In acute liver failure artificial nutrition should be considered irrespective of the nutritional state and should be commenced when oral nutrition cannot be restarted within 5 to 7 days. Whenever feasible, enteral nutrition should be administered via a nasoduodenal feeding tube.

  18. Nitrogen sparing by 2-ketoisocaproate in parenterally fed rats

    International Nuclear Information System (INIS)

    Yagi, M.; Matthews, D.E.; Walser, M.

    1990-01-01

    In rats receiving total parenteral nutrition with or without sodium 2-ketoisocaproate (KIC; 2.48 g.kg-1.day-1), L-[1- 13 C]leucine and [1- 14 C]KIC were constantly infused for 6 h. CO 2 production, 14 CO 2 production, 13 CO 2 enrichment, urinary urea nitrogen (N) plus ammonia N and total urinary N were measured. Whole body protein synthesis (S) was calculated in non-KIC-infused rats and also in unfed rats infused with [1- 14 C]leucine from fractional oxidation of labeled leucine (1-F), where F is fractional utilization for protein synthesis, and urea N plus ammonia N excretion (C) as S = C x F/(1-F). Addition of KIC caused a significant reduction in N excretion and a significant improvement in N balance. Fractional oxidation of labeled KIC increased, whereas fractional utilization of labeled KIC for protein synthesis decreased, but the extent of incorporation of infused KIC into newly synthesized protein (as leucine) amounted to at least 40% of the total rate of leucine incorporation into newly synthesized whole body protein. We conclude that addition of KIC spares N in parenterally fed rats and becomes a major source of leucine for protein synthesis

  19. Validation of cold chain during distribution of parenteral nutrition

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    Federico Tuan

    2015-09-01

    Full Text Available Objective: this study aims to demonstrate the suitability of the process used to condition the extemporaneous mixtures of parenteral nutrition for distribution, considering the objective of preserving the cold chain during transport until it reaches the patient, necessary to ensure stability, effectiveness and safety of these mixtures. Method: concurrent validation, design and implementation of a protocol for evaluating the process of packaging and distribution of MNPE developed by a pharmaceutical laboratory. Running tests, according to predefined acceptance criteria. It is performed twice, in summer and on routes that require longer transfer time. Evaluation of conservation of temperature by monitoring the internal temperature values of each type of packaging, recorded by data loggers calibrated equipment. Results: the different tests meet the established criteria. The collected data ensure the maintenance of the cold chain for longer than the transfer time to the most distant points. Conclusions: this study establishes the suitability of the processes to maintaining the cold chain for transfer from the laboratory to the patient pharmacist. Whereas the breaking of cold chain can cause changes of compatibility and stability of parenteral nutrition and failures nutritional support, this study contributes to patient safety, one of the relevant dimensions of quality of care the health.

  20. Impactos recientes de los cambios ambientales en los recursos hídricos superficiales de la cuenca del Duero

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    Morán Tejeda, Enrique

    2012-05-01

    Full Text Available In recent decades, the environmental changes due to human development have put pressure on water resources in the Mediterranean basin, a region where availability of water has been historically limited. In this work we analyze the evolution and variability (1961-2005 of streamflows in one of the largest rivers basin of the Iberian Peninsula, the Duero River basin. Moreover, the factors responsible for such evolution are assessed. Results show a significant and generalized decrease of water resources in the basin, together with changes in the timing of monthly distribution. Climate itself, with quasi-stationary precipitation and increasing temperatures in the long-term, is not enough to explain the decreasing streamflows. Thus, observed land-cover expansion in the headwaters is thought to be increasingly contributing to the hydrological depletion. On the other hand, impoundment of water through dams is increasing in the basin and consequently contributing the hydrological change. Results offer the basis for future projections of water availability in scenarios of water scarcity due to forthcoming climate changeLa disponibilidad de recursos hídricos ha sido históricamente un factor limitante de desarrollo en los países de la cuenca mediterránea. Durante las últimas décadas la presión sobre la disponibilidad se ha acentuado debido a los cambios ambientales observados como resultado del desarrollo industrial. En este trabajo se analizan la evolución y variabilidad recientes (1961-2005 de los recursos hídricos superficiales –el caudal en los ríos– en una de las cuencas hidrográficas de mayor entidad de la Península Ibérica, y los factores ambientales responsables de su evolución. Los resultados del trabajo muestran un descenso notable y generalizado en los caudales en la región, acompañado de un cambio en los regímenes fluviales. La evolución del clima, con unas precipitaciones muy variables pero sin tendencias notables a largo

  1. Algunas consideraciones generales acerca de la etiología del autismo: factores innatos y ambientales

    OpenAIRE

    Abal, Mauricio

    2015-01-01

    El presente trabajo se enmarca en el proyecto de investigación denominado “Las variedades del autismo: Sistematización y Evaluación de la Demanda Asistencial. Segunda Etapa” (2015-2017), acreditado y subsidiado por el Programa de Incentivos a la Investigación, UNLP, Dir. Lic. María Cristina Piro. En líneas generales pretende repasar algunas (y sólo algunas) de las consideraciones más sobresalientes sobre el autismo, las hipótesis etiológicas y sus implicancias a la hora de un abordaje tera...

  2. Evidencia de circulación del virus de la hepatitis A, subgenotipo IA, en muestras ambientales en Antioquia, Colombia

    Directory of Open Access Journals (Sweden)

    Paula Andrea Báez

    2016-08-01

    Conclusión. Este estudio permitió detectar la presencia del HAV en 6,6 % de las muestras de agua de abastecimiento y en 13,3 % de las muestras de agua residual de los municipios en estudio. Se reporta por primera vez la circulación del subgenotipo IA en muestras ambientales en Antioquia.

  3. Diseño de una matriz de análisis para temas ambientales en proyectos de ciencias naturales

    Directory of Open Access Journals (Sweden)

    Ana Ilse Benavides Lahnstein

    2015-12-01

    Full Text Available RESUMEN. En ésta investigación estudiamos los contenidos ambientales de dos proyectos de ciencias naturales del libro de texto para el sexto año de educación primaria en México. El trabajo por proyectos, el cual fue formalmente introducido al sistema de educación básica en el último proceso de reforma, es presentado como una estrategia para consolidar el conocimiento de los estudiantes para alcanzar los aprendizajes esperados. Nuestro estudio se guío por dos preguntas principales: ¿Satisfacen los contenidos ambientales de los proyectos seleccionados los aprendizajes esperados del currículo de ciencias naturales para sexto grado? ¿Son estos contenidos ambientales pertinentes con las problemáticas actuales de la educación ambiental para la sustentabilidad? Para contestarlas realizamos una investigación documental en documentos oficiales y diseñamos un instrumento para la codificación y el análisis del contenido de los proyectos. Los resultados se discutieron en tres unidades de análisis de acuerdo a los tres niveles de complejidad planteados en la matriz. Identificamos en los proyectos contenidos ambientales básicos con referencia a los aprendizajes esperados. Consideramos que el éxito potencial del contenido ambiental depende de las competencias de los docentes y de los estudiantes para ponerlos en práctica efectivamente.

  4. Parenteral nutrition in the ICU setting: need for a shift in utilization.

    Science.gov (United States)

    Oshima, Taku; Hiesmayr, Michael; Pichard, Claude

    2016-03-01

    The difficulties to feed the patients adequately with enteral nutrition alone have drawn the attention of the clinicians toward the use of parenteral nutrition, although recommendations by the recent guidelines are conflicting. This review focuses on the intrinsic role of parenteral nutrition, its new indication, and modalities of use for the critically ill patients. A recent trial demonstrated that selecting either parenteral nutrition or enteral nutrition for early nutrition has no impact on clinical outcomes. However, it must be acknowledged that the risk of relative overfeeding is greater when using parenteral nutrition and the risk of underfeeding is greater when using enteral nutrition because of gastrointestinal intolerance. Both overfeeding and underfeeding in the critically ill patients are associated with deleterious outcomes. Thus, early and adequate feeding according to the specific energy needs can be recommended as the optimal feeding strategy. Parenteral nutrition can be used to substitute or supplement enteral nutrition, if adequately prescribed. Testing for enteral nutrition tolerance during 2-3 days after ICU admission provides the perfect timing to start parenteral nutrition, if needed. In case of absolute contraindication for enteral nutrition, consider starting parenteral nutrition carefully to avoid overfeeding.

  5. Parenteral nutrition in patients with inborn errors of metabolism - a therapeutic problem.

    Science.gov (United States)

    Kaluzny, L; Szczepanik, M; Siwinska-Mrozek, Z; Borkowska-Klos, M; Cichy, W; Walkowiak, J

    2014-06-01

    Parenteral nutrition is now a standard part of supportive treatment in pediatric departments. We describe four cases in which parenteral nutrition was extremely difficult due to coincidence with inborn errors of metabolism. The first two cases was fatty acid beta-oxidation disorders associated with necrotizing enterocolitis and congenital heart disease. Thus, limitations of intravenous lipid intake made it difficult to maintain a good nutritional status. The third case was phenylketonuria associated with a facial region tumour (rhabdomyosarcoma), in which parenteral nutrition was complicated because of a high phenylalanine content in the amino acid formulas for parenteral nutrition. The fourth patient was a child with late-diagnosed tyrosinemia type 1, complicated with encephalopathy - during intensive care treatment the patient needed nutritional support, including parenteral nutrition - we observed amino acid formula problems similar to those in the phenylketonuria patient. Parenteral nutrition in children with inborn errors of metabolism is a rare, but very important therapeutic problem. Total parenteral nutrition formulas are not prepared for this group of diseases.

  6. Environmental impact of heavy metals. Vanadium; Impatto ambientale da metalli pesanti. Il vanadio (V)

    Energy Technology Data Exchange (ETDEWEB)

    Bressa, G. (comp.)

    2001-09-01

    In this paper is presented the environmental impact of vanadium production, environmental distribution biological accumulation are reported. [Italian] Il vanadio (V) e' un metallo scarsamente presente in natura, classificandosi al 21mo posto dopo l'arsenico per abbondanza nella crosta terrestre. Tuttavia e' rinvenibile nell'atmosfera di aree industrializzate dove si utilizzano il carbone fossile e l'olio combustibile. Infatti fonti principali di inquinamento ambientale sono costituiti dai greggi petroliferi che contengono in soluzione una serie di metalli tra cui il vanadio. Per inalazione di polveri contenenti V si hanno generalmente effetti sull'apparato respiratorio con irritazione nasale ed epistassi, bronchiti ed enfisema polmonare, mentre a livello nervoso si manifestano effetti neurotossici sul centro vasomotori e sul controllo nervoso della contrazione cardiaca, con riduzione complessiva della funzionalita' cardica. Recentemente e' stato osservato che il V esercita effetti allergici ed infiammatori.

  7. Las acciones ambientales en el derecho argentino. Amparo ambiental y acción popular

    Directory of Open Access Journals (Sweden)

    María Laura Peluffo

    2007-01-01

    Full Text Available Las acciones ambientales intentan tanto la recomposición del ambiente como el resarcimiento de los daños y perjuicios. Existen distintas acciones a través de las cuales se ha intentado acceder a la justicia a los fines de la tutela del derecho al ambiente sano de acuerdo con las disposiciones del artículo 41 de la Constitución nacional, y ello se ha prestado a diversas interpretaciones. El constituyente argentino previó una acción colectiva frente a un derecho de incidencia colectiva a todos los titulares del mismo, y el legislador, al reglamentar la prescripción constitucional, no legitima a cualquiera que no sea el titular del derecho a ejercer una acción, porque se trataría de una acción popular, y en Argentina no existe la misma.

  8. Las cumbres ambientales internacionales y la educación ambiental

    Directory of Open Access Journals (Sweden)

    María Luisa Eschenhagen

    2007-11-01

    Full Text Available Las grandes cumbres ambientales son referencias importantes, tanto para la generación de políticas nacionales específicas como para lineamientos teóricos como p.ej., en la educación ambiental. Pero no siempre se encuentran análisis minuciosos sobre los contenidos y los contextos teóricos e históricos de las cumbres. El presente artículo pretende realizar una aproximación a este reto, especialmente para poder identificar mejor el surgimiento y los intereses que giran alrededor de la educación ambiental. Es dentro de este contexto que se exponen las diferentes definiciones de la educación ambiental que surgen de esas cumbres.

  9. Variables ambientales que afectan la densidad de diez especies forestales en la Sierra Norte de Oaxaca

    Directory of Open Access Journals (Sweden)

    Patricia Bautista-Santiago

    2018-05-01

    Full Text Available Caracterizar las condiciones ambientales en las que se desarrollan las especies forestales es importante, porque permite conocer parte de su hábitat; información útil para tomar decisiones encaminadas a un aprovechamiento integral de los bosques, que incluya medidas preventivas que contrarresten su degradación o su extinción. El objetivo de este estudio fue identificar las variables ambientales que afectan significativamente la abundancia de 10 especies arbóreas que crecen en los bosques templados de Santiago Comaltepec, al norte de Oaxaca, México. Para ello, se utilizaron tres métodos de análisis: 1 componentes principales, 2 coeficientes de correlación no paramétrica, y 3 modelos lineales generalizados. Se evaluaron un total de 23 variables medioambientales, principalmente, registros de temperaturas mínimas y máximas; precipitaciones en el verano, en invierno y en primavera; así como atributos fisiográficos que incluyeron la pendiente, la exposición y la altitud. Todas mostraron una correlación significativa (p<0.001 con al menos tres especies, varias con coeficientes de correlación superior a 0.90. Se identificaron tres taxa que son más sensibles a las variables de temperatura, en particular, a la temperatura mínima, la superior a 5 °C, y al índice de aridez; otras tres que parecen tener mayor sensibilidad a la cantidad de lluvia registrada en la primavera, en el verano, en el invierno y en las precipitaciones de abril a septiembre.

  10. Prácticas ambientales de las empresas turísticas en valle de Bravo

    Directory of Open Access Journals (Sweden)

    Hernández Peñaloza1 Nadia

    2012-05-01

    Full Text Available El presente artículo analiza las prácticas ambientales de los actores sociales que se relacionan con las empresas turísticas del municipio de Valle de Bravo, Estado de México. Cabe mencionar que dichas prácticas se consideraron desde el punto de vista socio- económico, es decir, no sólo como se asumen en cuanto al manejo de los recursos naturales, sino también desde su entorno social y económico. Por ello, a partir de la propuesta metodológica de la teoría de sistemas complejos, se analizan los efectos producidos en los entornos de este destino turístico, lo que permite visualizar deuna manera holística la situación que prevalece para al cuidado del ambiente con la participación de todos los actores sociales de la localidad. Los resultados encontrados muestran una gran debilidaden la implementación de dichas prácticas, ya que éstas, actualmente, son impuestas por el gobierno municipal y no se asumen como una iniciativa de los propios actores que participan en las empresas turísticas. Por esta razón, las condiciones de deterioro ambiental en Valle de Bravo son cada vez mayores. A partir de los resultados generados por este estudio, se formulan recomendaciones de implementación y mejoramiento de las prácticas ambientales que contribuyen a la conservación y al cuidado del ambiente.

  11. Quality of newborn care: adherence to guidelines for parenteral nutrition in preterm infants in four European countries.

    Science.gov (United States)

    Lapillonne, Alexandre; Carnielli, Virgilio Paolo; Embleton, Nicholas David; Mihatsch, Walter

    2013-09-18

    The level of adherence to guidelines should be explored particularly in preterm infants for whom poor nutrition has major effects on outcomes in later life. The objective was to evaluate compliance to international guidelines for parenteral nutrition (PN) in preterm infants across neonatal intensive care units (NICUs) of four European countries. Clinical practice survey by means of a questionnaire addressing routine PN protocols, awareness and implementation of guidelines. NICUs in the UK, Italy, Germany and France. One senior physician per unit; 199 units which represent 74% of the NICUs of the four countries. Adherence of unit protocol to international guidelines. Factors that influence adherence to guidelines. 80% of the respondents stated that they were aware of some PN clinical practice guidelines. For amino acid infusion (AA), 63% of the respondents aimed to initiate AA on D0, 38% aimed to administer an initial dose ≥1.5 g/kg/day and 91% aimed for a target dose of 3 or 4 g/kg/day, as recommended. For parenteral lipids, 90% of the respondents aimed to initiate parenteral lipids during the first 3 days of life, 39% aimed to use an initial dose ≥1.0 g/kg/day and 76% defined the target dose as 3-4 g/kg/day, as recommended. Significant variations in PN protocols were observed among countries, but the type of hospital or the number of admissions per year had only a marginal impact on the PN protocols. Most respondents indicated that their clinical practice was based on common guidelines. However, the initiation of PN is frequently not compliant with current recommendations, with the main differences being observed during the first days of life. Continuous education focusing on PN practice is needed, and greater efforts are required to disseminate and implement international guidelines.

  12. Improved outcome in neonatal short bowel syndrome using parenteral fish oil in combination with ω-6/9 lipid emulsions.

    Science.gov (United States)

    Angsten, Gertrud; Finkel, Yigael; Lucas, Steven; Kassa, Ann-Marie; Paulsson, Mattias; Lilja, Helene Engstrand

    2012-09-01

    Newborn infants with short bowel syndrome (SBS) represent a high-risk group of developing intestinal failure-associated liver disease (IFALD), which may be fatal. However, infants have a great capacity for intestinal growth and adaptation if IFALD can be prevented or reversed. A major contributing factor to IFALD may be the soybean oil-based intravenous lipid emulsions used since the introduction of parenteral nutrition (PN) 40 years ago. This retrospective study compares the outcome in 20 neonates with SBS treated with parenteral fish oil (Omegaven) in combination with ω-6/9 lipid emulsions (ClinOleic) with the outcome in a historical cohort of 18 patients with SBS who received a soybean oil-based intravenous lipid emulsion (Intralipid). Median gestational age was 26 weeks in the treatment group and 35.5 weeks in the historical group. All patients were started on PN containing Intralipid that was switched to ClinOleic/Omegaven in the treatment group at a median age of 39 gestational weeks. In the treatment group, direct bilirubin levels were reversed in all 14 survivors with cholestasis (direct bilirubin >50 umol/L). Median time to reversal was 2.9 months. Only 2 patients died of liver failure (10%). In the historical cohort, 6 patients (33%) died of liver failure, and only 2 patients showed normalization of bilirubin levels. Parenteral fish oil in combination with ω-6/9 lipid emulsions was associated with improved outcome in premature neonates with SBS. When used instead of traditional soybean-based emulsions, this mixed lipid emulsion may facilitate intestinal adaptation by increasing the IFALD-free period.

  13. DIATOMEAS PERIFÍTICAS EN DIFERENTES TRAMOS DE DOS SISTEMAS LÓTICOS DE ALTA MONTAÑA (PÁRAMO DE SANTURBÁN, NORTE DE SANTANDER, COLOMBIA Y SU RELACIÓN CON LAS VARIABLES AMBIENTALES

    Directory of Open Access Journals (Sweden)

    ANGÉLICA M RAMÍREZ C

    2008-01-01

    Full Text Available En dos sistemas lóticos del páramo de Santurbán, durante lluvia y sequía, se seleccionaron tres tramos de muestreo: nacimiento, zona media y río, evaluando en cada tramo la influencia de las variables ambientales en la estructura del ensamblaje de diatomeas perifíticas. Un nálisis de componentes principales evaluó la variación ambiental y mediante una matriz de correlaciones se estableció la importancia de los factores ambientales en las especies registradas. La conductividad, el potencial redox, el pH y el caudal fueron factores determinantes de la variación ambiental y de las diferencias en la estructura del ensamblaje; el género Eunotia es tolerante a pH ácido, y la polución orgánica favoreció el desarrollo de los géneros Nitzschia y Navícula. Seis especies reportaron una abundancia significativa: Navicula tantula, Achnanthidium minutissimum, Achnanthidium lanceolatum, Gomphonema parvulum, Navicula cryptocephala y Gomphonema lagenula. Los tramos de los ríos presentaron valores altos de caudal y conductividad, que influyeron en la baja diversidad de estas zonas mientras que los valores bajos de caudal y la ausencia de condiciones químicas extremas en las zonas medias explicaron la mayor diversidad y la similitud del ensamblaje entre estas zonas. El ensamblaje no registró variación estacional significativa, presentando mayores diferencias entre los tramos que entre períodos de muestreo, indicando que las diatomeas perifíticas fueron afectadas principalmente por diferencias en el hábitat entre los tramos y enfatizando la importancia de las condiciones ambientales en los sistemas acuáticos tropicales de alta montaña sobre la composición y abundancia de diatomeas perifíticas.

  14. Managing an outpatient parenteral antibiotic therapy team: challenges and solutions

    Directory of Open Access Journals (Sweden)

    Halilovic J

    2014-06-01

    Full Text Available Jenana Halilovic,1 Cinda L Christensen,2 Hien H Nguyen31University of the Pacific Thomas J Long School of Pharmacy, Stockton, CA, USA; 2Department of Pharmaceutical Services, University of California, Davis Health System, Sacramento, CA, USA; 3Division of Infectious Diseases, Section of Hospital Medicine, University of California, Davis Health System, Sacramento, CA, USAAbstract: Outpatient parenteral antimicrobial therapy (OPAT programs should strive to deliver safe, cost effective, and high quality care. One of the keys to developing and sustaining a high quality OPAT program is to understand the common challenges or barriers to OPAT delivery. We review the most common challenges to starting and managing an OPAT program and give practical advice on addressing these issues.Keywords: OPAT, quality, safety, program management

  15. Kinetics of phytosterol metabolism in neonates receiving parenteral nutrition.

    Science.gov (United States)

    Nghiem-Rao, T Hang; Tunc, Ilker; Mavis, Alisha M; Cao, Yumei; Polzin, Elizabeth M; Firary, Mary F; Wang, Xujing; Simpson, Pippa M; Patel, Shailendra B

    2015-08-01

    Phytosterols in soybean oil (SO) lipids likely contribute to parenteral nutrition-associated liver disease (PNALD) in infants. No characterization of phytosterol metabolism has been done in infants receiving SO lipids. In a prospective cohort study, 45 neonates (36 SO lipid vs. 9 control) underwent serial blood sample measurements of sitosterol, campesterol, and stigmasterol. Mathematical modeling was used to determine pharmacokinetic parameters of phytosterol metabolism and phytosterol exposure. Compared to controls, SO lipid-exposed infants had significantly higher levels of sitosterol and campesterol (P Phytosterols in SO lipid accumulate rapidly in neonates. Very preterm infants receiving SO lipid have higher sitosterol exposure, and may have poorly developed mechanisms of eliminating phytosterols that may contribute to their vulnerability to PNALD.

  16. Trace Elements in Parenteral Nutrition: Considerations for the Prescribing Clinician.

    Science.gov (United States)

    Jin, Jennifer; Mulesa, Leanne; Carrilero Rouillet, Mariana

    2017-04-28

    Trace elements (TEs) are an essential component of parenteral nutrition (PN). Over the last few decades, there has been increased experience with PN, and with this knowledge more information about the management of trace elements has become available. There is increasing awareness of the effects of deficiencies and toxicities of certain trace elements. Despite this heightened awareness, much is still unknown in terms of trace element monitoring, the accuracy of different assays, and current TE contamination of solutions. The supplementation of TEs is a complex and important part of the PN prescription. Understanding the role of different disease states and the need for reduced or increased doses is essential. Given the heterogeneity of the PN patients, supplementation should be individualized.

  17. Safety of parenteral nutrition in newborns: Results from a nationwide prospective cohort study.

    Science.gov (United States)

    Lapillonne, Alexandre; Berleur, Marie-Pierre; Brasseur, Yvette; Calvez, Sophie

    2018-04-01

    Limited or delayed availability of parenteral nutrition (PN) solutions, as well as difficulties in ordering are often identified as reasons for non-compliance with international guidelines in newborns. This study aims at assessing the modality of use and safety of premixed standardized PN solutions in a nationwide prospective cohort of newborns treated in clinical practice. Two premixed fixed formulations with respective osmolarity of 715 and 790 mOsm/L specifically designed for neonates were made available throughout the country for clinical use from birth onwards. Descriptive data and modality of use were prospectively collected in a case report form, whereas all related and unrelated adverse events were recorded on a separate adverse event form. A total of 14,167 infants were prospectively included and 16,640 parenteral nutrition periods were analyzed. Mean age was 33 weeks of gestation, and mean weight was 2086 g. The majority of infants (81%) started the parenteral nutrition the first day of life or the day after. The route of parenteral nutrition delivery was peripheral in 47% of the parenteral nutrition periods. During the whole study, a total of 72 adverse events occurring in 68 infants were reported. Of these adverse events, 59 (0.37% of the nutrition periods), among which 19 serious adverse events, were reported as related to the parenteral nutrition solutions. The events related to parenteral nutrition solutions were general disorders and administration site conditions (n = 42 including 9 cases of cutaneous necrosis), and nutrition and metabolism disorders (n = 17). There was no case of thrombophlebitis. Six of the 19 serious events related to the parenteral nutrition solutions (32%) were due to the misuse of the infusion bag. These data support the concept that ready-to-use parenteral nutrition formulations can safely provide parenteral nutrition from birth onwards. They further support that parenteral solutions with an osmolarity up to 800

  18. Development of cyclosporine A microemulsion for parenteral delivery.

    Science.gov (United States)

    Yuan, Yue; Che, Xin; Zhao, Mingyi; Wang, Yan; Liu, Yajun; Schwendeman, Anna; Li, Sanming

    2015-01-01

    The goal of this study was to develop a parenteral microemulsion formulation of cyclosporine A (CyA). The CyA solubility in caprylic capric triglyceride (GTCC), ethyl oleate and soybean oil were determined. The pseudo-ternary diagrams of oil (GTCC), surfactant (Solutol® HS-15), cosurfactants (ethanol/polyethylene glycol 400 [PEG 400] mixture) and water were constructed to identify boundaries for microemulsion existence. The CyA was added at 3, 6 and 9% w/w to the optimal microemulsion composition. Microemulsion particle size, solution viscosity and conductivity were examined. The microemulsion stability and haemolytic potential were examined after dilution in 5% dextrose solution for injection to 1 mg/mL CyA. Microemulsion stability was examined after a three-month storage at 4 and 25 °C. The GTCC was selected as an oil phase for CyA microemulsion based on solubility results. The optimum CyA microemulsion formulation consisted of 2.5% CyA, 9% GTCC, 24% Solutol® HS 15, 8% PEG 400, 4% ethanol and 52.5% water based on weight percent. The average particle sizes of the optimized blank and drug-loaded microemulsions were 68.7 nm and 71.6 nm, respectively and remained unchanged upon 25-fold dextrose dilution. The results of microemulsion physical and CyA chemical were confirmed by a three-month stability study at 4 and 25 °C. In vitro haemolysis studies indicated that CyA microemulsions were well tolerated by erythrocytes. The novel microemulsion formulation of CyA was developed that is suitable for parenteral administration. This new formulation could potentially have less vehicle-associated side effects that current commercial formulation of CyA based on Cremophor® EL and ethanol solution.

  19. Patients' experiences with home parenteral nutrition: A grounded theory study.

    Science.gov (United States)

    Wong, Christina; Lucas, Beverley; Wood, Diana

    2018-04-01

    Parenteral nutrition (PN) provides nourishment and hydration as an intravenous infusion to patients with intestinal failure (IF). The aim of the study is to generate theory that explains the experiences of adult patients living with home parenteral nutrition (HPN) and complex medication regimens. A grounded theory methodology was used to explore the experiences of twelve patients receiving HPN. A semi-structured interview was conducted and recorded in each participant's home setting. Each interview was transcribed verbatim. The simultaneous process of data collection and analysis was followed reflecting the principles of the constant comparative approach. A total of 15 patients gave written consent, with 12 of them agreeing to be interviewed. All the participants had previously undergone surgery as a result of chronic ill health or sudden illness. Analysis revealed two core categories: stoma and HPN, and these were supported by the subcategories: maintaining stoma output, access to toilets, managing dietary changes, maintaining the HPN infusion routine, access to technical help to set up an HPN infusion, mobility with HPN equipment and general health changes. The strategy of living with loss was demonstrated by all the participants, and this was supported by the action strategies of maintaining daily activities and social interactions. This study generates new understanding and insight into the views and experiences of patients receiving HPN in the UK. The findings from these participants have been shown to resonate with the Kubler-Ross Model [1] of the five stages of grief. The theory of living with loss was generated by the use of a grounded theory methodology. This small scale exploratory study reveals opportunities for improvements in practice to be considered by the nutrition support team (NST) and other healthcare professionals involved in the patient's hospital stay prior to discharge on HPN. Copyright © 2018 European Society for Clinical Nutrition and

  20. Amino acids – Guidelines on Parenteral Nutrition, Chapter 4

    Directory of Open Access Journals (Sweden)

    Working group for developing the guidelines for parenteral nutrition of The German Association for Nutritional Medicine

    2009-11-01

    Full Text Available Protein catabolism should be reduced and protein synthesis promoted with parenteral nutrion (PN. Amino acid (AA solutions should always be infused with PN. Standard AA solutions are generally used, whereas specially adapted AA solutions may be required in certain conditions such as severe disorders of AA utilisation or in inborn errors of AA metabolism. An AA intake of 0.8 g/kg/day is generally recommended for adult patients with a normal metabolism, which may be increased to 1.2–1.5 g/kg/day, or to 2.0 or 2.5 g/kg/day in exceptional cases. Sufficient non-nitrogen energy sources should be added in order to assure adequate utilisation of AA. A nitrogen calorie ratio of 1:130 to 1:170 (g N/kcal or 1:21 to 1:27 (g AA/kcal is recommended under normal metabolic conditions. In critically ill patients glutamine should be administered parenterally if indicated in the form of peptides, for example 0.3–0.4 g glutamine dipeptide/kg body weight/day (=0.2–0.26 g glutamine/kg body weight/day. No recommendation can be made for glutamine supplementation in PN for patients with acute pancreatitis or after bone marrow transplantation (BMT, and in newborns. The application of arginine is currently not warranted as a supplement in PN in adults. N-acetyl AA are only of limited use as alternative AA sources. There is currently no indication for use of AA solutions with an increased content of glycine, branched-chain AAs (BCAA and ornithine-α-ketoglutarate (OKG in all patients receiving PN. AA solutions with an increased proportion of BCAA are recommended in the treatment of hepatic encephalopathy (III–IV.

  1. Tuberculosis and parenteral viral hepatitides: incidence of mixed forms

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    A. A. Asratyan

    2014-01-01

    Full Text Available Objective: to estimate the frequency of parenteral viral hepatitides (HB and HC (PVH in patients with tuberculosis in Moscow in relation to data on their incidence in the aggregate population of the capital.Materials and methods. The authors analyzed the incidence of (acute, chronic HB and HC (carriage and tuberculosis in Moscow in 2009. A total of 24,220 cards for infectious patients (No. 089/y and federal statistical follow-up forms (No. 2 were first processed to compare and search for personal data among the patients with tuberculosis and all forms of PVH and to establish the evidence of PVH and tuberculosis comorbidity.Results. The infection of tuberculosis patients with parenteral hepatitis B and C viruses was ascertained to be 5.5 to 284.9 times higher (in relation to the form of a hepatitis course than that in the aggregation population of Moscow, which suggests that PVH is of high significance for the tuberculosis patients and that it is necessary to improve a PVH prevention program among this cohort patients. Analysis of the sex-age structure shows that male tuberculosis patients in the 20-39-year-old group should be considered to be a special risk group that should attract special attention when implementing preventive measures. The tuberculosis mortality rate among mixed infected patients was 1.8-fold higher than among those who had PVH-uncomplicated tuberculosis.Conclusion. The results of the investigations are suggestive of the evidence of PVH and tuberculosis comorbidity. The mixed forms of these infections in different combinations have been established to be accompanied by their severer clinical course and high death rates. 

  2. PROTEIN NEEDS OF CRITICALLY ILL PATIENTS RECEIVING PARENTERAL NUTRITION.

    Science.gov (United States)

    Germano Borges de Oliveira Nascimento Freitas, Renata; Negrão Nogueira, Roberto José; Hessel, Gabriel

    2015-07-01

    assess whether the current protein intake recommendations may improve the biochemical parameters of critical patients receiving parenteral nutrition. longitudinal study with three evaluations made (during the first 72 hours, on the 7th and the 14th days of PN). The following tests were applied: albumin, C-reactive protein, prealbumin, total cholesterol, HDL, triglycerides, lymphocytes, and glutathione peroxidase. The severity was determined by SOFA. The statistical analysis included the Spearman and Mann-Whitney tests, as well as ANOVA (analysis of variance). among the 53 patients evaluated, 20 (37.74%) died. The mean calorie was 24.68 ± 9.78 kcal/kg (beginning of PN), 26.49 ± 8.89 kcal/kg (3rd to 7th days of PN), and 30.9 ± 12.19 kcal/kg (7th to 14th days of PN). The mean protein was 1.19 ± 0.44 g/kcal/kg (first 72 hours of PN), 1.29 ± 0.44 g/kcal/kg (3rd to 7th days of PN) and 1.49 ± 0.69 g/kcal/kg (7th to 14th days of PN). Prealbumin, albumin, total cholesterol and HDL were below the reference values, while the CRP levels were high. Throughout the three evaluation times, there was no a significant improvement on the levels of laboratory examinations. A strong and negative correlation was found between SOFA and prealbumin (r = -0.64, p = 0.05). the protein offer, according to the traditional recommendations, was not enough to improve the biochemical parameters of critical patients undergoing parenteral nutrition. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  3. Parenteral nutrition dysregulates bile salt homeostasis in a rat model of parenteral nutrition-associated liver disease.

    Science.gov (United States)

    Koelfat, Kiran V K; Schaap, Frank G; Hodin, Caroline M J M; Visschers, Ruben G J; Svavarsson, Björn I; Lenicek, Martin; Shiri-Sverdlov, Ronit; Lenaerts, Kaatje; Olde Damink, Steven W M

    2017-10-01

    Parenteral nutrition (PN), a lifesaving therapy in patients with intestinal failure, has been associated with hepatobiliary complications including steatosis, cholestasis and fibrosis, collectively known as parenteral nutrition-associated liver disease (PNALD). To date, the pathogenesis of PNALD is poorly understood and therapeutic options are limited. Impaired bile salt homeostasis has been proposed to contribute PNALD. The objective of this study was to establish a PNALD model in rats and to evaluate the effects of continuous parenteral nutrition (PN) on bile salt homeostasis. Rats received either PN via the jugular vein or received normal diet for 3, 7 or 14 days. Serum biochemistry, hepatic triglycerides, circulating bile salts and C4, IL-6 and TNF-alpha, and lipogenic and bile salt homeostatic gene expression in liver and ileum were assessed. PN increased hepatic triglycerides already after 3 days of administration, and resulted in conjugated bilirubin elevation after 7 or more days. This indicates PN-induced steatosis and impaired canalicular secretion of bilirubin, the latter which is in line with reduced hepatic expression of Mrp2 mRNA. There was no histological evidence for liver inflammation after PN administration, and circulating levels of pro-inflammatory cytokines IL-6 and TNF-α, were comparable in all groups. Hepatic expression of Fxr mRNA was decreased after 7 days of PN, without apparent effect on expression of Fxr targets Bsep and Shp. Nonetheless, Cyp7a1 expression was reduced after 7 days of PN, indicative for lowered bile salt synthesis. Circulating levels of C4 (marker of bile salt synthesis) were also decreased after 3, 7 and 14 days of PN. Levels of circulating bile salts were not affected by PN. This study showed that PN in rats caused early mild steatosis and cholestasis, while hepatic and systemic inflammation were not present. The onset of these abnormalities was associated with alterations in bile salt synthesis and transport. This

  4. Requerimientos para el diseño de una metodología que permita estimar el valor de pasivos ambientales mineros

    OpenAIRE

    Arango Aramburo, Marcela

    2011-01-01

    Los pasivos ambientales mineros (PAM) son la obligación económica asociada con los impactos ambientales no remediados de una operación minera abandonada. En Colombia no se han reglamentado los PAM, pero dada la antigüedad y la prevalencia de la informalidad en la explotación minera, el interés en definir, reglamentar y gestionar estas obligaciones es creciente. Una parte importante del manejo de los pasivos ambientales mineros es su valoración. Por medio de la valoración, se puede estimar...

  5. PIPIDA scintigraphy for cholecystitis: false positives in alcoholism and total parenteral nutrition

    International Nuclear Information System (INIS)

    Shuman, W.P.; Gibbs, P.; Rudd, T.G.; Mack, L.A.

    1982-01-01

    A review of gallbladder scintigraphy in patients with potentially compromised hepatobiliary function revealed two groups in whom cholecystitis might be mistakenly diagnosed. In 200 consecutive hospitalized patients studied with technetium-99m-PIPIDA for acute cholecystitis or cholestasis, there were 41 alcoholics and 17 patients on total parenteral nutrition. In 60% of the alcoholics and 92% of those on parenteral nutrition, absent or delayed visualization of the gallbladder occurred without physical or clinical evidence of cholecystitis. A cholecystagogue, sincalide, did not prevent the false-positive features which presumably are due to altered bile flow kinetics related to alcoholism and parenteral nutrition. Four patients on parenteral nutrition undergoing cholecystectomy for suspected cholecystitis had normal gallbladders filled with jellylike viscous thick bile. A positive (nonvisualized or delayed visualized) gallbladder PIPIDA scintigram in these two populations should not be interpreted as indicating a need for cholecystectomy

  6. Phylodynamic and Phylogeographic Patterns of the HIV Type 1 Subtype F1 Parenteral Epidemic in Romania

    Science.gov (United States)

    Hué, Stéphane; Buckton, Andrew J.; Myers, Richard E.; Duiculescu, Dan; Ene, Luminita; Oprea, Cristiana; Tardei, Gratiela; Rugina, Sorin; Mardarescu, Mariana; Floch, Corinne; Notheis, Gundula; Zöhrer, Bettina; Cane, Patricia A.; Pillay, Deenan

    2012-01-01

    Abstract In the late 1980s an HIV-1 epidemic emerged in Romania that was dominated by subtype F1. The main route of infection is believed to be parenteral transmission in children. We sequenced partial pol coding regions of 70 subtype F1 samples from children and adolescents from the PENTA-EPPICC network of which 67 were from Romania. Phylogenetic reconstruction using the sequences and other publically available global subtype F sequences showed that 79% of Romanian F1 sequences formed a statistically robust monophyletic cluster. The monophyletic cluster was epidemiologically linked to parenteral transmission in children. Coalescent-based analysis dated the origins of the parenteral epidemic to 1983 [1981–1987; 95% HPD]. The analysis also shows that the epidemic's effective population size has remained fairly constant since the early 1990s suggesting limited onward spread of the virus within the population. Furthermore, phylogeographic analysis suggests that the root location of the parenteral epidemic was Bucharest. PMID:22251065

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

    Directory of Open Access Journals (Sweden)

    Josiel Paiva Vieira

    2010-10-01

    Full Text Available PURPOSE: To compare the effect of parenteral versus enteral nutritional support in severe acute pancreatitis, with respect to efficacy, safety, morbidity, mortality and length of hospitalization. METHODS: The study was comprised of 31 patients, divided into a parenteral group (n=16 and an enteral group (n=15, who met severity criteria for abdominal tomography (Balthazar classes C, D, and E. The patients were compared by demographics, disease etiology, antibiotic prophylaxis, use or not of somatostatin, nutritional support, complications and disease progression. RESULTS: There was no statistical difference in the average duration of nutritional support, somatostatin, or antibiotics in the two groups. Imipenem was the drug of choice for prophylaxis of pancreatic infections in both groups. More complications occurred in the parenteral group, although the difference was not statistically significant (p=0.10. Infectious complications, such as catheter sepsis and infections of the pancreatic tissue, were significantly more frequent in the parenteral group (p=0.006. There was no difference in average length of hospitalization in the two groups. There were three deaths in the parenteral group and none in the enteral group. CONCLUSION: Enteral nutritional support is associated with fewer septic complications compared to parenteral nutritional support.OBJETIVO: Comparar o efeito do suporte nutricional parenteral versus enteral, em pancreatite aguda grave, com relação à eficácia, à segurança, à morbi-mortalidade e ao tempo de internação. MÉTODOS: Foram estudados 31 pacientes distribuídos em grupo parenteral (n=16, no período de 1995 a 1998 e grupo enteral (n=15, no período de 1999 a 2002, que preencheram os critérios de gravidade pela tomografia de abdome (Balthazar C,D,E. Os pacientes foram comparados quanto aos dados demográficos, etiologia, antibioticoprofilaxia, somatostatina, suporte nutricional, complicações e evolução. RESULTADOS

  8. Selected pharmacokinetic issues of the use of antiepileptic drugs and parenteral nutrition in critically ill patients

    Directory of Open Access Journals (Sweden)

    Abd Arwa Y

    2010-12-01

    Full Text Available Abstract Objectives To conduct a systematic review for the evidence supporting or disproving the reality of parenteral nutrition- antiepileptic drugs interaction, especially with respect to the plasma protein-binding of the drug. Methods The articles related to the topic were identified through Medline and PubMed search (1968-Feburary 2010 for English language on the interaction between parenteral nutrition and antiepileptic drugs; the search terms used were anti-epileptic drugs, parenteral nutrition, and/or interaction, and/or in vitro. The search looked for prospective randomized and nonrandomized controlled studies; prospective nonrandomized uncontrolled studies; retrospective studies; case reports; and in vitro studies. Full text of the articles were then traced from the Universiti Sains Malaysia (USM library subscribed databases, including Wiley-Blackwell Library, Cochrane Library, EBSCOHost, OVID, ScienceDirect, SAGE Premier, Scopus, SpringerLINK, and Wiley InterScience. The articles from journals not listed by USM library were traced through inter library loan. Results There were interactions between parenteral nutrition and drugs, including antiepileptics. Several guidelines were designed for the management of illnesses such as traumatic brain injuries or cancer patients, involving the use of parenteral nutrition and antiepileptics. Moreover, many studies demonstrated the in vitro and in vivo parenteral nutrition -drugs interactions, especially with antiepileptics. Conclusions There was no evidence supporting the existence of parenteral nutrition-antiepileptic drugs interaction. The issue has not been studied in formal researches, but several case reports and anecdotes demonstrate this drug-nutrition interaction. However, alteration in the drug-free fraction result from parenteral nutrition-drug (i.e. antiepileptics interactions may necessitate scrupulous reassessment of drug dosages in patients receiving these therapies. This

  9. Quality assessment of total parenteral nutrition admixtures by the use of fractional factorial design

    OpenAIRE

    Mirković, Dušica; Ibrić, Svetlana; Antunović, Mirjana

    2013-01-01

    Background/Aim. Parenteral nutrition as a specific aspect of providing nutritients still remains a permanent topic of both theoretical and experimental research. Total parenteral nutrition (TPN) admixtures have complex contents making difficult to maintain their stability. The most critical parameter is the diameter of a lipid droplet, i.e. droplet size distribution. It is recommended that droplet size should not be more than 5 m and that the presence of greater droplets should not exceed th...

  10. Home parenteral nutrition in management of patients with severe radiation enteritis

    International Nuclear Information System (INIS)

    Lavery, I.C.; Steiger, E.; Fazio, V.W.

    1980-01-01

    Five patients who would have been unable to survive because of intestinal complications of radiation therapy were able to lead an otherwise normal life with the use of parenteral nutrition administered at home. One patient died of recurrent carcinoma of the cervix after 14 months. Another patient died as the result of a totally avoidable pharmaceutical error after 2 1/2 years. The remaining three are still disease free without morbidity relating to the parenteral nutrition

  11. A Review of the Parenteral Nutrition Supply Service in an Irish Neonatal Unit

    LENUS (Irish Health Repository)

    Smith, A

    2018-06-01

    Neonatal Intensive Care (NICU) patients have individual nutritional requirements often requiring Patient Specific Parenteral Nutrition (PSPN). From October 2015, the national PSPN compounding service availability changed from 7 days per week service to 5 days per week (i.e. no weekend and limited bank holiday ordering available). The aim of this study was to examine the introduction of a 5 day only PSPN supply on neonatal patient parenteral nutrition availability in a tertiary NICU.

  12. Selected pharmacokinetic issues of the use of antiepileptic drugs and parenteral nutrition in critically ill patients.

    Science.gov (United States)

    Salih, Muhannad R M; Bahari, Mohd Baidi; Abd, Arwa Y

    2010-12-31

    To conduct a systematic review for the evidence supporting or disproving the reality of parenteral nutrition- antiepileptic drugs interaction, especially with respect to the plasma protein-binding of the drug. The articles related to the topic were identified through Medline and PubMed search (1968-Feburary 2010) for English language on the interaction between parenteral nutrition and antiepileptic drugs; the search terms used were anti-epileptic drugs, parenteral nutrition, and/or interaction, and/or in vitro. The search looked for prospective randomized and nonrandomized controlled studies; prospective nonrandomized uncontrolled studies; retrospective studies; case reports; and in vitro studies. Full text of the articles were then traced from the Universiti Sains Malaysia (USM) library subscribed databases, including Wiley-Blackwell Library, Cochrane Library, EBSCOHost, OVID, ScienceDirect, SAGE Premier, Scopus, SpringerLINK, and Wiley InterScience. The articles from journals not listed by USM library were traced through inter library loan. There were interactions between parenteral nutrition and drugs, including antiepileptics. Several guidelines were designed for the management of illnesses such as traumatic brain injuries or cancer patients, involving the use of parenteral nutrition and antiepileptics. Moreover, many studies demonstrated the in vitro and in vivo parenteral nutrition -drugs interactions, especially with antiepileptics. There was no evidence supporting the existence of parenteral nutrition-antiepileptic drugs interaction. The issue has not been studied in formal researches, but several case reports and anecdotes demonstrate this drug-nutrition interaction. However, alteration in the drug-free fraction result from parenteral nutrition-drug (i.e. antiepileptics) interactions may necessitate scrupulous reassessment of drug dosages in patients receiving these therapies. This reassessment may be particularly imperative in certain clinical situations

  13. Reconciling divergent results of the latest parenteral nutrition studies in the ICU.

    Science.gov (United States)

    Singer, Pierre; Pichard, Claude

    2013-03-01

    Recent studies on the optimal modalities to feed patients during the ICU stay show divergent results. The level and the timing of energy provision is a critical issue, associated with the clinical outcome. These results questioned the clinical relevance of the recent guidelines issued by American, Canadian and European academic societies. Four recent prospective randomized studies enrolled critically ill patients who received various nutritional regimens and tested the effect of nutritional support on outcome. The Tight Calorie balance Control Study (TICACOS) targeted on calorie administration according to measured energy expenditure and found increased ICU morbidity but improved hospital mortality. The large EpaNIC study compared 'early' with 'late' (parenteral nutrition) nutrition, mostly in patients after cardiac surgery, and found an increased morbidity associated with early parenteral nutrition. The supplemental parenteral nutrition (SPN) study randomized the patients after 3 days and targeted the calories administered by parenteral nutrition as a complement to unsuccessful enteral nutrition using indirect calorimetry. The SPN resulted in less nosocomial infections and shorter duration of mechanical ventilation. Finally, a recent Australian study enrolled patients unable to be early fed enterally to receive, or not, parenteral nutrition targeted at 1500 kcal. No complications were noted in the parenteral nutrition group. Lessons from all these studies are summarized and should help in designing better studies and guidelines. The critical analysis of recent prospective studies comparing various levels of calorie administration, enteral versus parenteral nutrition and enteral versus SPN confirms the recommendations to avoid underfeeding and overfeeding. Parenteral nutrition, required if enteral feeding is failing, and if adjusted up to a measured optimal level, may improve outcome. More studies on the optimal level of energy and protein administration to

  14. ROLE OF PARENTERAL NUTRITION IN ONCOLOGIC PATIENTS WITH INTESTINAL OCCLUSION AND PERITONEAL CARCINOMATOSIS.

    Science.gov (United States)

    Aría Guerra, Eva; Cortés-Salgado, Alfonso; Mateo-Lobo, Raquel; Nattero, Lía; Riveiro, Javier; Vega-Piñero, Belén; Valbuena, Beatriz; Carabaña, Fátima; Carrero, Carmen; Grande, Enrique; Carrato, Alfredo; Botella-Carretero, José Ignacio

    2015-09-01

    the precise role of parenteral nutrition in the management of oncologic patients with intestinal occlusion is not well defined yet. We aimed to identify the effects of parenteral nutrition in these patients regarding prognosis. 55 patients with intestinal occlusion and peritoneal carcinomatosis were included. Parenteral nutrition aimed at 20-35 kcal/Kg/day, and 1.0 g/kg/day of amino-acids. Weight, body mass index, type of tumor, type of chemotherapy, and ECOG among others were recorded and analyzed. 69.1% of the patients had gastrointestinal tumors, 18.2% gynecologic and 12.7% others. Age was 60 ± 13y, baseline ECOG 1.5 ± 0.5 and body mass index 21.6 ± 4.3. Malnutrition was present in 85%. Survival from the start of parenteral nutrition was not significant when considering baseline ECOG (log rank = 0.593, p = 0.743), previous lines of chemotherapy (log rank = 2.117, p = 0.548), baseline BMI (log rank = 2.686, p = 0.261), or type of tumor (log rank = 2.066, p = 0.356). Survival in patients who received home parenteral nutrition after hospital discharge was higher than those who stayed in-hospital (log rank = 7.090, p = 0.008). Survival in patients who started chemotherapy during or after parenteral nutrition was higher than those who did not so (log rank = 17.316, p Parenteral nutrition in patients with advanced cancer and intestinal occlusion is safe, and in tho se who respond to chemotherapy, further administration of home parenteral nutrition together with chemotherapy may enhance prolonged survival. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  15. Quality assessment of total parenteral nutrition admixtures by the use of fractional factorial design

    Directory of Open Access Journals (Sweden)

    Mirković Dušica

    2013-01-01

    Full Text Available Background/Aim. Parenteral nutrition as a specific aspect of providing nutritients still remains a permanent topic of both theoretical and experimental research. Total parenteral nutrition (TPN admixtures have complex contents making difficult to maintain their stability. The most critical parameter is the diameter of a lipid droplet, i.e. droplet size distribution. It is recommended that droplet size should not be more than 5

  16. Potential of polymeric particles as future vaccine delivery systems/adjuvants for parenteral and non-parenteral immunization against tuberculosis: A systematic review

    Directory of Open Access Journals (Sweden)

    Farzad Khademi

    2018-02-01

    Full Text Available Objective(s: Production of effective tuberculosis (TB vaccine is necessity. However, the development of new subunit vaccines is faced with concerns about their weak immunogenicity. To overcome such problems, polymers-based vaccine delivery systems have been proposed to be used via various routes. The purpose of this study was to determine the potential of polymeric particles as future vaccine delivery systems/adjuvants for parenteral and non-parenteral immunization against TB. Materials and Methods: PubMed, Scopus, Science-Direct, and the ISI web of knowledge databases were searched for related keywords. A total of 420 articles, written up to June 25, 2016, were collected on the potential of polymeric particles as TB vaccine delivery systems after parenteral and non-parenteral immunization. Thirty-one relevant articles were selected by applying inclusion and exclusion criteria. Results: It was shown that the immunogenicity of TB vaccines had been improved by using biodegradable and non-biodegradable synthetic polymers as well as natural polymers and they are better able to enhance the humoral and cellular immune responses, compared to TB vaccines alone. The present study revealed that various polymeric particles, after M. tuberculosis challenge in animal models, provide long-lasting protection against TB. PLGA (poly (lactide-co-glycolide and chitosan polymers were widely used as TB vaccine delivery systems/adjuvants. Conclusion: It seems that PLGA and chitosan polymers are well-suited particles for the parenteral and non-parenteral administration of TB vaccines, respectively. Non-biodegradable synthetic polymers in comparison with biodegradable synthetic and natural polymers have been used less frequently. Therefore, further study on this category of polymers is required.

  17. On-line preconcentration and determination of chromium in parenteral solutions by inductively coupled plasma optical emission spectrometry

    International Nuclear Information System (INIS)

    Gil, R.A.; Cerutti, S.; Gasquez, J.A.; Olsina, R.A.; Martinez, L.D.

    2005-01-01

    A method for the preconcentration and speciation of chromium was developed. On-line preconcentration and determination were obtained using inductively coupled plasma optical emission spectrometry (ICP-OES) coupled with flow injection. To determinate the chromium (III) present in parenteral solutions, chromium was retained on activated carbon at pH 5.0. On the other hand, a step of reduction was necessary in order to determine total chromium content. The Cr(VI) concentration was then determined by difference between the total chromium concentration and that of Cr(III). A sensitivity enrichment factor of 70-fold was obtained with respect to the chromium determination by ICP-OES without preconcentration. The detection limit for the preconcentration of 25 ml of sample was 29 ng l -1 . The precision for the 10 replicate determinations at the 5 μg l -1 Cr level was 2.3% relative standard deviation, calculated with the peak heights. The calibration graph using the preconcentration method for chromium species was linear with a correlation coefficient of 0.9995 at levels near the detection limits up to at least 60 μg l -1 . The method can be applied to the determination and speciation of chromium in parenteral solutions

  18. Nutritional status and hyperglycemia in the peritransplant period: a review of associations with parenteral nutrition and clinical outcomes

    Directory of Open Access Journals (Sweden)

    Marina Verdi Schumacher

    Full Text Available ABSTRACT Hematopoietic stem cell transplantation is an established treatment option for various hematological diseases. This therapy involves complex procedures and is associated with several systemic complications. Due to the toxic effects of the conditioning regimen used in allogeneic transplantations, patients frequently suffer from severe gastrointestinal complications and are unable to feed themselves properly. This complex clinical scenario often requires specialized nutritional support, and despite the increasing number of studies available, many questions remain regarding the best way to feed these patients. Parenteral nutrition has been traditionally indicated when the effects on gastrointestinal mucosa are significant; however, the true benefits of this type of nutrition in reducing clinical complications have been questioned. Hyperglycemia is a common consequence of parenteral nutrition that seems to be correlated to poor transplantation outcomes and a higher risk of infections. Additionally, nutrition-related pre-transplantation risk factors are being studied, such as impaired nutritional status, poorly controlled diabetes mellitus and obesity. This review aims to discuss some of these recent issues. A real case of allogeneic transplant was used to illustrate the scenario and to highlight the most important topics that motivated this literature review.

  19. Nutritional status and hyperglycemia in the peritransplant period: a review of associations with parenteral nutrition and clinical outcomes.

    Science.gov (United States)

    Verdi Schumacher, Marina; Moreira Faulhaber, Gustavo Adolpho

    Hematopoietic stem cell transplantation is an established treatment option for various hematological diseases. This therapy involves complex procedures and is associated with several systemic complications. Due to the toxic effects of the conditioning regimen used in allogeneic transplantations, patients frequently suffer from severe gastrointestinal complications and are unable to feed themselves properly. This complex clinical scenario often requires specialized nutritional support, and despite the increasing number of studies available, many questions remain regarding the best way to feed these patients. Parenteral nutrition has been traditionally indicated when the effects on gastrointestinal mucosa are significant; however, the true benefits of this type of nutrition in reducing clinical complications have been questioned. Hyperglycemia is a common consequence of parenteral nutrition that seems to be correlated to poor transplantation outcomes and a higher risk of infections. Additionally, nutrition-related pre-transplantation risk factors are being studied, such as impaired nutritional status, poorly controlled diabetes mellitus and obesity. This review aims to discuss some of these recent issues. A real case of allogeneic transplant was used to illustrate the scenario and to highlight the most important topics that motivated this literature review. Copyright © 2017 Associação Brasileira de Hematologia, Hemoterapia e Terapia Celular. Published by Elsevier Editora Ltda. All rights reserved.

  20. Changes in intestinal absorption of nutrients and brush border glycoproteins after total parenteral nutrition in rats.

    Science.gov (United States)

    Miura, S; Tanaka, S; Yoshioka, M; Serizawa, H; Tashiro, H; Shiozaki, H; Imaeda, H; Tsuchiya, M

    1992-01-01

    The effect of total parenteral nutrition on nutrients absorption and glycoprotein changes of brush border membrane was examined in rat small intestine. In total parenteral nutrition rats, a marked decrease in activity of brush border enzymes was observed mainly in the proximal and middle segments of the intestine. Galactose perfusion of jejunal segment showed that hexose absorption was significantly inhibited, while intestinal absorption of glycine or dipeptide, glycylglycine was not significantly affected by total parenteral nutrition treatment. When brush border membrane glycoprotein profile was examined by [3H]-glucosamine or [3H]-fucose incorporation into jejunal loops, significant changes were observed in the glycoprotein pattern of brush border membrane especially in the high molecular weight range over 120 kDa after total parenteral nutrition treatment, suggesting strong dependency of glycoprotein synthesis on luminal substances. Molecular weight of sucrase isomaltase in brush border membrane detected by specific antibody showed no significant difference, however, in total parenteral nutrition and control rats. Also, molecular weight of specific sodium glucose cotransporter of intestinal brush border membrane detected by selective photoaffinity labelling was not altered in total parenteral nutrition rats. It may be that prolonged absence of oral food intake may produce significant biochemical changes in brush border membrane glycoprotein and absorptive capacity of small intestine, but these changes were not observed in all brush border membrane glycoproteins. Images Figure 1 Figure 2 Figure 3 Figure 4 PMID:1582592

  1. Quality of Life and Nutrition Condition of Patients Improve Under Home Parenteral Nutrition: An Exploratory Study.

    Science.gov (United States)

    Girke, Jutta; Seipt, Claudia; Markowski, Andrea; Luettig, Birgit; Schettler, Anika; Momma, Michael; Schneider, Andrea S

    2016-10-01

    Patients with end-stage cancer and advanced chronic bowel disease are often malnourished, which has a negative effect on patients' outcome, well-being, and activity. It is inconclusive whether these patients benefit from home parenteral nutrition. This prospective exploratory study investigates its influence on nutrition state, muscle strength, mobility, and quality of life. Patients ≥18 years old with an indication for home parenteral nutrition were included and followed for 2-24 months. Nutrition parameters, activity, and quality of life were assessed. Forty-eight patients participated (mean age 11.5 years), and 85% were severely malnourished (subjective global assessment score, class C). Four weeks after parenteral nutrition, patients with tumors demonstrated a deterioration in phase angle (from 3.9 to 3.4) and extracellular mass:body cell mass ratio (from 1.6 to 2.1), while patients with bowel disease improved (from 3.4 to 4.0 and 2.1 to 1.6, respectively); grip strength remained constant in both groups (difference: 1.11 and -2.11, respectively). Activity improved in patients with bowel disease but stayed the same in the tumor group (P = .02 and P = .33, respectively). When the groups were pooled, emotional and social functioning domain scores (P parenteral nutrition. Both groups seem to benefit from home parenteral nutrition without harmful side effects. If the indication is determined early, the patients' disease course could perhaps be improved. © 2016 American Society for Parenteral and Enteral Nutrition.

  2. Modelación de aspectos ambientales en la cadena de suministro del bioetanol

    Directory of Open Access Journals (Sweden)

    Danny Ibarra

    2013-07-01

    Full Text Available En este artículo se ha construido un modelo en el que se incluye algunos aspectos ambientales, asociados a la cadena de suministro de bioetanol en Colombia, tales como vinazas, bagazo de caña y emisiones de CO2, teniendo en cuenta que una de las orientaciones más importantes en la actualidad para que una empresa sea competitiva, es la gerencia de la cadena de suministro verde o sostenible. Dicha cadena es de naturaleza dinámica, por las relaciones complejas entre las partes asociadas y el flujo constante de información, bienes y materiales. Por esto se utilizó la metodología de análisis basada en la dinámica de sistemas, la cual resulta de mucha utilidad para abordar problemas complejos y sistémicos, en  que se asocian variables externas como las ambientales, logrando entender mejor y haciendo la toma de decisiones más acertada. Este trabajo muestra a través de las simulaciones que es necesario vincular estrategias de gestión ambiental en la cadena de suministro de bioetanol, para mitigar el impacto ambiental causado por sus residuos. In this paper has been constructed a model that includes some environmental issues, associated with the supply chain of bioetanol in Colombia, such as stillage, bagasse and CO2 emissions. Considering that one of the most important issues today for  company to be competitive, is the management of the supply chain, withth is one of the fundamental pillars to ensure the promise of value offered to customers. The chainis dynamic in nature, by the complex relation ships between the partner sand the constant flow of information, good sand materials. Therefore, it used the analysis methodology based on system dynamics, that is very useful in addressing complex and systemic problems in the associated external and environmental variables, achieving better understanding and making decisions more accurate. This paper shows, through simulations, that it isnecessary to link environmental management strategies in

  3. Effects of luminal nutrient absorption, intraluminal physical stimulation, and intravenous parenteral alimentation on the recovery responses of duodenal villus morphology following feed withdrawal in chickens.

    Science.gov (United States)

    Tarachai, P; Yamauchi, K

    2000-11-01

    The aim of this study was to clarify which of the following three factors induces villus morphological recovery best: enteral nutrient absorption, intraluminal physical stimulation, or intravenous parenteral alimentation. At 142 d, male White Leghorn chickens (Gallus gallus domesticus) were divided into eight groups of five birds each as follows: 1) access given ad libitum to a commercial layer mash diet (CP, 17.5%; ME, 2,830 kcal/kg) (control), 2) 5-d feed withdrawal (feed withdrawal), 3) 3-d feed withdrawal (3-FW), followed by refeeding the same diet as the control for 2 d (refeeding), 4) 3-FW followed by force-feeding enteral hyperalimentation (enteral), 5) 3-FW followed by force-feeding an indigestible (nonabsorbable) substance (kaolin), 6) 3-FW followed by force-feeding water for 2 d (force-fed control), 7) 3-FW followed by parenteral hyperalimentation (parenteral), and 8) 3-FW followed by no alimentation (sham control) for 2 d. In the refeeding and enteral groups, BW significantly recovered (P alimentation, but by enteral nutrient absorption.

  4. Estrategia para el fortalecimiento del Sistema de Indicadores Ambientales Marinos y Costeros de Colombia Proyecto SPINCAM Colombia.

    OpenAIRE

    2011-01-01

    Establecer un marco de referencias de Indicadores para el Manejo Integrado de Áreas Costeras (MIZC) en cada país de la región del Pacífico Sureste (Chile, Colombia, Ecuador, Panamá y Perú), enfocado en las condiciones ambientales, socioeconómicas y de gobernabilidad en el contexto de desarrollo sostenible y manejo integrado del área costera.

  5. Identificación de los servicios ambientales potenciales de los suelos en el paisaje urbano del Distrito Federal

    Directory of Open Access Journals (Sweden)

    Silke Cram

    2009-10-01

    Full Text Available El crecimiento y expansión de las ciudades ha ocasionado un fuerte deterioro de la salud e integridad de los ecosistemas in situ disminuyendo su posibilidad de ofrecer servicios ambientales. El suelo constituye uno de los primeros componentes alterados que dejan de proporcionar numerosos beneficios necesarios para el mantenimiento de la calidad de vida de la población urbana. En este trabajo se lleva a cabo una primera evaluación de la situación actual de los suelos en el Distrito Federal y sus servicios ambientales potenciales. Para ello, se utilizaron mapas e imágenes de satélite recientes para la construcción de un mapa morfoedafológico. Con base en esta información se detectaron como prioridades: a el cuidado y atención de suelos sobre pendientes > 10º indicando las delegaciones implicadas; b el incremento y/o mejora en la atención de los espacios no sellados que aún se mantienen en cada Delegación; c la necesidad de elaborar políticas y propuestas de manejo para el Distrito Federal que consideren la diversidad de usos y de sus unidades morfoedafológicas. Además se identifican algunos de los servicios ambientales que deberían incorporarse en las políticas y el manejo de los suelos.

  6. Standardised versus Individualised Parenteral Nutrition. Further Food for Thought.

    Science.gov (United States)

    McCarthy, R; Segurado, R; Crealey, M; Twomey, A

    2016-04-11

    Parenteral Nutrition may be prescribed as a standard PN (SPN) formulation or as an individualised PN (IPN) formulation. SPN may have advantages in terms of rapid availability, less prescription errors, decreased risk of infection and cost savings but IPN, specifically tailored to an infants needs, may achieve better outcomes in terms of nutrient intake and weight gain. The aim of our study was to determine if VLBW infants in our NICU benefited from receiving IPN over currently available SPN solutions. Our findings were that VLBW infants prescribed IPN received significantly more amino acid (28%), glucose (6%), energy (11%) and calcium (8%) from the aqueous phase of PN than had they received a similar volume of SPN. The benefits were seen over all the days for which PN was administered. In conclusion, IPN was found to offer significant benefits to our VLBW infants. Modifications to currently available SPN would result in better SPN formulations. Our study also supported the recent recommendation to reduce the calcium:phosphate ratio in PN solutions to avoid early hypophosphataemia.

  7. Hematologic disorders in trauma patients during parenteral alimentation with lipids.

    Science.gov (United States)

    Faintuch, J; Machado, F K; Freire, A N; Reis, J R; Machado, M; Pinto, L P; Ramos, S M; Loebens, M; Jovchelevich, V; Pinotti, H W

    1996-01-01

    Total parenteral nutrition with lipids is a well-accepted modality of metabolic support in seriously ill trauma patients. Intolerance to lipid administration is unusual when dosage limits are not exceeded, and few hematologic disturbances have been recorded with modern fat emulsions. In the course of intravenous alimentation of six adults admitted for traumatic lesions, eosinophilia with or without leukocytopenia was noticed after periods of four days to five weeks. Principal clinical events and hematologic derangements were documented in this population. Sepsis was not always present in the patients by the time of the complication, and in those that did require antibiotics and other drugs, the prescription remained unchanged along the episode. Discontinuation of the nutritional regimen with lipids was followed by normalization of the hematologic profile, suggesting that an acute or sub-acute allergic reaction was responsible. The appearance of skin rash in two occasions reinforces this hypothesis, and the possibility of hemophagocytosis merits consideration in two of the cases who displayed reversible acute leukocytopenia. It is concluded that blood cell aberrations are possible during intravenous feeding with lipids in trauma subjects, but tend to respond to suppression of the lipid-containing nutritional prescription.

  8. Carbohydrates – Guidelines on Parenteral Nutrition, Chapter 5

    Directory of Open Access Journals (Sweden)

    Working group for developing the guidelines for parenteral nutrition of The German Association for Nutritional Medicine

    2009-11-01

    Full Text Available The main role of carbohydrates in the human body is to provide energy. Carbohydrates should always be infused with PN (parenteral nutrition in combination with amino acids and lipid emulsions to improve nitrogen balance. Glucose should be provided as a standard carbohydrate for PN, whereas the use of xylite is not generally recommended. Fructose solutions should not be used for PN. Approximately 60% of non-protein energy should be supplied as glucose with an intake of 3.0–3.5 g/kg body weight/day (2.1–2.4 mg/kg body weight/min. In patients with a high risk of hyperglycaemia (critically ill, diabetes, sepsis, or steroid therapy an lower initial carbohydrate infusion rate of 1–2 g/kg body weight/day is recommended to achieve normoglycaemia. One should aim at reaching a blood glucose level of 80–110 mg/dL, and at least a glucose level <145 mg/dL should be achieved to reduce morbidity and mortality. Hyperglycaemia may require addition of an insulin infusion or a reduction (2.0–3.0 g/kg body weight/day or even a temporary interruption of glucose infusion. Close monitoring of blood glucose levels is highly important.

  9. Carbohydrates – Guidelines on Parenteral Nutrition, Chapter 5

    Science.gov (United States)

    Bolder, U.; Ebener, C.; Hauner, H.; Jauch, K. W.; Kreymann, G.; Ockenga, J.; Traeger, K.

    2009-01-01

    The main role of carbohydrates in the human body is to provide energy. Carbohydrates should always be infused with PN (parenteral nutrition) in combination with amino acids and lipid emulsions to improve nitrogen balance. Glucose should be provided as a standard carbohydrate for PN, whereas the use of xylite is not generally recommended. Fructose solutions should not be used for PN. Approximately 60% of non-protein energy should be supplied as glucose with an intake of 3.0–3.5 g/kg body weight/day (2.1–2.4 mg/kg body weight/min). In patients with a high risk of hyperglycaemia (critically ill, diabetes, sepsis, or steroid therapy) an lower initial carbohydrate infusion rate of 1–2 g/kg body weight/day is recommended to achieve normoglycaemia. One should aim at reaching a blood glucose level of 80–110 mg/dL, and at least a glucose level <145 mg/dL should be achieved to reduce morbidity and mortality. Hyperglycaemia may require addition of an insulin infusion or a reduction (2.0–3.0 g/kg body weight/day) or even a temporary interruption of glucose infusion. Close monitoring of blood glucose levels is highly important. PMID:20049080

  10. [Home parenteral nutrition for terminal stage of cancer patient].

    Science.gov (United States)

    Takamura, S; Sakuyama, T; Nakamura, Y; Takahashi, N; Hattori, M

    1997-12-01

    In the last 6 years, we have experienced 20 cancer patients who received home parenteral nutrition for terminal stage. The patients had 13 gastric cancers, 3 esophageal cancers and 5 others. The prognosis of upper G-I cancer is known to be poorer than that of colon cancer. The home care of our cases, the gastric cancer lasted 25 days on average, which was shorter than others. So the home care for patients in the terminal stage of gastric cancer is very short. Therefore we decide the home care for the terminal stage of gastric cancer as soon as possible. We conducted a questionnaire survey of our cases and family. We finally found that the most important thing is the safety of patient for the maintenance of home care. Our home care system is made up of a 3-way relationship among the patient, support system and doctor. The doctor is on call for the problems of the patient for 24 hours. Therefore, we believe that this system is comfortable for both the patient and family.

  11. A parenteral nutrition use survey with gap analysis.

    Science.gov (United States)

    Boullata, Joseph I; Guenter, Peggi; Mirtallo, Jay M

    2013-03-01

    Parenteral nutrition (PN) is a high-alert medication for which safe practice guidelines are available. Recent adverse events associated with PN have been widely reported. A survey of current practices was indicated as new guidelines are being considered. A web-based survey consisting of 70 items was made available for the month of August 2011. Respondents provided answers to questions that addressed all aspects of the PN use process. There were a total of 895 respondents to the survey, including dietitians, nurses, pharmacists, and physicians. They predominantly represented hospital settings (89%), with 44% from academic institutions. Most organizations use a once-daily PN admixture with 21% outsourcing preparation. Electronic PN order entry is available in one-third of organizations, and the use of standardized order sets prevails. Unfortunately, electronic interfaces between computer systems remain infrequent, meaning that at least one transcription step is required by most in the PN use process. There are a wide variety of methods for ordering PN components, many of which are inconsistent with safe practices. Most organizations dedicate a pharmacist to review the PN orders, many of which require clarifications. Documentation at each step of the PN use process with oversight to identify deviations from best practice recommendations is infrequent. A significant proportion (44%) does not track PN-related medication errors. The survey data are a valuable snapshot of current practices with PN. Poor compliance with some of the safe practice guidelines continues. This will help guide new safety initiatives for the PN use process.

  12. Nutritional intake of gut failure patients on home parenteral nutrition

    International Nuclear Information System (INIS)

    DiCecco, S.; Nelson, J.; Burnes, J.; Fleming, C.R.

    1987-01-01

    Nutrient intake patterns were analyzed in 23 patients with gut failure who were receiving home parenteral nutrition (HPN). All patients had stable weights without changes in intravenous calories or protein for 3 consecutive months. Our objectives were to assess oral intake of calories, carbohydrates, fat, and protein, to examine relationships between oral nutrient intakes and disease categories, and to compare oral and intravenous intakes to calculated resting energy expenditure (REE). Two patterns of oral nutrient intake were identified among the patients. Patients with short bowel syndrome, regardless of the underlying disease, consumed calories by mouth that clearly exceeded calculated resting energy expenditure (short bowel, non-Crohn's, 170% of REE; short bowel, Crohn's, 200 of REE); however, calories approximating the REE had to be given via HPN, suggesting that efficiency of absorption was at a very low level. Patients with diffuse gut diseases (radiation enteritis or pseudo-obstruction syndromes) had very low intakes of oral nutrients. The distribution of oral calories among carbohydrate, protein, and fat did not differ among the disease categories

  13. Standardised versus Individualised Parenteral Nutrition. Further Food for Thought

    LENUS (Irish Health Repository)

    McCarthy, R

    2016-04-01

    Parenteral Nutrition may be prescribed as a standard PN (SPN) formulation or as an individualised PN (IPN) formulation. SPN may have advantages in terms of rapid availability, less prescription errors, decreased risk of infection and cost savings but IPN, specifically tailored to an infant’s needs, may achieve better outcomes in terms of nutrient intake and weight gain. The aim of our study was to determine if VLBW infants in our NICU benefited from receiving IPN over currently available SPN solutions. Our findings were that VLBW infants prescribed IPN received significantly more amino acid (28%), glucose (6%), energy (11%) and calcium (8%) from the aqueous phase of PN than had they received a similar volume of SPN. The benefits were seen over all the days for which PN was administered. In conclusion, IPN was found to offer significant benefits to our VLBW infants. Modifications to currently available SPN would result in better SPN formulations. Our study also supported the recent recommendation to reduce the calcium:phosphate ratio in PN solutions to avoid early hypophosphataemia

  14. Organization of managed clinical networking for home parenteral nutrition.

    Science.gov (United States)

    Baxter, Janet P; McKee, Ruth F

    2006-05-01

    Home parenteral nutrition (HPN) is an established treatment for intestinal failure, and organization of HPN is variable throughout the UK and Europe. Managed clinical networking is the single most important feature of the UK National Health Service strategy for acute services in Scotland and has the potential to improve the management of HPN patients. This review addresses the role of managed clinical networking in HPN and compares outcome data between centres. The Scottish HPN Managed Clinical Network has published the main body of the current literature supporting the concept of managed clinical networking in this context. The Network is responsible for the organization and quality assurance of HPN provision in Scotland, and has been established for 5 years. It has captured significant patient data for the purpose of clinical audit and illustrates that this is an effective model for the management of this patient population. This review provides advice for other areas wishing to improve equity of access, and to smooth the patient journey between primary, secondary and tertiary health care in the context of artificial nutrition support.

  15. Neonatology/Paediatrics – Guidelines on Parenteral Nutrition, Chapter 13

    Directory of Open Access Journals (Sweden)

    Fusch, C.

    2009-11-01

    Full Text Available There are special challenges in implementing parenteral nutrition (PN in paediatric patients, which arises from the wide range of patients, ranging from extremely premature infants up to teenagers weighing up to and over 100 kg, and their varying substrate requirements. Age and maturity-related changes of the metabolism and fluid and nutrient requirements must be taken into consideration along with the clinical situation during which PN is applied. The indication, the procedure as well as the intake of fluid and substrates are very different to that known in PN-practice in adult patients, e.g. the fluid, nutrient and energy needs of premature infants and newborns per kg body weight are markedly higher than of older paediatric and adult patients. Premature infants <35 weeks of pregnancy and most sick term infants usually require full or partial PN. In neonates the actual amount of PN administered must be calculated (not estimated. Enteral nutrition should be gradually introduced and should replace PN as quickly as possible in order to minimise any side-effects from exposure to PN. Inadequate substrate intake in early infancy can cause long-term detrimental effects in terms of metabolic programming of the risk of illness in later life. If energy and nutrient demands in children and adolescents cannot be met through enteral nutrition, partial or total PN should be considered within 7 days or less depending on the nutritional state and clinical conditions.

  16. Parenteral opioids for maternal pain management in labour.

    Science.gov (United States)

    Smith, Lesley A; Burns, Ethel; Cuthbert, Anna

    2018-06-05

    Parenteral opioids (intramuscular and intravenous drugs including patient-controlled analgesia) are used for pain relief in labour in many countries throughout the world. This review is an update of a review first published in 2010. To assess the effectiveness, safety and acceptability to women of different types, doses and modes of administration of parenteral opioid analgesia in labour. A second objective is to assess the effects of opioids in labour on the baby in terms of safety, condition at birth and early feeding. We searched Cochrane Pregnancy and Childbirth's Trials Register, ClinicalTrials.gov, the WHO International Clinical Trials Registry Platform (ICTRP) (11 May 2017) and reference lists of retrieved studies. We included randomised controlled trials examining the use of intramuscular or intravenous opioids (including patient-controlled analgesia) for women in labour. Cluster-randomised trials were also eligible for inclusion, although none were identified. We did not include quasi-randomised trials. We looked at studies comparing an opioid with another opioid, placebo, no treatment, other non-pharmacological interventions (transcutaneous electrical nerve stimulation (TENS)) or inhaled analgesia. Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. We assessed the quality of each evidence synthesis using the GRADE approach. We included 70 studies that compared an opioid with placebo or no treatment, another opioid administered intramuscularly or intravenously or compared with TENS applied to the back. Sixty-one studies involving more than 8000 women contributed data to the review and these studies reported on 34 different comparisons; for many comparisons and outcomes only one study contributed data. All of the studies were conducted in hospital settings, on healthy women with uncomplicated pregnancies at 37 to 42 weeks' gestation. We excluded studies focusing on women with pre

  17. Complications and Monitoring – Guidelines on Parenteral Nutrition, Chapter 11

    Directory of Open Access Journals (Sweden)

    Working group for developing the guidelines for parenteral nutrition of The German Association for Nutritional Medicine

    2009-11-01

    Full Text Available Compared to enteral or hypocaloric oral nutrition, the use of PN (parenteral nutrition is not associated with increased mortality, overall frequency of complications, or longer length of hospital stay (LOS. The risk of PN complications (e.g. refeeding-syndrome, hyperglycaemia, bone demineralisation, catheter infections can be minimised by carefully monitoring patients and the use of nutrition support teams particularly during long-term PN. Occuring complications are e.g. the refeeding-syndrome in patients suffering from severe malnutrition with the initiation of refeeding or metabolic, hypertriglyceridemia, hyperglycaemia, osteomalacia and osteoporosis, and hepatic complications including fatty liver, non-alcoholic fatty liver disease, cholestasis, cholecystitis, and cholelithiasis. Efficient monitoring in all types of PN can result in reduced PN-associated complications and reduced costs. Water and electrolyte balance, blood sugar, and cardiovascular function should regularly be monitored during PN. Regular checks of serum electrolytes and triglycerides as well as additional monitoring measures are necessary in patients with altered renal function, electrolyte-free substrate intake, lipid infusions, and in intensive care patients. The metabolic monitoring of patients under long-term PN should be carried out according to standardised procedures. Monitoring metabolic determinants of bone metabolism is particularly important in patients receiving long-term PN. Markers of intermediary, electrolyte and trace element metabolism require regular checks.

  18. TIC y Sostenibilidad: Obstáculos y posibilidades para los educadores ambientales

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    Fernando Ojeda-Barceló

    2011-01-01

    enfrentan, las actitudes y valoración de aquellas, sus ventajas e inconvenientes y su integración concreta en la programación de aula. Ello se hizo a través de una investigación que parte de la constitución de una comunidad virtual internacional, participando un total de 232 educadores ambientales de doce países iberoamericanos que respondieron a una encuesta «on line» con items cerrados y abiertos. Las categorías de análisis se generaron a partir de los objetivos del estudio y las subcategorías en las respuestas abiertas se formularon de forma inductiva-deductiva. Los resultados evidencian una alta consideración de los educadores hacia las TIC aunque la realidad de su uso es menos optimista, dado que existe un bajo nivel de preparación y se enfrentan a dificultades técnicas, organizativas, económicas o, incluso, de convicción sobre su utilidad en sustitución del contacto con el medio natural, lo que hace que el uso de las TIC no sea lo frecuente que sería deseable ni se aprovechan las múltiples posibilidades de la web 2.0.

  19. Efectos económicos y ambientales del impuesto especial sobre determinados medios de transporte

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    Jaume Freire González

    2014-02-01

    Full Text Available El principal objetivo de la reforma del Impuesto Especial sobre Determinados Medios de Transporte (IEDMT, que entró en vigor en enero de 2008, fue incentivar un progresivo cambio en el parque automovilístico español hacia vehículos menos contaminantes. La presente investigación realiza una estimación, a partir de técnicas econométricas, de los efectos económicos y ambientales de la nueva configuración del IEDMT. La reforma del impuesto ha tenido un efecto positivo y significativo sobre la reducción de las emisiones de CO2 de los nuevos vehículos matriculados. The main objective of the reform of the Vehicle Registration Tax (IEDMT in Spain, which came into force in January 2008, was to encourage a gradual change in the Spanish fleet towards less polluting vehicles. This research estimates the economic and environmental effects of the new configuration of IEDMT using econometric techniques. The tax reform had a positive and significant effect on the reduction of CO2 emissions of new registered vehicles.

  20. Propuesta de un modelo para identificar impactos ambientales del turismo en espacios naturales

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    Manuela Andrés Abellán

    2000-01-01

    Full Text Available En este trabajo se propone un modelo para predecir y estimar de forma cualitativa los impactos ambientales que los visitantes de un área recreativa provocan, dependiendo del tipo de actividades que realizan y de las características del paraje. Este método podría servir como herramienta para gestionar el turismo y planificar las áreas recreativas de forma que pueda satisfacerse la demanda de los usuarios sin alterar de forma irreversible los recursos naturales. La aplicación del modelo en distintas áreas recreativas («El Barco, en Cuenca; «Los Chorros del río Mundo, en Albacete y los ((Campamentos de Peñascosa, en Albacete, ha permitido establecer diferentes zonas de impacto potencial, muy útiles para proponer nuevas medidas de gestión de uso público, como la distribución de los visitantes por lugares donde el riesgo de impacto sea menor

  1. El centro histórico de Barranquilla: problemáticas ambientales y sociales

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    Myriam Graciela Bonilla Becerra

    2007-01-01

    Full Text Available Los procesos de rehabilitación de los centros históricos en diversas ciudades del mundo, no solo se enfocan en los aspectos arquitectónicos o de espacio público, sino que deben atender los problemas ambientales. El centro histórico es por lo general el área con mayor degradación ambiental a nivel de contaminación atmosférica, contaminación por ruido, manejo de residuos sólidos y otras formas de contaminación de la ciudad; pero en el caso de Barranquilla el sistema de caños de la ciudad ha sido afectado por las actividades propias de su centro histórico, llevándolos a un estado de degradación y contaminación que no ha sido solucionado en forma definitiva. La recuperación de los caños de Barranquilla es un asunto prioritario y es por esto que el gobierno colombiano ha aprobado la “Implementación Plan de Saneamiento de los Caños de la Cuenca Oriental de la Ciudad de Barranquilla”, cuyo costo asciende 75.554 millones de pesos. Lo que permitirá darle una nueva cara al centro histórico de la ciudad.

  2. Microconflictos ambientales y crisis de gobernabilidad en la Amazonía ecuatoriana

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    Fontaine , Guillaume

    2005-01-01

    Full Text Available Este artículo analiza la relación entre contaminación y conflictos ambientales en el norte de la Amazonía ecuatoriana. La idea central que se defiende es que el manejo de conflictos por la empresa petrolera del Ecuador, Petroecuador, puede llevar a negociaciones ¿eficientes¿ a corto plazo, a costa de la institucionalización de los arreglos y de un tratamiento de las causas estructurales de los conflictos. Este entorno, condicionado por una gestión ambiental inadecuada en el norte de la Amazonía, constituye el telón de fondo de los conflictos radicales en el centro y el sur de la región y seguirá siendo un marco referencial contra la política petrolera del Estado. En particular, el clima de tensión social que resulta de esta situación es agravado aún más por la mediatización del juicio contra Chevrón-Texaco. Sin una redefinición de las políticas públicas ¿en particular políticas ambiental y social responsables y equitativas¿ este clima amenaza con desembocar en una crisis de gobernabilidad democrática.

  3. Contabilidad de costos ambientales en la industria cárnica, recomendaciones para su desarrollo

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    Yunier Maresma-Hernández

    2016-01-01

    Full Text Available La contabilidad ambiental ha logrado darle un matiz económico y financiero al uso, cuidado y conservación del medio ambiente, convirtiéndose esta, en una valiosa herramienta para la toma de decisiones, generando beneficios tanto para las organizaciones como para el medio natural. Es por tal razón que se enfoca este trabajo al estudio de los sistemas de costos empleados por la industria cárnica; tomando como estudio de caso la Empresa Cárnica Holguín. Para la realización de la investigación se utilizaron los métodos revisión de documentos, estudio de casos, análisis y síntesis, entrevistas a especialistas contables donde se pudo esclarecer aspectos descritos en el manual de costo. Se realizó un examen a los sistemas de costos empleados y los procedimientos contables que se aplican para la distribución de los gastos y como resultado de esta investigación se dan sugerencias para la implementación de un sistema de costos ambientales en esta entidad.

  4. Aislamiento de Sporothrix pallida complex en muestras clínicas y ambientales de Chile

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    Rodrigo M Cruz Choappa

    2014-12-01

    Full Text Available Se informa para Chile el aislamiento de S. pallida complex desde muestras médicas y del suelo del hogar de una paciente. Los hongos del complejo Sporothrix schenckii pueden causar distintas infecciones. En Chile, los aislamientos médicos y ambientales de este complejo son poco frecuentes. El objetivo de este trabajo fue identificar un agente atípico en un caso de onicomicosis y detectar su presencia en el suelo del jardín del hogar de la paciente. Para esto, las muestras clínicas se obtuvieron por raspado subungueal del primer dedo del pie derecho, y las muestras de suelo, de diferentes sectores del jardín. La identificación de las especies se realizó por morfofisiología y para la confirmación molecular se envió una de las cepas aisladas de la uña de la paciente al CBS (14.062. Se identificó S. pallida complex tanto de las muestras de uña como de aquellas provenientes del suelo del jardín.

  5. El valor de los servicios ambientales en la cuenca baja del río Mayo

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    Alma Angelina Haro Martínez

    2015-01-01

    Full Text Available en este trabajo se presentan los resultados de la valora-ción económica de los servicios ambientales, para la cuencabaja del río Mayo, en Sonora, en el noroeste de México,donde las actividades económicas han impactado severa-mente y sustituido los ecosistemas naturales en la mayorparte del territorio. La metodología utilizada consistió en ladelimitación de los servicios en función de su distribuciónespacial y, en algunos casos, se usaron componentes de losecosistemas como proxy. Se compararon nueve servicios,que abarcan los cuatro grupos de funciones ecosistémicas(regulación, soporte, provisión y cultural. Los cálculos sebasaron en valores estimados de mercado por servicio y porunidad de área. Esto generó nueve mapas individuales y unodonde se integra el valor total por unidad de área.

  6. Caracterización fenotípica de aislamientos ambientales de Cryptococcus neoformans.

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    Sandra Huérfano

    2003-09-01

    Full Text Available La criptococosis es causada por las tres variedades de Cryptococcus neoformans, las cuales presentan diferencias fisiológicas y de virulencia, algunas de las cuales se han estudiado para reconocer aspectos de su biología. Este trabajo evaluó las características fenotípicas de aislamientos ambientales de las variedades grubii y gattii, con el fin de establecer diferencias asociadas con el ciclo de vida y la virulencia. Se estudiaron 28 aislamientos serotipo A y 31 serotipo C. Se evaluaron la morfología macroscópica y microscópica de blastoconidias cultivadas en agar Sabouraud y suelos, el crecimiento a 37 °C, la producción de 22 enzimas extracelulares, la frecuencia del fenómeno de fructificación haploide, la pareja sexual, el patrón de sensibilidad a toxinas asesinas (killer y la virulencia en ratones Balb/c. No se observaron diferencias entre las dos variedades en la morfología macroscópica, la microscópica, ni en el crecimiento a 37 °C (p>0,05; sin embargo, se observó disminución del tamaño celular y capsular de blastoconidias cultivadas en suelo comparado con el tamaño en Sabouraud (p

  7. Implicaciones ambientales de las tecnologías de energía renovable

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    Jan Mahirt-Smith

    2011-12-01

    Full Text Available Las tecnologías de energía renovable como la eólica, la solar y la biomasa, hacen un uso del suelo más intenso que las de combustibles fósiles tradicionales y, geográficamente, sus implicaciones ambientales son más heterogéneas, por lo que presentan un gran desafío para las técnicas de evaluación de su ciclo de vida. Este trabajo presenta los resultados de una investigación bibliográfica alrededor de los siguientes temas: 1 cambios en el uso del suelo debido a la mayor producción de energía renovable; 2 impactos del uso de suelo; 3 variabilidad geográfica en el inventario de datos; y 4 efectos de la distribución de energía. Además, se revisa el grado de investigación que actualmente se aplica acerca de las tecnologías de energía renovable en campos como el eólico, el solar y la bioenergía y en la evaluación del ciclo de vida en general.

  8. Conflictos ambientales y conflictos ambientalistas en el México porfiriano

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    Inmaculada Simón Ruiz

    2010-01-01

    Full Text Available En estas páginas vamos a hablar de conflictos ambientalistas en perspectiva histórica. Se presentarán dos estudios de caso en torno al servicio público o privado del agua en la Ciudad de México y al abastecimiento de la misma desde el Desierto de los Leones durante el porfiriato. Las partes en el conflicto serán: los empresarios particulares, el gobierno del Ayuntamiento de la Ciudad de México, el gobierno del Distrito Federal y el poder central. Presentaremos el conflicto como una parte del enfrentamiento entre el poder local y el poder central en un momento crítico de la historia mexicana previo a la Revolución, e introduciremos en el debate la preocupación del momento por cuestiones ambientales. Producto de este enfrentamiento fueron las primeras leyes de protección ambiental entendidas como defensa de un "proyecto nacional" en el que se considera la defensa del medio ambiente como defensa del patrimonio de la nación.

  9. Emergencias ambientales y el papel del Centro Nacional de Sanidad Ambiental

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    Francisco José Ruiz Boada

    2015-05-01

    Full Text Available La finalidad primordial del Centro Nacional de Sanidad Ambiental (CNSA del Instituto de Salud Carlos III, es la caracterización del riesgo potencial a que está expuesta la población ante potenciales episodios de contaminación ambiental. El CNSA, en base a su experiencia, conocimiento científico y recursos tecnológicos, y para dar cumplimiento a su principal función, de servir como apoyo científico-técnico a las Administraciones Públicas en aspectos sanitarios relacionados con el medio ambiente, creó a finales del año 2012, una Unidad de Emergencias constituida por las capacidades, tanto de personal como de medios, existentes en sus diferentes Áreas, Servicios y Unidades y así proyectar sus capacidades e intervenir en aquellas emergencia con repercusiones en el medioambiente en las que se requiera, por la administración competente, su apoyo y asesoramiento. Con el fin de probar su operatividad y puesta a punto tanto de su procedimiento operativo de actuación en estas emergencias, como de los planes de calidad específicos desarrollados para las diferentes matrices ambientales, ha participado desde su creación en cuatro ejercicios organizados desde la Dirección General de Protección Civil y la Unidad Militar de Emergencias, con las que se han firmado convenios marco de colaboración.

  10. Vitamin E in new-generation lipid emulsions protects against parenteral nutrition-associated liver disease in parenteral nutrition-fed preterm pigs

    Science.gov (United States)

    Parenteral nutrition (PN) in preterm infants leads to PN-associated liver disease (PNALD). PNALD has been linked to serum accumulation of phytosterols that are abundant in plant oil but absent in fish oil emulsions. Whether modifying the phytosterol and vitamin E composition of soy and fish oil lipi...

  11. Parenteral nutrition following intensive cytotoxic therapy: an exploratory study on the need for parenteral nutrition after various treatment approaches for haematological malignancies

    NARCIS (Netherlands)

    Iestra, J. A.; Fibbe, W. E.; Zwinderman, A. H.; Romijn, J. A.; Kromhout, D.

    1999-01-01

    Patients receiving intensive cytotoxic therapy are traditionally supported with parenteral nutrition (PN), although it is unclear whether all patients benefit from PN. This study aimed to identify regimen-associated differences in PN requirements, to reveal discrepancies between the number of PN

  12. Evidence for the use of parenteral nutrition in the pediatric intensive care unit.

    Science.gov (United States)

    Fivez, Tom; Kerklaan, Dorian; Mesotten, Dieter; Verbruggen, Sascha; Joosten, Koen; Van den Berghe, Greet

    2017-02-01

    During hospitalization in a pediatric intensive care unit (PICU), critically ill children are fed artificially. Administered via the preferred enteral route, caloric targets are often not reached. Hence, parenteral nutrition is given to this patient population. In this review we analyzed the available evidence from randomized controlled trials (RCTs) that supports the use of parenteral nutrition in children during critical illness. A search strategy in Ovid MEDLINE and Ovid EMBASE was created and trial registries were screened to identify the relevant RCTs. Studies were included if they were randomized controlled trials, involved pediatric patients admitted to PICU, and compared different dosing/compositions of parenteral nutrition. Descriptive studies and reviews were excluded. Of the 584 articles identified by the search strategy, only 114 articles were retained after title screening. Further abstract and full text screening identified 6 small RCTs that compared two dosing/composition strategies of parenteral nutrition. These trials reported differences in surrogate endpoints without an effect on hard clinical endpoints. The RCTs observed improvements in these surrogate endpoints with the use of more calories or when parenteral glutamine or fish oil was added. The few RCTs suggest that surrogate endpoints can be affected by providing parenteral nutrition to critically ill children, but the studies were not statistically powered to draw meaningful clinical conclusions. Large RCTs with clinically relevant outcome measures are urgently needed to support the current nutritional guidelines that advise the use of parenteral nutrition in the PICU. Copyright © 2015 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  13. Hepatitis C virus infection in Guinea-Bissau: a sexually transmitted genotype 2 with parenteral amplification?

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    Mireille Plamondon

    Full Text Available BACKGROUND: Sub-Saharan Africa is the continent with the highest prevalence of Hepatitis C virus (HCV infection. Genotype 2 HCV is thought to have originated from West Africa several hundred years ago. Mechanisms of transmission remain poorly understood. METHODOLOGY/PRINCIPAL FINDINGS: To delineate mechanisms for HCV transmission in West Africa, we conducted a cross-sectional survey of individuals aged >or=50 years in Bissau, Guinea-Bissau. Dried blood spots were obtained for HCV serology and PCR amplification. Prevalence of HCV was 4.4% (47/1066 among women and 5.0% (27/544 among men. In multivariate analysis, the independent risk factors for HCV infection were age (baseline: 50-59 y; 60-69 y, adjusted odds ratio [AOR]: 1.67, 95% CI: 0.91-3.06; >or=70 y, AOR: 3.47, 95% CI: 1.89-6.39, belonging to the Papel, Mancanha, Balanta or Mandjako ethnic groups (AOR: 2.45, 95% CI:1.32-4.53, originating from the Biombo, Cacheu or Oio regions north of Bissau (AOR: 4.16, 95% CI: 1.18-14.73 and having bought or sold sexual services (AOR: 3.60, 95% CI: 1.88-6.89. Of 57 isolates that could be genotyped, 56 were genotype 2. CONCLUSIONS: Our results suggest that transmission of HCV genotype 2 in West Africa occurs through sexual intercourse. In specific locations and subpopulations, medical interventions may have amplified transmission parenterally.

  14. O significado da nutrição parenteral para o cliente no contexto hospitalar

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    Consuelo Helena Aires de Freitas Lopes

    1996-06-01

    Full Text Available A necessidade de compreender o significado da nutrição parenteral para o cliente no contexto hospitalar surgiu das nossas inquietações diante do cuidado de enfermagem. Realizaram-se observações participantes, entrevistas e anotações de campo junto a sete clientes hospitalizados, que se encontravam sob nutrição parenteral. O sentido das investigações foi centrado na indagação: como você está se sentindo com a nutrição parenteral? Os dados foram analisados numa abordagem interacionista, mostrando as dificuldades enfrentadas pelos clientes na assistência hospitalar, como percebiam eles a nutrição parenteral e que significados eram atribuídos a essa terapêutica. O estudo revelou os sentimentos, comportamentos e atitudes relacionados aos aspectos biológico, emocional e sócio-cultural do cliente, ligados à nutrição parenteral, demonstrando, também as limitações impostas ao cliente sob esse tratamento, bem como as dificuldades na assistência de enfermagem.

  15. Reversal of growth arrest in adolescents with Crohn's disease after parenteral alimentation.

    Science.gov (United States)

    Layden, T; Rosenberg, F; Nemchausky, G; Elson, C; Rosenberg, I

    1976-06-01

    Growth arrest and delayed onset of puberty often complicate childhood onset Crohn's disease of the small bowel (granulomatous enteritis). Nutritional deficits arising from inadequate dietary intake, malabsorption, and increased caloric needs may contribute to growth retardation. To assess whether a sustained high caloric and nitrogen intake could reestablish growth, 4 children with extensive Crohn's disease of the small bowel were studied before and after parenteral alimentation which was instituted for symtomatic disease control. Weight gain, positive nitrogen balance, and improved nutritional status were achieved during parenteral alimentation in each patient. In 2 patients weight gain was sustained using oral nutritional supplements, and a substantial increase in linear skeletal growth continued in the ensuing months. One patient entered puberty within 4 months of parenteral alimentation and another had the onset of menarche and the development of secondary sex characteristics 4 months after parenteral alimentation and resection of diseased bowel. Growth may be reestablished in some growth-arrested children if intake is sufficient to establish a sustained positive caloric and nitrogen balance. Nutritional requirements imposed by the demands of growth and active disease and often compounded by the catabolic effects of corticosteroids may be excessive; growth may occur only if these needs are met orally and/or parenterally.

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

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    Juan A. Sanchez

    2013-02-01

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

  17. Accelerated in-vitro release testing methods for extended-release parenteral dosage forms.

    Science.gov (United States)

    Shen, Jie; Burgess, Diane J

    2012-07-01

    This review highlights current methods and strategies for accelerated in-vitro drug release testing of extended-release parenteral dosage forms such as polymeric microparticulate systems, lipid microparticulate systems, in-situ depot-forming systems and implants. Extended-release parenteral dosage forms are typically designed to maintain the effective drug concentration over periods of weeks, months or even years. Consequently, 'real-time' in-vitro release tests for these dosage forms are often run over a long time period. Accelerated in-vitro release methods can provide rapid evaluation and therefore are desirable for quality control purposes. To this end, different accelerated in-vitro release methods using United States Pharmacopeia (USP) apparatus have been developed. Different mechanisms of accelerating drug release from extended-release parenteral dosage forms, along with the accelerated in-vitro release testing methods currently employed are discussed. Accelerated in-vitro release testing methods with good discriminatory ability are critical for quality control of extended-release parenteral products. Methods that can be used in the development of in-vitro-in-vivo correlation (IVIVC) are desirable; however, for complex parenteral products this may not always be achievable. © 2012 The Authors. JPP © 2012 Royal Pharmaceutical Society.

  18. Accelerated in vitro release testing methods for extended release parenteral dosage forms

    Science.gov (United States)

    Shen, Jie; Burgess, Diane J.

    2012-01-01

    Objectives This review highlights current methods and strategies for accelerated in vitro drug release testing of extended release parenteral dosage forms such as polymeric microparticulate systems, lipid microparticulate systems, in situ depot-forming systems, and implants. Key findings Extended release parenteral dosage forms are typically designed to maintain the effective drug concentration over periods of weeks, months or even years. Consequently, “real-time” in vitro release tests for these dosage forms are often run over a long time period. Accelerated in vitro release methods can provide rapid evaluation and therefore are desirable for quality control purposes. To this end, different accelerated in vitro release methods using United States Pharmacopoeia (USP) apparatus have been developed. Different mechanisms of accelerating drug release from extended release parenteral dosage forms, along with the accelerated in vitro release testing methods currently employed are discussed. Conclusions Accelerated in vitro release testing methods with good discriminatory ability are critical for quality control of extended release parenteral products. Methods that can be used in the development of in vitro-in vivo correlation (IVIVC) are desirable, however for complex parenteral products this may not always be achievable. PMID:22686344

  19. [Clinical outcomes of parenterally administered shuxuetong--analysis of hospital information system data].

    Science.gov (United States)

    Zhi, Ying-Jie; Zhang, Hui; Xie, Yan-Ming; Yang, Wei; Yang, Hu; Zhuang, Yan

    2013-09-01

    Hospital information system data of cerebral infaction patients who received parenterally administered Shuxuetong was analyzed. This provided frequency data regarding patients' conditions and related information in order to provide a clinical reference guide. In this study, HIS data from 18 hospitals was analyzed. Patients receiving parenterally administered Shuxuetong for the treatment of cerebral infarction were included. Information on age, gender, costsand route of administration were collated. The average age of patients was 66 years old. Days of hospitalization ranged from 15 to 28 days. The majority of patients were classified as having phlegm and blood stasis syndrome, which is inaccordance with the indications for this drug. The most commonly used drugs used in combination with parenterally administered Shuxuetong were: aspirin, insulin and heparin. Patients with cerebral infarction crowd using parenterally administered Shuxuetong were a mostly elderly population, with an average age of 66. Although generally use was in accordance with indications, dosage, and route of administration, there were however some discrepancies. Therefore, doctors need to pay close attention to guidelines and closely observe patients when using parenterally administered Shuxuetong and to consider both the clinical benefits and risks.

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

    Science.gov (United States)

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

    2013-01-01

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

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

    Science.gov (United States)

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

    2015-09-01

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

  2. Clinical relevance of trace element measurement in patients on initiation of parenteral nutrition.

    Science.gov (United States)

    Salota, Rashim; Omar, Sohail; Sherwood, Roy A; Raja, Kishor; Vincent, Royce P

    2016-11-01

    Background and Aims Serum zinc, copper and selenium are measured in patients prior to commencing on parenteral nutrition; however, their interpretation can be difficult due to acute phase reactions. We assessed (i) the relationship of raised C-reactive protein with trace elements and albumin (ii) benefits of measuring trace elements when C-reactive protein is raised in patients requiring short-term parenteral nutrition. Methods Samples were collected for zinc, copper, selenium and albumin at baseline and then every two weeks and correlated with C-reactive protein results in patients on parenteral nutrition. Results were categorized into four groups based on the C-reactive protein concentrations: (i)  0.05), whereas selenium and albumin were lower in the group with C-reactive protein > 40 mg/L ( P parenteral nutrition, measurement of C-reactive protein is essential when interpreting zinc and selenium but not copper results. Routine measurement of trace elements prior to commencing parenteral nutrition has to be considered on an individual basis in patients with inflammation.

  3. Evolución de los riesgos ambientales en el contexto de la crisis económica. Informe SESPAS 2014

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    Ferran Ballester

    2014-06-01

    Full Text Available Nuestro objetivo es analizar el impacto de la crisis económica-financiera en los determinantes ambientales de la salud. La Organización Mundial de la Salud estima que entre un 13% y un 27% de la carga de enfermedad de los países podría prevenirse mejorando el medio ambiente. Los efectos son de mayor magnitud en poblaciones más vulnerables, en especial entre los más pobres. En la última década, la contaminación atmosférica exterior (el riesgo ambiental más relevante, en términos de salud, para la mayoría de los países europeos se ha reducido moderadamente, sobre todo por las políticas europeas de reducción de emisiones y por la disminución de la actividad con la crisis económica. En los últimos años esta mejora de la calidad del aire ha sido simultánea a una reducción en las inversiones en protección ambiental, por lo que, a medio plazo, podría verse contrarrestada. La tendencia al incremento de las temperaturas en España y Europa no se ha visto reducida con la crisis económica, ya que el cambio climático es un fenómeno global que no se relaciona directamente con las emisiones locales. Para reducir el riesgo de un incremento del impacto sobre la salud de los factores ambientales existen aspectos fundamentales que deben ser considerados, como la necesidad de mantener o desarrollar sistemas de vigilancia y control adecuados y la oportunidad de aplicar políticas que ayuden a mejorar la calidad ambiental y a reducir la vulnerabilidad de diferentes grupos de la población, en un marco de trabajo intersectorial, de transparencia y de participación de la ciudadanía.

  4. Refeeding syndrome: screening, incidence, and treatment during parenteral nutrition.

    Science.gov (United States)

    Walmsley, Russell S

    2013-12-01

    The possible deleterious effects of feeding after a period of prolonged starvation have been known for over 60 years. The resultant biochemical disturbance, symptoms, and signs have been termed the refeeding syndrome (RS). The key to the pathophysiology is the stimulation of insulin release resulting in anabolic activity. Depleted electrolyte and micronutrient stores are overwhelmed and cellular function disrupted. A concise definition of RS is not agreed and hampers interpretation of clinical data. Hypophosphatemia and appearance of tissue edema/pathological fluid shifts are the most often agreed diagnostic criteria. The characteristics of particular patient groups at risk have been recognized for some time, and there are guidelines from the National Institute for Clinical Excellence in the UK to aid recognition of individuals at high risk along with protocols for initiating nutrition. Using loose diagnostic criteria, RS appears to occur in 4% of cases of parenteral nutrition (PN) when case records were reviewed by experts in a large study into PN care in the UK. Disappointingly, prescribers recognized only 50% of at risk cases. Early data from a similar study in New Zealand appear to show a similar pattern. Prospective series looking at patients receiving nutrition support in institutions with Nutrition Support Teams have found an incidence of 1-5%. RS is still underrecognized. Patients receiving PN should be counted as being in a high-risk category and feeding protocols to avoid RS applied. Low rates of RS then occur and death from this cause be avoided. © 2013 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd.

  5. [Suppression of cycling activity in sheep using parenteral progestagen treatment].

    Science.gov (United States)

    Janett, F; Camponovo, L; Lanker, U; Hässig, M; Thun, R

    2004-03-01

    The objective of this study was to evaluate the effect of two synthetic progestagen preparations Chlormadinone acetate (CAP, Chronosyn, Veterinaria AG Zürich) and Medroxyprogesterone acetate (MPA, Nadigest, G Streuli & Co. Uznach) on cycling activity and fertility in sheep. A flock of 28 non pregnant white alpine sheep was randomly divided into three groups, A (n = 10), B (n = 9) and C (n = 9). During a period of 4 weeks the cycling activity was confirmed by blood progesterone analysis. Thereafter, the animals of group A were treated with 50 mg CAP, those of group B with 140 mg MPA and those of group C with physiological saline solution. All injections were given intramuscularly. Suppression of endogenous progesterone secretion lasted from 28 to 49 days (mean = 39 days) in group A and from 42 to 70 days (mean = 50 days) in group B. The synchronization effect of both preparations was unsatisfactory as the occurrence of first estrus was distributed over a period of 3 weeks in group A and 4 weeks in group B. These findings could also be confirmed by the lambing period which lasted 52 days in group A and 36 days in group B. Control animals lambed within 9 days due to the synchronizing effect of the ram. The first fertile estrus was observed 36 days (group A) and 45 days (group B) after the treatment. In group A all 10 animals and in groups B and C 8 of 9 ewes each became pregnant. Parenteral progestagen application with CAP and MPA is a simple, safe and reversible method of estrus suppression in the sheep. The minimal suppressive duration of 4 (CAP) and 5 weeks (MPA) is not sufficient when a period of 3 months (alpine pasture period) is desired.

  6. Enteral and parenteral lipid requirements of preterm infants.

    Science.gov (United States)

    Lapillonne, Alexandre

    2014-01-01

    Lipids provide infants with most of their energy needs. The major portion of the fat in human milk is found in the form of triglycerides, the phospholipids and cholesterol contributing for only a small proportion of the total fat. Long-chain polyunsaturated fatty acids (LC-PUFAs) are crucial for normal development of the central nervous system and have potential for long-lasting effects that extend beyond the period of dietary insufficiency. Given the limited and highly variable formation of docosahexaenoic acid (DHA) from α-linolenic acid, and because DHA is critical for normal retinal and brain development in the human, DHA should be considered to be conditionally essential during early development. In early enteral studies, the amount of LC-PUFAs administered in formula was chosen to produce the same concentration of arachidonic acid and DHA as in term breast milk. Recent studies report outcome data in preterm infants fed formula with DHA content 2-3 times higher than the current concentration. Overall, these studies show that providing larger amounts of DHA supplements is associated with better neurological outcomes and may provide other health benefits. One study further suggests that the smallest babies are the most vulnerable to DHA deficiency and likely to reap the greatest benefit from high-dose DHA supplementation. Current nutritional management may not provide sufficient amounts of preformed DHA during the parenteral and enteral nutrition periods and in very preterm/very low birth weight infants until due date and higher amounts than those routinely used are likely to be necessary to compensate for intestinal malabsorption, DHA oxidation, and early deficit. Recommendations for the healthcare provider are made in order to prevent lipid and more specifically LC-PUFA deficit. Research should be continued to fill the gaps in knowledge and to further refine the adequate intake for each group of preterm infants. © 2014 S. Karger AG, Basel.

  7. Gastroenterology – Guidelines on Parenteral Nutrition, Chapter 15

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    Schulz, R. J.

    2009-11-01

    Full Text Available In patients with Crohn's disease and ulcerative colitis parenteral nutrition (PN is indicated when enteral nutrition is not possible or should be avoided for medical reasons. In Crohn's patients PN is indicated when there are signs/symptoms of ileus or subileus in the small intestine, scars or intestinal fistulae. PN requires no specific compounding for chronic inflammatory bowel diseases. In both diseases it should be composed of 55–60% carbohydrates, 25–30% lipids and 10–15% amino acids. PN helps in the correction of malnutrition, particularly the intake of energy, minerals, trace elements, deficiency of calcium, vitamin D, folic acid, vitamin B12, and zinc. Enteral nutrition is clearly superior to PN in severe, acute pancreatitis. An intolerance to enteral nutrition results in an indication for total PN in complications such as pseudocysts, intestinal and pancreatic fistulae, and pancreatic abscesses or pancreatic ascites. If enteral nutrition is not possible, PN is recommended, at the earliest, 5 days after admission to the hospital. TPN should not be routinely administered in mild acute pancreatitis or nil by moth status <7 days, due to high costs and an increased risk of infection. The energy requirements are between 25 and 35 kcal/kg body weight/day. A standard solution including lipids (monitoring triglyceride levels! can be administered in acute pancreatitis. Glucose (max. 4–5 g/kg body weight/day and amino acids (about 1.2–1.5 g/kg body weight/day should be administered and the additional enrichment of TPN with glutamine should be considered in severe, progressive forms of pancreatitis.

  8. Enteral versus parenteral nutrition in cancer patients: evidences and controversies.

    Science.gov (United States)

    Cotogni, Paolo

    2016-01-01

    The debate over the use of enteral nutrition (EN) and parenteral nutrition (PN) is an old but evergreen and hot topic. Since many years, studies comparing EN and PN have been a pivotal 'leitmotif' in the published literature on artificial nutrition (AN). Actually, there is a background misunderstanding in this debate; specifically, that EN and PN are competitors in the choice of the route for delivering nutrition support in cancer patients. Conversely, EN and PN have specific indications and contraindications. This review has the purpose to discuss the indications and complications as well as pros and cons of EN and PN in cancer patients, the crucial role of nutrition support in oncology patients during anticancer treatments and throughout the course of disease, and, finally, the role of AN in advanced cancer patients. In summary, we have no evidence-based data able to definitively indicate the optimal method for delivering AN in cancer patients. EN and PN have to be considered equally effective in maintaining or improving nutritional status in cancer patients. Besides, this review strongly supports the recommendation that a baseline nutritional assessment should be carried out by a healthcare professional expert in AN for all cancer patients at the time of diagnosis or anticancer treatment plan, taking the nutritional status, estimated duration of AN, AN-related potential benefits and possible complications into consideration on an individual basis. Moreover, the patient symptoms, performance status, estimated life expectancy, and mainly, will or preferences have to be evaluated and incorporated into the nutrition support plan before the definitive choice of the route for delivering nutrients is decided. Finally, applying a decision-making process tailored to patient needs-regardless of whether receiving or not anticancer treatment-allows to choose reasonably the optimal nutritional support strategy.

  9. Adult classical homocystinuria requiring parenteral nutrition: Pitfalls and management.

    Science.gov (United States)

    Tran, Christel; Bonafé, Luisa; Nuoffer, Jean-Marc; Rieger, Julie; Berger, Mette M

    2017-07-25

    Homocystinuria due to cystathionine beta synthase (CBS) deficiency presents with a wide clinical spectrum. Treatment by the enteral route aims at reducing homocysteine levels by using vitamin B6, possibly methionine-restricted diet, betaine and/or folate and vitamin B 12 supplementation. Currently no nutritional guidelines exist regarding parenteral nutrition (PN) under acute conditions. Exhaustive literature search was performed, in order to identify the relevant studies describing the pathogenesis and nutritional intervention of adult classical homocystinuria requiring PN. Description of an illustrative case of an adult female with CBS deficiency and intestinal perforation, who required total PN due to contraindication to enteral nutrition. Nutritional management of decompensated classical homocystinuria is complex and currently no recommendation exists regarding PN composition. Amino acid profile and monitoring of total homocysteine concentration are the main tools enabling a precise assessment of the severity of metabolic alterations. In case of contraindication to enteral nutrition, compounded PN will be required, as described in this paper, to ensure adequate low amounts of methionine and others essential amino acids and avoid potentially fatal toxic hypermethioninemia. By reviewing the literature and reporting successful nutritional management of a decompensated CBS deficiency using tailored PN with limited methionine intake and n-3 PUFA addition, we would like to underscore the fact that standard PN solutions are not adapted for CBS deficient critical ill patients: new solutions are required. High methionine levels (>800 μmol/L) being potentially neurotoxic, there is an urgent need to improve our knowledge of acute nutritional therapy. Copyright © 2017 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  10. Assessment of parenteral nutrition prescription in Canadian acute care settings.

    Science.gov (United States)

    Adjemian, Daniela; Arendt, Bianca M; Allard, Johane P

    2018-05-01

    Parenteral nutrition (PN) prescription can be challenging in patients with complex conditions and has potential complications. To assess PN prescription, monitoring, and PN-related complications in a Canadian acute care setting. This was a prospective cohort study in which patients receiving PN were assessed by an auditor for nutritional status, PN-related prescription, monitoring, and complications. In addition, length of stay and mortality were recorded. 147 patients (mean ± SD 56.1 ± 16.4 y) with complex diseases (Charlson comorbidity index, median [p25-p75] 2 [1-4]) were enrolled. Before starting PN, 18.6%, 63.9%, and 17.5% of patients were classified as subjective global assessment A, B, and C, respectively. Body mass index remained unchanged during the period on PN. On average, 89% and 73% of patients received <90% of their energy and protein requirements, respectively, but 65% received oral or enteral nutrition at some point during PN. The average daily energy provided by PN increased and stabilized on day 10, reaching 87.2 ± 20.1% of the requirements. Line sepsis (6.8% of patients) and hyperglycemia (6.9%) were the most common complications. The overall mortality was 15.6%. For those alive, length of stay was 30 (range: 4-268) d. PN was discontinued because of transitioning to an oral diet (56.6%), enteral nutrition (17.6%), home PN (14.7%), palliative care (5.1%), death (4.4%), or other (1.5%). Most patients were malnourished at the start of PN. Energy and protein provided from PN were less than requirements, and the goals were reached with delay. Mortality was high, possibly as a result of complex diseases. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Lung ventilation-perfusion scintigraphy in children on long-term parenteral nutrition

    Energy Technology Data Exchange (ETDEWEB)

    Pifarre, Paloma; Roca, Isabel [Universitat Autonoma de Barcelona, Department of Nuclear Medicine, Hospital de la Vall d' Hebron, Barcelona (Spain); Irastorza, Inaki; Hill, Susan [Great Ormond Street Hospital, Department of Gastroenterology, London (United Kingdom); Simo, Marc [Instituto Universitario Dexeus, Department of Nuclear Medicine, Barcelona (Spain); Biassoni, Lorenzo; Gordon, Isky [Great Ormond Street Hospital, Department of Nuclear Medicine, London (United Kingdom)

    2009-06-15

    Pulmonary emboli (PE) are one of the major complications associated with total parenteral nutrition (TPN). Ventilation-perfusion scintigraphy (V/Q) remains the most used test for the diagnosis of PE and follow-up of patients on TPN. The aim of our study was to demonstrate the high prevalence of undiagnosed PE in children on TPN. The medical and imaging files of 64 patients on TPN who underwent V/Q examinations covering the period of 1986-2004 were reviewed. Children were aged between 3.18 months and 21.6 years. TPN was started at birth (range 0-15 years). All children had a normal chest radiograph and no symptoms at the time of the V/Q scan. A comparative analysis between the prevalence of PE and risk factors number of days per week with lipophilic content of the TPN, bowel inflammation and thrombophilic factors (protein C and S) was performed. Of the 64 patients, 25 (39%) had an abnormal V/Q scan. A total of 29 PE episodes were diagnosed in all patients. Two children had three episodes of PE. The median age at PE diagnosis was 4.6 years. In 17 patients (68%) diagnosis was achieved on the first V/Q scan performed. PE was bilateral in 56% and unilateral in 44%. PE was the main cause of 2 out 15 recorded deaths. All risk factors were associated with an increase in PE prevalence by statistical analysis. PE is underdiagnosed in children on long-term TPN. Lung V/Q scintigraphy is useful in the diagnosis of PE in children with a low pretest probability. (orig.)

  12. DESAFÍOS DIDÁCTICOS EN EL ABORDAJE DE CONTENIDOS AMBIENTALES EN LA ESCUELA MEDIA

    Directory of Open Access Journals (Sweden)

    Andrea Viviana Ajón

    2015-12-01

    Full Text Available Los contenidos ambientales en la enseñanza de la Geografía representan desde hace tiempo, un atajo de la disciplina para mostrar el espíritu renovador del temario en la escuela, a través del ingreso de nuevos conceptos y del abordaje de problemáticas de relevancia social. La inclusión de dichos contenidos en el aula expresó un giro didáctico –impulsado desde el currículum- en la medida que favoreció la revisión del peso de la geografía física en las clases, en los libros escolares y en la planificación anual del profesor. Propició el tratamiento de problemáticas en diferentes escalas, el reconocimiento de actores sociales y sus intereses, el papel del Estado y organizaciones civiles, despertando el genuino interés de los alumnos. Sin embargo, este proceso no estuvo ni está exento de preguntas, desafíos metodológicos y dificultades. Particularmente se registran tres debilidades: la abundancia de información proveniente de los medios masivos de comunicación e Internet que suele reemplazar la explicación de lo ambiental desde la geografía; la persistencia de la importancia asignada a la geografía física previo al análisis de un caso ambiental; ciertas limitaciones provenientes de la línea renovada para la enseñanza de temáticas ambientales en la escuela. Os conteúdos ambientais no ensino da geografia tem representado a algum tempo um atalho da disciplina para mostrar o espírito inovador do seu currículo na escola, através da entrada de novos conceitos e abordagem de com relevância social. A inclusão destes conteúdos na sala de aula expressou uma rotação educacional – impulsionado pelo currículo - na medida em que favoreceu a revisão do peso da geografia física nas aulas, nos livros didáticos e no planejamento anual do professor. Proporcionando o tratamento da problemática em diferentes escalas, com o reconhecimento dos atores sociais e seus interesses, e do o papel do Estado e das organizações civis

  13. Muerte celular inducida por condiciones ambientales adversas en Calibrachoa parviflora (Petunia

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    Daniela Montes Berrueta

    2012-03-01

    Full Text Available Se ha descrito que condiciones ambientales extremas tales como altas temperaturas, luz ultravioleta y el efecto invernadero, alteran la tasa de crecimiento de las plantas. En este trabajo se investigó el efecto agudo de dos condiciones ambientales extremas tales como la limitación de nutrientes y la acidificación del suelo con ácido sulfúrico, un compuesto comúnmente depositado en los suelos como consecuencia de la llamada lluvia ácida, sobre la tasa de muerte y proliferación celular en petunias (Calibrachoa parviflora. Para tales efectos, grupos de petunias fueron sometidas a tres condiciones diferentes: grupo A o control, mantenida en condiciones óptimas y de suministro de nutrientes, grupo B en ausencia de nutrientes y de luz natural, y grupo C expuestas a agua acidificada con ácido sulfúrico. En un seguimiento hasta 72 horas, se analizaron muestras de pétalos, hojas y tallos de cada una de las plantas y, posterior a la extracción de los núcleos, estos fueron teñidos con ioduro de propidio, un agente intercalante del ADN, y analizados mediante citometría de flujo y microscopía de fluorescencia. Los resultados muestran que ambas condiciones extremas generan un desbalance en el proceso de muerte/sobrevida de las petunias, pero a diferencia de las plantas del grupo B, las plantas del grupo C no incrementaron la tasa de proliferación celular. Estos resultados sugieren que las plantas que crecen en suelos ácidos pierden la capacidad compensatoria ante la señal de estrés que se genera a consecuencia de la exposición aguda a concentraciones tóxicas de ácido sulfúrico. Cell death induced by adverse environmental conditions in Calibrachoa parviflora (petunia Abstract It has been previously reported that extreme environmental conditions such as high temperatures, ultraviolet light and the greenhouse effect, alter the rate of growth in plants. In this study we investigated the acute effect of two extreme environmental conditions

  14. CULTIVOS TRANSGÉNICOS: ENTRE LOS RIESGOS BIOLOGICOS Y LOS BENEFICIOS AMBIENTALES Y ECONOMICOS.

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    Alejandro Chaparro Giraldo

    2011-09-01

    cultivos GM, alrededor del análisis ponderado de los riegos biológicos y los beneficios ambientales y económicos. Los riesgos biológicos se definen por los posibles efectos negativos sobre el consumidor humano o sobre el ambiente en que se liberan. Los beneficios ambientales tienen que ver con los efectos de la reducción en el uso de agroquímicos (insecticidas y herbicidas, y los beneficios económicos con la reducción en las perdidas debidas al ataque de insectos y a la competencia de malezas, así como a la reducción de los costos de producción. El debate debe considerar también, que las herramientas desarrolladas para la transferencia de genes entre diferentes organismos, facilitan la apropiación de los recursos genéticos vía derechos de propiedad intelectual. Apropiarse de este conocimiento y ponerlo a jugar al lado de sus intereses, es un asunto vital para los países biodiversos como Colombia.

  15. Experiencias formativas, auto-adscripciones y conflictos ambientales en el sudoeste de Misiones (Argentina

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    Ana Padawer

    2015-04-01

    Full Text Available En este artículo abordaremos cómo se relacionan las experiencias formativas vinculadas al trabajo rural, las identificaciones y los conflictos ambientales en San Ignacio, Misiones (Argentina. Nos interesa problematizar cómo los aprendizajes ligados a las tareas rurales se vinculan con las auto-adscripciones de los sujetos, teniendo como referencia las categorías de actores sociales agrarios regionales y las denominaciones que provienen de agendas estatales de intervención. Estos procesos acontecen en un contexto de creciente concentración de propiedades que se destinan a la explotación forestal, donde observamos, en algunos casos, cierta ambientalización de los históricos conflictos territoriales.Utilizando materiales provenientes de un trabajo de campo etnográfico que iniciamos en 2008, presentaremos a dos familias de pobladores rurales. En ambos casos es posible ver cómo el acceso a la tierra es decisivo para las experiencias formativas en las actividades de reproducción social, y que se liga con identificaciones como “gente de la colonia” y una incipiente referencia a la “agricultura familiar” a partir de las intervenciones del Estado. Estas dos familias permiten mostrar cómo las experiencias e identificaciones se expresan en el contexto de la participación de los sujetos en conflictos sociales, que asumen en un caso la forma histórica de reclamos fundiarios mientras que, en el otro, es posible ver que el ambiente tiene protagonismo incipiente.

  16. Hongos ambientales en una biblioteca: un año de estudio

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    Dante J. Bueno

    2003-01-01

    Full Text Available Este artículo analiza los hongos presentes en una biblioteca científica situada en un centro de investigación (el cual trabaja con microorganismos en Tucumán, Argentina, desde Febrero del 2000 a Enero del 2001. Se identificaron 33 géneros, además de las levaduras y de los hongos clasificados como Mycelia sterilia y Basidiomycetes. Los géneros que presentaron la mayor frecuencia fueron Cladosporium sp. (30.1%, Fusarium sp (8.6%, Alternaria sp. (8.4%, Acremonium sp. (6.4% y Aspergillus sp. (5.5%. La mayor cantidad de esporas fúngicas fue observada en Octubre y la mínima en Julio. La temperatura estuvo entre 16,5 y 28,5ºC. El género Cladosporium sp. fue aislado en todos los meses muestreados. Este género predominó en Febrero (19.6%, junto a Alternaria sp., Mayo (29.6%, Junio (35.7%, Julio (33.3%, Agosto (40%, septiembre (27.5% y octubre (51.3%, mientras que Acremonium sp. predominó en Marzo (26.5%, Ceratosporium sp. en Abril (20.4% y los Basidiomycetes en Noviembre (17.6%. Además, Alternaria sp. fue el más abundante en Diciembre (20% y Enero (35.9%. A pesar del uso de un muestreo no volumétrico, este estudio provee una información útil sobre la incidencia de los hongos ambientales en la biblioteca testada. Sabiendo que su presencia es incuestionable y difícil de erradicar, son necesarias futuras investigaciones para examinar los efectos de su exposición sobre los problemas de salud relacionados.

  17. Procesos institucionales en el pago por servicios ambientales, cuenca alta del río Pasto

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    Yesenia Alejandra Narváez

    2016-06-01

    Full Text Available El pago por servicios ambientales (PSA, es la disponibilidad que tiene un individuo o grupo social para aprovechar o conservar la oferta ambiental natural. Este estudio se realizó en cuenca alta del río Pasto, donde el principal servicio ambiental, es la provisión hídrica del 85% de los habitantes de Pasto, Nariño, convirtiéndolo en un ecosistema estratégico que requiere de alternativas viables para su conservación y manejo. El objetivo fue evaluar los procesos relacionados con PSA, adelantados por algunas Instituciones; para ello, se diseñó una entrevista estructurada, aplicada a funcionarios de cuatro instituciones, que contemplaba las variables: institución, conocimiento normativo, recursos financieros, apoyo técnico, actividades realizadas actualmente y posibles alternativas para PSA. Con el programa Decisión Explorer 3.3 y con integrantes de las instituciones se propusieron alternativas para mejorar el PSA. Se pudo determinar que en el corregimiento de Cabrera se están ejecutando las alternativas: implementación de sistemas agroforestales, familias guardabosques y adquisición de predios para avanzar en PSA. Se concluyó que en la Cuenca Alta del río Pasto, el PSA aún es incipiente pero promisorio, hay poco conocimiento institucional y los procesos se han centrado en la compra de tierras para la conservación de fuentes abastecedoras de acueductos rurales y de cabeceras municipales.

  18. Criminología Ambiental: Los delitos ambientales/Environmental criminology: the environmental crimes

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    Israel Estrada Camacho (México

    2010-01-01

    Full Text Available Es del dominio público que la actividad humana- desde el punto de vista Social, Político, Jurídico e incluso Cultural- está provocando desajustes que sacuden al mundo. La contaminación del agua, el aire y el suelo; el deterioro de la capa de ozono; el calentamiento del planeta; la progresiva desertificación; la perdida constante de bosques y selvas, que a su vez causa la extinción de flora y fauna. México es considerado como uno de los países más ricos en biodiversidad. Razón de más para profundizar en el aprovechamiento y conservación de los recursos bióticos, de nuestro país. El Artículo cuarto de nuestra constitución política, en su párrafo 4to, consagra como una garantía el derecho a un ambiente adecuado para el desarrollo y bienestar. De este ordenamiento se desprenden muchas más normas jurídicas para proteger los recursos naturales. Por ello el presente trabajo abordo la temática ambiental y el paradigma en torno de los delitos ambientales, ya que ello nos permitirá comprender mejor el problema y de esta manera se podrá asumir un compromiso de manera más responsable, con la protección del medio ambiente en nuestro país.

  19. Independence From Parenteral Nutrition and Intravenous Fluid Support During Treatment With Teduglutide Among Patients With Intestinal Failure Associated With Short Bowel Syndrome

    DEFF Research Database (Denmark)

    Iyer, Kishore R; Kunecki, Marek; Boullata, Joseph I

    2017-01-01

    BACKGROUND: In phase III clinical studies, treatment with teduglutide was associated with clinically meaningful reductions (≥20% from baseline) in parenteral support (PS; parenteral nutrition and/or intravenous fluids) requirements in adult patients with intestinal failure associated with short...

  20. TRATAMIENTO ANAEROBIO DE LAS AGUAS RESIDUALES DEL PROCESO DE EXTRACCIÓN DE ALMIDÓN DE YUCA. OPTIMIZACIÓN DE VARIABLES AMBIENTALES Y OPERACIONALES

    Directory of Open Access Journals (Sweden)

    ANDREA PÉREZ VIDAL

    2009-01-01

    Full Text Available La etapa de sedimentación del proceso de extracción de almidón de yuca genera la mayor carga contaminante en términos de cantidad y calidad de agua residual. En el norte del departamento del Cauca existen varios filtros anaerobios para su tratamiento, los cuales han mostrado deficiencias asociadas a factores ambientales y operacionales. La evaluación del arranque y desempeño de un filtro anaerobio a escala real evidenció la necesidad de acondicionar químicamente el agua residual con una dosis mínima de 2180 mg NaHCO3/L y el Índice Tampón (IB se mostró como una herramienta simple y eficiente para el control del proceso, pues permitió determinar condiciones de inestabilidad cuando su valor era superior a 0.35. En condiciones estables (TRHteórico 12 horas; TRHreal 10.2 horas, con acondicionamiento químico e IB dentro del rango adecuado (0.20 - 0.30, el reactor alcanzó eficiencias de reducción de DQO y SST superiores a 77 y 76% respectivamente.

  1. Use of parenteral glucocorticoids and the risk of new onset type 2 diabetes mellitus : A case-control study

    NARCIS (Netherlands)

    Keyany, Ala; Nielen, Johannes T H; Souverein, Patrick C.; de Vries, Frank; van den Bemt, Bart

    2018-01-01

    Background: Use of oral glucocorticoids (GCs) has been associated with hyperglycaemia and type 2 diabetes mellitus (T2DM). However, unlike oral GCs, there is minimal or no data on the effect of parenteral GC use on T2DM. Objective: To assess the association between use of parenteral GCs and the risk

  2. Protocol compliance of administering parenteral medication in Dutch hospitals: an evaluation and cost-estimation of the implementation.

    NARCIS (Netherlands)

    Schilp, J.; Boot, S.; Blok, C. de; Spreeuwenberg, P.; Wagner, C.

    2014-01-01

    Objectives: Preventable adverse drug events (ADEs) are closely related to administration processes of parenteral medication. The Dutch Patient Safety Program provided a protocol for administering parenteral medication to reduce the amount of ADEs. The execution of the protocol was evaluated and a

  3. Long-term follow-up of patients on home parenteral nutrition in Europe: implications for intestinal transplantation

    DEFF Research Database (Denmark)

    Pironi, Loris; Joly, Francisca; Forbes, Alastair

    2011-01-01

    The indications for intestinal transplantation (ITx) are still debated. Knowing survival rates and causes of death on home parenteral nutrition (HPN) will improve decisions.......The indications for intestinal transplantation (ITx) are still debated. Knowing survival rates and causes of death on home parenteral nutrition (HPN) will improve decisions....

  4. Parenteral and oral antibiotic duration for treatment of pediatric osteomyelitis: a systematic review protocol

    Science.gov (United States)

    2013-01-01

    Background Pediatric osteomyelitis is a bacterial infection of bones requiring prolonged antibiotic treatment using parenteral followed by enteral agents. Major complications of pediatric osteomyelitis include transition to chronic osteomyelitis, formation of subperiosteal abscesses, extension of infection into the joint, and permanent bony deformity or limb shortening. Historically, osteomyelitis has been treated with long durations of antibiotics to avoid these complications. However, with improvements in management and antibiotic treatment, standard of care is moving towards short durations of intravenous antibiotics prior to enteral antibiotics. Methods/Design The authors will perform a systematic review based on PRISMA guidelines in order to evaluate the literature, looking for evidence to support the optimal duration of parenteral and enteral therapy. The main goals are to see if literature supports shorter durations of either parenteral antibiotics and/or enteral antibiotics. Multiple databases will be investigated using a thorough search strategy. Databases include Medline, Cochrane, EMBASE, SCOPUS, Dissertation Abstracts, CINAHL, Web of Science, African Index Medicus and LILACS. Search stream will include medical subject heading for pediatric patients with osteomyelitis and antibiotic therapy. We will search for published or unpublished randomized and quasi-randomized controlled trials. Two authors will independently select articles, extract data and assess risk of bias by standard Cochrane methodologies. We will analyze comparisons between dichotomous outcomes using risk ratios and continuous outcomes using mean differences. 95% confidence intervals will be computed. Discussion One of the major dilemmas of management of this disease is the duration of parenteral therapy. Long parenteral therapy has increased risk of serious complications and the necessity for long therapy has been called into question. Our study aims to review the currently available

  5. Distribución y condiciones ambientales asociadas al comportamiento del delfín bufeo (Tursiops truncatus y el delfín manchado (Stenella attenuata (Cetacea: Delphinidae en el Golfo Dulce, Costa Rica

    Directory of Open Access Journals (Sweden)

    Priscilla Cubero-Pardo

    2007-06-01

    Full Text Available Las características del hábitat que influyen en las especies animales varían de un lugar a otro. Al mismo tiempo, toda especie es rodeada por una serie de factores ambientales que interactúan entre sí, pero la influencia que una característica ambiental particular pueda ejercer sobre una especie depende no sólo de las demás variables, sino de las condiciones morfológicas, fisiológicas y sociales de esa especie. En este estudio, desarrollado de junio 1996 a julio 1997, la pregunta fue enfocada a determinar si comportamientos específicos en el delfín bufeo (Tursiops truncatus y el delfín manchado (Stenella attenuata están relacionados con áreas de distribución y factores ambientales particulares. El área de estudio fue cubierta siguiendo transectos lineares oblicuos predeterminados y cada grupo fue observado de 15 min a 5 h. Las variables ambientales fueron medidas al inicio y al final de cada avistamiento junto con la determinación de la posición geográfica y el comportamiento llevado a cabo por los delfines. Para el bufeo, las actividades de forrajeo/ alimentación mostraron coincidencia exclusiva con bocas de ríos y áreas de coral y manglar, y las actividades sociales y de merodeo, se asociaron a áreas cercanas a los sitios de forrajeo. El desplazamiento ocurrió a lo largo de diferentes puntos paralelos a la costa, con un bajo porcentaje de casos a través del golfo (16.56 %, lo cual sugiere que el bufeo rara vez cruza el golfo. En el caso del manchado, no fue posible asociar zonas comportamientos particulares, pues todo el grupo se mueve junto; sin embargo, si fue observada la presencia de distintos comportamientos en un mismo momento, llevados a cabo por grupos específicos dentro de la manada. Se consideraron factores ambientales tales como la profundidad, la temperatura, la salinidad y la distancia respecto a la costa, entre otros. El ANDEVA de bloques no reveló una relación marcada entre actividades y zonas

  6. Phytosterols Promote Liver Injury and Kupffer Cell Activation in Parenteral Nutrition–Associated Liver Disease

    Science.gov (United States)

    El Kasmi, Karim C.; Anderson, Aimee L.; Devereaux, Michael W.; Vue, Padade M.; Zhang, Wujuan; Setchell, Kenneth D. R.; Karpen, Saul J.; Sokol, Ronald J.

    2014-01-01

    Parenteral nutrition–associated liver disease (PNALD) is a serious complication of PN in infants who do not tolerate enteral feedings, especially those with acquired or congenital intestinal diseases. Yet, the mechanisms underlying PNALD are poorly understood. It has been suggested that a component of soy oil (SO) lipid emulsions in PN solutions, such as plant sterols (phytosterols), may be responsible for PNALD, and that use of fish oil (FO)–based lipid emulsions may be protective. We used a mouse model of PNALD combining PN infusion with intestinal injury to demonstrate that SO-based PN solution causes liver damage and hepatic macrophage activation and that PN solutions that are FO-based or devoid of all lipids prevent these processes. We have furthermore demonstrated that a factor in the SO lipid emulsions, stigmasterol, promotes cholestasis, liver injury, and liver macrophage activation in this model and that this effect may be mediated through suppression of canalicular bile transporter expression (Abcb11/BSEP, Abcc2/MRP2) via antagonism of the nuclear receptors Fxr and Lxr, and failure of up-regulation of the hepatic sterol exporters (Abcg5/g8/ABCG5/8). This study provides experimental evidence that plant sterols in lipid emulsions are a major factor responsible for PNALD and that the absence or reduction of plant sterols is one of the mechanisms for hepatic protection in infants receiving FO-based PN or lipid minimization PN treatment. Modification of lipid constituents in PN solutions is thus a promising strategy to reduce incidence and severity of PNALD. PMID:24107776

  7. Standardised neonatal parenteral nutrition formulations – an Australasian group consensus 2012

    Science.gov (United States)

    2014-01-01

    Standardised parenteral nutrition formulations are routinely used in the neonatal intensive care units in Australia and New Zealand. In 2010, a multidisciplinary group was formed to achieve a consensus on the formulations acceptable to majority of the neonatal intensive care units. Literature review was undertaken for each nutrient and recommendations were developed in a series of meetings held between November 2010 and April 2011. Three standard and 2 optional amino acid/dextrose formulations and one lipid emulsion were agreed by majority participants in the consensus. This has a potential to standardise neonatal parenteral nutrition guidelines, reduce costs and prescription errors. PMID:24548745

  8. Parenteral Nutrition Basics for the Clinician Caring for the Adult Patient.

    Science.gov (United States)

    Derenski, Karrie; Catlin, Jennifer; Allen, Livia

    2016-10-01

    Parenteral nutrition (PN) is a life-sustaining therapy providing nutrients to individuals with impaired intestinal tract function and enteral access challenges. It is one of the most complex prescriptions written routinely in the hospital and home care settings. This article is to aid the nutrition support clinician in the safe provision of PN, including selecting appropriate patients for PN, vascular access, development of a PN admixture, appropriate therapy monitoring, recognition of preparation options, and awareness of preparation and stability concerns. © 2016 American Society for Parenteral and Enteral Nutrition.

  9. Identification of Particles in Parenteral Drug Raw Materials.

    Science.gov (United States)

    Lee, Kathryn; Lankers, Markus; Valet, Oliver

    2018-04-18

    complementarity of the techniques provides the advantage of identifying various chemical and molecular components, as well as elemental and image analyses. Correct interpretation of the results from these techniques is also very important. Copyright © 2018, Parenteral Drug Association.

  10. Formulation and pharmacokinetics of diclofenac lipid nanoemulsions for parenteral application.

    Science.gov (United States)

    Ramreddy, Srividya; Kandadi, Prabhakar; Veerabrahma, Kishan

    2012-01-01

    The objective of the present study was to formulate and determine the pharmacokinetics of stable o/w parenteral lipid nanoemulsions (LNEs) of diclofenac acid used to treat arthritic conditions. The LNEs of diclofenac acid with a mean size ranging from 200 to 240 nm and a zeta potential of -29.4 ± 1.04 mV (negatively charged LNEs) and 62.1 ± 3.5 (positively charged LNEs) emulsions were prepared by hot homogenization and ultrasonication process. The influence of formulation variables, such as the change in proportion of cholesterol, was studied, and optimized formulations were developed. The optimized formulations were relatively stable during centrifugal stress, dilution stress, and storage. The drug content and entrapment efficiency were determined using high-performance liquid chromatography. The in vitro drug release was carried out in phosphate-buffered saline pH 7.4 and cumulative amount of drug released was estimated using a UV-visible spectro-photometer. During in vivo pharmacokinetic studies in male Wistar rats, diclofenac serum concentration from LNEs was higher than that of Voveran injection and was detectable up to 12 h. Diclofenac in LNEs showed improved pharmacokinetic profile with increase in area under the curve, elimination half-life and mean residence time in comparison to Voveran. Our aim was to prepare and determine the pharmacokinetics of injectable lipid nanoemulsions of diclofenac acid for treating arthritic conditions by reducing the frequency of dosing and pain at site of injection. The nanoemulsions of diclofenac acid were prepared by homogenization and ultrasonication process. The sizes and charges of oil globules were determined. The effect of cholesterol on stability of emulsion was studied, and an optimized preparation was developed. The optimized formulations were stable during centrifugation, dilution, and storage. The total amount of drug in emulsion and percentage amount of drug present in emulsion globules were determined using

  11. Anticoagulants for the prevention and treatment of catheter-related thrombosis in adults and children on parenteral nutrition: a systematic review and critical appraisal

    NARCIS (Netherlands)

    Barco, Stefano; Atema, Jasper J.; Coppens, Michiel; Serlie, Mireille J.; Middeldorp, Saskia

    2017-01-01

    Patients on parenteral nutrition require a central venous access and are at risk of catheter-related thrombosis, pulmonary embolism, and vena cava syndrome. Parenteral nutrition guidelines suggest anticoagulation for the primary prevention of catheter-related thrombosis during long-term parenteral

  12. Estudio de un brote de bacteremia secundaria asociada con nutrición parenteral en una unidad de recién nacidos de tercer nivel.

    OpenAIRE

    Jaime A. del Río; Carmen M. Jurado; Fernando Arango

    2009-01-01

    Ante la evidencia de un brote de bacteremia secundaria neonatal, en la Unidad de Recién Nacidos, Hospital de Caldas, Manizales, se realizó un estudio de casos y controles 1:4, para determinar la asociación de factores de riesgo importantes para los pediatras como nutrición parenteral, terapia respiratoria, tubo orotraqueal, cámara cefálica, parto vaginal, la aplicación de hemoderivado, remisión de otra unidad, leche materna por sonda, peso y edad. Como definición de caso se adoptó la clínica ...

  13. Conflictos socio-ambientales/territoriales y el surgimiento de identidades post neoliberales (Valparaíso-Chile)

    OpenAIRE

    Bolados García, Paola

    2016-01-01

    Resumen: En este artículo analizamos los conflictos socio-ambientales/territoriales asociados a la expansión de las fronteras minera y agroexportadora en la zona central de Chile. Nos centramos en el conflicto por la usurpación del agua en la precordillera de la Provincia de Petorca, así como los conflictos asociados a la contaminación producida por el Complejo Industrial Ventanas en los límites de las comunas de Puchuncaví y Quintero. Desde una perspectiva crítica que se nutre de la ecología...

  14. Indicadores ambientales y educación ambiental en función de la responsabilidad social empresaria

    OpenAIRE

    Giuffré de López Camelo, Lidia L.; Basso, Lorenzo Ricardo; Ratto de Miguez, Silvia Elisa

    2008-01-01

    p.99-106 Se realizó un análisis documental de las presentaciones voluntarias de 44 empresas signatarias del Pacto Global correspondientes al año 2005 en la red argentina. Los indicadores ambientales y el rol de la educación ambiental fueron las herramientas utilizadas para resumir las extensas comunicaciones. La educación apareció como una preocupación dentro de la responsabilidad social empresaria, considerando acciones de educación ambiental no formal e informal que se transmiten a la co...

  15. La responsabilidad civil extracontractual por daños ambientales y las instituciones del Código Civil Ecuatoriano

    OpenAIRE

    Narváez Alvarez, María José

    2008-01-01

    Las instituciones clásicas de la responsabilidad civil en los sistemas jurídicos que mantienen el régimen subjetivo, y el ecuatoriano en particular, procuran la defensa de los derechos ambientales a partir de una concepción patrimonialista; razón por la cual los instrumentos normativos han sido diseñados para proteger por separado cada uno de los elementos de la naturaleza, asumidos como bienes específicos de tutela jurídica y en consecuencia ignorando su función integral; hech...

  16. Retos para la política ambiental: el debate internacional sobre el comercio de bienes y servicios ambientales

    OpenAIRE

    Diego Alejandro Martínez Ballesteros

    2006-01-01

    Los lineamientos de la actual política ambiental nacional enfatizan la promoción y el aprovechamiento sostenible de bienes y servicios ambientales. A nivel internacional, el tema se está tratando en la Organización Mundial del Comercio, por el mandato de la Declaración Ministerial de Doha (2001). Así mismo, se encuentra tácitamente en la actual agenda del desarrollo. El debate ha girado alrededor de lograr un acuerdo sobre definiciones y ...

  17. Mejoras ambientales para el desarrollo de la competitividad en tres cadenas agroalimentarias costarricenses. (SDT 001-2008)

    OpenAIRE

    Hartley, Marjorie; Díaz, Rafael

    2008-01-01

    Este documento de trabajo presenta los resultados de la aplicación de la Evaluación de Ciclo de Vida (LCA por sus siglas en inglés) a tres agrocadenas costarricenses, la de melón, chayote y café. El objetivo es identificar y cuantificar los impactos ambientales y sobre la salud humana, más importantes a lo largo de estas agrocadenas, distinguiéndolos por segmentos. La aplicación del LCA permite evaluar el perfil ambiental de las agrocadenas "desde la cuna hasta la tumba" para identific...

  18. Heavy metal environmental impact. Nickel (Ni); Impatto ambientale da metalli pesanti. Il Nichel (Ni)

    Energy Technology Data Exchange (ETDEWEB)

    Bressa, G. [Padua Univ. Padua (Italy). Dipt. di Farmacologia, Lab. di Tossicologia

    2001-02-01

    Nickel (Ni) is a heavy metal in over 3.000 different alloys used to produce kitchen utensils, batteries, coins, etc.. Human extractive and industrial activities are therefore a cause for environmental dispersion of this metal into the biosphere. This shows how in urban areas car traffic and house-heating are the main sources of nickel pollution. Nickel is relatively non-toxic, such as iron, cobalt, copper and zinc; nevertheless prolonged inhalation of dust containing such compounds as Ni O or NiCl{sub 2} concurs in the outbreak of respiratory pathologies. The carcinogenic effect of such compounds as Ni S, Ni O and Ni(CO){sub 4} has been confirmed by experiments on laboratory animals. Ni potentially toxic concentrations, and as a consequence of potential environmental impact, are to be mainly found in populated areas where the main sources are represented by industries and landfills. [Italian] Il nichel (Ni) e' un metallo presente in oltre 3.000 differenti leghe che vengono utilizzate per la produzione di utensili da cucina, batterie, monete, ecc.. Le attivita' estrattive ed industriali dell'uomo sono quindi causa di una dispersione del metallo nella biosfera. Sono stati riscontrati elevati tassi di Ni nell'atmosfera di aree urbane. Cio' sta a dimostrare che nelle aree urbane il traffico automobilistico e il riscaldamento domestico sono le fonti principali di inquinamento da tale metallo. Il nichel e' relativamente atossico, analogamente a ferro, cobalto, rame e zinco, tuttavia l'inalazione protratta di polveri contenenti composti come il NiO o il NiCl{sub 2} contribuisce al manifestarsi di patologie dell'apparato respiratorio. E' stato confermato sperimentalmente su animali da laboratorio l'effetto cancerogeno di alcuni composti quali NiS, NiO e Ni(CO){sub 4}. Concentrazioni potenzialmente tossiche di Ni, e quindi di probabile impatto ambientale, sono maggiormente da ricercare nelle zone antropizzate dove le fonti

  19. Alternative refrigerants performance in plate heat condenser for air conditioning; Scambiatori compatti per il condizionamento ambientale

    Energy Technology Data Exchange (ETDEWEB)

    Boccardi, G.; Celata, G.P.; Marchesi Donati, F. [ENEA, Rome (Italy). Inst. of Thermal-Fluid Dynamics; Cumo, M. [Rome Univ. La Sapienza, Rome (Italy). Dept. of Nuclear Engineering and Energy Conversion; Gerosa, A. [Rome Univ. Tor Vergata, Rome (Italy). Dept. of Mechanical Engineering; Zorzin, A. [R and D Alfa Laval Artec Spa Vicenza, Vicenza (Italy)

    1999-12-01

    An experimental campaign on plate heat exchangers, used as evaporators and condenser in domestic refrigeration loops is presented in this paper. The research's purpose is to test the influence of some thermal-hydraulic parameters on the global overall heat transfer coefficient. R134a, R407C, R410A, and R22 are the fluids tested under reference thermal conditions. The experimental tests allows one to withdraw conclusions on the substitution effect on the thermal and global efficiency of the plant. Also, a new method for calculating the thermodynamical mixture parameters is applied to the condensation of mixtures R407C and R410A and its benefit evaluated. The refrigerant loop overall performance and the condenser global heat transfer coefficient are the parameters chosen to enlighten the characteristics of the alternative refrigerants (R134a, R407C, and R410A) with respect to the fluid that they are supposed to substitute (R22). [Italian] Scambiatori a piastre compatti impiegati come evaporatori e condensatori nei circuiti frigoriferi, sono l'oggetto della ricerca presentata in questo articolo. L'efficienza termica di tali componenti e' valutata in condizioni di riferimento commerciali. I refrigeranti utilizzati sono tre fluidi proposti per sostituire l'R22, un Hcfc, attualmente il refrigerante piu' utilizzato nel condizionamento ambientale. Una serie di prove condotte con quest'ultimo fluido consente di studiare gli effetti della sostituzione del fluido di progetto sulle prestazioni sia degli scambiatori, sia piu' in generale, dell'intero circuito frigorifero. In particolare sono state studiate le prestazioni di due coppie di evaporatori e condensatori in termini di coefficiente globale di scambio termico e di Cop dell'impianto. Nel presente lavoro e' inoltre presentato e utilizzato un metodo termodinamico per il calcolo della temperatura di saturazione per le miscele zeotropiche in bifase; uno dei refrigeranti

  20. Modello predittivo di idoneità ambientale per il cervo nell'Appennino centrale

    Directory of Open Access Journals (Sweden)

    G. Opramolla

    2003-10-01

    l?idoneità ambientale potrebbe essere correlata non solo alle maggiori possibilità di rifugio ma anche ad una maggiore protezione dalle condizioni climatiche estreme. La complessità del perimetro delle aree boscate corrisponderebbe ad un maggiore sviluppo ecotonale, che influirebbe positivamente sulle opportunità trofiche. In aree a forte innevamente invernale, infine, le aree con esposizione tendente a sud potrebbero costituire importanti aree di svernamento ed alimentazione dal tardo autunno all?inizio della primavera.

  1. Environmental analysis applied to schools. Methodologies for data acquisition; Analisi ambientale iniziale per gli istituti d'istruzione. Metodologia per l'acquisizione dei dati

    Energy Technology Data Exchange (ETDEWEB)

    Andriola, L.; Ceccacci, R. [ENEA, Div. Caratterizzazione dell' Ambiente e del Territorio, Centro Ricerche Casaccia, Rome (Italy)

    2001-07-01

    The environment analysis is the basis of environmental management for organizations and it is considered as the first step in EMAS. It allows to identify, deal with the issues and have a clear knowledge on environmental performances of organizations. Schools can be included in the organizations. Nevertheless, the complexity of environmental issues and applicable regulations makes very difficult for a school, that wants to implement an environmental management system (EMAS, ISO 14001, etc.), to face this first step. So, it has been defined an instrument, that is easy but complete and coherent with reference standard, to let schools choose their process for elaborating the initial environmental revue. This instrument consists, essentially, in cards that, if completed, facilitate the drafting of the environmental analysis report. [Italian] L'analisi ambientale iniziale costituisce il presupposto di qualsiasi azione di gestione ambientale da parte di un'organizzazione ed e' esplicitamente prevista, come prima tappa, in EMAS. Essa consente infatti di individuare ed approfondire le problematiche ambientali e di fotografare, per mezzo di riferimenti oggettivi, le prestazioni ambientali di un'organizzazione, e quindi anche di una scuola, in modo da poter stabilire e controllare nel tempo gli obiettivi di miglioramento. Tuttavia la complessita' delle problematiche ambientali e delle relative normative di riferimento rende estremamente difficoltoso, per un istituto scolastico che intenda intraprendere un percorso di gestione ambientale comunque finalizzato (EMAS, ISO 14001, Comunicazione ambientale, ecc.) compiere questo passo iniziale. E' stato pertanto realizzato uno strumento semplificato, ma comunque completo e coerente con gli standard di riferimento, per consentire alle scuole di effettuare il percorso di elaborazione di un'analisi ambientale iniziale. Lo strumento consiste essenzialmente in schede che, una volta compilate

  2. Environmental analysis applied to schools. Methodologies for data acquisition; Analisi ambientale iniziale per gli istituti d'istruzione. Metodologia per l'acquisizione dei dati

    Energy Technology Data Exchange (ETDEWEB)

    Andriola, L; Ceccacci, R [ENEA, Div. Caratterizzazione dell' Ambiente e del Territorio, Centro Ricerche Casaccia, Rome (Italy)

    2001-07-01

    The environment analysis is the basis of environmental management for organizations and it is considered as the first step in EMAS. It allows to identify, deal with the issues and have a clear knowledge on environmental performances of organizations. Schools can be included in the organizations. Nevertheless, the complexity of environmental issues and applicable regulations makes very difficult for a school, that wants to implement an environmental management system (EMAS, ISO 14001, etc.), to face this first step. So, it has been defined an instrument, that is easy but complete and coherent with reference standard, to let schools choose their process for elaborating the initial environmental revue. This instrument consists, essentially, in cards that, if completed, facilitate the drafting of the environmental analysis report. [Italian] L'analisi ambientale iniziale costituisce il presupposto di qualsiasi azione di gestione ambientale da parte di un'organizzazione ed e' esplicitamente prevista, come prima tappa, in EMAS. Essa consente infatti di individuare ed approfondire le problematiche ambientali e di fotografare, per mezzo di riferimenti oggettivi, le prestazioni ambientali di un'organizzazione, e quindi anche di una scuola, in modo da poter stabilire e controllare nel tempo gli obiettivi di miglioramento. Tuttavia la complessita' delle problematiche ambientali e delle relative normative di riferimento rende estremamente difficoltoso, per un istituto scolastico che intenda intraprendere un percorso di gestione ambientale comunque finalizzato (EMAS, ISO 14001, Comunicazione ambientale, ecc.) compiere questo passo iniziale. E' stato pertanto realizzato uno strumento semplificato, ma comunque completo e coerente con gli standard di riferimento, per consentire alle scuole di effettuare il percorso di elaborazione di un'analisi ambientale iniziale. Lo strumento consiste essenzialmente in schede che, una volta compilate, faciliteranno la stesura del rapporto di

  3. A Comparison of Hospital Versus Outpatient Parenteral Antibiotic Therapy at Home for Pyelonephritis and Meningitis.

    Science.gov (United States)

    Hensey, Conor C; Sett, Arun; Connell, Tom G; Bryant, Penelope A

    2017-09-01

    Despite the benefits of home treatment with outpatient parenteral antimicrobial therapy (OPAT), children with pyelonephritis and meningitis are rarely included. We aimed to compare clinical characteristics and outcomes between hospital and home treatment for these conditions and to identify factors influencing home treatment. Children admitted to the hospital with pyelonephritis or proven and presumed bacterial meningitis from January 1, 2012, to December 31, 2013 were identified retrospectively. Patients who received any OPAT (home group) received daily visits via our Hospital-in-the-Home (HITH) program; inpatients (hospital group) received standard care. Clinical and demographic features, length of stay, readmission rate and cost were compared between hospital and home groups. One hundred thirty-nine children with pyelonephritis and 70 with meningitis were identified, of which 127 and 44 were potentially suitable for OPAT, respectively. Of these, 12 (9%) with pyelonephritis received OPAT, contrasting with 29 (66%) with meningitis. Clinical features did not differ between hospital- and home-treated patients for either condition. Patients with meningitis in the hospital group were younger than those transferred to HITH (1 vs. 2 months; P = 0.01). All patients were afebrile before transfer to HITH. Admissions for pyelonephritis were brief with inpatients having a shorter length of stay than home patients (median: 3 vs. 4.5 days; P = 0.002). Unplanned readmission rates were comparable across all groups. Transfer to HITH resulted in a saving of AU$178,180. Children with pyelonephritis and meningitis can feasibly receive OPAT. Age, treatment duration and fever influence this decision. None of these should be barriers to OPAT, and the cost savings support change in practice.

  4. Environmental analysis of a tourist development project; Analisi ambientale per un progetto di sviluppo turistico

    Energy Technology Data Exchange (ETDEWEB)

    Forni, A.; Colonna, N.; Olivetti, I. [ENEA, Divisione Caratterizzazione dell' Ambiente e del Territorio, Centro Ricerche Casaccia, Rome (Italy)

    2001-07-01

    delle condizioni ambientali ottimali per il territorio e per la comunita' antropica residente. Le tematiche ambientali hanno dovuto quindi orientare e integrare anche il processo di stesura del Master Plan del Golfo degli Angeli. La relazione tra turismo ed ambiente passa attraverso l'integrazione di tre soggetti: la popolazione, i turisti e il paesaggio. Tutti e tre ricevono vantaggi e svantaggi dall'attivita' turistica e nell'interagire tra loro. Il turismo come bisogno viene soddisfatto mettendo in stretta relazione le proprie personali caratteristiche e le caratteristiche del territorio, fino a raggiungere intense utilizzazioni dello stesso. Il paesaggio e' il concetto con cui si sintetizza l'insieme dell'ambiente naturale ed antropico del territorio, ed il portato della normale attivita' economica produttiva locale. Per realizzare uno sviluppo sostenibile incentrato sul turismo le autorita' competenti in materia ambientale devono valutare la possibilita' di inserire le tematiche ambientali nell'ambito degli investimenti e della formazione in campo turistico. L'ipotesi di sviluppo esplicitata nel progetto per il Golfo degli Angeli comporta il raddoppio delle presenze antropiche nel periodo turistico, con conseguenti aumenti di utilizzazione di risorse naturali, suolo (edificabile e non), acqua (potabile e non), energia (elettrica e non) e di produzione di rifiuti, liquidi e solidi. Tale aumento del carico antropico, concentrato in brevi stagioni dell'anno, comporta la necessita' di avere una notevole attenzione per l'ambiente, in termini gestionali/organizzativi ed anche tecnologici. Il lavoro analizza in dettaglio il turismo, i suoi impatti ambientali e le criticita' ambientali dell'area approfondendo in specifico i seguenti temi: le insufficienze e/o inefficienze degli impianti di depurazione delle acque, l'approvigionamento idrico, le insufficienze degli impianti di

  5. Environmental analysis of a tourist development project; Analisi ambientale per un progetto di sviluppo turistico

    Energy Technology Data Exchange (ETDEWEB)

    Forni, A; Colonna, N; Olivetti, I [ENEA, Divisione Caratterizzazione dell' Ambiente e del Territorio, Centro Ricerche Casaccia, Rome (Italy)

    2001-07-01

    condizioni ambientali ottimali per il territorio e per la comunita' antropica residente. Le tematiche ambientali hanno dovuto quindi orientare e integrare anche il processo di stesura del Master Plan del Golfo degli Angeli. La relazione tra turismo ed ambiente passa attraverso l'integrazione di tre soggetti: la popolazione, i turisti e il paesaggio. Tutti e tre ricevono vantaggi e svantaggi dall'attivita' turistica e nell'interagire tra loro. Il turismo come bisogno viene soddisfatto mettendo in stretta relazione le proprie personali caratteristiche e le caratteristiche del territorio, fino a raggiungere intense utilizzazioni dello stesso. Il paesaggio e' il concetto con cui si sintetizza l'insieme dell'ambiente naturale ed antropico del territorio, ed il portato della normale attivita' economica produttiva locale. Per realizzare uno sviluppo sostenibile incentrato sul turismo le autorita' competenti in materia ambientale devono valutare la possibilita' di inserire le tematiche ambientali nell'ambito degli investimenti e della formazione in campo turistico. L'ipotesi di sviluppo esplicitata nel progetto per il Golfo degli Angeli comporta il raddoppio delle presenze antropiche nel periodo turistico, con conseguenti aumenti di utilizzazione di risorse naturali, suolo (edificabile e non), acqua (potabile e non), energia (elettrica e non) e di produzione di rifiuti, liquidi e solidi. Tale aumento del carico antropico, concentrato in brevi stagioni dell'anno, comporta la necessita' di avere una notevole attenzione per l'ambiente, in termini gestionali/organizzativi ed anche tecnologici. Il lavoro analizza in dettaglio il turismo, i suoi impatti ambientali e le criticita' ambientali dell'area approfondendo in specifico i seguenti temi: le insufficienze e/o inefficienze degli impianti di depurazione delle acque, l'approvigionamento idrico, le insufficienze degli impianti di trattamento rifiuti e delle discariche, il sistema produttivo, l'attuazione delle normative ambientali EMAS

  6. SELECCIÓN DE PREDICTORES AMBIENTALES PARA EL MODELADO DE LA DISTRIBUCIÓN DE ESPECIES EN MAXENT

    Directory of Open Access Journals (Sweden)

    Gustavo Cruz-Cárdenas

    2014-01-01

    Full Text Available A ntes de realizar el modelado de la distribución potencial de una especie, se recomienda ha - cer una preselección de covariables pues la redundancia o variables irrelevantes pueden in - ducir sesgos en la mayoría de los modelos. En este estudio, se propuso un método automati - zado para la selección a priori de covariables utilizadas en el modelado. Se emplearon cinco especies típicas de la flora mexicana ( Catopheria chiapensis, Liquidambar styraciflua, Quercus martinezii, Telanthopora grandifolia y Viburnum acutifolium y 56 covariables ambientales. Se generaron matrices de presencia-ausencia para cada especie y se analizaron empleando regresión logística; el modelo resul - tante de cada especie se evaluó mediante un remuestreo bootstrap. La distribución de las cinco especies se modeló usando el algoritmo de máxima entropía y con el empleo de tres conjuntos de covariables ambientales. La precisión de los modelos generados se evaluó con intervalos de confianza de cada curva característica operativa del receptor (COR. Los intervalos de confianza de las curvas COR resultantes no mostraron diferencia significativa ( P < 0.05 entre los tres modelos predictivos generados; sin em - bargo, el modelo más parsimonioso se obtuvo con el método propuesto.

  7. Alteraciones de los bosques nativos en el norte argentino: normativas y mecanismos de compensación por servicios ambientales

    Directory of Open Access Journals (Sweden)

    Claudia Luna

    2017-12-01

    Full Text Available Los recursos naturales conforman los insumos de cualquier actividad económica desarrollada por el hombre; pero es una realidad que la mayoría de los ecosistemas forestales nativos de Argentina presentan desde serias alteraciones con su consecuente pérdida de biodiversidad; no hay mejor estrategia de política ambiental que aquélla que concurra simultáneamente a resolver los problemas ambientales y los socio-económicos con la insustituible acción del Estado. El objetivo de este trabajo es analizar la situación de los bosques del norte argentino luego de la ley de presupuestos mínimos para la protección ambiental de los mismos; para conocer en profundidad los procesos asociados a su alteración, las normativas vigentes para su protección y uso sustentable, como así también los mecanismos de compensación por servicios ambientales que surgen a partir de ellos.

  8. Problemáticas ambientales en el área de Los Antiguos, provincia de Santa Cruz

    Directory of Open Access Journals (Sweden)

    Jacquelina Maribel Díaz Viegas

    2014-06-01

    Full Text Available En este informe se presentan los resultados de una beca de iniciación a la investigación para alumnos avanzados de la UNPA, cuyo objetivo consistió en la identificación de los usos del suelo y las problemáticas ambientales en el área de Los Antiguos. La metodología utilizada consistió en búsquedas bibliográficas, interpretación visual de imágenes satelitales de alta resolución espacial, relevamientos de campo y entrevistas a informantes calificados. Se detectaron como principales problemas ambientales los asociados con la disposición de los residuos urbanos y tratamiento de líquidos cloacales, inundaciones en la rivera del lago Buenos Aires y en zonas urbanas, deslizamiento de laderas en la loma Del Mirador, entre otros. En el informe se explican estas problemáticas, se analiza la legislación vigente y se proponen algunas medidas de mitigación.

  9. Caracterización de los componentes genéticos y ambientales implicados en el envejecimiento de las levaduras vínicas

    OpenAIRE

    Orozco Valverde, María Elena

    2012-01-01

    La mayor parte de la fermentación vínica discurre cuando las células de la levadura Saccharomyces cerevisiae han dejado de dividirse. Así pues, la viabilidad en fase estacionaria, llamada longevidad cronológica (LC), es esencial para que la vinificación se lleve a buen término. En este trabajo de tesis doctoral, se han caracterizado diversos componentes ambientales y genéticos que influyen en la longevidad cronológica de las levaduras vínicas. En cuanto a los componentes ambientales, el incre...

  10. La integración del valor de cambio de los servicios ambientales en las cuentas verdes de las áreas naturales

    OpenAIRE

    Campos Palacín, Pablo; Caparrós Gass, Alejandro

    2009-01-01

    Los bienes y servicios de mercado se miden en la contabilidad nacional por sus valores de cambio (precio por cantidad), mientras que los métodos de valoración ambiental de los servicios ambientales estiman el excedente del consumidor o las variaciones hicksianas. Esto impide una agregación directa de los valores ambientales en la contabilidad nacional. Este artículo propone una metodología que permite la agregación en condiciones homogéneas. Para el libre acceso de los visitantes re...

  11. AGRICULTURIZACION E IMPACTOS AMBIENTALES EN EL PARTIDO DE NECOCHEA, PROVINCIA DE BUENOS AIRES, ARGENTINA - AGRICULTURIZATION AND ENVIRONMENTAL IMPACTS IN NECOCHEA COUNTY, BUENOS AIRES, ARGENTINA

    OpenAIRE

    Patricia Vazquez; Laura Zulaica; Belen Benavidez

    2017-01-01

    El modelo actual de producción agropecuaria de la región pampeana argentina, ha mostrado una tendencia a la agriculturización, con un efecto directo sobre la dinámica de los agroecosistemas, generando impactos ambientales con consecuencias sobre la base de los recursos naturales. Tomando el partido de Necochea inserto en la región, esta investigación propone analizar los cambios en el uso del suelo en dicho Partido entre 2003-2011, mediante sensores remotos, y estimar los impactos ambientales...

  12. Cuentas ambientales del departamento de Pando en Bolivia: Aplicación del enfoque insumo producto a nivel sub-nacional

    OpenAIRE

    Suxo, Johnny

    2017-01-01

    La estimación de las cuentas ambientales a nivel subnacional es importante en Bolivia, debido a la heterogénea distribución espacial de los activos ambientales en el territorio nacional, en particular para departamentos de escasa diversificación productiva, donde la extracción de recursos naturales constituye su principal base económica. El presente trabajo se concentra en el departamento de Pando en Bolivia. Aplica la metodología non-survey de regionalización de matrices insumo producto, a u...

  13. El reconocimiento de los costos ambientales como instrumento para el empoderamiento económico de las comunidades afectadas (caso vereda Chipautá)

    OpenAIRE

    Díaz Montaño, Evelyn Ivonne

    2015-01-01

    La industria tiene la obligación de dar cuenta y encaminar esfuerzos para prevenir, mitigar o reparar daños ambientales. El proceso de internalización de costos ambientales puede llegar a constituir un elemento que promueva el empoderamiento de las comunidades afectadas. La vereda Chipautá refleja la dicotomía entre empresa y comunidad, como muchas otras del territorio nacional, sus antecedentes frente al fenómeno de exploración petrolífera ha pasado por problemas de orden social, político, e...

  14. ROLE OF PARENTERAL AMINO ACIDS SUPPLEMENATION IN OLIGOHYDRAMNIOS & IUGR COMPLICATED PREGNANCIES

    OpenAIRE

    Anuradha; Malini; Sumit

    2015-01-01

    OBJECTIVES: To see whether parenteral nutritional supplementation of women with oligohydramnios/IUGR can improve the amount of liquor and to evaluate the role of pareneral therapy in improving maternal and perinatal outcome and to correlate between the occurrence of oligohydramnios and IUGR among women of different age, parity, education and socioe...

  15. Refeeding syndrome in a small-for-dates micro-preemie receiving early parenteral nutrition.

    Science.gov (United States)

    Mizumoto, Hiroshi; Mikami, Masamitsu; Oda, Hirotsugu; Hata, Daisuke

    2012-10-01

    This report describes a small-for-date extremely low birth weight infant who manifested bradycardic events, respiratory failure, and hemolytic jaundice during her first week of life. These complications were attributed to severe hypophosphatemia and hypokalemia. Inadequate supply and refeeding syndrome triggered by early aggressive parenteral nutrition were responsible for electrolyte abnormalities. © 2012 The Authors. Pediatrics International © 2012 Japan Pediatric Society.

  16. Responses of Preterm Pigs to an Oral Fluid Supplement During Parenteral Nutrition

    DEFF Research Database (Denmark)

    Berding, Kirsten; Makarem, Patty; Hance, Brittany

    2016-01-01

    Background: Nutrients and electrolytes in amniotic fluid swallowed by fetuses are important for growth and development. Yet, preterm infants requiring parenteral nutrition (PN) receive minimal or no oral inputs. With the limited availability of amniotic fluid, we evaluated the responses of preterm...

  17. Chronic parenteral nutrition induces hepatic inflammation, steatosis and insulin resistance in neonatal pigs

    Science.gov (United States)

    Prematurity and overfeeding in infants are associated with insulin resistance in childhood and may increase the risk of adult disease. Total parenteral nutrition (TPN) is a major source of infant nutrition support and may influence neonatal metabolic function. Our aim was to test the hypothesis that...

  18. [Treatment of children with intestinal failure: intestinal rehabilitation, home parenteral nutrition or small intestine transplantation?

    NARCIS (Netherlands)

    Neelis, E.G.; Oers, H.A. van; Escher, J.C.; Damen, G.M.; Rings, E.H.; Tabbers, M.M.

    2014-01-01

    Intestinal failure is characterised by inadequate absorption of food or fluids, which is caused by insufficient bowel surface area or functioning. Children with chronic intestinal failure are dependent on parenteral nutrition (PN), which can be provided at home (HPN). In the Netherlands, HPN for

  19. Continuous intravenous infusion of ampicillin and gentamicin during parenteral nutrition in 88 newborn infants

    DEFF Research Database (Denmark)

    Colding, H; Møller, S; Andersen, G E

    1982-01-01

    Ampicillin and gentamicin were dissolved once a day in an L-amino acid solution especially prepared for parenteral nutrition of newborn infants and infused continuously to 88 infants in whom septicaemia was suspected or had been proved. The mean dosages were 162 and 5.3 mg/kg per 24 hours...

  20. Essential fatty acid deficiency in patients receiving home parenteral nutrition 1,2

    DEFF Research Database (Denmark)

    Jeppesen, P. B.; Høy, Carl-Erik; Mortensen, Per B

    1998-01-01

    Home parenteral nutrition (HPN), initiated in patients with severe malabsorption or decreased oral intake, may exhaust stores of essential fatty acids and cause clinical manifestations, mainly dermatitis. Plasma fatty acid profiles were measured by gas-liquid chromatography in 37 healthy control...

  1. 76 FR 25358 - 2011 Parenteral Drug Association/Food and Drug Administration Glass Quality Conference; Public...

    Science.gov (United States)

    2011-05-04

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2011-N-0002] 2011 Parenteral Drug Association/Food and Drug Administration Glass Quality Conference; Public Conference AGENCY: Food and Drug Administration, HHS. ACTION: Notice of public conference. SUMMARY: The Food...

  2. Continuous parenteral and enteral nutrition induces metabolic dysfunction in neonatal pigs

    DEFF Research Database (Denmark)

    Stoll, Barbara; Puiman, Patrycja Jolanta; Cui, Liwei

    2012-01-01

    We previously showed that parenteral nutrition (PN) compared with formula feeding results in hepatic insulin resistance and steatosis in neonatal pigs. The current aim was to test whether the route of feeding (intravenous [IV] vs enteral) rather than other feeding modalities (diet, pattern) had...

  3. Review of macronutrients in parenteral nutrition for neonatal intensive care population.

    Science.gov (United States)

    Johnson, Patricia J

    2014-01-01

    Parenteral nutrition (PN) has become essential in the management of sick and growing newborn populations in the NICU. In the past few decades, PN has become fundamental in the nutritional management of the very low birth weight infant (macronutrients in PN, including carbohydrates, protein, and fat. A subsequent article will review the micronutrients in PN, including electrolytes, minerals, and vitamins.

  4. Alanine turnover in the postabsorptive state and during parenteral hyperalimentation before and after surgery

    NARCIS (Netherlands)

    Sauerwein, H. P.; Michels, R. P.; Cejka, V.

    1981-01-01

    Influence of total parenteral nutrition and operation on alanine turnover and venous alanine concentration was determined in 5 patients with stomach carcinoma using single technique of U-14C alanine. Every patient served at his own control. In the postabsorptive state alanine turnover was 1.63 +/-

  5. Nutrition quality control in the prescription and administration of parenteral nutrition therapy for hospitalized patients.

    Science.gov (United States)

    Shiroma, Glaucia Midori; Horie, Lilian Mika; Castro, Melina Gouveia; Martins, Juliana R; Bittencourt, Amanda F; Logullo, Luciana; Teixeira da Silva, Maria de Lourdes; Waitzberg, Dan L

    2015-06-01

    Nutrition quality control in parenteral nutrition therapy (PNT) allows the identification of inadequate processes in parenteral nutrition (PN). The objective of this study was to assess the quality of PNT at a hospital with an established nutrition support team (NST). This observational, longitudinal, analytical, and prospective study examined 100 hospitalized PNT adult patients under the care of an NST for 21 days or until death/hospital discharge. The American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) 2007 guidelines for PNT prescription were followed. PNT indications were not in accordance with the A.S.P.E.N. 2007 guidelines in 15 patients. Among the remaining 85 patients, 48 (56.5%) did not receive adequate PNT (≥80% of the total volume prescribed). Non-NST medical orders, progression to and from enteral nutrition, changes in the central venous catheter, unknown causes, and operational errors (eg, medical prescription loss, PN nondelivery, pharmacy delays, inadequate PN bag temperature) were associated with PNT inadequacy (P nutrition therapy related to estimated energy expenditure and protein requirements and glycemia levels reached the expected targets; however, the central venous catheter infection rate was higher than 6 per 1000 catheters/d and did not meet the expected targets. Despite an established NST, there was a moderate level of PNT inadequacy in indications, administration, and monitoring. It is important to establish periodic meetings among different health professionals who prescribe and deliver PNT to define responsibilities and protocols. © 2015 American Society for Parenteral and Enteral Nutrition.

  6. The parenteral nutritional regimen in pigs for basic studies in physiology of nutrition

    International Nuclear Information System (INIS)

    Matkowitz, R.; Harting, W.; Souffrant, W.B.; Junghans, P.; Boerner, P.

    1983-01-01

    Experimental studies concerning a parenteral nutritional regimen were performed in pigs aiming at comparative metabolic investigations to evaluate clinically relevant problems within nutritional research. By means of the 15 N tracer technique the evaluation of the postoperative protein turnover was rendered possible by this animal model

  7. Environmental radioactivity networks in Italy, 1994-1997; Reti nazionali di sorveglianza della radioattivita' ambientale in Italia: 1994-1997

    Energy Technology Data Exchange (ETDEWEB)

    Belli, M; Notaro, M; Rosamilia, S; Sansone, U [Agenzia Nazionale per la Protezione dell' Ambiente, Rome (Italy). Dipt. StatoAmbiente, Controlli e Sistemi Informativi, Unita' Interdipartimentale di Metrologia Ambientale

    1999-07-01

    This report contains the environmental radioactivity data collected in Italy from 1994 to 1997 by the National Environmental Radioactivity Networks of Italy. The National Environmental Protection Agency (ANPA) is law-fully responsible for publishing the environmental and dietary contamination data, provided by the organisations participating to the National Environmental Radioactivity Networks. The complete list of the participants is reported at the end of the present document. The National Environmental Radioactivity Networks of Italy are aimed at survey of the pattern of environmental and dietary contamination in order to assess the radiation doses which the Italian population may receive. The sampling networks have been designed on regional basis, to provide information on the average extent of environmental and dietary contamination. The sampling programmes are planned to obtain representative samples able to reveal the average situation both in time and space. To guarantee that the laboratories of the organisations participating to the National Environmental Radioactivity Networks, perform measurements with a certain degree of accuracy and maintain the quality of their systems, the National Environmental Protection Agency organises yearly an intercalibration programme of the analytical methods used for measuring radioactivity in food and environmental samples. The calibration programme is performed with the collaboration of the National Institute of Ionising Radiation Metrology (ENEA). Routine tests with transfer standards are used for accurate calibration, so that the results can be traceable to a common reference point. [Italian] Il presente rapporto contiene una sintesi dei dati di radioattivita' ambientale raccolti in Italia dal 1994 al 1997 nell'ambito delle Reti Nazionali di Sorveglianza della Radioattivita' Ambientale. Obiettivo principale delle Reti Nazionali e' il rilevamento dell'andamento della radioattivita' ambientale sul territorio nazionale, al

  8. Stability of furosemide and aminophylline in parenteral solutions

    Directory of Open Access Journals (Sweden)

    Carolina Alves dos Santos

    2011-03-01

    Full Text Available Parenteral solutions (PS are one of the most commonly used drug delivery vehicles. Interactions among the drug, components in the drug's formulation, and the PS can result in the formation of inactive complexes that limit efficacy or increase side effects. The aim of this work was to evaluate possible interactions between the drugs and PS, assess drug stability and to identify degradation products after 20 h at room temperature. Furosemide (FSM and Aminophylline (APN were added to PS containing either 20% mannitol or 0.9% NaCl at pH 6.5-7.5 and 10-11. Their behavior was studied individually and as an admixture, after 1 h oxidation with H2O2, using a spectrophotometer and HPLC. Individually, FSM and APN added to 20% mannitol and 0.9% NaCl solutions had the highest stability at pH 10-11. When FSM and APN were combined, the behavior of FSM was similar to the behavior observed for the drug individually in the same solutions. With the drugs combined in 20% mannitol pH 10-11, HPLC showed that both drugs were stable after a 20 h period yielding two distinct peaks; in oxidized samples, the elution profile showed four peaks with retention times unrelated to the untreated samples.Soluções parenterais de grande volume são frequentemente utilizadas no ambiente hospitalar para a veiculação de fármacos. No entanto, possíveis incompatibilidades entre as estruturas dos fármacos, em diferentes veículos de administração, podem gerar possíveis associações antagônicas ou sinérgicas, resultando em alterações das propriedades físico-químicas, consequentemente, dos efeitos farmacológicos e das respostas clínicas esperadas. Este artigo avaliou a estabilidade e a possível formação de produtos de degradação entre os fármacos furosemida e aminofilina quando estes foram veiculados em soluções parenterais, após o preparo e após o período de 20 h. Furosemida e aminofilina foram adicionadas às soluções de 20% manitol e 0,9% NaCl nos valores

  9. Early Post Operative Enteral Versus Parenteral Feeding after Esophageal Cancer Surgery

    Directory of Open Access Journals (Sweden)

    Mohammadtaghi Rajabi Mashhadi

    2015-09-01

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

  10. Brief Parenteral Nutrition Accelerates Weight Gain, Head Growth Even in Healthy VLBWs

    Science.gov (United States)

    Morisaki, Naho; Belfort, Mandy B.; McCormick, Marie C.; Mori, Rintaro; Noma, Hisashi; Kusuda, Satoshi; Fujimura, Masanori

    2014-01-01

    Introduction Whether parenteral nutrition benefits growth of very low birth weight (VLBW) preterm infants in the setting of rapid enteral feeding advancement is unclear. Our aim was to examine this issue using data from Japan, where enteral feeding typically advances at a rapid rate. Methods We studied 4005 hospitalized VLBW, very preterm (23–32 weeks' gestation) infants who reached full enteral feeding (100 ml/kg/day) by day 14, from 75 institutions in the Neonatal Research Network Japan (2003–2007). Main outcomes were weight gain, head growth, and extra-uterine growth restriction (EUGR, measurement parenteral nutrition. Adjusting for maternal, infant, and institutional characteristics, infants who received parenteral nutrition had greater weight gain [0.09 standard deviation (SD), 95% CI: 0.02, 0.16] and head growth (0.16 SD, 95% CI: 0.05, 0.28); lower odds of EUGR by head circumference (OR 0.66, 95% CI: 0.49, 0.88). No statistically significant difference was seen in the proportion of infants with EUGR at discharge. SGA infants and infants who took more than a week until full feeding had larger estimates. Discussion Even in infants who are able to establish enteral nutrition within 2 weeks, deprivation of parenteral nutrition in the first weeks of life could lead to under nutrition, but infants who reached full feeding within one week benefit least. It is important to predict which infants are likely or not likely to advance on enteral feedings within a week and balance enteral and parenteral nutrition for these infants. PMID:24586323

  11. Behavioral and dermatologic changes and low serum zinc and copper concentrations in two premature infants after parenteral alimentation.

    Science.gov (United States)

    Sivasubramanian, K N; Henkin, R I

    1978-11-01

    Two premature infants were observed to develop behavioral and dermatologic changes and low serum zinc and copper concentrations following cessation of prolonged parenteral alimentation, while being fed exclusively with human milk. Following treatment with exogenous oral zinc supplementation, prompt relief of symptoms and increases of serum zinc and copper concentrations were observed in both infants. These patients comprise about 5% of our premature infants who are treated with parenteral alimentation for more than two weeks. We recommend that premature infants on prolonged parenteral alimentation should be monitored for changes in serum zinc and copper concentrations and, if a marked fall is observed, supplementation should be considered.

  12. Conclusions to the first Baxter-Senpe workshop on: ready-to-use (RTU) products for parenteral nutrition

    OpenAIRE

    García de Lorenzo Mateos, A.; Bermejo Vicedo, T.; Gómez Candela, C.; Planas Vila, M.

    2005-01-01

    Conclusiones de la Mesa de Trabajo sobre productos listos para su uso (RTU) en nutrición parenteral. Se efectúa una aproximación a la definición y a las ventajas en comparación con otros modelos de nutrición parenteral. Destacan los aspectos relacionados con la gestión, composición de la RTU e indicaciones tanto intrahospitalarias como domiciliarias.Conclusions to the workshop on ready-to use (RTU) products for parenteral nutrition. An approximation is done to the definition and advantages in...

  13. Functioning and health in patients with cancer on home-parenteral nutrition: a qualitative study.

    Science.gov (United States)

    Mueller, Martin; Lohmann, Stefanie; Thul, Paul; Weimann, Arved; Grill, Eva

    2010-04-16

    Malnutrition is a common problem in patients with cancer. One possible strategy to prevent malnutrition and further deterioration is to administer home-parenteral nutrition (HPN). While the effect on survival is still not clear, HPN presumably improves functioning and quality of life. Thus, patients' experiences concerning functioning and quality of life need to be considered when deciding on the provision of HPN. Currently used quality of life measures hardly reflect patients' perspectives and experiences. The objective of our study was to investigate the perspectives of patients with cancer on their experience of functioning and health in relation to HPN in order to get an item pool to develop a comprehensive measure to assess the impact of HPN in this population. We conducted a series of qualitative semi-structured interviews. The interviews were analysed to identify categories of the International Classification of Functioning, Disability and Health (ICF) addressed by patients' statements. Patients were consecutively included in the study until an additional patient did not yield any new information. We extracted 94 different ICF-categories from 16 interviews representing patient-relevant aspects of functioning and health (32 categories from the ICF component 'Body Functions', 10 from 'Body Structures', 32 from 'Activities & Participation', 18 from 'Environmental Factors'). About 8% of the concepts derived from the interviews could not be linked to specific ICF categories because they were either too general, disease-specific or pertained to 'Personal Factors'. Patients referred to 22 different aspects of functioning improving due to HPN; mainly activities of daily living, mobility, sleep and emotional functions. The ICF proved to be a satisfactory framework to standardize the response of patients with cancer on HPN. For most aspects reported by the patients, a matching concept and ICF category could be found. The development of categories of the component

  14. Functioning and health in patients with cancer on home-parenteral nutrition: a qualitative study

    Directory of Open Access Journals (Sweden)

    Lohmann Stefanie

    2010-04-01

    Full Text Available Abstract Background Malnutrition is a common problem in patients with cancer. One possible strategy to prevent malnutrition and further deterioration is to administer home-parenteral nutrition (HPN. While the effect on survival is still not clear, HPN presumably improves functioning and quality of life. Thus, patients' experiences concerning functioning and quality of life need to be considered when deciding on the provision of HPN. Currently used quality of life measures hardly reflect patients' perspectives and experiences. The objective of our study was to investigate the perspectives of patients with cancer on their experience of functioning and health in relation to HPN in order to get an item pool to develop a comprehensive measure to assess the impact of HPN in this population. Methods We conducted a series of qualitative semi-structured interviews. The interviews were analysed to identify categories of the International Classification of Functioning, Disability and Health (ICF addressed by patients' statements. Patients were consecutively included in the study until an additional patient did not yield any new information. Results We extracted 94 different ICF-categories from 16 interviews representing patient-relevant aspects of functioning and health (32 categories from the ICF component 'Body Functions', 10 from 'Body Structures', 32 from 'Activities & Participation', 18 from 'Environmental Factors'. About 8% of the concepts derived from the interviews could not be linked to specific ICF categories because they were either too general, disease-specific or pertained to 'Personal Factors'. Patients referred to 22 different aspects of functioning improving due to HPN; mainly activities of daily living, mobility, sleep and emotional functions. Conclusions The ICF proved to be a satisfactory framework to standardize the response of patients with cancer on HPN. For most aspects reported by the patients, a matching concept and ICF category

  15. Environmental conditions associated with swordfish size compositions and catches off the Chilean coast Condiciones ambientales asociadas a la estructura de tallas y capturas de pez espada frente a Chile

    Directory of Open Access Journals (Sweden)

    Eleuterio Yáñez

    2009-01-01

    Full Text Available Multivariate analyses were applied to explore the relative influence of environmental factors on swordfish (Xiphias gladius size compositions and catches off Chile. A first analysis was applied to a commercial fishing data base made up of biological-fishery and environmental records from 343 fishing sets performed between 2000 and 2002 by two longline vessels. Furthermore, a data base of fishing research cruises over the Cordillera de Nazca was analyzed; this set consisted of biological-fishery and environmental satellite information recorded for 43 fishing sets done in summer and winter 2003 and autumn and spring 2005. Principal component and hierarchical classification analyses were applied to seven environmental variables (Latitude, Longitude, Sea surface temperature, Chlorophyll a concentration, Sea surface height, Sea sur-face salinity, Bathymetry, all of which may affect the distribution of swordfish size compositions and catches. The analyses indicate four spatial groups representing specific latitudinal locations and typologies of environmental conditions associated with the swordfish size compositions and catches in the study área. Swordfish were caught within a range of SST that varied from 16 to 22°C, with larger catches given smaller SSTs, greater chlorophyll concentrations, and higher latitudes. A latitudinal gradient in size composition is af-firmed, with juvenile specimens associated with warmer conditions, greater salinity, lower chlorophyll concentrations, and lower latitudes. The geographic distribution of the recruitment zone is associated with the Cordillera de Nazca marine area.Se aplicaron análisis multivariados para explorar la influencia relativa de factores ambientales sobre la estructura de tallas y capturas de pez espada (Xiphias gladius frente a Chile. Un primer análisis se aplicó a una base de datos de pesca comercial, correspondiente a registros biológico-pesqueros y ambientales de 343 lances de pesca

  16. Aerobiological monitoring in the fields of health and environment; Il monitoraggio aerobiologico e le sue applicazioni in campo sanitario e ambientale

    Energy Technology Data Exchange (ETDEWEB)

    Cesare, M.R.; Bari, A. [ENEA, Rome (Italy). Div. Protezione dell' Uomo e degli Ecosistemi

    2000-10-01

    Aerobiology, a continuously evolving field, is used in environmental protection programmes to detect atmospheric changes as well as harmful biological particles. [Italian] L'aerobiologia e' una disciplina in continua evoluzione utilizzata nell'ambito dei programmi di protezione ambientale per evidenziare non solo le particelle biologiche nocive, ma anche i tradizionali inquinanti atmosferici.

  17. El diseño de material didáctico como aporte al abordaje de los problemas ambientales en entornos educativos y comunitarios

    Directory of Open Access Journals (Sweden)

    Julián David Becerra-Barón

    2014-01-01

    Full Text Available La necesidad de diseñar materiales que promuevan reflexiones alrededor de los problemas ambientales, hace que las instituciones educativas asuman escenarios promotores en la generación de estrategias didácticas en relación al tema. En este trabajo, se presenta el proceso de diseño de un módulo didáctico denominado: “Reflexionemos sobre los Problemas Ambientales del Municipio de Tunja”, que tiene como finalidad el reconocimiento de los problemas ambientales más relevantes que afectan a esta ciudad. El diseño fue abordado en tres etapas: a Exploración del contexto y documentación, para verificar la relevancia del tema en la comunidad; b. Selección del modelo didáctico y c. Construcción del módulo. Finalmente, se presenta a modo de ejemplo una actividad de juego de roles, diseñada bajo el enfoque de enseñanza-aprendizaje de educación para la sostenibilidad y cuestiones socio-científicas (CSC que permite reflexionar cada uno de los problemas ambientales tratados.

  18. Exploración y explotación de petróleo: enfoque geográfico de los efectos ambientales en el Piedemonte llanero

    Directory of Open Access Journals (Sweden)

    Yesenia Vargas Tejedor

    2017-03-01

    Full Text Available La investigación sobre los efectos ambientales de actividades económicas de gran incidencia para el país como lo son la exploración y la explotación de petróleo, abordadas desde la perspectiva de la geografía económica y la geografía ambiental (Eco geografía y Ecología política, permite desarrollar y utilizar métodos y técnicas para dimensionar de forma integral el conflicto existente en zonas de explotación de petróleo, como es el caso del Piedemonte llanero en el departamento de Casanare así como en otras áreas de similares características. En la identificación y el análisis de efectos ambientales se realizó una revisión crítica de los resultados obtenidos en dos componentes (ambiental y económico, generando una matriz por década que permitió comparar los principales hitos reconocibles en la implementación de las políticas sectoriales y ambientales. Esto contrasta con variables como los cambios de cobertura, licencias ambientales, y otros resultados que lograron evidenciarse con la metodología empleada.

  19. High incidence of rickets in extremely low birth weight infants with severe parenteral nutrition-associated cholestasis and bronchopulmonary dysplasia.

    Science.gov (United States)

    Lee, Soon Min; Namgung, Ran; Park, Min Soo; Eun, Ho Sun; Park, Kook In; Lee, Chul

    2012-12-01

    Risk factors for rickets of prematurity have not been re-examined since introduction of high mineral formula, particularly in ELBW infants. We analyzed the incidence and the risk factors of rickets in extremely low birth weight (ELBW) infants. As a retrospective case-control study from 2004 to 2008, risk factors were analyzed in 24 patients with rickets versus 31 patients without. The frequency of rickets in ELBW infants was 24/55 (44%). Infants with rickets were diagnosed at 48.2 ± 16.1 days of age, and improved by 85.3 ± 25.3 days. By radiologic evaluation, 29% were grade 1 rickets, 58% grade 2 and 13% grade 3. In univariate analysis, infants with rickets had significantly higher incidence of patent ductus arteriosus, parenteral nutrition associated cholestasis (PNAC), severe PNAC and moderate/severe bronchopulmonary dysplasia (BPD). In multiple regression analysis, after adjustment for gestation and birth weight, rickets significantly correlated with severe PNAC and with moderate/severe BPD. Serum peak alkaline phosphatase levels were significantly elevated in rickets (P rickets of prematurity remains high and the incidence of severe PNAC and moderate/severe BPD was significantly increased 18 and 3 times, respectively.

  20. Parenteral treatment of episodic tension-type headache: a systematic review.

    Science.gov (United States)

    Weinman, Danielle; Nicastro, Olivia; Akala, Olabiyi; Friedman, Benjamin W

    2014-02-01

    Tension-type headache is highly prevalent in the general population and is a consistent if not frequent cause of visits to acute care settings. Analgesics such as nonsteroidal anti-inflammatory drugs, acetaminophen, and salicylates are considered first-line therapy for treatment of tension-type headache. For patients who present to an acute care setting with persistent tension-type headache despite analgesic therapy, it is not clear which parenteral agent should be administered. We performed a systematic review of the medical literature to determine whether parenteral therapies other than salicylates or nonsteroidals are efficacious for acute tension-type headache. We performed a systematic review of Medline, EMBASE, CINAHL, Google scholar, and the Cochrane Central Registry of Controlled Trials from inception through August, 2012 using the search terms "tension-type headache" and "parenteral or subcutaneous or intramuscular or intravenous." Our goal was to identify randomized trials in which one parenteral treatment was compared to another active comparator or to placebo for the acute relief of tension-type headache. Parenteral was defined as intravenous, intramuscular, or subcutaneous administration. We only included studies that distinguished tension-type headache from other primary headache disorders, such as migraine. The primary outcome for this review was measures of efficacy one hour after medication administration. Data abstraction was performed by two authors. Disagreements were resolved by a third author. We assessed the internal validity of trials using the Cochrane Collaboration risk of bias tool. Because of the small number of trials identified, and the substantial heterogeneity among study design and medications, we decided that combining data and reporting summary statistics would serve no useful function. The results of individual studies are presented using Number Needed to Treat (NNT) with 95%CI when dichotomous outcomes were available and

  1. Indicaciones no quirúrgicas de la nutrición parenteral periférica Parenteral periferic nutrition: non surgical indications

    OpenAIRE

    A. Ayúcar Ruiz de Galarreta; F. Pita Gutiérrez; F. Mosteiro Pereira; L. Cordero Lorenzana; S. Gómez Canosa; C. Seco Vilariño

    2011-01-01

    Introducción: La Nutrición Parenteral Perif��rica, definida como la mezcla de macronutrientes, vitaminas y minerales con osmolaridad menor de 800 mOsm/L, permite evitar los riesgos del catéter central. Clásicamente ha sido utilizada en postoperados, pero actualmente la patología médica también puede beneficiarse de ella, bien como única fuente de nutrientes, ya que un alto porcentaje de pacientes precisan menor aporte calórico de lo que se creía, o como complementaria. Objetivo: Evaluación de...

  2. Differences in essential fatty acid requirements by enteral and parenteral routes of administration in patients with fat malabsorption

    DEFF Research Database (Denmark)

    Jeppesen, Palle B; Høy, Carl-Erik; Mortensen, Per B

    1999-01-01

    Background: Essential fatty acid (EFA) requirements of patients receiving home parenteral nutrition (HPN) are uncertain. Objective: The objective was to evaluate the influence of the route of administration (enteral compared with parenteral) on plasma phospholipid EFA concentrations. Design......: Intestinal absorption, parenteral supplement of EFAs, and plasma phospholipid EFA concentrations were investigated in balance studies in 4 groups (A, B, C, and D) of 10 patients with short-bowel syndrome and a fecal loss of >2000 kJ/d. Groups A (fat malabsorption 50%) did...... absorption was negligible in groups C and D. Thus, intestinal absorption of EFAs in group A. corresponded to parenteral EFA supplements in group C, whereas group D was almost totally deprived of EFAs. The median plasma phospholipid concentration of linoleic acid decreased by 21.9%, > 16.3%, >13.8%, 11...

  3. Pago por servicios ambientales hidrológicos: caso de estudio Parque Nacional del Nevado de Toluca, México

    Directory of Open Access Journals (Sweden)

    Edgar Brunett

    2011-01-01

    Full Text Available El potencial hídrico que representa el Parque Nacional Nevado de Toluca se ha visto disminuido por numerosos impactos antrópicos, lo que exige crear estrategias para su conservación. Este estudio tiene como objetivo estimar la disposición a pagar haciendo una encuesta en una muestra de usuarios del Valle de Toluca en el marco de un programa de Pago por Servicios Ambientales Hidrológicos. Los resultados muestran que los usuarios dispuestos a pagar rebasan el 50%, con cantidades que oscilan entre 30 y 80 pesos mensuales, sin embargo hay un sector de los encuestados que no estarían dispuestos a contribuir, pero realizarían acciones enfocadas al cuidado del medio ambiente.

  4. Modernización ecológica y políticas ambientales: notas para un debate (Brasil).

    OpenAIRE

    Olivier, Alejandro Gabriel; Domínguez, Carlos Federico

    2011-01-01

    El propósito del presente artículo es explorar conceptualmente la teoría de la modernización ecológica. Se trata de demostrar que dicha teoría, inicialmente sustentada por autores tales como Joseph Huber y Marteen Jänicke, y con desarrollos conceptuales más complejos a partir de los trabajos de Arthur Mol y Gert Spaargarem, entre otros, puede conducir a una revisión sustancial en la percepción, en la formulación y en la implementación de las políticas ambientales. El artículo concluye con el ...

  5. Efectos urbano-ambientales de la política de vivienda en la Ciudad de México

    Directory of Open Access Journals (Sweden)

    Georgina Isunza Vizuet

    2010-01-01

    Full Text Available Este trabajo ofrece una reflexión sobre los efectos ambientales y urbanos de la política de vivienda, a partir de dos ejes rectores: primero, los obstáculos que enfrentan los programas de vivienda sustentable derivados de la vulnerabilidad social de las familias, el rezago habitacional y la rigidez de los esquemas de financiamiento que han tendido a responder más al interés del negocio inmobiliario y financiero, que a la necesidad social de vivienda. Segundo, el impacto del intenso dinamismo que adquieren las empresas inmobiliarias en la construcción del espacio habitable, las cuales promueven un patrón de urbanización cada vez más disperso y fragmentado, agravando la crisis ambiental. El análisis se basa especialmente en la experiencia de la Ciudad de México desde una perspectiva metropolitana.

  6. Pago por servicios ambientales hidrológicos: caso de estudio Parque Nacional del Nevado de Toluca, México

    Directory of Open Access Journals (Sweden)

    Edgar Brunett

    2010-01-01

    Full Text Available El potencial hídrico que representa el Parque Nacional Nevado de Toluca se ha visto disminuido por numerosos impactos antrópicos, lo que exige crear estrategias para su conservación. Este estudio tiene como objetivo estimar la disposición a pagar haciendo una encuesta en una muestra de usuarios del Valle de Toluca en el marco de un programa de Pago por Servicios Ambientales Hidrológicos. Los resultados muestran que los usuarios dispuestos a pagar rebasan el 50%, con cantidades que oscilan entre 30 y 80 pesos mensuales, sin embargo hay un sector de los encuestados que no estarían dispuestos a contribuir, pero realizarían acciones enfocadas al cuidado del medio ambiente.

  7. El papel de las variables ambientales en la nueva geografía económica

    Directory of Open Access Journals (Sweden)

    Diego Azqueta Oyarzun

    2004-01-01

    Full Text Available Este trabajo analiza algunas repercusiones que el incremento en la demanda social por una mayor calidad ambiental puede tener sobre los patrones de especialización espacial, con independencia de la escala de análisis. Se observa cómo, junto a las posibilidades que para las regiones menos desarrolladas puede suponer este desplazamiento de la demanda, podrían generarse, al mismo tiempo, soluciones subóptimas desde un punto de vista social. En esta misma línea, se plantea la posibilidad de que una asignación eficiente de recursos (incorporando consideraciones ambientales, pueda resultar incompatible con la liberalización del comercio internacional y, en concreto, con el desmantelamiento del proteccionismo agrícola en los países desarrollados. Se hace referencia, específicamente, al impacto sobre la diversidad biológica.

  8. Nanotecnología y producción de alimentos: impactos económicos, sociales y ambientales

    Directory of Open Access Journals (Sweden)

    Gian Carlo Delgado

    2009-01-01

    Full Text Available La nanotecnología, dígase la capacidad de manipular la materia a escala nanométrica, se perfila, junto con la biotecnología, la electroinformática y las ciencias congnitivas, como uno de los frentes tecnológicos de vanguardia de principios del siglo XXI. Las fuertes promesas que genera y la incertidumbre que la caracteriza son ciertamente algunos de sus elementos distintivos. El presente texto revisa el contexto social-discursivo del desarrollo de la nanotecnología en el área de los alimentos, tanto en términos de sus potenciales impactos económicos y sociales, como en cuanto a sus posibles implicaciones ambientales y a la salud.

  9. Estudio de la contaminación por pesticidas en aguas ambientales de la provincia de Almería

    OpenAIRE

    Martínez Vidal, José Luis; González Rodríguez, Manuel J.; Belmonte Vega, Antonio; Garrido Frenich, Antonia

    2004-01-01

    En este estudio se han determinado más de cuarenta plaguicidas (organofosforados y organoclorados), de entre los más ampliamente utilizados en tratamientos agrícolas en la provincia de Almería (España), en aguas ambientales de ésta área. El análisis de los plaguicidas se realizó mediante microextracción en fase sólida (SPME) acoplada a cromatografía de gases con detección en modo de espectrometría de masas en tándem (GC-MS/MS). Se tomaron 9 muestras de aguas superficiales y 15 muestr...

  10. Hypoglycemia in noncritically ill patients receiving total parenteral nutrition: a multicenter study. (Study group on the problem of hyperglycemia in parenteral nutrition; Nutrition area of the Spanish Society of Endocrinology and Nutrition).

    Science.gov (United States)

    Olveira, Gabriel; Tapia, María José; Ocón, Julia; Cabrejas-Gómez, Carmen; Ballesteros-Pomar, María D; Vidal-Casariego, Alfonso; Arraiza-Irigoyen, Carmen; Olivares, Josefina; Conde-García, Maria Carmen; García-Manzanares, Álvaro; Botella-Romero, Francisco; Quílez-Toboso, Rosa P; Matía, Pilar; Rubio, Miguel Ángel; Chicharro, Luisa; Burgos, Rosa; Pujante, Pedro; Ferrer, Mercedes; Zugasti, Ana; Petrina, Estrella; Manjón, Laura; Diéguez, Marta; Carrera, Ma José; Vila-Bundo, Anna; Urgelés, Juan Ramón; Aragón-Valera, Carmen; Sánchez-Vilar, Olga; Bretón, Irene; García-Peris, Pilar; Muñoz-Garach, Araceli; Márquez, Efren; Del Olmo, Dolores; Pereira, José Luis; Tous, María C

    2015-01-01

    Hypoglycemia is a common problem among hospitalized patients. Treatment of hyperglycemia with insulin is potentially associated with an increased risk for hypoglycemia. The aim of this study was to determine the prevalence and predictors of hypoglycemia (capillary blood glucose parenteral nutrition (TPN). This prospective multicenter study involved 19 Spanish hospitals. Noncritically ill adults who were prescribed TPN were included, thus enabling us to collect data on capillary blood glucose and insulin dosage. The study included 605 patients of whom 6.8% (n = 41) had at least one capillary blood glucose <70 mg/dL and 2.6% (n = 16) had symptomatic hypoglycemia. The total number of hypoglycemic episodes per 100 d of TPN was 0.82. In univariate analysis, hypoglycemia was significantly associated with the presence of diabetes, a lower body mass index (BMI), and treatment with intravenous (IV) insulin. Patients with hypoglycemia also had a significantly longer hospital length of stay, PN duration, higher blood glucose variability, and a higher insulin dose. Multiple logistic regression analysis showed that a lower BMI, high blood glucose variability, and TPN duration were risk factors for hypoglycemia. Use of IV insulin and blood glucose variability were predictors of symptomatic hypoglycemia. The occurrence of hypoglycemia in noncritically ill patients receiving PN is low. A lower BMI and a greater blood glucose variability and TPN duration are factors associated with the risk for hypoglycemia. IV insulin and glucose variability were predictors of symptomatic hypoglycemia. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Actores sociales y ambitos de construccion de politicas ambientales Social actors and scenarios in the generation of environmental politics

    Directory of Open Access Journals (Sweden)

    Eduardo Gudynas

    2001-06-01

    Full Text Available Se analiza el concepto de "actores claves" en la generación de políticas ambientales. Independientemente de la definición de actor social que se maneje, el asumir la existencia de actores claves ofrece limitaciones conceptuales y prácticas, ya que éstos son coyunturales a cada situación específica. Todos pueden ser actores claves en generar políticas ambientales cumpliendo papeles diferenciales. Como alternativa se utiliza el término de "actores destacados" y se revisan aspectos sobresalientes de varios de ellos en América Latina. Seguidamente se postula que el análisis se debe centrar en los escenarios sociales donde esos actores se pueden manifestar. Se ofrece una distinción preliminar de escenarios que permite integrar a nuevos y viejos movimientos sociales y establecer relaciones de articulación y equivalencia.The concept of "key actors" in the field of environmental politics is analyzed. Beyond the definition of social actor, the assumption of the existence of key actors implies conceptual and practical limitations, as it depends of each specific situation. Everyone could be a key actor under differential roles in the generation of environmental politics. As an alternative, the term "noteworthy actors" is used and a brief review of them in Latin America is presented. The relevant question should address the social scenarios from where these actors can express themselves. A preliminary distinction of scenarios is presented, in which old and new social movements could be integrated and relationships of articulation and equivalence could be established.

  12. CAPACIDAD TECNOLÓGICA Y POLÍTICAS PÚBLICAS DE LAS ORGANIZACIONES GESTORAS DE RIESGOS AMBIENTALES

    Directory of Open Access Journals (Sweden)

    Johana Quintero

    2014-07-01

    Full Text Available El desarrollo del País esta indivisiblemente unido al aprendizaje tecnológico que generan las capacidades tecnológicas necesarias para lograr un cambio tecnológico. La presente investigación analiza la capacidad tecnológica y las políticas públicas de las organizaciones que gestionan los riesgos ambientales en Venezuela y formula los lineamientos teóricos en materia de políticas públicas que beneficien la interrelación del estado venezolano con las organizaciones que gestionan de los riesgos. Para alcanzar los objetivos de la investigación, se fundamentó en las teorías de Mora y Barrios (2000, CLAD (2000, Gaynor (1999, Vásquez (2000, de la misma manera se consultaron leyes, decretos y normativas vigentes. La investigación fue de tipo descriptiva, documental, de campo, con un diseño no experimental transaccional descriptivo, correlacional, utilizando como técnicas e instrumentos de recolección de datos los documentos bibliográficos, el cuestionario y la entrevista, los cuales fueron aplicados a veintitrés sujetos quienes  representan los informantes claves de las organizaciones población de estudio. Con los resultados obtenidos se concluyó que la capacidad tecnológica se incorpora en forma creciente en las organizaciones debido a la consecución de sus cuatro componentes y se comprobó que interactúan entre si y cada uno de ellos contribuye de modo diferente a las mismas, permitiendo integrar las políticas públicas en materia de riesgos ambientales, para poder lograr así una orientación en la elaboración de lineamientos teóricos para el desarrollo de ambas variables.

  13. PAGO POR SERVICIOS HIDROLÓGICOS AMBIENTALES EN LA CUENCA DEL RÍO GUAYALEJO, TAMAULIPAS, MÉXICO

    Directory of Open Access Journals (Sweden)

    H. Rodríguez Rodríguez

    2012-01-01

    Full Text Available La parte baja de la Cuenca del Guayalejo en el sur del Estado de Tamaulipas, México se ha beneficiado por el agua que capta la “Reserva de la Biosfera El Cielo”, el presente trabajo tuvo como objetivo estimar el costo por servicios ambientales hidrológicos, por uso de agua. Se realizó un seguimiento en cuatro sitios al cultivo de la caña de azúcar. Se obtuvo información estadística con relación a la disponibilidad y uso del agua en la Cuenca, para el análisis se aplicaron los métodos; cambios en la producción (uso agrícola y el valor de recuperación (uso potable e industrial. Los resultados mostraron que los sistemas de riego presurizados influyeron en el mayor rendimiento de caña y eficiencia en el uso de agua, el sitio Katanga tuvo una producción de 126,25 t ha-1, en el predio Mexicali con 0,7 cm de agua produjo una tonelada de caña. El análisis mostró que el costo por servicios ambientales hidrológicos por uso del agua para la agricultura fue de $0,39 (pesos mexicanos por metro cúbico de agua utilizado y para uso potable el costo de recuperación fue de $0,12 por metro cúbico de agua potable e industrial consumido.

  14. Retos para la política ambiental: el debate internacional sobre el comercio de bienes y servicios ambientales

    Directory of Open Access Journals (Sweden)

    Diego Alejandro Martínez Ballesteros

    2006-11-01

    Full Text Available Los lineamientos de la actual política ambiental nacional enfatizan la promoción y el aprovechamiento sostenible de bienes y servicios ambientales. A nivel internacional, el tema se está tratando en la Organización Mundial del Comercio, por el mandato de la Declaración Ministerial de Doha (2001. Así mismo, se encuentra tácitamente en la actual agenda del desarrollo. El debate ha girado alrededor de lograr un acuerdo sobre definiciones y criterios de bienes y servicios ambientales para el comercio. Se ha mantenido una visión restringida sobre estos ítems, que excluye apreciaciones integrales desde la economía ambiental. Los bienes y servicios relacionados con la biodiversidad y los que proporcionan los ecosistemas, que podrían interesar a los países ‘megadiversos’ como Colombia no ocupan el centro del debate. La ausencia y la pasividad en este debate pueden conllevar a la pérdida de beneficios y oportunidades de la utilización sostenible de los recursos naturales, en contravía con la intención de la actual política ambiental. Así mismo, los resultados que se logren en la OMC tendrán repercusiones en otros tratados comerciales bilaterales o regionales que celebre el país y en el nivel de autonomía sobre el control de recursos naturales estratégicos.

  15. Retos para la política ambiental: el debate internacional sobre el comercio de bienes y servicios ambientales

    Directory of Open Access Journals (Sweden)

    Diego Alejandro Martínez Ballesteros

    2006-01-01

    Full Text Available Los lineamientos de la actual política ambiental nacional enfatizan la promoción y el aprovechamiento sostenible de bienes y servicios ambientales. A nivel internacional, el tema se está tratando en la Organización Mundial del Comercio, por el mandato de la Declaración Ministerial de Doha (2001. Así mismo, se encuentra tácitamente en la actual agenda del desarrollo. El debate ha girado alrededor de lograr un acuerdo sobre definiciones y criterios de bienes y servicios ambientales para el comercio. Se ha mantenido una visión restringida sobre estos ítems, que excluye apreciaciones integrales desde la economía ambiental. Los bienes y servicios relacionados con la biodiversidad y los que proporcionan los ecosistemas, que podrían interesar a los países ‘megadiversos’ como Colombia no ocupan el centro del debate. La ausencia y la pasividad en este debate pueden conllevar a la pérdida de beneficios y oportunidades de la utilización sostenible de los recursos naturales, en contravía con la intención de la actual política ambiental. Así mismo, los resultados que se logren en la OMC tendrán repercusiones en otros tratados comerciales bilaterales o regionales que celebre el país y en el nivel de autonomía sobre el control de recursos naturales estratégicos

  16. Revisión de indicadores de comunicación de aspectos ambientales para el consumo de productos sustentables

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    Gabriel Cereceda

    2012-12-01

    Full Text Available Si consideramos que la viabilidad de todo Desarrollo pasa por su factibilidad económica y que la base de toda economía es el consumo de bienes, podríamos decir que la viabilidad económica de un Desarrollo Sustentable pasa por el consumo de productos Sustentables. Esto nos lleva a que como sociedad debemos cambiar comportamientos y hábitos de consumo, pero no la manera de consumir, pues desestabilizaríamos el sistema económico actual. En tal sentido, el consumo de estos bienes, pasa por la capacidad de éstos para diferenciarse de los productos tradicionales y de comunicar sus aspectos ambientales. Históricamente, el instrumento utilizado para este fin ha sido la Ecoetiqueta, pero ésta no ha logrado influenciar las decisiones de compra y ha causado confusión en los consumidores principalmente por el tipo de indicadores que utiliza para comunicar los aspectos ambientales de un producto y la manera de hacerlo. De este modo, la definición de indicadores mixtos que permitan generar estándares de comparación entre productos similares; el uso de información clara que disminuya la asimetría de información en el mercado; y una información creíble, certificada por una tercera parte, parecen ser la solución al problema de comunicación para el consumo de productos sustentables.

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

    International Nuclear Information System (INIS)

    Fietkau, R.

    1998-01-01

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

  18. A case of organophosphate poisoning presenting with seizure and unavailable history of parenteral suicide attempt

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    Pandit Vinay

    2011-01-01

    Full Text Available Organophosphate (OP poisoning is common in India. Only few case reports of parenteral OP poisoning have been described. We report a case of self-injected methyl parathion poisoning, presenting after four days with seizure, altered sensorium, and respiratory distress which posed a diagnostic and therapeutic dilemma. Despite nonavailability of history of OP poisoning, he was treated based on suspicion and showed a good clinical response to treatment trial with atropine and pralidoxime, and had a successful recovery. Atypical presentations may be encountered following parenteral administration of OP poison, and even a slight suspicion of this warrants proper investigations and treatment for a favorable outcome. Persistently low plasma cholinesterase level is a useful marker for making the diagnosis.

  19. Recent advances in polymeric microspheres for parenteral drug delivery--part 1.

    Science.gov (United States)

    Mao, Shirui; Guo, Chunqiang; Shi, Yi; Li, Luk Chiu

    2012-09-01

    Polymeric microspheres have been established as a valuable parenteral drug delivery system for sustained release of therapeutic agents via subcutaneous or intramuscular injection. Biodegradable polymers which are either synthetic or from natural sources are reviewed with respect to recent advances in exploring their applications for microsphere fabrications. New information on the impact of formulation variables on the properties of microspheres formed by an emulsion method was also presented. The characterization of microspheres using advanced physical analytical techniques was also reviewed and the utilization of the information in assessing in vivo performance of the product was also highlighted. The broad clinical use of microspheres for delivery of therapeutic agents in particular biologics such as proteins has not been realized commercially. The limited availability of biodegradable polymers with a long history of regulatory approval and the challenges in gaining regulatory approval of a new polymer have hindered the development of microspheres for parenteral drug delivery.

  20. Safety, cost, and clinical considerations for the use of premixed parenteral nutrition.

    Science.gov (United States)

    Hall, Jacob W

    2015-06-01

    Premixed parenteral nutrition (PN) can be used for PN therapy in place of traditional compounded or customized PN. Premixed PN may have a number of advantages over compounded PN such as decreased costs, decreased compounding time, reduced chance for error, and reduced incidence of bloodstream infections. However, premixed PN may not be appropriate for all patients and may have other additional costs associated with its use. This article discusses the data available with regard to the use of premixed PN, focusing on the potential advantages and disadvantages of using premixed PN, and also discusses the implementation of premixed PN in a large tertiary cancer center. © 2015 American Society for Parenteral and Enteral Nutrition.

  1. Parenteral nutrition in radiation therapy and combined treatment of patients with esophageal cancer

    International Nuclear Information System (INIS)

    Sudzhyan, A.V.; Buzovkina, L.P.; Biletov, B.V.; Breusenko, E.Ya.; Krasnova, A.I.; Tsaryuk, V.F.

    1980-01-01

    Results obtained while studying 165 patients with esophageal cancer are presented. It is shown that radiation therapy and combined treatment result in the body mass loss, in the increase of katabolic processes in organism, in the negative nitrogen balance. Weaken patients, being under starvation conditions, are subjected more often to reaction changes and complications developing during the treatment. A comparison characteristics of two methods providing the organism with nutrition is given, i.e. gastrostomy and parenteral nutrition. Shown is the advantage of the adequate parenteral nutrition preventing the appearence of reaction changes and complications, improving the subjective state of patients, homeostasis indices, promoting the elimination of esophagitis phenomena, general radiation response and reaction to chemical preparations; resulting in the increase of quantity of leucocytes at leukopenia

  2. Alterations in pentobarbital pharmacokinetics in response to parenteral and enteral alimentation in the rat.

    Science.gov (United States)

    Knodell, R G; Spector, M H; Brooks, D A; Keller, F X; Kyner, W T

    1980-12-01

    Recent in vitro observations suggest that the intestine, in addition to the liver, may be an important organ of first-pass drug metabolism. While a variety of changes in intestinal morphology and function in response to continuous parenteral and enteral nutrition have been documented, the effect of different routes of alimentation on intestinal drug metabolism has not been previously investigated. Objectives of this study were to assess the contribution of intestinal pentobarbital metabolism to overall in vivo pentobarbital pharmacokinetics in the rat and to determine if differences in pentobarbital pharmacokinetics were seen between parenterally and enterally nourished animals. After 7 days of continuous infusion of amino acid-glucose mixture via a gastric or jugular vein catheter, pharmacokinetic parameters were determined after 40 mg/kg of pentobarbital was given orally or into the portal or femoral vein. Reduced systemic availability of pentobarbital after oral administration as compared to portal vein injection was seen in both alimentation groups indicating that significant intestinal metabolism of pentobarbital occurred in vivo. Total area under the pentobarbital plasma concentration-time curve was significantly greater in parenterally nourished animals as compared with enterally alimented animals after oral, portal vein and systemic vein drug administration. Differences in pentobarbital, pharmacokinetics between the two alimentation groups appeared to be primarly due to effects on hepatic pentobarbital metabolism. While the mechanism producing these changes has not been defined, differences in gut hormones release and/or pancreatic secretion in response to the two routes of alimentation may be contributory. The widespread use of enteral and parenteral alimentation in clinical medicine suggests that studies to determine if nutrition route of administration similarly influences drug metabolism in humans may be indicated.

  3. Concomitant parenteral nutrition and systemic cytotoxic therapy in a metastatic colorectal cancer patient

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    A. A. Popov

    2012-01-01

    Full Text Available Pathologic nutrients metabolism presents a severe problem in metastatic colorectal cancer patients, especially those with canceromatosis. A hypermetabolism-catabolism syndrome frequently develops in in patients with progressing canceromatosis. This leads to cachexia anorexia syndrome, which significantly impedes available treatment options. Artificial nutrition allows to improve available treatment in such patients. We present a successful case of concomitant parenteral nutrition and systemic cytotoxic therapy in metastatic colorectal cancer patient with peritoneal canceromatosis.

  4. Adverse effects of parenteral dexamethasone in the treatment of pemphigus vulgaris

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    Mohammad Jamal Uddin

    2016-08-01

    Full Text Available Background: Pemphigus vulgaris is associated with high morbidity as well as significant mortality rate. Today the risk of death in pemphigus from the side effect of oral prednisolone is greater than risk of death from the disease itself. Objec­tive: To observe the adverse effects of parenteral dexamethasone compared with oral prednisolone in the treatment of pemphigus vulgaris. Methods: An interventional study was carried out in the department of Dermatology and Venereol­ogy, Bangabandu Sheikh Mujib Medical University, Dhaka, Bangladesh. Total number of patients was thirty and among them fifteen patients were treated with parenteral dexamethasone (Group-A and other fifteen were treated with oral prednisolone (Group-B. Results: The study showed statistically significant differences of skin lesion as well as mucosal lesion of pemphigus after 6 weeks of therapy between of two groups (P<0.05. The most common adverse effects were increased body weight(40%, increased appetite(40%, and puffy face(40% in dexamethasone group. In prednisolone group, these side effects were 60% of the subjects. Other side effects in dexamethasone group were hyperglycemia (33.33%, hypertension (26.66%, and sleep disturbance (13.33%. In prednisolone group, other side effects were hyperglycemia(33.33%, hypertension(40%, gastritis (33.33%, nausea, vomiting (13.33% in each , reactivation of tuberculosis, herpes zoster infection, sleep disturbance, and mood change were 6.66% in each group. Conclusion: In the light of the findings of the study, we conclude that each of the treatment of dexamethasone group and prednisolone group is individually effective and safe in the treatment of pemphigus vulgaris but adverse effects are less in parenteral dexamethasone group than oral prednisolone group. So parenteral dexamethasone can be used as an alternative drug in the treatment of pemphigus vulgaris.

  5. [Studies on calf salmonellosis. 4. Oral and parenteral immunization with live (Smd) and killed antigens].

    Science.gov (United States)

    Meyer, H; Steinbach, G; Hartmann, H; Hauke, H; Koch, H; Stelzner, A; Linde, K; Schmerbauch, A; Kiupel, H

    1977-01-01

    Reported are results obtained from studies into oral and parenteral immunisation of calf. The approaches had included the use of live (Smd) or dead antigen from Salmonella (S.) dublin and a combination of the two immunisation methods. Live antigen (Smd) was superior to thermally activated dead antigen, when the oral route was used to prevent S.-dublin injection of calves. The above findings were supported by results from analogous studies in which S. typhimurium and S. dublin or live antigen (Smd) or dead antigen, made of the two, had been applied to mice. (One single subcutaneous) parenteral administration did hardly reveal any difference in favour of live vaccine (Smd). Parenteral administration of live or dead antigen proved to be less effective than repeated oral immunisation, particularly when live vaccine (Smd) was used. Immunity not less than up to six months of age against S. dublin wild strain infection can be provided for young calves by oral immunisation, with Smd vaccine (5. 1010 to 1. 1011 live germs/d) being given on ten consecutive days. Calves orally immunised with live antigen (ten repetitive applications of Smd mutants) are likely to develop an antibody titre (H-agglutinins) against S. dublin. Parenteral boostering,using live antigen, has been accompanied by sensitisation due to oral live antigen administration as well as by dose dependence, as was seen from the bactericidal values. Sensitisation was established from orally immunised calves up to three months old (typical booster reaction). Some of it was attributabale to confrontation with wild strains of Salmonella. The H-agglutinin titres of animals aged threemonths in a calf herd with salmonelloses in which all animals had been orally Smd-immunised were close to those recorded from calves in stocks with no salmonellosis occurrence. Under the conditions of oral immunisation, there had obviously been no action of the wild strain which might have triggered intensive antibody formation.

  6. Hyperintense brain lesions on T1-weighted MRI after parenteral nutrition

    International Nuclear Information System (INIS)

    Saitoh, Yoshiaki; Kimura, Seiji; Nezu, Atsuo; Ohtsuki, Noriyuki; Kobayashi, Takuya; Osaka, Hitoshi; Uehara, Saori

    1996-01-01

    We experienced five children having T 1 -shortening lesions in basal ganglia or thalami on magnetic resonance imaging (MRI), which were supposed to be caused by manganese (Mn) overdoses. Instead of the presence of above-mentioned lesions, no neurological manifestations corresponding to them had developed in all patients. This observation suggests that MRI is useful for detecting side effects caused by overdoses of Mn in patients having parenteral nutrition. (author)

  7. Comparison between Total Parenteral Nutrition Vs. Partial Parenteral Nutrition on Serum Lipids Among Chronic Ventilator Dependent Patients; A Multi Center Study.

    Science.gov (United States)

    Radpay, Rojan; Poor Zamany Nejat Kermany, Mahtab; Radpay, Badiozaman

    2016-01-01

    Malnutrition is very common among chronically hospitalized patients, especially those in the intensive care unit (ICU). Identifying the patients at risk and providing suitable nutritional support can prevent and/or overcome malnutrition in them. Total parenteral nutrition (TPN) and partial parenteral nutrition (PPN) are two common routes to deliver nutrition to hospitalized patients. We conducted a multicenter, prospective double blind randomized controlled trial to evaluate the benefits and compare their adverse effects of each method. 97 patients were enrolled and divided into two groups based on the inclusion criteria. Serum protein, serum albumin, serum transferrin, and total lymphocyte count were measured on days 7 and 14. We did not find any statistically significant differences in clinical status or laboratory values between the two groups but there were significant improvements in measured lab values between days 7 and 14 (pnutritional status in each groups. This study shows that both TPN and PPN can be used safely in chronic ICU patients to provide nutritional support and prevent catabolic state among chronic critically ill patients. We need to develop precise selection criteria in order to choose the patients who would benefit the most from TPN and PPN. In addition, appropriate laboratory markers are needed to monitor the metabolic requirements of the patients and assess their progress.

  8. Effects of parenteral administration of enrofloxacin on electrocardiographic parameters in hospitalized dogs

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    Carlos Fernando Agudelo Ramírez

    2012-01-01

    Full Text Available The effect of enrofloxacin on the QT interval of the electrocardiogram was studied in 30 hospitalized dogs. The experimental group (n = 15 received enrofloxacin parenterally (subcutaneously at a dose of 5 mg/kg twice daily and amoxicillin-clavulanate intravenously at a dose of 22 mg/kg three times daily. The control group (n = 15 received only amoxicillin-clavulanate. Electrocardiography was carried out for 5 min once daily for 6 days. The QT interval was corrected by four different formulae. No differences were found between the two groups or within each group for the duration of the study. On the last day of the study the average QT interval for the control and experimental groups was 213.2 ms and 202.9 ms, respectively. Enrofloxacin did not cause prolongation of the QT or corrected QT intervals. We can conclude that the parenteral administration of enrofloxacin in non-cardiac dogs does not adversely affect the electrocardiographic indicators (no prolongation of the QT or corrected QT interval and does not induce ventricular arrhythmias. Parenteral use of enrofloxacin is thus safe and effective in non-cardiac dogs.

  9. Parenteral corticosteroids followed by early surgical resection of large amblyogenic eyelid hemangiomas in infants

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    El Essawy R

    2013-05-01

    Full Text Available Rania El Essawy,1 Rasha Essameldin Galal21Department of Ophthalmology, 2Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, EgyptBackground: The purpose of this study was to evaluate the results and complications of early surgical resection of large amblyogenic subdermal eyelid hemangiomas in infants after prior short-term parenteral administration of corticosteroids.Methods: Sixteen infants were given dexamethasone 2 mg/kg/day in two divided doses for three consecutive days prior to scheduled surgical excision of large eyelid hemangiomas. The lesions were accessed via an upper eyelid crease, subeyebrow incision, or a lower eyelid subciliary incision.Results: In all cases, surgical excision of the entire lesion was possible with no significant intraoperative or postoperative complications. The levator muscle/aponeurosis complex was involved in 31.25% of cases and was managed by reinsertion or repositioning without resection. A satisfactory lid position and contour with immediate clearing of the visual axis was achieved in all but one case (93.8%.Conclusion: Parenteral corticosteroids helped in reducing volume and blood flow from the hemangiomas, allowing for very early total excision of large subdermal infantile hemangiomas without significant intraoperative hemorrhage. This resulted in immediate elimination of any reason for occlusion amblyopia. Long-term follow-up of visual development in these patients would help to demonstrate the effectiveness of this strategy compared with more conservative measures.Keywords: large eyelid hemangiomas, early surgical resection, parenteral corticosteroids

  10. Impact of Complete Parenteral Nutrition on Metabolic Processes in Cancer Patients in the Early Postoperative Period

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    O. A. Obukhova

    2011-01-01

    Full Text Available Objective: to estimate blood glucose levels during complete parenteral nutrition (CPN, by using the three-in-one system with a high glucose level. Subjects and methods. Thirty adult patients without diabetes mellitus (including 18 men were examined. Twelve and 18 patients were operated on for colonic and gastric cancers, respectively. CPN (Oliclinomel No. 7 — 1000, 1500 ml; glucose, 240 g in 1500 ml, Baxter, Belgium was carried out at the Surgery Department in the early postoperative period (3-5 postoperative days with stable hemodynamics and no organ dysfunction (acute respiratory, renal, hepatic failure. The preparation was administered at a rate of about 83 ml/h over 18 hours. Insulin was not used. Serum glucose concentrations were measured before the study and then for 24 hours at an interval of 6 hours. Results. Glucose concentrations were not found to exceed the allowable values in the majority of patients during CPN at the given rate. In 5 (16.7% patients, short-term glucose increases up to 13.3 mmol/l were corrected, by decreasing the infusion rate. There was no hypoglycemia or other complications during CPN. Conclusion. Our findings suggest that three-in-one parenteral feeding is safe and causes no metabolic disturbances if simple principles are followed, the basic ones of which are to observe the intake of an adequate total dose and the rate of administration of nutrients. Key words: parenteral feeding, hyperglycemia, metabolic disturbances.

  11. An Overview of Chitosan Nanoparticles and Its Application in Non-Parenteral Drug Delivery

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    Munawar A. Mohammed

    2017-11-01

    Full Text Available The focus of this review is to provide an overview of the chitosan based nanoparticles for various non-parenteral applications and also to put a spotlight on current research including sustained release and mucoadhesive chitosan dosage forms. Chitosan is a biodegradable, biocompatible polymer regarded as safe for human dietary use and approved for wound dressing applications. Chitosan has been used as a carrier in polymeric nanoparticles for drug delivery through various routes of administration. Chitosan has chemical functional groups that can be modified to achieve specific goals, making it a polymer with a tremendous range of potential applications. Nanoparticles (NP prepared with chitosan and chitosan derivatives typically possess a positive surface charge and mucoadhesive properties such that can adhere to mucus membranes and release the drug payload in a sustained release manner. Chitosan-based NP have various applications in non-parenteral drug delivery for the treatment of cancer, gastrointestinal diseases, pulmonary diseases, drug delivery to the brain and ocular infections which will be exemplified in this review. Chitosan shows low toxicity both in vitro and some in vivo models. This review explores recent research on chitosan based NP for non-parenteral drug delivery, chitosan properties, modification, toxicity, pharmacokinetics and preclinical studies.

  12. [Domiciliary parenteral antibiotic therapy: a prospective analysis of the last 12 years].

    Science.gov (United States)

    Peláez Cantero, M J; Madrid Rodríguez, A; Urda Cardona, A L; Jurado Ortiz, A

    2014-08-01

    Parenteral antibiotic treatment has been classically developed in hospitals and is considered as a hospital procedure. The development of Hospital at Home Units (HHU) has led to an increase in outpatient parenteral antibiotic therapy (OPAT) in paediatrics patients. The objective of this study is to describe our experience, as an HHU integrated within a Paediatric Department, in home antimicrobial therapy over a period of 12 years. This prospective and descriptive study included every patient with a disease requiring parenteral antimicrobial therapy who was admitted to our HHU from January 2000 to December 2012. During the study there were 163 cases on OPAT. The mean age of the patients was 11.1 years, and the sample group was comprised of 33 males and 22 feamales. The main sources of the treated infections were respiratory tract (76%), catheter-related bloodstream (9.2%), and urinary tract infections (5.5%). Amikacin was the most widely used antibiotic. Almost all treatments (96.6%) were via an intravenous route. Catheter-associated complications were more common than drug-associated complications. Successful at-home treatment was observed in 90.2% of cases. OPAT is a good and safe alternative in many paediatric diseases. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  13. Validation of the aseptic filling at the Parenteral Products Plant 3 in BioCen

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    Marisol Álvarez-González

    2016-07-01

    Full Text Available As part of the continuous improvement process, a new parenterals production plant (PPP3 was constructed at the National Center for Bioproducts. The validation of the aseptic filling process is a key element to carry out before manufacturing products. Therefore, the aim of this work was to obtain documented evidence that all the operations were carried out according the regulations of Good Manufacturing Practices for liquid and lyophilized sterile products during the aseptic filling at the Parenterals Product Plant 3. The study was designed for lyophilized products connected to the manifold of the peristaltic pump and to the four rotary piston pumps. Besides, during the filling operation four interventions were planned. The validation was carried out with three consecutive batches of media fill. In the first processed lot no vial was contaminated, but in the second and third lots there was one contaminated vial. For that reason, an investigation was performed in order to know the cause of the contamination. Finally, with this wok the validated condition was obtained, following the regulations of Good Manufacturing Practices for sterile liquids and lyophilizes products during the aseptic filling process at the Parenterals Products Plant 3.

  14. Nitrite and nitrate concentrations and metabolism in breast milk, infant formula, and parenteral nutrition.

    Science.gov (United States)

    Jones, Jesica A; Ninnis, Janet R; Hopper, Andrew O; Ibrahim, Yomna; Merritt, T Allen; Wan, Kim-Wah; Power, Gordon G; Blood, Arlin B

    2014-09-01

    Dietary nitrate and nitrite are sources of gastric NO, which modulates blood flow, mucus production, and microbial flora. However, the intake and importance of these anions in infants is largely unknown. Nitrate and nitrite levels were measured in breast milk of mothers of preterm and term infants, infant formulas, and parenteral nutrition. Nitrite metabolism in breast milk was measured after freeze-thawing, at different temperatures, varying oxygen tensions, and after inhibition of potential nitrite-metabolizing enzymes. Nitrite concentrations averaged 0.07 ± 0.01 μM in milk of mothers of preterm infants, less than that of term infants (0.13 ± 0.02 μM) (P milk. Concentrations in parenteral nutrition were equivalent to or lower than those of breast milk. Freeze-thawing decreased nitrite concentration ~64%, falling with a half-life of 32 minutes at 37°C. The disappearance of nitrite was oxygen-dependent and prevented by ferricyanide and 3 inhibitors of lactoperoxidase. Nitrite concentrations in breast milk decrease with storage and freeze-thawing, a decline likely mediated by lactoperoxidase. Compared to adults, infants ingest relatively little nitrite and nitrate, which may be of importance in the modulation of blood flow and the bacterial flora of the infant GI tract, especially given the protective effects of swallowed nitrite. © 2013 American Society for Parenteral and Enteral Nutrition.

  15. Induration at Injection or Infusion Site May Reduce Bioavailability of Parenteral Phenobarbital Administration.

    Science.gov (United States)

    Nakayama, Hirokazu; Echizen, Hirotoshi; Ogawa, Ryuichi; Akabane, Atsuya; Kato, Toshiaki; Orii, Takao

    2017-06-01

    Phenobarbital is well tolerated and effective for controlling agitation or preventing convulsion at the end of life. No information is available concerning parenteral bioavailability of phenobarbital when induration develops at the injection or infusion site. We investigated whether induration at injection or infusion site is related to phenobarbital bioavailability via parenteral routes of continuous subcutaneous infusion and intermittent subcutaneous or intramuscular injection. A retrospective analysis was conducted on the medical data obtained from 18 patients who received chronic subcutaneous or intramuscular injections of phenobarbital for the prevention of convulsions and underwent plasma concentration monitoring of the drug. Patients whose concomitant medications were altered during the observation periods were excluded from the analysis. Comparisons were performed for concentration/dose (C/D) ratios obtained from patients with induration at injection or infusion sites (induration group, n = 6) and those without induration (noninduration group, n = 12). P phenobarbital may be reduced when induration develops at the injection or infusion site in patients treated parenterally by continuous subcutaneous infusion or intramuscular injection.

  16. Cost analysis of premixed multichamber bags versus compounded parenteral nutrition: breakeven point.

    Science.gov (United States)

    Bozat, Erkut; Korubuk, Gamze; Onar, Pelin; Abbasoglu, Osman

    2014-02-01

    Industrially premixed multichamber bags or hospital-manufactured compounded products can be used for parenteral nutrition. The aim of this study was to compare the cost of these 2 approaches. Costs of compounded parenteral nutrition bags in an university hospital were calculated. A total of 600 bags that were administered during 34 days between December 10, 2009 and February 17, 2010 were included in the analysis. For quality control, specific gravity evaluation of the filled bags was performed. It was calculated that the variable cost of a hospital compounded bag was $26.15. If we take the annual fixed costs into consideration, the production cost reaches $36.09 for each unit. It was estimated that the cost for the corresponding multichamber bag was $37.79. Taking the fixed and the variable costs into account, the breakeven point of the hospital compounded and the premixed multichamber bags was seen at 5,404 units per year. In specific gravity evaluation, it was observed that the mean and interval values were inside the upper and lower control margins. In this analysis, usage of hospital-compounded parenteral nutrition bags showed a cost advantage in hospitals that treat more than 15 patients per day. In small volume hospitals, premixed multichamber bags may be more beneficial.

  17. Lipid emulsions in parenteral nutrition of intensive care patients: current thinking and future directions

    Science.gov (United States)

    Jensen, Gordon L.; Koletzko, Berthold V.; Singer, Pierre; Wanten, Geert J. A.

    2010-01-01

    Background Energy deficit is a common and serious problem in intensive care units and is associated with increased rates of complications, length of stay, and mortality. Parenteral nutrition (PN), either alone or in combination with enteral nutrition, can improve nutrient delivery to critically ill patients. Lipids provide a key source of calories within PN formulations, preventing or correcting energy deficits and improving outcomes. Discussion In this article, we review the role of parenteral lipid emulsions (LEs) in the management of critically ill patients and highlight important biologic activities associated with lipids. Soybean-oil-based LEs with high contents of polyunsaturated fatty acids (PUFA) were the first widely used formulations in the intensive care setting. However, they may be associated with increased rates of infection and lipid peroxidation, which can exacerbate oxidative stress. More recently developed parenteral LEs employ partial substitution of soybean oil with oils providing medium-chain triglycerides, ω-9 monounsaturated fatty acids or ω-3 PUFA. Many of these LEs have demonstrated reduced effects on oxidative stress, immune responses, and inflammation. However, the effects of these LEs on clinical outcomes have not been extensively evaluated. Conclusions Ongoing research using adequately designed and well-controlled studies that characterize the biologic properties of LEs should assist clinicians in selecting LEs within the critical care setting. Prescription of PN containing LEs should be based on available clinical data, while considering the individual patient’s physiologic profile and therapeutic requirements. PMID:20072779

  18. Plasma Aluminum Concentrations in Pediatric Patients Receiving Long-Term Parenteral Nutrition.

    Science.gov (United States)

    Courtney-Martin, Glenda; Kosar, Christina; Campbell, Alison; Avitzur, Yaron; Wales, Paul W; Steinberg, Karen; Harrison, Debra; Chambers, Kathryn

    2015-07-01

    Patients receiving long-term parenteral nutrition (PN) are at increased risk of aluminium (Al) toxicity because of bypass of the gastrointestinal tract during PN infusion. Complications of Al toxicity include metabolic bone disease (MBD), Al-associated encephalopathy in adults, and impaired neurological development in preterm infants. Unlike the United States, there are no regulations regarding Al content of large- and small-volume parenterals in Canada. We, therefore, aimed to present our data on plasma Al concentration and Al intake from our cohort of pediatric patients receiving long-term PN. Plasma Al concentration was retrospectively gathered from the patient charts of all 27 patients with intestinal failure (IF) receiving long-term PN at The Hospital for Sick Children, Toronto, Canada, and compared with age- and sex-matched controls recruited for comparison. In addition, Al concentration was measured in PN samples collected from 10 randomly selected patients with IF and used to determine their Al intake. The plasma Al concentration of patients with IF receiving long-term PN was significantly higher than that of control participants (1195 ± 710 vs 142 ± 63 nmol/L; P Parenteral and Enteral Nutrition.

  19. Iodine Supplementation for Pediatric Patients Receiving Long-Term Parenteral Nutrition.

    Science.gov (United States)

    Santoro, Jonathan D; Nespor, Colleen; Poole, Robert L; Kerner, John A

    2016-04-01

    Patients dependent on parenteral nutrition (PN) are among a group at risk of developing iodine deficiency. Supplementation with iodine in this population has been debated in a number of studies, resulting in variable clinical practices. The Committee on Clinical Practice Issues of the American Society for Clinical Nutrition recommends a dose of 1 mcg/kg/d of parenteral iodine for patients receiving PN. At our institution, PN trace elements do not include iodine, although this is not the case internationally. Our study sought to assess iodine levels and thyroid function in a cohort of PN-dependent pediatric patients. A retrospective analysis studied 32 pediatric patients with a variety of medical diagnoses who received PN as a primary means of nutrition for 6 months or longer. Patients received variable proportions of their total caloric intake as PN, which ranged from 14%-100%. Iodine and thyroid function levels were obtained by serum sampling. No patient in our cohort of 32 demonstrated thyroid dysfunction or developed iodine deficiency. The length of time on PN and the percentage of total nutrition intake as PN were not associated with iodine levels (P Parenteral and Enteral Nutrition.

  20. Management of Ready-to-Use Parenteral Nutrition in Newborns: Systematic Review.

    Science.gov (United States)

    Mena, Karen Daniela Romero; Espitia, Olga Lucia Pinzón; Vergara, José Alejandro Daza

    2018-04-27

    Parenteral support has increased the possibility of neonatal recovery. However, complications associated with its use have been documented. One commercial method developed to decrease the complications of this type of support is the ready-to-use parenteral nutrition (PN), a 3-chamber bag that provides a complete nutrient mix. This systematic review seeks, through the Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology, to establish the benefits in newborns. Seven databases and gray literature were used. The search was limited to publications from 2007-2017 and to articles written in English, Spanish, and Portuguese. Articles that did not meet the inclusion criteria and studies with low quality evaluated with the Scottish Intercollegiate Guidelines Network guidelines, which were without information about the study or analytical methods, were excluded. A total of 24,193 articles were obtained, which were initially evaluated by title and abstract according to the inclusion criteria. A total of 24,167 articles were discarded, obtaining 27 eligible for follow-up evaluation. After a detailed evaluation of the full text, 13 articles were selected. It was found that ready-to-use PN has the potential benefit to reduce the risks for infections, provide an adequate supply of nutrients, generate growth within the expected range, provide ease of use, decrease prescription errors, and potentially reduce costs. It is necessary to evaluate the short- and long-term impact of its use. © 2018 American Society for Parenteral and Enteral Nutrition.

  1. Investigation of Possible Maillard Reaction Between Acyclovir and Dextrose upon Dilution Prior to Parenteral Administration.

    Science.gov (United States)

    Siahi Shadbad, Mohammad Reza; Ghaderi, Faranak; Hatami, Leila; Monajjemzadeh, Farnaz

    2016-12-01

    In this study the stability of parenteral acyclovir (ACV) when diluted in dextrose (DEX) as large volume intravenous fluid preparation (LVIF) was evaluated and the possible Maillard reaction adducts were monitored in the recommended infusion time. Different physicochemical methods were used to evaluate the Maillard reaction of dextrose with ACV to track the reaction in real infusion condition. Other large volume intravenous fluids were checked regarding the diluted drug stability profile. Differential scanning calorimetry (DSC), Fourier transform infrared spectroscopy (FTIR), and mass data proved the reaction of glucose with dextrose. A Maillard-specific high performance liquid chromatography (HPLC) method was used to track the reaction in real infusion condition in vitro. The nucleophilic reaction occurred in diluted parenteral preparations of acyclovir in 5% dextrose solutions. The best diluent solution was also selected as sodium chloride and introduced based on drug stability and also its adsorption onto different infusion sets (PVC or non PVC) to provide an acceptable administration protocol in clinical practices. Although, the Maillard reaction was proved and successfully tracked in diluted solutions, and the level of drug loss when diluted in dextrose was reported to be between 0.27 up to 1.03% of the initial content. There was no drug adsorption to common infusion sets. The best diluent for parenteral acyclovir is sodium chloride large volume intravenous fluid.

  2. Cost of goods sold and total cost of delivery for oral and parenteral vaccine packaging formats.

    Science.gov (United States)

    Sedita, Jeff; Perrella, Stefanie; Morio, Matt; Berbari, Michael; Hsu, Jui-Shan; Saxon, Eugene; Jarrahian, Courtney; Rein-Weston, Annie; Zehrung, Darin

    2018-03-14

    Despite limitations of glass packaging for vaccines, the industry has been slow to implement alternative formats. Polymer containers may address many of these limitations, such as breakage and delamination. However, the ability of polymer containers to achieve cost of goods sold (COGS) and total cost of delivery (TCOD) competitive with that of glass containers is unclear, especially for cost-sensitive low- and lower-middle-income countries. COGS and TCOD models for oral and parenteral vaccine packaging formats were developed based on information from subject matter experts, published literature, and Kenya's comprehensive multiyear plan for immunization. Rotavirus and inactivated poliovirus vaccines (IPV) were used as representative examples of oral and parenteral vaccines, respectively. Packaging technologies evaluated included glass vials, blow-fill-seal (BFS) containers, preformed polymer containers, and compact prefilled auto-disable (CPAD) devices in both BFS and preformed formats. For oral vaccine packaging, BFS multi-monodose (MMD) ampoules were the least expensive format, with a COGS of $0.12 per dose. In comparison, oral single-dose glass vials had a COGS of $0.40. BFS MMD ampoules had the lowest TCOD of oral vaccine containers at $1.19 per dose delivered, and ten-dose glass vials had a TCOD of $1.61 per dose delivered. For parenteral vaccines, the lowest COGS was achieved with ten-dose glass vials at $0.22 per dose. In contrast, preformed CPAD devices had the highest COGS at $0.60 per dose. Ten-dose glass vials achieved the lowest TCOD of the parenteral vaccine formats at $1.56 per dose delivered. Of the polymer containers for parenteral vaccines, BFS MMD ampoules achieved the lowest TCOD at $1.89 per dose delivered, whereas preformed CPAD devices remained the most expensive format, at $2.25 per dose delivered. Given their potential to address the limitations of glass and reduce COGS and TCOD, polymer containers deserve further consideration as alternative

  3. Alteration of lipid metabolism in rats with intestinal syndrome of raiation sickness in conditions of parenteral feeding with lipofundfin and infusolipol

    International Nuclear Information System (INIS)

    Stepanov, S.A.; Yusupova, I.U.; Grozdov, S.P.

    1988-01-01

    Local X-irradiation of rat abdomen (13.5 Gy) caused a pronounced intestinal syndrome which was partially coped with by parenteral feeding. The results indicate (1) a satisfactory assimilation of fatty emulsions used at certain doses and with certain parenteral diet composition, (2) a favourable effect of fatty emulsions on lipid metabolism in irradiated rats, and (3) some advantages of the parenteral feeding with infusolipol over lipofundin S

  4. Effect of early supplemental parenteral nutrition in the paediatric ICU: a preplanned observational study of post-randomisation treatments in the PEPaNIC trial.

    Science.gov (United States)

    Vanhorebeek, Ilse; Verbruggen, Sascha; Casaer, Michaël P; Gunst, Jan; Wouters, Pieter J; Hanot, Jan; Guerra, Gonzalo Garcia; Vlasselaers, Dirk; Joosten, Koen; Van den Berghe, Greet

    2017-06-01

    Large randomised controlled trials have shown that early supplemental parenteral nutrition in patients admitted to adult and paediatric intensive care units (PICUs) is harmful. Overdosing of energy with too little protein was suggested as a potential reason for this. This study analysed which macronutrient was associated with harm caused by early supplemental parenteral nutrition in the Paediatric Early versus Late Parenteral Nutrition In Critical Illness (PEPaNIC) randomised trial. Patients in the initial randomised controlled trial were randomly assigned to receive suppplemental parenteral nutrition (PN) within 24 h of PICU admission (early PN) or to receive such PN after 1 week (late PN) when enteral nutrition was insufficient. In this post-randomisation, observational study, doses of glucose, lipids, and aminoacids administered during the first 7 days of PICU stay were expressed as % of reference doses from published clinical guidelines for age and weight. Independent associations between average macronutrient doses up to each of the first 7 days and likelihood of acquiring an infection in the PICU, of earlier live weaning from mechanical ventilation, and of earlier live PICU discharge were investigated using multivariable Cox proportional hazard analyses. The three macronutrients were included in the analysis simultaneously and baseline risk factors were adjusted for. From June 18, 2012, to July 27, 2015, 7519 children aged between newborn and 17 years were assessed for eligibility. 6079 patients were excluded, and 1440 children were randomly assigned to receive either early PN (n=723) or late PN (n=717). With increasing doses of aminoacids, the likelihood of acquiring a new infection was higher (adjusted hazard ratios [HRs] per 10% increase between 1·043-1·134 for days 1-5, p≤0·029), while the likelihood of earlier live weaning from mechanical ventilation was lower (HRs 0·950-0·975 days 3-7, p≤0·045), and the likelihood of earlier live PICU

  5. Cloud point extraction of vanadium in pharmaceutical formulations, dialysate and parenteral solutions using 8-hydroxyquinoline and nonionic surfactant

    International Nuclear Information System (INIS)

    Khan, Sumaira; Kazi, Tasneem G.; Baig, Jameel A.; Kolachi, Nida F.; Afridi, Hassan I.; Wadhwa, Sham Kumar; Shah, Abdul Q.; Kandhro, Ghulam A.; Shah, Faheem

    2010-01-01

    A cloud point extraction (CPE) method has been developed for the determination of trace quantity of vanadium ions in pharmaceutical formulations (PF), dialysate (DS) and parenteral solutions (PS). The CPE of vanadium (V) using 8-hydroxyquinoline (oxine) as complexing reagent and mediated by nonionic surfactant (Triton X-114) was investigated. The parameters that affect the extraction efficiency of CPE, such as pH of sample solution, concentration of oxine and Triton X-114, equilibration temperature and time period for shaking were investigated in detail. The validity of CPE of V was checked by standard addition method in real samples. The extracted surfactant-rich phase was diluted with nitric acid in ethanol, prior to subjecting electrothermal atomic absorption spectrometry. Under these conditions, the preconcentration of 50 mL sample solutions, allowed raising an enrichment factor of 125-fold. The lower limit of detection obtained under the optimal conditions was 42 ng/L. The proposed method has been successfully applied to the determination of trace quantity of V in various pharmaceutical preparations with satisfactory results. The concentration ranges of V in PF, DS and PS samples were found in the range of 10.5-15.2, 0.65-1.32 and 1.76-6.93 μg/L, respectively.

  6. A high risk of hepatitis C infection among Egyptian blood donors: the role of parenteral drug abuse.

    Science.gov (United States)

    Bassily, S; Hyams, K C; Fouad, R A; Samaan, M D; Hibbs, R G

    1995-06-01

    To determine the prevalence and risk factors of hepatitis C virus (HCV) infection among Egyptian blood donors, 188 consecutive adult blood donors from four hospitals and one temporary donor center located in Cairo, Egypt were evaluated. Sera were tested for HCV antibodies (anti-HCV) using second-generation enzyme-linked immunosorbent assay (ELISA) test kits. Sera that were repeatedly reactive by ELISA were further verified by a second-generation recombinant immunoblot assay (RIBA). Antibodies to HCV were detected by RIBA in 26.6% of the blood donors, which is higher than the 10-19% prevalence of antibody found in other studies of Egyptian blood donors. A history of selling blood (odds ratio [OR] = 12.1) and the use of illicit parenteral drugs (OR = 2.5) were significantly associated with anti-HCV seropositivity after controlling for age and gender. These data indicate that the use of illicit drugs may be one reason for high levels of reported HCV infection among Egyptian blood donors. These findings also indicate that Egyptian blood donors should be screened for anti-HCV and individuals who have a history of drug abuse should be deferred from donating blood.

  7. Rapid parenteral rehydration in children with dehydration due to acute diarrheal disease Hidratación parenteral rápida en pacientes deshidratados por enfermedad diarreica aguda

    Directory of Open Access Journals (Sweden)

    Myriam Bastidas

    1989-03-01

    Full Text Available

    Between May and July 1987, we studied 36 children with second or third degree dehydration secondary to acute diarrheal disease of less than one week duration; they had no serious associated problems. Parenteral rehydration was carried out with a solution similar in composition to the one recommended by the World Health Organization for Oral Rehydration Therapy (ORT. Rehydration was achieved in 30 patients within 6 hours and In 3 more within 12 hours; there were no cases of hypernatremia or hyperkalemia. It is concluded that parenteral rehydration with a solution similar to the one employed for ORT is an adequate alternative when oral rehydration is not indicated in children with diarrheal disease.

    Entre mayo y julio de 1987 se estudiaron 36 niños que ingresaron al Hospital Infantil de Medellín con deshidratación de segundo o tercer grado, secundaria a enfermedad diarreica de evolución menor de una semana y sin enfermedad grave asociada. La hidratación se llevó a cabo parenteralmente empleando una mezcla de composición similar a la que recomienda la Organización Mundial de la Salud para la Terapia de Rehidratación Oral (TRO. Se logró la hidratación en un lapso de 6 horas en 30 de los 36 pacientes y en 3 más en las siguientes 6 horas; no se produjeron casos de hipernatremia ni de hiperkalemia. Se concluye que la hidratación parenteral, con una solución de composición similar a la de la TRO, es una alternativa adecuada cuando no está indicada la hidratación oral del niño con enfermedad diarreica.

  8. PROGRAMA PARA LA VERIFICACION DE LA TECNOLOGIA AMBIENTAL - CULTIVANDO ASOCIACIONES PARA EL INCREMENTO DE LAS SELECCIONES DE TECNOLOGIAS AMBIENTALES A LOS SECTORES PUBLICO Y PRIVADO EN LOS ESTADOS UNIDOS Y EN EL EXTERIOR (EPA/600/F-97/005A)

    Science.gov (United States)

    La meta del ETV es verificar, a travs de unaevaluacin de informacin objectiva y de calidad, las caracteristicas del desempeo de tecnologascomerciales ambientales. As el ETV proporciona alos compradores y los licenciadores potenciales una valoracin imparcial y creble d...

  9. Gestión urbanística integral del suelo: plusvalías y servicios ambientales

    Directory of Open Access Journals (Sweden)

    Jorge Agudo González

    2009-12-01

    Full Text Available Nuestro Derecho urbanístico ha dedicado enormes esfuerzos en desarrollar mecanismos jurídicos que permiten explicar tanto la generación de plusvalías, como su concesión y distribución equitativa entre los propietarios de suelo urbanizable. Éste es el resultado de configurar nuestro urbanismo como un modelo de “urbanismo rentable” basado en la creación de ciudad. Esta cuestión ha influido en el tratamiento jurídico-urbanístico dedicado a los suelos no urbanizables, centrado en su protección y en la negación de contenidos urbanísticos rentables. Sin embargo, este planteamiento no ha considerado adecuadamente que los suelos rústicos con valores merecedores de protección prestan servicios ambientales a toda la comunidad sin contraprestación alguna para sus propietarios. Para corregir esa dinámica, el ordenamiento ha previsto mecanismos jurídicos diversos cuya finalidad es la colectivización de las cargas que supone la prestación de servicios ambientales. No obstante, estos instrumentos sólo contribuyen al costeamiento de la ejecución de las obligaciones inherentes a la función social de la propiedad, pero no la valorizan. Esos mecanismos han sido superados por la aplicación renovada de técnicas urbanísticas tradicionales que permiten integrar al suelo no urbanizable que presta servicios ambientales en el marco de una ordenación y gestión urbanística integral que compensa la prestación de esos servicios. Spanish urban Law has dedicated important efforts to justify and to develop legal mechanisms that allow explaining both the generation of capital gains, and its granting and equitable distribution among land owners. This is the result of determining our town planning as a model of ‘profitable’ urbanism based on the ‘creation’ of city. The prominence of this question has influenced in the legal-urban processing dedicated to rural lands, concentrating on its protection and in the negation of any profitable

  10. Los ostrácodos como trazadores ambientales en medios contaminados: el río Odiel (SO España

    Directory of Open Access Journals (Sweden)

    López-González, N.

    2007-06-01

    Full Text Available In this paper, ostracods are used as tracers of the environmental changes observed in the lower estuary of the Odiel River during the last decades. These microorganisms have a differential behaviour according to the sedimentary environment studied (ebb-end channels, distributaries, main channels. In the ebb-end channels draining the salt marsh bodies, the subaerial exposure is the main factor controlling the evolution of the ostracod assemblages. In the deeper distributaries and the main channel, the acid wastes derived from two industrial concentrations cause the disappearance of these microcrustaceans between 1966 and 1985. In the distributaries, a recovery was observed in the present-day sediments, whereas no individuals were collected in the main channel. The ostracod carapace is a good indicator of water pollution. Percentages of SO3, FeO and CuO are higher in the valves belonging to the pre-industrial (before 1966 and industrial periods. These components may be derived from the industrial wastes, with a latter tidal redistribution along the estuary.En este trabajo, los ostrácodos son usados como trazadores de los cambios ambientales detectados en el estuario bajo del río Odiel durante las últimas décadas. Estos microorganismos tienen un comportamiento diferencial dependiendo del medio sedimentario estudiado (canales finalizadores, distribuidores, principales. En los canales finalizadores, la exposición subaérea es el principal factor que controla la evolución de las asociaciones de ostrácodos. En los distributarios más profundos y en el canal principal, los desechos ácidos procedentes de dos concentraciones industriales causaron la desaparición de estos microcrustáceos entre 1966 y 1985. En los distributarios, se ha apreciado una parcial recuperación en los sedimentos actuales, en tanto que los primeros centímetros del canal principal no contenían valvas o caparazones de ostrácodos. El caparazón de los ostrácodos es un

  11. Correlaciones fenotípicas, genéticas y ambientales en Cucurbita moschata Duch. Ex Poir

    Directory of Open Access Journals (Sweden)

    Baena García D.

    2005-03-01

    Full Text Available El estudio estimó las correlaciones fenotípicas, genéticas y ambientales entre doce caracteres agronómicos en dos dialélicos de zapallo (uno entre cinco variedades y otro entre cinco líneas S1, originadas de las anteriores. Se usó un diseño en bloques completos al azar con 15 tratamientos (5 progenitores + 10 cruzamientos F1 para cada dialélico y cinco repeticiones. Los resultados señalaron mayor estimación de las correlaciones (en magnitud y significancia estadística a favor del dialélico de líneas S1. Las correlaciones genéticas fueron superiores a las fenotípicas y las ambientales. La producción por planta (PFP presentó las correlaciones parciales fenotípicas y genéticas más altas con el peso por fruto (PPF y el número de frutos por planta (NFP (rPF y rPG > 0.80. El PPF y NFP pueden usarse como criterios de selección para la obtención de cultivares de altos rendimientos en C. moschata. ABSTRACT Phenotypic, genotypic and environmental correlations in Cucurbita moschata Duch. Ex Poir. The study evaluated phenotypic, genotypic and environmental correlations among 12 agronomy characters, in two set diallelic from five parents each one. The first set from five open pollinated varieties and the second one from five self-pollinated lines S1, obtained from the previous varieties. The two experiments were in completely randomized blocks with five replications. A higher estimation of correlation (in magnitude and statistical significance was observed in favor of the S1 lines diallelic. The genetic correlations were higher than the phenotypic and environmental correlations. The plant yield (PFP showed the highest partial phenotypic and genetic correlations with the fruit weight (PPF and fruits per plant (NFP (rPF and rPG > 0.80. It is suggested to use the PPF and NFP as selection criteria for breeding of C. moschata for development of high yield cultivars. Key words: Calabaza (cucurbita, genetic correlation, agronomic

  12. ASPECTOS AMBIENTALES EN LA EXPERIMENTACIÓN QUÍMICA PARA PREVENIR RIESGOS A LA SALUD Y AL AMBIENTE

    Directory of Open Access Journals (Sweden)

    María O. Peña O.

    2011-01-01

    Full Text Available Un aspecto ambiental se considera como cualquier material o elemento físico o químico que el hombre arroja al agua, al aire y al suelo o que interactúe con el ambiente y propicie un riesgo para la salud y para el medio ambiente. Los residuos originados durante el desarrollo de actividades relacionadas con la experimentación química, aunque en una proporción menor que en un proceso industrial, ellos pueden ser residuos peligrosos al medio ambiente. Los aspectos ambientales se asocian con las actividades de generación de residuos, derrames, emisión a la atmósfera, el consumo de recursos naturales y ruido. Este estudio tuvo como objetivo proponer directrices para identificar y clasificar a los residuos que son generados en una experimentación química e introducir aspectos de seguridad para la salud y para el medio ambiente dentro de los procedimientos analíticos. Se inició con una evaluación diagnóstica sobre el conocimiento de la normativa en materia de gestión de los residuos o desechos, dirigida a técnicos y profesores que realizan actividades en ocho laboratorios para la enseñanza de la Química. Se siguió con la selección de un procedimiento analítico, como caso estudio, para revisar y aplicar estrategias de reusar, reciclar y reducir la generación de los residuos. Se encontró un desconocimiento de la normativa ambiental, representada por el 73% de los encuestados y un escaso tratamiento de residuos. Se concluye que la extensión de aspectos ambientales en los procedimientos analíticos puede ayudar a prevenir la contaminación ambiental, a fortalecer aspectos toxicológicos, de seguridad y de prevención de riesgos laborales.

  13. Actitudes y comportamientos ambientales en estudiantes de enfermería de una universidad pública del norte del Perú

    Directory of Open Access Journals (Sweden)

    Marco Rivera-Jacinto

    2009-07-01

    Full Text Available Se desarrolló un estudio descriptivo para determinar actitudes y comportamientos relacionados con salud ambiental en 143 estudiantes universitarios de enfermería. Se emplearon cuestionarios elaborados en base a escalas validadas tipo Likert de actitudes y de comportamientos ambientales, con 8 y 12 ítems respectivamente. Las actitudes positivas más importantes se relacionaron con aquellas en que se afecta la salud y los comportamientos más frecuentes con el uso adecuado del agua y energía; hubo una débil correlación entre actitudes y comportamiento ambientales (rs=0,30. De acuerdo con las escalas empleadas, los participantes tienen una actitud ambiental positiva que no se refleja en sus comportamientos lo cual puede influir de manera negativa en sus próximas actividades como promotores de la salud ambiental.

  14. Diferencias salariales asociadas a atributos ambientales en trece ciudades colombianas: una estimación de salarios hedónicos

    Directory of Open Access Journals (Sweden)

    Fabio Arias

    2007-06-01

    Full Text Available El principal objetivo de este artículo es determinar cuál es la valoración que las personas tienen por la sensación de bienestar físico asociado de manera directa al clima. Para ello, se identifican, a través de la estimación de un modelo de salarios hedónicos, las diferencias de salario entre las trece capitales más importantes de Colombia en el año 2003; se incluye el indicador de confort térmico entre las variables del modelo. El artículo prueba la existencia de diferenciales de salario asociadas a características ambientales y de convivencia y seguridad entre ciudades. También se verifica que las variables ambientales pueden incidir en los ajustes del mercado de trabajo.

  15. Vitamin E in new Generation Lipid Emulsions Protects Against Parenteral Nutrition-Associated Liver disease in Parenteral Nutrition-Fed Preterm Pigs

    DEFF Research Database (Denmark)

    Kenneth, Ng; Stoll, Barbara; Chacko, Shaji

    2016-01-01

    Introduction: Parenteral nutrition (PN) in preterm infants leads to PN-associated liver disease (PNALD). PNALD has been linked to serum accumulation of phytosterols that are abundant in plant oil but absent in fish oil emulsions. Hypothesis: Whether modifying the phytosterol and vitamin E...... composition of soy and fish oil lipid emulsions affects development of PNALD in preterm pigs. Methods: We measured markers of PNALD in preterm pigs that received 14 days of PN that included 1 of the following: (1) Intralipid (IL, 100% soybean oil), (2) Intralipid + vitamin E (ILE, d-α-tocopherol), (3......, OV, and PS compared to IL. Hepatic cholesterol 7-hydroxylase and organic solute transporter-α expression was lower (P E1 fatty acid...

  16. Vitamin E in New-Generation Lipid Emulsions Protects Against Parenteral Nutrition–Associated Liver Disease in Parenteral Nutrition–Fed Preterm Pigs

    Science.gov (United States)

    Ng, Kenneth; Stoll, Barbara; Chacko, Shaji; de Pipaon, Miguel Saenz; Lauridsen, Charlotte; Gray, Matthew; Squires, E. James; Marini, Juan; Zamora, Irving J.; Olutoye, Oluyinka O.; Burrin, Douglas G.

    2015-01-01

    Introduction Parenteral nutrition (PN) in preterm infants leads to PN-associated liver disease (PNALD). PNALD has been linked to serum accumulation of phytosterols that are abundant in plant oil but absent in fish oil emulsions. Hypothesis Whether modifying the phytosterol and vitamin E composition of soy and fish oil lipid emulsions affects development of PNALD in preterm pigs. Methods We measured markers of PNALD in preterm pigs that received 14 days of PN that included 1 of the following: (1) Intralipid (IL, 100% soybean oil), (2) Intralipid + vitamin E (ILE, d-α-tocopherol), (3) Omegaven (OV, 100% fish oil), or (4) Omegaven + phytosterols (PS, β-sitosterol, campesterol, and stigmasterol). Results Serum levels of direct bilirubin, gamma glutamyl transferase, serum triglyceride, low-density lipoprotein, and hepatic triglyceride content were significantly lower (P phytosterols to Omegaven did not produce evidence of PNALD. PMID:25596209

  17. Derecho ambiental - Delitos ambientales. Ilicitud y aspectos sancionatorios: La regulación de los delitos ambientales en el derecho contemporáneo, un desafío más de la sociedad del riesgo

    Directory of Open Access Journals (Sweden)

    Gastón Casaux

    2014-03-01

    Full Text Available Los delitos ambientales propiamente dichos, son ante todo, una novedad del Derecho Ambiental contemporáneo. Quizás sea un tema ancestral, pero lo que sí constituye un sabor diferente es, indudablemente, su análisis, su disección, su entender y su regulación. En el derecho comparado existe una prolija y desusada bibliografía sobre dicha temática vinculada al Riesgo, pero a nivel nacional, es harto diferente. No tenemos aún la conciencia de su trascendencia. Es por ello que el legislador se ha preocupado en el último lustro de acentuar el perfil de dichos delitos, incluyéndolos por ende en el marco regulatorio oficial. Cada vez que surge una figura delictiva, o toda vez que se dibuja un anticipo de la misma, el investigador debe resolver prima facie qué hacer, en suma dónde ubicar a estos elementos de una alquimia propia. La legislación incurre siempre en el mismo error: insertar al delito ambiental en el capítulo de Delitos contra la Salud Pública previstos en el Código Penal, en lugar de crear un capítulo autónomo, propio, independiente, tal como lo ha recomendado la  moderna doctrina española.

  18. Caracterización del estado nutricional, enteroparasitosis y condiciones socio-ambientales de la población infanto-juvenil del partido de La Plata

    Directory of Open Access Journals (Sweden)

    Oyhenart, Evelia Edith

    2013-12-01

    Full Text Available En el presente trabajo se caracterizaron el estado nutricional, las enteroparasitosis y las condiciones socio-ambientales de niños residentes en el Casco urbano y 11 localidades del Partido de La Plata, provincia de Buenos Aires, mediante un estudio transversal. Se midieron peso y talla de 6.397 niños entre 4.0 y 13.9 años. Se calculó el índice de masa corporal y se estimó el estado nutricional utilizando NHANES III. Las variables socio-ambientales se relevaron mediante encuesta estructurada. El análisis parasitológico se realizó en 729 niños sobre muestras seriadas de materia fecal analizadas mediante la técnica de Ritchie y escobillado anal. Los resultados globales indicaron: 22.1% de exceso de peso, 8.7% de desnutrición y 68.5% de parasitosis, siendo más prevalentes Enterobius vermicularis (38.7%, Blastocystis hominis (36.1%, Giardia lamblia (19.1% y protozoos comensales (26.1%. Los geohelmintos tuvieron valores inferiores (9.3%. El partido de La Plata presenta gran heterogeneidad en el estado nutricional y las infecciones parasitarias de los niños por cuanto resultan dependientes de las características socio-ambientales. Las deficientes condiciones ambientales, el bajo nivel educativo y la falta de trabajo formal de los padres explicarían la coexistencia de parasitosis y desnutrición infantil, prevaleciendo la de tipo crónico. Por otra parte, las localidades en las que hay menor grado de cobertura de servicios urbanos básicos, pero los padres poseen mayor nivel educativo y trabajo formalizado, presentan prevalencias más elevadas de exceso de peso.

  19. Estudio de la biodegradación de bolsas oxo - biodegradables en agua dulce y salada, simulando condiciones ambientales de Costa, Sierra y Oriente Ecuatoriano.

    OpenAIRE

    Escobar Silva, Nelly Jacqueline

    2014-01-01

    This work allowed the study of biodegradation of four types of oxo-biodegradable bags by environmental conditions simulated in fresh and salt water of the Costa, Sierra and Oriente regions. El presente trabajo permitió el estudio de la biodegradación de cuatro tipos de bolsas oxo-biodegradables mediante condiciones ambientales simuladas en el agua dulce y salada de las regiones Costa, Sierra y Oriente ecuatoriano.

  20. [When enteral nutrition is not possible in intensive care patients: whether to wait or use parenteral nutrition?

    Science.gov (United States)

    Habes, Q L M; Pickkers, P

    2016-01-01

    - Overfeeding of critically ill patients is associated with a higher incidence of infections and an increased length of ventilation. However, trophic nutrition or permissive underfeeding appears to have no negative effect on the patient and may even provide a survival benefit.- Initiation of enteral nutrition within 24-48 hours after Intensive Care Unit (ICU) admission may reduce the number of complications and increase the chance of survival.- Total parenteral nutrition is associated with a higher risk of infections than enteral nutrition. This seems to be related to the higher calorie intake with parenteral nutrition rather than the route of administration.- In previously well-nourished patients, in whom enteral nutrition is only partially successful, it is safe to wait for up to 8 days before initiating supplemental parenteral nutrition.- In critically ill children, it is also safe to start supplemental parenteral nutrition at a late (on the 8th day after admission) rather than an early stage (within 24 hours of admission). Late supplemental parenteral nutrition may even result in fewer infectious complications and shorter hospitalisation.

  1. Acute impact of home parenteral nutrition in patients with late-stage cancer on family caregivers: preliminary data.

    Science.gov (United States)

    Santarpia, Lidia; Bozzetti, Federico

    2018-02-01

    Since there is no information regarding quality of life of caregivers assisting patients with advanced malignancy on home parenteral nutrition, herewith we report a preliminary series of 19 patients who received total parenteral nutrition at home under the strict supervision of their relatives. The relatives of 19 incurable patients with cancer-related cachexia, discharged from the hospital with a home parenteral nutrition program, were prospectively studied. They filled out a validated questionnaire, the Family Strain Questionnaire Short Form, prior to patient discharge and after 2 weeks of home care. The questionnaire included 30 items, which explored different domains regarding the superimposed burden on caregivers in relation to the assistance given to their relatives. Our findings show that the basal level of strain was relatively high (about three quarters of positive answers) but did not increase after 2 weeks of home care. Similarly, there was no difference in the nutritional status and quality of life of the patients. Eight patients and their relatives could be also analyzed after 2 months and the results maintained unchanged. This preliminary investigation shows that home parenteral nutrition does not exacerbate the level of strain on caregivers involved in surveillance of such a supportive intervention. It is possible that the perception of an active contribution to the benefit of patients, who maintained unchanged their nutritional status and quality of life, could gratify caregivers despite the objective burden in the constant supervision of administering Parenteral Nutrition.

  2. Pediatric parenteral nutrition-associated liver disease and cholestasis: Novel advances in pathomechanisms-based prevention and treatment.

    Science.gov (United States)

    Orso, Giuseppe; Mandato, Claudia; Veropalumbo, Claudio; Cecchi, Nicola; Garzi, Alfredo; Vajro, Pietro

    2016-03-01

    Parenteral nutrition constitutes a life-saving therapeutic tool in patients unable to ingest/absorb oral or enteral delivered nutrients. Liver function tests abnormalities are a common therapy-related complication, thus configuring the so-called Parenteral Nutrition Associated Liver Disease (PNALD) or cholestasis (PNAC). Although the damage is frequently mild, and resolves after discontinuation of parenteral nutrition, in some cases it progresses into cirrhotic changes, especially in neonates and infants. We present a literature review focusing on the pathogenetic mechanisms-driven prevention and therapies for the cases where parenteral nutrition cannot be discontinued. Ursodeoxycholic acid has been proposed in patients with cholestatic hepatopathy, but its efficacy needs to be better established. Little evidence is available on efficacy of anti-oxidants, antibiotics, probiotics and anti TNFα. Lipid emulsions based on fish oil with a high content of long-chain polyunsaturated fatty acids ω-3 appear effective both in decreasing intrahepatic inflammation and in improving biliary flow. Most recent promising variations such as soybean/MCT/olive/fish oil emulsion [third generation lipid emulsion (SMOFlipid)] are under investigation. In conclusion, we remark the emergence of a number of novel pathomechanisms underlying the severe liver impairment damage (PNALD and PNAC) in patients treated with parenteral nutrition. Only few traditional and innovative therapeutic strategies have hitherto been shown promising. Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  3. Comparison of the effects of enteral feeding with continuous and intermittent parenteral nutrition on hepatic triglyceride secretion in human beings

    International Nuclear Information System (INIS)

    Isabel-Martinez, L.; Skinner, C.; Parkin, A.; Hall, R.I.

    1989-01-01

    Plasma triglyceride turnover was measured during steady-state conditions in 22 postoperative patients. Nine had received nutritional support with an enteral regimen, seven had received an equivalent regimen as continuous parenteral nutrition, and six received the same parenteral regimen as a cyclical infusion. After 5 days of nutritional support, each patient received an intravenous bolus of tritiated glycerol. Plasma radiolabeled triglyceride content was measured during the subsequent 24 hours. The data were analyzed by means of a simple deterministic model of plasma triglyceride kinetics and compared with the results obtained by stochastic analysis. The rates of hepatic triglyceride secretion obtained by deterministic analysis were higher than those obtained by the stochastic approach. However, the mode of delivery of the nutritional regimen did not affect the rate of hepatic triglyceride secretion regardless of the method of analysis. The results suggest that neither complete nutritional bypass of the gastrointestinal tract nor interruption of parenteral nutrition in an attempt to mimic normal eating has any effect on hepatic triglyceride secretion. Any beneficial effect that enteral feeding or cyclical parenteral nutrition may have on liver dysfunction associated with standard parenteral nutrition appears to be unrelated to changes in hepatic triglyceride secretion

  4. EL IMAGINARIO "VERDE" Y EL VERDE URBANO COMO INSTRUMENTO DE CONSUMO INMOBILIARIO: CONFIGURANDO LAS CONDICIONES AMBIENTALES DEL ÁREA METROPOLITANA DE SANTIAGO

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    Felipe Irarrázaval Irarrázaval

    2012-01-01

    Full Text Available La mercantilización e instrumentalización de diversos elementos y procesos naturales ha condicionado perfectas plataformas para la acumulación de riquezas. Esto ha sido posible en la medida que existen las condiciones políticas, sociales y económicas para que suceda. Además, en el caso de las condiciones ambientales urbanas, se suma un "imaginario verde" en un amplio espectro de la población, la cual presenta un gran interés por vivir en espacios dotados de naturaleza. Estas condiciones han determinado que en las ciudades se desarrolle una desigual distribución de las condiciones ambientales, dado que cuando la gestión urbana queda en manos del sector privado, sólo las elites con poder adquisitivo pueden acceder a áreas verdes y al arbolado urbano. La presente investigación busca reconocer a la naturaleza urbana como un "instrumento de consumo" inmobiliario, así como sus implicancias en la distribución de las condiciones ambientales en Santiago de Chile. Para esto se reconoce el espacio urbano en ciudades capitalistas como un eslabón dentro de las plataformas de acumulación de capital. A su vez, se integra la perspectiva de los imaginarios ofertados/empleados por el sector inmobiliario como un tema central para concretar la plataforma de acumulación.

  5. LINEAMIENTOS PARA LA FORMULACIÓN DE PAGOS POR SERVICIOS AMBIENTALES. ESTUDIO DE CASO: ALTA CUENCA DEL RÍO SAUCE GRANDE. ARGENTINA

    Directory of Open Access Journals (Sweden)

    Gerardo Andrés Denegri

    2010-01-01

    Full Text Available Los objetivos de este trabajo son: presentar un diagnóstico integral de los principales problemas ambientales generados a partir de la pérdida de suelo por erosión hídrica superficial y exponer los principales lineamientos para la formulación del PSA de la Cuenca Alta del Río Sauce Grande. Metodológicamente se procedió a caracterizar el área en estudio, cuantificar la degradación por erosión hídrica superficial, describir las actividades productivas, conocer los principales consumidores de agua, definir los principales actores del sistema, e identificar los Servicios Ambientales, factibles de ser incluidos en un sistema de PSA. La cuenca presenta procesos erosivos de diferente magnitud y en algunas zonas dificultades en el abastecimiento de agua para la población. Existe un proceso de cambio en el uso de suelo de ganadero a agrícola y a turismo rural. Se concluye que en la cuenca existen condiciones para la implementación de un PSA porque se detectaron dos servicios ambientales factibles de ser pagados: agua y paisaje, con demanda creciente y existen actores e instituciones factibles de ejecutarlo.

  6. Metodología para la construcción de indicadores ambientales para el monitoreo de puertos

    Directory of Open Access Journals (Sweden)

    Osorio Arias 1 Andrés F.

    2011-11-01

    Full Text Available La actividad portuaria genera impactos negativos que deterioran la calidad ambiental en las zonas de influencia, conllevando con esto a un deterioro de la calidad de vida de las poblaciones humanas asentadas en los alrededores por exposición a la contaminación y por cambios en los hábitos de relacionamiento social y cultural. Esta es una propuesta dirigida hacia la construcción de la ruta metodológica para elaborar indicadores ambientales, con el fin de mejores monitoreos a la calidad ambiental en zonas portuarias y, además, apoyar la gestión de la autoridad ambiental en la toma de decisiones. La investigación se ha basado en la realidad actual del monitoreo portuario en Colombia, replicable a cualquier otro país para proponer nuevos indicadores de medición, basados en el contexto socioambiental que los rodea, en los diferentes componentes físico, biótico y social, de cara hacia el uso y aprovechamiento de los recursos naturales y del desarrollo sostenible.

  7. Conflictos ambientales urbanos. Estrategias de movilización asociadas al acceso al agua potable en Tandil, Argentina

    Directory of Open Access Journals (Sweden)

    Elsa Marcela Guerrero

    2011-01-01

    Full Text Available La protesta social se caracteriza por una trama de esfuerzos coordinados y de nuevas formas de organización en red que enfatizan códigos culturales y roles identitarios a nivel comunitario. Estas formas de movilización y organización llaman la atención de los medios, la opinión pública, pero al mismo tiempo estimulan el pensamiento académico con enfoques diferentes como el de los nuevos movimientos sociales (NMS. Distintas formas de organización social han tenido presencia en la última década en la ciudad de Tandil, Argentina. Algunas de estas movilizaciones son debidas a los efectos ambientales de la actividad minera, la instalación de actividades nocivas, etc. En particular, el trabajo caracteriza las luchas locales por acceso al agua potable a partir del análisis historiográfico y documental. Ello permitió detectar analogías conceptuales con otros procesos similares comprendidos globalmente en los denominados NMS.

  8. CONFLICTOS AMBIENTALES URBANOS. ESTRATEGIAS DE MOVILIZACIÓN ASOCIADAS AL ACCESO AL AGUA POTABLE EN TANDIL, ARGENTINA

    Directory of Open Access Journals (Sweden)

    Elsa Marcela Guerrero

    2010-04-01

    Full Text Available La protesta social se caracteriza por una trama de esfuerzos coordinados y de nuevas formas de organización en red que enfatizan códigos culturales y roles identitarios a nivel comunitario. Estas formas de movilización y organización llaman la atención de los medios, la opinión pública, pero al mismo tiempo estimulan el pensamiento académico con enfoques diferentes como el de los nuevos movimientos sociales (NMS. Distintas formas de organización social han tenido presencia en la última década en la ciudad de Tandil, Argentina. Algunas de estas movilizaciones son debidas a los efectos ambientales de la actividad minera, la instalación de actividades nocivas, etc. En particular, el trabajo caracteriza las luchas locales por acceso al agua potable a partir del análisis historiográfico y documental. Ello permitió detectar analogías conceptuales con otros procesos similares comprendidos globalmente en los denominados NMS. (1

  9. METODOLOGÍA GENERAL PARA CORRELACIONAR SAGS CON EVENTOS AMBIENTALES U OPERATIVOS DEL SISTEMA DE DISTRIBUCIÓN

    Directory of Open Access Journals (Sweden)

    Alejandro Castillo Guasca

    2013-07-01

    Full Text Available Es de gran importancia conocer cuáles son las causas  para que se presenten sags en las barrajes de distribución, debido a que la afectación sobre los clientes industriales es de carácter relevante. Por esta razón se planteó  una metodología para buscar la correlación existente entre sags y los eventos ambientales u operativos del sistema de distribución. A manera de ejemplo, se aplicó en tres subestaciones, las cuales se encuentran ubicadas en diferentes sectores de la ciudad. Para el desarrollo de esta metodología, se realizó la correlación de los datos mediante la implementación de tablas dinámicas y programación en Access, donde se evidenció qué tipo de eventos son los que tienen un mayor impacto sobre los clientes. De acuerdo a los resultados obtenidos se sugiere algunas recomendaciones para mitigar este tipo de eventos en el sistema de distribución.

  10. A Pilot Project Demonstrating that Combat Medics Can Safely Administer Parenteral Medications in the Emergency Department.

    Science.gov (United States)

    Schauer, Steven G; Cunningham, Cord W; Fisher, Andrew D; DeLorenzo, Robert A

    2017-12-01

    Introduction Select units in the military have improved combat medic training by integrating their functions into routine clinical care activities with measurable improvements in battlefield care. This level of integration is currently limited to special operations units. It is unknown if regular Army units and combat medics can emulate these successes. The goal of this project was to determine whether US Army combat medics can be integrated into routine emergency department (ED) clinical care, specifically medication administration. Project Design This was a quality assurance project that monitored training of combat medics to administer parenteral medications and to ensure patient safety. Combat medics were provided training that included direct supervision during medication administration. Once proficiency was demonstrated, combat medics would prepare the medications under direct supervision, followed by indirect supervision during administration. As part of the quality assurance and safety processes, combat medics were required to document all medication administrations, supervising provider, and unexpected adverse events. Additional quality assurance follow-up occurred via complete chart review by the project lead. Data During the project period, the combat medics administered the following medications: ketamine (n=13), morphine (n=8), ketorolac (n=7), fentanyl (n=5), ondansetron (n=4), and other (n=6). No adverse events or patient safety events were reported by the combat medics or discovered during the quality assurance process. In this limited case series, combat medics safely administered parenteral medications under indirect provider supervision. Future research is needed to further develop this training model for both the military and civilian setting. Schauer SG , Cunningham C W, Fisher AD , DeLorenzo RA . A pilot project demonstrating that combat medics can safely administer parenteral medications in the emergency department. Prehosp Disaster Med. 2017;32(6):679-681.

  11. Subunit Rotavirus Vaccine Administered Parenterally to Rabbits Induces Active Protective Immunity

    Science.gov (United States)

    Ciarlet, Max; Crawford, Sue E.; Barone, Christopher; Bertolotti-Ciarlet, Andrea; Ramig, Robert F.; Estes, Mary K.; Conner, Margaret E.

    1998-01-01

    Virus-like particles (VLPs) are being evaluated as a candidate rotavirus vaccine. The immunogenicity and protective efficacy of different formulations of VLPs administered parenterally to rabbits were tested. Two doses of VLPs (2/6-, G3 2/6/7-, or P[2], G3 2/4/6/7-VLPs) or SA11 simian rotavirus in Freund’s adjuvants, QS-21 (saponin adjuvant), or aluminum phosphate (AlP) were administered. Serological and mucosal immune responses were evaluated in all vaccinated and control rabbits before and after oral challenge with 103 50% infective doses of live P[14], G3 ALA lapine rotavirus. All VLP- and SA11-vaccinated rabbits developed high levels of rotavirus-specific serum and intestinal immunoglobulin G (IgG) antibodies but not intestinal IgA antibodies. SA11 and 2/4/6/7-VLPs afforded similar but much higher mean levels of protection than 2/6/7- or 2/6-VLPs in QS-21. The presence of neutralizing antibodies to VP4 correlated (P < 0.001, r = 0.55; Pearson’s correlation coefficient) with enhanced protection rates, suggesting that these antibodies are important for protection. Although the inclusion of VP4 resulted in higher mean protection levels, high levels of protection (87 to 100%) from infection were observed in individual rabbits immunized with 2/6/7- or 2/6-VLPs in Freund’s adjuvants. Therefore, neither VP7 nor VP4 was absolutely required to achieve protection from infection in the rabbit model when Freund’s adjuvant was used. Our results show that VLPs are immunogenic when administered parenterally to rabbits and that Freund’s adjuvant is a better adjuvant than QS-21. The use of the rabbit model may help further our understanding of the critical rotavirus proteins needed to induce active protection. VLPs are a promising candidate for a parenterally administered subunit rotavirus vaccine. PMID:9765471

  12. Preventive effect of ursodeoxycholic acid on parenteral nutrition-associated liver disease in infants

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    Simić Dušica

    2014-01-01

    Full Text Available Introduction. Parenteral nutrition-associated cholestasis is well recognized phenomenon in the term and preterm infant receiving long-term parenteral nutrition. Objectives. The aim of this study was to evaluate the effect of ursodeoxycholic acid (UDCA use on cholestasis in newborns on prolonged TPN. Methods. A total of 56 infants were enrolled in this retrospective study: control group consisted of lower (1500 g birth weight infants (n=30, as well as the group of pediatric (n=11 and surgical patients (n=15 treated with UDCA. Blood chemistries were obtained two times weekly. Results. All of 56 newborns developed cholestasis but duration of parenteral nutrition (PN before onset of cholestasis was significantly longer in UDCA treated patients. Average duration of PN before the onset of cholestasis in control group of patients was 25 days in distinction from treated pediatric and surgical patients (39 and 34 days, respectively. The peak serum conjugated bilirubin (CB, AST, ALT and alkaline phosphatase (AP levels were significantly lower in the treated groups. There was no significant difference among treated pediatric and surgical patients and between lower and higher birth weight infants considering the CB, ALT, AST and AP peak. Duration of cholestasis was significantly decreased in all treated groups. There was a significant difference in time needed to achieve complete enteral intake between pediatric and surgical patient group. Conclusion. Cholestasis developed significantly later in treated groups than in the controls. UDCA appears to be very successful in reducing the symptoms of cholestasis. The difference in efficacy of UDCA treatment between lower and higher birth weight infants could not be proven.

  13. [Value of early application of different doses of amino acids in parenteral nutrition among preterm infants].

    Science.gov (United States)

    Liu, Zhi-Juan; Liu, Guo-Sheng; Chen, Yong-Ge; Zhang, Hui-Li; Wu, Xue-Fen

    2015-01-01

    To study the short-term response and tolerance of different doses of amino acids in parenteral nutrition among preterm infants. This study included 86 preterm infants who had a birth weight between 1 000 to 2 000 g and were admitted to the hospital within 24 hours of birth between March 2013 and June 2014. According to the early application of different doses of amino acids, they were randomized into low-dose group (n=29, 1.0 g/kg per day with an increase of 1.0 g/kg daily and a maximum of 3.5 g/kg per day), medium-dose group (n=28, 2.0 g/kg per day with an increase of 1.0 g/kg daily and a maximum of 3.7 g/kg per day), and high-dose group (n=29, 3.0 g/kg per day with an increase of 0.5-1.0 g/kg daily and a maximum of 4.0 g/kg per day). Other routine parenteral nutrition and enteral nutrition support were also applied. The maximum weight loss was lower and the growth rate of head circumference was greater in the high-dose group than in the low-dose group (Pnutrition, shorter duration of hospital stay, and less hospital cost than those in the low-dose group (P0.05). Parenteral administration of high-dose amino acids in preterm infants within 24 hours after birth can improve the short-term nutritional status of preterm infants, but there is a transient increase in BUN level.

  14. Effect of early enteral combined with parenteral nutrition in patients undergoing pancreaticoduodenectomy.

    Science.gov (United States)

    Zhu, Xin-Hua; Wu, Ya-Fu; Qiu, Yu-Dong; Jiang, Chun-Ping; Ding, Yi-Tao

    2013-09-21

    To investigate the effect of early enteral nutrition (EEN) combined with parenteral nutritional support in patients undergoing pancreaticoduodenectomy (PD). From January 2006, all patients were given EEN combined with parenteral nutrition (PN) (EEN/PN group, n = 107), while patients prior to this date were given total parenteral nutrition (TPN) (TPN group, n = 67). Venous blood samples were obtained for a nutrition-associated assessment and liver function tests on the day before surgery and 6 d after surgery. The assessment of clinical outcome was based on postoperative complications. Follow-up for infectious and noninfectious complications was carried out for 30 d after hospital discharge. Readmission within 30 d after discharge was also recorded. Compared with the TPN group, a significant decrease in prealbumin (PAB) (P = 0.023) was seen in the EEN/PN group. Total bilirubin (TB), direct bilirubin (DB) and lactate dehydrogenase (LDH) were significantly decreased on day 6 in the EEN/PN group (P = 0.006, 0.004 and 0.032, respectively). The rate of grade I complications, grade II complications and the length of postoperative hospital stay in the EEN/PN group were significantly decreased (P = 0.036, 0.028 and 0.021, respectively), and no hospital mortality was observed in our study. Compared with the TPN group (58.2%), the rate of infectious complications in the EEN/PN group (39.3%) was significantly decreased (P = 0.042). Eleven cases of delayed gastric emptying were noted in the TPN group, and 6 cases in the EEN/PN group. The rate of delayed gastric emptying and hyperglycemia was significantly reduced in the EEN/PN group (P = 0.031 and P = 0.040, respectively). Early enteral combined with PN can greatly improve liver function, reduce infectious complications and delayed gastric emptying, and shorten postoperative hospital stay in patients undergoing PD.

  15. Drug Utilization Review of parenteral opioid analgesics in cardiovascular surgery department of Shahid Modarres Hospital, Tehran

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    Vatanpour H, Soltani M,

    2016-08-01

    Full Text Available Persistent pain continues to be a common problem among patients undergoing cardiac operations and the need for controlling such pain is believed to be as a prime necessity in terms of the patient’s well being, health care costs and avoiding negative consequences provoked by the pain itself. Regarding to the newly established guidelines, opioid analgesic agents are considered as the mainstay of moderate to severe acute pain. Nonetheless, the underutilization of opioids for pain relief is still a persisting huge challenge. This survey, applying as a concurrent Drug Utilization Review using ATC/DDD system provided and recommended by the DUR group of the World Health Organization, conducted on 108 inpatients who received opioid drugs by parenteral route during 9 months from February to November 2013 at the post-ICU ward of Shahid Modarres Cardiovascular Hospital, affiliated to Shahid Beheshti University of Medical Science, in Tehran. Our findings revealed that morphine was the most commonly prescribed parenteral opioid in the hospitalized patients and pethidine usage was in the lowest level for the geriatric patients, resulting in satisfaction with the analgesic procedure among most of the cases in our study. Both of the mentioned drugs were prescribed by intramuscular route, regarding PRN way of injecting as well. Comparative results of our study with the literature revealed relatively moderate and roughly rational consumption of morphine (10.282 DDD/100bed-days and pethidine (0.013 DDD/100bed-days. Applying multivariate conditional regression modeling on the question of determining independent predictors for opioid usage, disclosed a direct correlation between the patient’s weight and daily dose of parenteral opioid consumption.

  16. INFLUENCIA DE LAS CARACTERÍSTICAS URBANÍSTICAS AMBIENTALES EN EL NIVEL DE ACTIVIDAD FÍSICA DE LA POBLACIÓN DE 18 A 65 AÑOS DEL ÁREA METROPOLITANA DE PAMPLONA

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    Mª Rosario Orzanco-Garralda

    2016-01-01

    Full Text Available Un entorno adecuado puede favorecer la práctica de la actividad física, siendo una opción fácil para la población. El objetivo fue determinar la influencia de la percepción de los factores urbanísticos am - bientales en el nivel de actividad física de las personas adultas. Métodos: Estudio transversal basado en el International Physical Ac - tivity and the Environment Network . Las personas participantes fueron se - leccionadas de forma aleatoria y estratificada de la población de las zonas básicas de salud del Área Metropolitana de Pamplona entre las que tenían edad de 18 a 65 años. Se utilizó un cuestionario autoadministrado que inclu - yó la versión completa de la escala Neighborhood Environment Walkability Scale para valorar la percepción de los factores urbanísticos ambientales y la versión larga del International Physical Activity Questionnaire para recoger datos de actividad física. Se calculó la chi 2 y se realizó un análisis multiva - riable mediante regresión logística no condicional. Resultados: Participaron 905 sujetos (54,70% mujeres. Tener sendas de paseo próximas al domicilio o lugar de trabajo se relacionó con practicar actividad física moderada OR: 3,86 (IC 95% 1,70-8,74] y actividad física total (suma de actividad física vigorosa, moderada y caminar OR: 2,61 (IC 95% 1,24-5,45]. La presencia en el barrio de lugares a los que podían ir caminando se asoció con dedicar más tiempo a caminar [OR: 1,26 (IC 95% 1,01-1,58] y disponer cerca del domicilio o lugar de trabajo de espacios deportivos se asoció con practicar más actividad física vigorosa [OR: 1,46 (IC 95% 1,01 - 2,12. Conclusiones: Existe asociación directa entre la práctica de la actividad física y las características urbanísticas ambientales, como la existencia de sendas de paseo o instalaciones deportivas.

  17. Análisis de impactos ambientales producidos durante la fase de ejecución en edificación: operaciones de limpieza y recuperación de aguas de lavado de hormigones en España

    Directory of Open Access Journals (Sweden)

    Flores-Alés, V.

    2015-06-01

    Full Text Available The aim of this work is to assess the environmental aspects arising during the execution phase of building construction and to analyse the possibilities of reducing the negative impacts. We have studied the environmental factors associated with the use and handling of the materials, focusing the research on two of the most qualitatively significant processes: operations to clean the works and the recovery of concrete-washing water. In both cases, a qualitative analysis of environmental impact has been made. In the wash-water study, basic parameters (density by differential weighing, pH by pHmeter and chemical composition by X ray fluorescence of ten samples were analysed to evaluate the quality of the discharges and thus be able to propose solutions and technological improvements (filtering, neutralization,… applicable to construction works with the aim of decreasing the volume of dislodged solids and improve the quality of water discharged.El presente trabajo evalúa aspectos ambientales durante la fase de ejecución de obra de edificación y analiza las posibilidades de reducción de impactos negativos. Se han estudiado factores ambientales asociados al uso y manipulación de los materiales, centrando la investigación en dos de los procesos cualitativamente más relevantes: las limpiezas de la obra y la recuperación de aguas de lavado de hormigones. En ambos casos se hace un análisis cualitativo de la incidencia ambiental; en el estudio de aguas de lavado se han analizado parámetros básicos (densidad por pesada diferencial, pH mediante pHmetría y composición química por fluorescencia de rayos X de diez muestras procedentes de distintas obras para evaluar la calidad de los vertidos. Se proponen soluciones aplicables y mejoras tecnológicas (filtrado, neutralización,.. en obra con el fin de disminuir el volumen de sólidos arrastrados y mejorar la calidad del agua vertida.

  18. [Applied studies of structured triglycerides for parenteral nutrition in severe hemorrhagic shock patients after resuscitation].

    Science.gov (United States)

    Su, Mao-sheng; He, Lei; Liu, Zhi-wei; Ma, Huan-xian; Zhao, Qing-hua; Zhang, Wen-zhi

    2012-03-27

    To evaluate the effects of structured triglycerides in parenteral nutrition versus a physical medium-chain triglycerides (MCT)/long-chain triglycerides (LCT) mixture on severe hemorrhagic shock patients after resuscitation. In a randomized trial, we studied 20 critical patients with a total blood loss of over 3000 ml perioperatively and/or intraoperatively. The use of triglycerides started from Day 3 postoperation and parenteral nutrition lasted for no less than 5 days. They were allocated to receive one of two nutrition regiments: structured triglycerides in Group A (n = 10) and MCT/LCT in Group B (n = 10). There were no significant differences of general conditions in two groups. Before the start of parenteral nutrition (d0), d1 d3 and d5 after start of infusion, the following parameters were measured: hemoglobin (Hb), platelet count (Plt), alanine aminotransferase (ALT), total bilirubin (TB), direct bilirubin (DB), serum triglycerides (TG), prealbumin (PA) and transferrin (TF). And mean artery pressure (MAP), heart rate (HR) and central vein pressure (CVP) were also recorded at the same time-points. Then the post-TG changes of the above data were compared in both groups. After the use of triglycerides, there were no significant differences of MAP, HR, CVP, Hb and Plt in both groups (P > 0.05). At D3 and D5, the serum levels of TG ((2.1 ± 0.4) vs (1.6 ± 0.6) mg/L, (2.3 ± 0.7) vs (1.5 ± 0.3) mg/L) and alanine aminotransferase ((133 ± 58) vs (97 ± 26) U/L; (116 ± 48) vs (77 ± 31) U/L) were significantly higher in Group B versus those receiving structured triglycerides in Group A (P 0.05). The serum levels of such nutrition markers as PA ((195 ± 55) vs (166 ± 55) mg/L,(245 ± 53) vs (195 ± 58) mg/L) and TF ((2.6 ± 0.5) vs (2.5 ± 0.6) g/L, (3.3 ± 0.8) vs (2.9 ± 0.6) g/L)were significantly higher in Group A than those in Group B (P synthesis and hepatocyte protection, structured triglycerides in parenteral nutrition is advantageous to standard MCT

  19. Effect of parenteral nutrition on the bone marrow recovery under exsperimental conditions of uneven irradiation

    International Nuclear Information System (INIS)

    Moroz, B.B.; Fedorovskij, L.L.; Deshevoj, Yu.B.

    1986-01-01

    Using white rats-males the effect of parenteral nutrition (PN) on blood formation (hemopoiesis) recovery under the conditions of total (control), subtotal (shielding of animal hind limb) with 7.5 Gy and X-ray partial irradiation of abdomen region with the 13.5 Gy has been studied. It has been found that bone marrow recovery increases either at subtotal or partial irradiation under the conditions of PN. Mechanisms of PN favourable effect are discussed. The advisability of using PN under uneven irradiations of organism is indicated

  20. Third-Generation Fatty Emulsions as Part of Parenteral Feeding in Operated Cancer Patients

    Directory of Open Access Journals (Sweden)

    S. V. Lomidze

    2010-01-01

    Full Text Available Objective: to study the efficacy of third- versus secondary-generation fatty emulsions as part of parenteral nutrition in patients operated on for gastric cancer. Subjects and methods. Envelope randomization was used to make up two groups, each comprising 10 patients, operated on for gastric cancer in the scope of gastrectomy. A control group received parenteral nutrition having the following components: Lipofundin MST/LST 20%, (500 ml daily + Nutriflex 48/150 (B. Braun (1000 ml daily, 1744 kcal/day. The study group patients were given Lipoplus 20% (500 ml daily + Nutriflex 48/150 (1000 ml daily, 1745 kcal/day. Parenteral nutrition was used on postoperative days 1 to 5. Results. Nutritional status evaluation revealed a significant increase in the concentration of total protein and albumin in the control and study group patients on postoperative day 6. The use of both second- and third-generation fatty emulsions caused a significant increase in the concentration of triglycerides on day 6 after surgery; no differences were found between the groups. On day 6 following surgery, there was a significant decrease in IL-4 in both groups (p<0.05. At the same time the Lipofundin MST/LST group showed a significantly lower concentration of IL-4 than did the study group (p<0.05. After termination of a parenteral nutrition course, the study and control groups showed a significant decrease in one of the major pro-inflammatory cytokines — IL-6. Conclusion. In the study group, the serum anti-inflammatory activity of IL-4 was more evident than that in the control group and the proinflammatory activity (IL-6 concentration decreased, which can support that as compared with the second-generation fatty emulsions, third-generation ones with a balanced omega 3 to omega-6 fatty acid ratio (1:2.7 had a normalizing effect on systemic inflammatory processes and cytokine balance with increased anti-inflammatory and reduced proinflammatory activities. Key words: third

  1. Catheter-Related Bloodstream Infections in Adults Receiving Home Parenteral Nutrition

    DEFF Research Database (Denmark)

    Tribler, Siri; Brandt, Christopher F; Hvistendahl, Mark

    2018-01-01

    BACKGROUND: A common complication in patients receiving home parenteral nutrition (HPN) is catheter-related bloodstream infections (CRBSIs). The CRBSI incidence has been advocated as an outcome parameter assessing the quality of care. This study aimed to illustrate how the use of different CRBSI......) and European Society for Clinical Nutrition (ESPEN) CRBSI criteria. Employing a catheter-salvaging strategy, 40% of the CRBSI diagnoses were supported by the paired blood culture positivity criteria and only 6% by a positive catheter tip. In 53%, CRBSIs were categorized as a clinical or "probable CRBSI...

  2. Effect of parenteral nutrition on postradiational metabolic changes under experimental conditions

    International Nuclear Information System (INIS)

    Grozdov, S.P.; Moroz, B.B.; Fedorovskij, L.L.; Vasil'evskaya, V.V.; Lyrshchikova, A.V.

    1978-01-01

    The assimilation of carbohydrates, nitrogen compounds, fat and electrolytes during parenteral feeding (PF) of irradiated animals was studied. Rats were subjected to PF from 2nd to 5th day after total gamma irradiation at 750 R, dogs - from 8th to 11th day after irradiation at 300 R. The results are indicative of a satisfactory assimilation of carbohydrates, nitrogen compounds, fat and electrolytes by animals in the cource of PF. The negative nitrogen balance characteristic of irradiated animals was expressed to a lesser degree. A trend to a lower sodium excretion has been observed during PF period

  3. Problems concerning the parenteral nutrition within the complex therapy of radiation injuries of the intestine

    International Nuclear Information System (INIS)

    Sloventantor, V.Yu.; Kurpesheva, A.K.; Kaplan, M.A.; Bardychev, M.S.; Khmelevskij, Ya.M.

    1982-01-01

    The treatment results of 52 patients with radiation enterocolitis and rectosygmoiditis are reported. The complex therapy included a partial or a complete parenteral nutrition according to the indication. The treatment caused an improvement in 86.7% of the cases, no changes in 5.7% and a deterioration of the condition in 7.6%. The additional nutritive therapy rendered it possible to hold the cell mass of the body constant and to decrease the protein losses of the gastrointestinal tract significantly. (author)

  4. Higher versus lower amino acid intake in parenteral nutrition for newborn infants.

    Science.gov (United States)

    Osborn, David A; Schindler, Tim; Jones, Lisa J; Sinn, John Kh; Bolisetty, Srinivas

    2018-03-05

    Sick newborn and preterm infants frequently are not able to be fed enterally, necessitating parenteral fluid and nutrition. Potential benefits of higher parenteral amino acid (AA) intake for improved nitrogen balance, growth, and infant health may be outweighed by the infant's ability to utilise high intake of parenteral AA, especially in the days after birth. The primary objective is to determine whether higher versus lower intake of parenteral AA is associated with improved growth and disability-free survival in newborn infants receiving parenteral nutrition.Secondary objectives include determining whether:• higher versus lower starting or initial intake of amino acids is associated with improved growth and disability-free survival without side effects;• higher versus lower intake of amino acids at maximal intake is associated with improved growth and disability-free survival without side effects; and• increased amino acid intake should replace non-protein energy intake (glucose and lipid), should be added to non-protein energy intake, or should be provided simultaneously with non-protein energy intake.We conducted subgroup analyses to look for any differences in the effects of higher versus lower intake of amino acids according to gestational age, birth weight, age at commencement, and condition of the infant, or concomitant increases in fluid intake. We used the standard search strategy of the Cochrane Neonatal Review Group to search the Cochrane Central Register of Controlled Trials (2 June 2017), MEDLINE (1966 to 2 June 2017), Embase (1980 to 2 June 2017), and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) (1982 to 2 June 2017). We also searched clinical trials databases, conference proceedings, and citations of articles. Randomised controlled trials of higher versus lower intake of AAs as parenteral nutrition in newborn infants. Comparisons of higher intake at commencement, at maximal intake, and at both commencement and maximal

  5. [Indication and effectiveness of endoscopic percutaneous gastrostomy as a route of parenteral alimentation for the home care patient].

    Science.gov (United States)

    Ueda, T; Hida, S; Higasa, K; Shinomiya, S; Matsumoto, T; Fukuoka, K; Yamanaka, E; Ozaki, S; Takayama, E

    2000-12-01

    We are managing 8 home care patients who have a gastrostomy made using an endoscopic percutaneous technique as a route of parenteral alimentation. Based on our experience, the preconditions for an endoscopic percutaneous gastrostomy as a route of parenteral alimentation are 1. normal gastrointestinal function, 2. difficulty in swallowing, 3. possibility that the caregiver can manage the gastrostomy. When we performed an endoscopic percutaneous gastrostomy as a route of parenteral alimentation for 8 home care patients, we obtained the several advantages mentioned below. 1. Swallowing pneumonia was prevented. 2. Adequate amount of alimental liquid could be infused. 3. Patient could take a bath or shower with the gastrostomy, and good QOL was realized. 4. The home care patient with the gastrostomy could have a satisfactorily long life.

  6. Transition from parenteral to enteral nutrition induces immediate diet-dependent gut histological and immunological responses in preterm neonates

    DEFF Research Database (Denmark)

    Siggers, Jayda; Sangild, Per T.; Jensen, Tim Kåre

    2011-01-01

    bacterial groups (Clostridium, Enterococcus, Streptococcus species) increased with time. We conclude that a switch from parenteral to enteral nutrition rapidly induces diet-dependent histopathological, functional, and proinflammatory insults to the immature intestine. Great care is required when introducing......-six preterm pigs were fed total parenteral nutrition (TPN) for 48 h followed by enteral feeding for 0, 8, 17, or 34 h with either colostrum (Colos, n = 20) or formula (Form, n = 31). Macroscopic NEC lesions were detected in Form pigs throughout the enteral feeding period (20/31, 65%), whereas most Colos pigs...... no histopathological lesions, increased maltase activity, and induced changes in gene expressions related to tissue development. Total bacterial density was high after 2 days of parenteral feeding and was not significantly affected by diet (colostrum, formula) or length of enteral feeding (8–34 h), except that a few...

  7. Sistema de indicadores ambientales de la Universidad Nacional (2008-2011. Aspectos de significancia: electricidad, agua, combustible y teléfono

    Directory of Open Access Journals (Sweden)

    David Benavides Ramírez

    2013-03-01

    Full Text Available Como parte de los esfuerzos ambientales llevados a cabo por la Universidad Nacional (UNA de Costa Rica, incluyendo todas sus dependencias, oficinas, centros y sedes y el Programa UNA Campus Sostenible, nuestra institución ha consolidado en el tiempo un Sistema de Indicadores Ambientales con aspectos de significancia enmarcados en un Programa de Gestión Ambiental Institucional (PGAI, el cual mide el desempeño ambiental de la institución desde 2008, generando iniciativas como la campaña “Únase al ahorro”, la cual busca disminuir la facturación de los servicios públicos. Por medio de la aplicación de esta herramienta de evaluación ambiental, la Dirección de Gestión de Calidad Ambiental (DIGECA-MINAET y la UNA han establecido una medición del desempeño ambiental de forma estandarizada e integrada en cuatro aspectos ambientales que se mencionan a continuación: • Consumo eléctrico • Consumo de agua • Consumo de combustibles • Uso del teléfono Las principales características del modelo que impulsa el PGAI se basan en los conceptos de integración y sostenibilidad, que analizan los aspectos ambientales mencionados y las actividades asociadas para su mitigación y minimización, con el fin de llegar a una ecoeficiencia en la operatividad propia de la Universidad. Recientemente, la UNA presentó la “Actualización del Plan de Gestión Ambiental Institucional” ante la DIGECA-MINAET, el cual cumple de manera satisfactoria con lo requerido por esta Dirección, según lo establecido en el Decreto Ejecutivo 36499-S-MINAET. Se debe mencionar que este proceso se ha llevado a cabo gracias a la colaboración y participación activa de toda la comunidad universitaria y que se deben redoblar esfuerzos para continuar con esta visión ambiental propia y pionera de la UNA hacia los nuevos retos ambientales.

  8. Relationship between turnover rate and oxidation rate of alanine in the post-absorptive state and during parenteral nutrition before and after surgery

    NARCIS (Netherlands)

    Sauerwein, H. P.; Michels, R. P.; Cejka, V.

    1985-01-01

    The influence of total parenteral nutrition and stomach resection on alanine turnover rate and alanine oxidation rate was measured in ten patients after single injection of U-14 C-alanine. Sequential studies were done in three patients. During parenteral nutrition alanine turnover was significantly

  9. Enteral nutrients potentiate glucagon-like peptide-2 action and reduce dependence on parenteral nutrition in a rat model of human intestinal failure

    DEFF Research Database (Denmark)

    Brinkman, Adam S; Murali, Sangita G; Hitt, Stacy

    2012-01-01

    human SBS and requires parenteral nutrition (PN). Male Sprague-Dawley rats were assigned to one of five groups and maintained with PN for 18 days: total parenteral nutrition (TPN) alone, TPN + GLP-2 (100 μg·kg(-1)·day(-1)), PN + EN + GLP-2(7 days), PN + EN + GLP-2(18 days), and a nonsurgical oral...

  10. Results of home parenteral nutrition in patients with severe inflammatory bowel disease - an alternative for surgery of malnourished patients.

    Science.gov (United States)

    Turkot, Maryla; Sobocki, Jacek

    2017-10-31

    In the world, the inflammatory bowel disease affects an increasing number of younger and younger patients, and in some of them parenteral nutrition is an alternative to high-risk surgical intervention due to advancement of the disease and malnutrition. The aim of the study was to assess the results of home parenteral nutrition in patients with severe bowel inflammatory disease, in whom surgical treatment is associated with high risk of complications. A retrospective analysis was conducted on 46 patients, who received home parenteral nutrition instead of another surgical intervention. The inclusion criteria included home parenteral nutrition and diagnosis of Crohn's disease or ulcerative colitis. Mean number of complications requiring hospital admission per patient was 1.76, the BMI increased by 4.3 on average [kg/m2]. During parenteral nutrition, the percentage of patients, in whom anti-inflammatory or immunosuppressant drugs were completely discontinued, was 17.4%. In the whole group, at least one immunosuppressive drug was discontinued in onefifth of patients. Mean albumin level increased by 2.4 g/L, lymphocyte count dropped by 474 lymphocytes/mm3, and leukocyte count increased by 747.6/mm3. The patients described their condition as good in 87%, and 7.4% of patients were able to work. Home parenteral nutrition positively affects patient's general condition by increasing BMI and normalizing biochemical test results. The results indicate the need to consider this method as an alternative to surgical intervention in severe bowel inflammatory disease with high perioperative risk, which could reduce the complication rate.

  11. Usefulness of gram staining of blood collected from total parenteral nutrition catheter for rapid diagnosis of catheter-related sepsis.

    Science.gov (United States)

    Moonens, F; el Alami, S; Van Gossum, A; Struelens, M J; Serruys, E

    1994-01-01

    The accuracy of Gram staining of blood drawn from catheters used to administer total parenteral nutrition was compared with paired quantitative blood cultures for the diagnosis of catheter-related sepsis. Gram staining was positive in 11 of 18 episodes of catheter-related sepsis documented by quantitative culture (sensitivity, 61%) but in none of the 5 episodes of fever unrelated to catheter infection. Thus, this procedure enabled the rapid presumptive diagnosis and guidance of antimicrobial therapy for total parenteral nutrition catheter sepsis, with a positive predictive value of 100% and a negative predictive value of 42%. PMID:7521359

  12. Paracoccidioidomicose subaguda progressiva: tratamento de um doente com anfotericina B e nutrição parenteral

    Directory of Open Access Journals (Sweden)

    Paulo Camara Marques Pereira

    1985-10-01

    Full Text Available Os Autores descrevem um caso de paracoccidioidomicose subaguda progressiva, com quadro clínico sugestivo de síndrome de má absorção, em que o doente não se beneficiara apenas com o tratamento antifúngico convencional. Ao se introduzir como medida auxiliar a nutrição parenteral houve evidente melhora clínica e laboratorial. Desta maneira os Autores propõe o uso associado da nutrição parenteral no tratamento de doentes com esta forma clínica de paracoccidioidomicose.

  13. [Evaluation of central parenteral alimentation in critically ill newborn infants at a provincial pediatric hospital].

    Science.gov (United States)

    Yunes-Zárraga, J L; de la Garza-Garza, G; Velázquez-Quintana, N

    1989-04-01

    A revision was made on files of newborns whom received total parenteral nutrition (TPN) in the neonatal intensive care unit of the Hospital Infantil de Tamaulipas during a two and a half years period. We try to correlate dosage and caloric intake with weight gain, survival and complications. We reviewed the principal indications that motivated the use of total parenteral nutrition. The average period of administration was 15 days and caloric intake average 75 cal. There was significance in weight gain in newborns older than 35 weeks (14.6 g/kg/day) compared with younger than 34 weeks (9.2 g/kg/day) (p less than 0.001). There was no relation between days and dosage in both groups. Only one case showed cholestatic jaundice. Hyperglycemia was present statistically more frequent in the group lesser gestational age. There were no important electrolytic disturbances. Necrotizing enterocolitis was present more frequent in the older group. Some comments are made in relation to sepsis and a discussion of possible causes that do no permit a better assimilation of nutrients in these babies.

  14. Water, electrolytes, vitamins and trace elements – Guidelines on Parenteral Nutrition, Chapter 7

    Directory of Open Access Journals (Sweden)

    Working group for developing the guidelines for parenteral nutrition of The German Association for Nutritional Medicine

    2009-11-01

    Full Text Available A close cooperation between medical teams is necessary when calculating the fluid intake of parenterally fed patients. Fluids supplied parenterally, orally and enterally, other infusions, and additional fluid losses (e.g. diarrhea must be considered. Targeted diagnostic monitoring (volume status is required in patients with disturbed water or electrolyte balance. Fluid requirements of adults with normal hydration status is approximately 30–40 ml/kg body weight/d, but fluid needs usually increase during fever. Serum electrolyte concentrations should be determined prior to PN, and patients with normal fluid and electrolyte balance should receive intakes follwing standard recommendations with PN. Additional requirements should usually be administered via separate infusion pumps. Concentrated potassium (1 mval/ml or 20% NaCl solutions should be infused via a central venous catheter. Electrolyte intake should be adjusted according to the results of regular laboratory analyses. Individual determination of electrolyte intake is required when electrolyte balance is initially altered (e.g. due to chronic diarrhea, recurring vomiting, renal insufficiency etc.. Vitamins and trace elements should be generally substituted in PN, unless there are contraindications. The supplementation of vitamins and trace elements is obligatory after a PN of >1 week. A standard dosage of vitamins and trace elements based on current dietary reference intakes for oral feeding is generally recommended unless certain clinical situations require other intakes.

  15. Hypophosphatemia occurs with insulin administration during refeeding by total parenteral nutrition in rats.

    Science.gov (United States)

    Kawamura, Hiromi; Tanaka, Sarasa; Uenami, Yuri; Tani, Mariko; Ishitani, Midori; Morii, Saeko; Sakaue, Motoyoshi; Ito, Mikiko

    2018-01-01

    Refeeding syndrome (RFS) is characterized by the metabolic and clinical changes that occur following aggressive nutritional supplementation in malnourished patients. Hypophosphatemia is the hallmark of RFS and is key to its prevention and treatment in clinical practice. However, the mechanism of hypophosphatemia during RFS is unclear because of the lack of an animal model. In this study, we developed a rat RFS model as a first step to clarifying the molecular mechanism. After establishing the parenteral route, rats were fasted for 5 days and refeeding was started using total parenteral nutrition. The animals were infused with a high calorie solution with or without insulin administration. Results showed that plasma phosphate levels did not decrease in rats infused with the high calorie solution alone;in contrast, a 20% reduction compared to baseline was observed in rats administered insulin. In addition, rats infused with the high calorie solution containing added phosphate did not present with hypophosphatemia. Thus, we developed a rat RFS model with hypophosphatemia by tube feeding and insulin administration, and demonstrated the importance of phosphate in preventing refeeding hypophosphatemia. J. Med. Invest. 65:50-55, February, 2018.

  16. Standardized Parenteral Nutrition for the Transition Phase in Preterm Infants: A Bag That Fits.

    LENUS (Irish Health Repository)

    Brennan, Ann-Marie

    2018-02-02

    The optimal composition of standardized parenteral nutrition (SPN) is not yet known, contributing to nutrient deficit accrual and growth failure, with the period of parenteral nutrition weaning, i.e., transition (TN) phase, being identified as particularly vulnerable. We created a comprehensive nutrition database, representative of the nutritional course of a diverse range of preterm infants (n = 59, birth weight ≤ 1500 g, gestation < 34 weeks) by collecting hourly macronutrient intake data as part of a prospective, observational study over 19 months. Using a nutrient modeling technique for the TN phase, various amino acid (AA) concentrations of SPN were tested within the database, whilst acknowledging the nutritional contribution from enteral feeds until target AA intakes were consistently achieved. From the modeling, the AA composition of SPN was determined at 3.5 g\\/100 mL, which was the maximum to avoid exceeding target intakes at any point in the TN phase. However, in order to consistently achieve target AA intakes, additional nutritional strategies were required, which included increasing the exclusion of enteral feeds in fluid and nutrient calculations from <20 mL\\/kg\\/day to <40 mL\\/kg\\/day, and earlier fortification of breastmilk at 80 mL\\/kg\\/day. This data-driven nutrient modeling process supported the development of an improved SPN regimen for our preterm population in the TN phase.

  17. Patient Characteristics and Outcomes of Outpatient Parenteral Antimicrobial Therapy: A Retrospective Study

    Directory of Open Access Journals (Sweden)

    Marie Yan

    2016-01-01

    Full Text Available Outpatient parenteral antimicrobial therapy (OPAT is a safe and effective alternative to hospitalization for many patients with infectious diseases. The objective of this study was to describe the OPAT experience at a Canadian tertiary academic centre in the absence of a formal OPAT program. This was achieved through a retrospective chart review of OPAT patients discharged from Sunnybrook Health Sciences Centre within a one-year period. Between June 2012 and May 2013, 104 patients (median age 63 years were discharged home with parenteral antimicrobials. The most commonly treated syndromes included surgical site infections (33%, osteoarticular infections (28%, and bacteremia (21%. The most frequently prescribed antimicrobials were ceftriaxone (21% and cefazolin (20%. Only 56% of the patients received follow-up care from an infectious diseases specialist. In the 60 days following discharge, 43% of the patients returned to the emergency department, while 26% required readmission. Forty-eight percent of the return visits were due to infection relapse or treatment failure, and 23% could be attributed to OPAT-related complications. These results suggest that many OPAT patients have unplanned health care encounters because of issues related to their infection or treatment, and the creation of a formal OPAT clinic may help improve outcomes.

  18. Standardized Parenteral Nutrition for the Transition Phase in Preterm Infants: A Bag That Fits

    Directory of Open Access Journals (Sweden)

    Ann-Marie Brennan

    2018-02-01

    Full Text Available The optimal composition of standardized parenteral nutrition (SPN is not yet known, contributing to nutrient deficit accrual and growth failure, with the period of parenteral nutrition weaning, i.e., transition (TN phase, being identified as particularly vulnerable. We created a comprehensive nutrition database, representative of the nutritional course of a diverse range of preterm infants (n = 59, birth weight ≤ 1500 g, gestation < 34 weeks by collecting hourly macronutrient intake data as part of a prospective, observational study over 19 months. Using a nutrient modeling technique for the TN phase, various amino acid (AA concentrations of SPN were tested within the database, whilst acknowledging the nutritional contribution from enteral feeds until target AA intakes were consistently achieved. From the modeling, the AA composition of SPN was determined at 3.5 g/100 mL, which was the maximum to avoid exceeding target intakes at any point in the TN phase. However, in order to consistently achieve target AA intakes, additional nutritional strategies were required, which included increasing the exclusion of enteral feeds in fluid and nutrient calculations from <20 mL/kg/day to <40 mL/kg/day, and earlier fortification of breastmilk at 80 mL/kg/day. This data-driven nutrient modeling process supported the development of an improved SPN regimen for our preterm population in the TN phase.

  19. ASSISTÊNCIA DE ENFERMAGEM A PACIENTES SUBMETIDOS À HIPERALIMENTAÇÃO PARENTERAL

    Directory of Open Access Journals (Sweden)

    Maria Isabel Pedreira de Freitas Ceribelli

    1975-03-01

    Full Text Available RESUMO A hiperalimentação parenteral consiste no fornecimento de alta dosagem de glicose hipertónica, soluções de aminoácidos, sais minerais e vitaminas para garantir anabolismo proteico e síntese tissular em pacientes debitados. Está indicada em casos em que a via digestiva não pode ser utilizada ou não é suficiente para manter as necessidades metabólicas. Este procedimento requer conduta especializada com cuidadosa assistência de enfermagem relacionada ao preparo do paciente, do material para punção e da solução de hiperalimentação parenteral. Uma vez instalada, há necessidade de verificação sistemática quanto ao fluxo da solução, quanto às manifestações do paciente e quanto aos cuidados com o catéter de infusão. Os resultados obtidos são altamente significativos, mas o riscos a que o paciente está sujeito também são numerosos. Seu sucesso dependerá grandemente das disponibilidades econômicas locais e da especialização da equipe de saúde.

  20. Validation of doubly labeled water for measuring energy expenditure during parenteral nutrition

    International Nuclear Information System (INIS)

    Schoeller, D.A.; Kushner, R.F.; Jones, P.J.

    1986-01-01

    The doubly labeled water method was compared with intake-balance for measuring energy expenditure in five patients receiving total parenteral nutrition (TPN). Because parenteral solutions were isotopically different from local water, patients had to be placed on TPN at least 10 days before the metabolic period. Approximately 0.1 g 2H2O and 0.25 g H2(18)O per kg total body water were given orally. We collected saliva before, 3 h, and 4 h after the dose for measurement of total body water and urine before, 1 day, and 14 days after the dose for measurement of isotope eliminations. On day 14, total body weight was remeasured and change in body energy stores was calculated, assuming constant hydration. Intake was assessed from weights of TPN fluids plus dietary record for any oral intake. Energy expenditure from doubly labeled water (+/- SD) averaged 3 +/- 6% greater than intake-balance. Doubly labeled water method is a noninvasive, nonrestrictive method for measuring energy expenditure in patients receiving TPN