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Sample records for perioperative coagulation profile

  1. [Perioperative changes of coagulation functions in the local advanced liver cancer patients receiving liver transplantation].

    Science.gov (United States)

    Wang, Hao-Yuan; Zhao, Qing-Yu; Yuan, Yun-Fei

    2008-07-01

    Liver transplantation is widely accepted as an effective therapy of hepatoma. Perioperative dynamic observation of coagulation function is important for graft-receivers. This study was to explore perioperative changes of coagulation functions in the local advanced liver cancer patients who received liver transplantation. Clinical data of 31 local advanced liver cancer patients, underwent liver transplantation from Sep. 2003 to Jan. 2007, were analyzed. Platelet (PLT) counting, prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), fibrinogen (Fib) and international normalized ratio (INR) before operation, at anhepatic phase and the first week after operation were analyzed to evaluate congulation function. The coagulation functions of most patients were normal before operation. The six parameters varied significantly at anhepatic phase and on most days of the first week after operation when compared with the preoperative levels (Pfunctions of local advanced liver cancer patients shift from hypocoagulatory to hypercoagulatory or normal in perioperative period, therefore, prevention of bleeding should be focused on at anhepatic phase and on 1-2 days after operation while prevention of thrombosis should be focused on after the first week after operation. The degree of liver cirrhosis and Child-Pugh level could help to evaluate postoperative coagulation disorder.

  2. Haematology and coagulation profiles in cats with congenital portosystemic shunts.

    Science.gov (United States)

    Tzounos, Caitlin E; Tivers, Michael S; Adamantos, Sophie E; English, Kate; Rees, Alan L; Lipscomb, Vicky J

    2017-12-01

    Objectives The objectives of this study were, first, to report the haematological parameters and coagulation times for cats with a congenital portosystemic shunt (CPSS) and the influence of surgical shunt attenuation on these parameters; and, second, to identify any association between prolongation in coagulation profiles and incidence of perioperative haemorrhage. Methods This was a retrospective clinical study using client-owned cats with a CPSS. Signalment, shunt type (extra- or intrahepatic), degree of shunt attenuation (complete or partial), haematological parameters, prothrombin time (PT) and activated partial thromboplastin time (aPTT) test results, and occurrence of any perioperative clinical bleeding complications were recorded for cats undergoing surgical treatment of a CPSS at the Royal Veterinary College, UK, between 1994 and 2011. Results Forty-two cats were included. Thirty-six (85.7%) had an extrahepatic CPSS and six (14.3%) had an intrahepatic CPSS. Preoperatively, mean cell volume (MCV) and mean cell haemoglobin (MCH) were below the reference interval (RI) in 32 (76.2%) and 31 (73.8%) cats, respectively. Red blood cell count and mean cell haemoglobin concentration (MCHC) were above the RI in 10 (23.8%) and eight (19.1%) cats, respectively. Postoperatively, there were significant increases in haematocrit ( P = 0.044), MCV ( P = 0.008) and MCH ( P = 0.002). Despite the significant increase in MCV postoperatively, the median MCV postoperatively was below the RI, indicating persistence of microcytosis. Preoperatively, PT was above the upper RI in 14 cats (87.5%), and aPTT was above the upper RI in 11 cats (68.8%). No cat demonstrated a perioperative clinical bleeding complication. Conclusions and relevance Cats with a CPSS are likely to present with a microcytosis, but rarely present with anaemia, leukocytosis or thrombocytopenia. Surgical attenuation of the CPSS results in a significant increase in the HCT and MCV. Coagulation profiles in cats with a

  3. Perioperative coagulation management and blood conservation in cardiac surgery: a Canadian Survey.

    Science.gov (United States)

    Taneja, Ravi; Fernandes, Philip; Marwaha, Gulshan; Cheng, Davy; Bainbridge, Daniel

    2008-10-01

    To determine which strategies are currently used for (anti)coagulation management and blood conservation during cardiac surgery in Canada. Institutional survey. University hospital. All sites performing cardiac surgery in Canada. None. The response rate was 85%. Anticoagulation with heparin is monitored routinely through the activated coagulation time (ACT). Less than 10% of centers use heparin concentrations (Hepcon HMS, Medtronic), thromboelastography, or other point-of-care tests perioperatively. Eighty percent of centers routinely use tranexamic acid as the primary antifibrinolytic agent; however aprotinin until recently, was used more commonly for patients at increased risk for bleeding. Retrograde autologous prime is commonly used (62%); however, cell savers are uncommon for routine patients undergoing cardiac surgery (29%). Although most hospitals use a hematocrit of 20% to 21% for transfusing red blood cells, more than 50% of intensive care units do not have written guidelines for the administration of protamine, fresh frozen plasma, platelets, or factor VIIa. At least one third of centers do not audit their transfusion practices regularly. The majority of Canadian institutions do not use point-of-care tests other than ACT. Most institutions do not have algorithms for management of bleeding following cardiac surgery and at least 30% do not monitor their transfusion practice perioperatively. Cardiac surgery patients in Canada may benefit from a standardized approach to blood conservation in the perioperative period.

  4. Effect of perioperative crystalloid or colloid fluid therapy on hemorrhage, coagulation competence, and outcome

    DEFF Research Database (Denmark)

    Rasmussen, Kirsten C; Secher, Niels H.; Pedersen, Tom

    2016-01-01

    Background: A meta-analysis concerning perioperative coagulation competence, hemorrhage, and outcome was conducted including the use of hydroxyethyl starches (HESs), dextran, or albumin versus administration of a crystalloid as control to assess the efficacy and safety of colloids and crystalloids...

  5. Coagulation profile of children with sickle cell anemia in steady state ...

    African Journals Online (AJOL)

    Background: Sickle cell anemia is associated with a hypercoagulable state that may lead to alterations in a coagulation profile. Measurements of coagulation factors are known to have some predictive value for clinical outcome. Objectives: To determine the coagulation profile of children with SCA in steady state and crisis ...

  6. The Coagulation Profile of End-Stage Liver Disease and Considerations for Intraoperative Management.

    Science.gov (United States)

    Forkin, Katherine T; Colquhoun, Douglas A; Nemergut, Edward C; Huffmyer, Julie L

    2018-01-01

    The coagulopathy of end-stage liver disease results from a complex derangement in both anticoagulant and procoagulant processes. With even minor insults, cirrhotic patients experience either inappropriate bleeding or clotting, or even both simultaneously. The various phases of liver transplantation along with fluid and blood product administration may contribute to additional disturbances in coagulation. Thus, anesthetic management of patients undergoing liver transplantation to improve hemostasis and avoid inappropriate thrombosis in the perioperative environment can be challenging. To add to this challenge, traditional laboratory tests of coagulation are difficult to interpret in patients with end-stage liver disease. Viscoelastic coagulation tests such as thromboelastography (Haemonetics Corporation, Braintree, MA) and rotational thromboelastometry (TEM International, Munich, Germany) have helped to reduce transfusion of allogeneic blood products, especially fresh frozen plasma, but have also lead to the increased use of fibrinogen-containing products. In general, advancements in surgical techniques and anesthetic management have led to significant reduction in blood transfusion requirements during liver transplantation. Targeted transfusion protocols and pharmacologic prevention of fibrinolysis may further aid in the management of the complex coagulopathy of end-stage liver disease.

  7. Coagulation management in patients undergoing neurosurgical procedures.

    Science.gov (United States)

    Robba, Chiara; Bertuetti, Rita; Rasulo, Frank; Bertuccio, Alessando; Matta, Basil

    2017-10-01

    Management of coagulation in neurosurgical procedures is challenging. In this contest, it is imperative to avoid further intracranial bleeding. Perioperative bleeding can be associated with a number of factors, including anticoagulant drugs and coagulation status but is also linked to the characteristic and the site of the intracranial disorder. The aim of this review will be to focus primarily on the new evidence regarding the management of coagulation in patients undergoing craniotomy for neurosurgical procedures. Antihemostatic and anticoagulant drugs have shown to be associated with perioperative bleeding. On the other hand, an increased risk of venous thromboembolism and hypercoagulative state after elective and emergency neurosurgery, in particular after brain tumor surgery, has been described in several patients. To balance the risk between thrombosis and bleeding, it is important to be familiar with the perioperative changes in coagulation and with the recent management guidelines for anticoagulated patients undergoing neurosurgical procedures, in particular for those taking new direct anticoagulants. We have considered the current clinical trials and literature regarding both safety and efficacy of deep venous thrombosis prophylaxis in the neurosurgical population. These were mainly trials concerning both elective surgical and intensive care patients with a poor grade intracranial bleed or multiple traumas with an associated severe traumatic brain injury (TBI). Coagulation management remains a major issue in patients undergoing neurosurgical procedures. However, in this field of research, literature quality is poor and further studies are necessary to identify the best strategies to minimize risks in this group of patients.

  8. Novel approaches in management of perioperative coagulopathy.

    Science.gov (United States)

    Tanaka, Kenichi A; Bader, Stephen O; Görlinger, Klaus

    2014-02-01

    The recent advances in hemostatic monitoring, and discussion of the clinical implications of hemostatic therapies based on different blood components and factor concentrates. Implementing suitable laboratory tests and transfusion protocols is highly recommended because the laboratory test guided, protocol-driven transfusion approach reduces blood component utilization, and possibly leads to improved outcomes. Timely assessment of coagulation has been difficult using conventional coagulation tests, but thrombocytopenia, fibrin polymerization defects, and fibrinolysis can be quickly assessed on thromboelastometry. The latter testing can be applied to guide the dosing of fibrinogen and prothrombin complex concentrate, which are selectively used to correct fibrinogen deficiency, and improve thrombin generation in acquired coagulopathy. These therapeutic approaches are novel, and potentially effective in reducing the exposure to allogeneic components (e.g., plasma and platelets) and side-effects of transfusion. Although the accessibility of different therapies among different countries, tranexamic acid is widely available, and is an effective blood conservation measure with a good safety profile in various surgical settings. Our understanding of perioperative coagulopathy, diagnostic tools, and therapeutic approaches has evolved in recent years. Additional multidisciplinary efforts are required to understand the optimal combinations, cost-effectiveness, and safety profiles of allogeneic components, and available factor concentrates.

  9. Coagulation Profile as a Risk Factor for 30-day Morbidity Following Cervical Laminectomy and Fusion.

    Science.gov (United States)

    Bronheim, Rachel S; Oermann, Eric K; Cho, Samuel K; Caridi, John M

    2018-02-15

    Retrospective analysis of prospectively collected data. The aim of this study was to determine the ability of abnormal coagulation profile to predict adverse events following posterior cervical laminectomy and fusion (PCLF). PCLF is an increasingly common procedure used to treat a variety of traumatic and degenerative spinal conditions. Abnormal coagulation profile is associated with postoperative adverse events, including blood transfusion. There is a paucity of literature that specifically addresses the relationship between coagulation profile and complications following PCLF. ACS-NSQIP was utilized to identify patients undergoing PCLF between 2006 and 2013. A total of 3546 patients met inclusion criteria. Multivariate analysis was utilized to identify associations between abnormal coagulation profile and postoperative complications. Membership in the low-platelet cohort was an independent risk factor for myocardial infarction (Odds Ratio (OR) = 5.4 [1.0, 29.1], P = 0.049) and bleeding transfusion (OR = 2.0 [1.2, 3.4], P = 0.011). Membership in the high international normalized ratio group was an independent risk factor for pneumonia (OR = 6.3 [2.5, 16.1], P 48 hours (OR = 6.5 [2.3, 18.4], P 48 hours (OR = 4.8 [1.9, 12.4], P = 0.001), cerebrovascular accident/stroke with neurological deficit (OR = 24.8 [2.9, 210.6], P = 0.003), bleeding transfusion (OR = 2.1 [1.1, 4.1], P = 0.032), reoperation (OR = 3.6 [1.4, 9.3], P = 0.008), and sepsis (OR = 3.4 [1.1, 10.4], P = 0.031). This is the first large study to document abnormal coagulation profile as an independent predictor of outcomes following PCLF. Abnormal coagulation profile represents a predictor of complications that can be medically mitigated, and is therefore a valuable parameter to assess preoperatively. Coagulation profile should continue to play a role in targeting patients for risk stratification, preoperative optimization, and

  10. Overview of the coagulation system.

    Science.gov (United States)

    Palta, Sanjeev; Saroa, Richa; Palta, Anshu

    2014-09-01

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

  11. Overview of the coagulation system

    Directory of Open Access Journals (Sweden)

    Sanjeev Palta

    2014-01-01

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

  12. Commonly Used Dietary Supplements on Coagulation Function during Surgery

    Directory of Open Access Journals (Sweden)

    Chong-Zhi Wang

    2015-07-01

    Full Text Available Background: Patients who undergo surgery appear to use dietary supplements significantly more frequently than the general population. Because they contain pharmacologically active compounds, dietary supplements may affect coagulation and platelet function during the perioperative period through direct effects, pharmacodynamic interactions, and pharmacokinetic interactions. However, in this regard, limited studies have been conducted that address the pharmacological interactions of dietary supplements. To avoid possible bleeding risks during surgery, information about the potential complications of dietary supplements during perioperative management is important for physicians. Methods: Through a systematic database search of all available years, articles were identified in this review if they included dietary supplements and coagulation/platelet function, while special attention was paid to studies published after 1990. Results: Safety concerns are reported in commercially available dietary supplements. Effects of the most commonly used natural products on blood coagulation and platelet function are systematically reviewed, including 11 herbal medicines (echinacea, ephedra, garlic, ginger, ginkgo, ginseng, green tea, kava, saw palmetto, St John’s wort, and valerian and four other dietary supplements (coenzyme Q10, glucosamine and chondroitin sulfate, fish oil, and vitamins. Bleeding risks of garlic, ginkgo, ginseng, green tea, saw palmetto, St John’s wort, and fish oil are reported. Cardiovascular instability was observed with ephedra, ginseng, and kava. Pharmacodynamic and pharmacokinetic interactions between dietary supplements and drugs used in the perioperative period are discussed. Conclusions: To prevent potential problems associated with the use of dietary supplements, physicians should be familiar with the perioperative effects of commonly used dietary supplements. Since the effects of dietary supplements on coagulation and platelet

  13. Commonly Used Dietary Supplements on Coagulation Function during Surgery

    Science.gov (United States)

    Wang, Chong-Zhi; Moss, Jonathan; Yuan, Chun-Su

    2015-01-01

    Abstract Background Patients who undergo surgery appear to use dietary supplements significantly more frequently than the general population. Because they contain pharmacologically active compounds, dietary supplements may affect coagulation and platelet function during the perioperative period through direct effects, pharmacodynamic interactions, and pharmacokinetic interactions. However, in this regard, limited studies have been conducted that address the pharmacological interactions of dietary supplements. To avoid possible bleeding risks during surgery, information about the potential complications of dietary supplements during perioperative management is important for physicians. Methods Through a systematic database search of all available years, articles were identified in this review if they included dietary supplements and coagulation/platelet function, while special attention was paid to studies published after 1990. Results Safety concerns are reported in commercially available dietary supplements. Effects of the most commonly used natural products on blood coagulation and platelet function are systematically reviewed, including 11 herbal medicines (echinacea, ephedra, garlic, ginger, ginkgo, ginseng, green tea, kava, saw palmetto, St John’s wort, and valerian) and four other dietary supplements (coenzyme Q10, glucosamine and chondroitin sulfate, fish oil, and vitamins). Bleeding risks of garlic, ginkgo, ginseng, green tea, saw palmetto, St John’s wort, and fish oil are reported. Cardiovascular instability was observed with ephedra, ginseng, and kava. Pharmacodynamic and pharmacokinetic interactions between dietary supplements and drugs used in the perioperative period are discussed. Conclusions To prevent potential problems associated with the use of dietary supplements, physicians should be familiar with the perioperative effects of commonly used dietary supplements. Since the effects of dietary supplements on coagulation and platelet function are

  14. Commonly Used Dietary Supplements on Coagulation Function during Surgery.

    Science.gov (United States)

    Wang, Chong-Zhi; Moss, Jonathan; Yuan, Chun-Su

    2015-09-01

    Patients who undergo surgery appear to use dietary supplements significantly more frequently than the general population. Because they contain pharmacologically active compounds, dietary supplements may affect coagulation and platelet function during the perioperative period through direct effects, pharmacodynamic interactions, and pharmacokinetic interactions. However, in this regard, limited studies have been conducted that address the pharmacological interactions of dietary supplements. To avoid possible bleeding risks during surgery, information of potential complications of dietary supplements during perioperative management is important for physicians. Through a systematic database search of all available years, articles were identified in this review if they included dietary supplements and coagulation/platelet function, while special attention was paid to studies published after 1990. Safety concerns are reported in commercially available dietary supplements. Effects of the most commonly used natural products on blood coagulation and platelet function are systematically reviewed, including 11 herbal medicines (echinacea, ephedra, garlic, ginger, ginkgo, ginseng, green tea, kava, saw palmetto, St John's wort, and valerian) and 4 other dietary supplements (coenzyme Q 10 , glucosamine and chondroitin sulfate, fish oil, and vitamins). Bleeding risks of garlic, ginkgo, ginseng, green tea, saw palmetto, St John's wort, and fish oil are reported. Cardiovascular instability was observed with ephedra, ginseng, and kava. Pharmacodynamic and pharmacokinetic interactions between dietary supplements and drugs used in the perioperative period are discussed. To prevent potential problems associated with the use of dietary supplements, physicians should be familiar with the perioperative effects of commonly used dietary supplements. Since the effects of dietary supplements on coagulation and platelet function are difficult to predict, it is prudent to advise their

  15. Changes of plasma IL-6 and TNF-α levels during peri-operative period in patients undergoing laser photo-coagulation of greater saphenous varicosities

    International Nuclear Information System (INIS)

    Wang Taihan; Wang Chunxi

    2005-01-01

    Objective: To investigate the plasma levels of IL-6 and TNF-α during peri-operative period in patients undergoing laser photocoagulation of greater saphenous varicosities. Methods: Plasma IL-6 and TNF-α levels were determined with RIA before operation and 1, 3, 7, 14 days post-operatively in 110 patients with greater saphenous vein varicosity undergoing different forms of treatment (intravascular laser photo-coagulation 43, photo-coagulation combined with venous valve repair 35, high ligation and segmental stripping 32). Skin trophic disturbances were present in 56 of the 110 patients. Plasma IL-6 and TNF-α levels were also measured in 33 controls. Results: The plasma IL-6 and TNF-α levels in patients with skin trophic disturbances were significantly higher than those in controls (P<0.01), while levels in patients without skin lesions were not much changed. The plasma IL-6 and TNF-α levels were increased at first and dropped later to approaching pre-operative value by d14 in all the 110 patients after operation, however, the amount of increase was least and the normalization was also soonest in the simple photo-coagulation group, the reverse was true for the conventional operation group. Conclusion: Laser photo-coagulation is least stressful among the three types of operation and magnitude of changes of plasma IL-6 and TNF-α levels correctly reflects the intensity of stress. (authors)

  16. Coagulation Profile in Patients with Different Etiologies for Cushing Syndrome: A Prospective Observational Study.

    Science.gov (United States)

    Tirosh, Amit; Lodish, Maya; Lyssikatos, Charalampos; Belyavskaya, Elena; Feelders, Richard A; Stratakis, Constantine A

    2017-05-01

    Previous studies reported a higher prevalence of venous-thromboembolic events among patients with Cushing disease (CD) compared to those with ACTH-independent Cushing syndrome (CS) from adrenal sources. The objective of the current study was to evaluate the coagulation profile of patients with CS from different etiologies. A prospective observational study was conducted at a clinical research center. The study included adult patients admitted for evaluation of suspected CS (n=85), that were divided into 3 groups: CD (n=22), ACTH-independent CS from an adrenal tumor/hyperplasia (adrenal CS, n=21), and a control group consisting of subjects with negative screening for CS (rule-out CS, n=42). Coagulation profiles were drawn before and 8.5±4.3 months after surgery (trans-sphenoidal or adrenalectomy, n=18), and included fibrinogen, Factor VIII (FVIII), von Willebrand factor antigen (vWF:Ag), plasminogen activator inhibitor-1 (PAI-1), antithrombin III (ATIII), Protein C (PC), Protein S (PS), α2-antiplasmin (α2AP), and aPTT measurements. Patients with CD had higher baseline mean cortisol levels, ATIII activity and vWF:Ag levels compared with adrenal CS. Differences in ATIII activity and vWF:Ag levels remained even after controlling for BMI, and ATIII after also controlling for 24-h urinary free cortisol collections. Our study showed for the first time the differences in coagulation profiles between various etiologies of CS. We assume that the higher cortisol burden among CD patients may explain the differences found in the coagulation profile as well as the higher risk for VTE compared with primary adrenal CS patients. © Georg Thieme Verlag KG Stuttgart · New York.

  17. Predictive Value of Whole Blood and Plasma Coagulation Tests for Intra- and Postoperative Bleeding Risk: A Systematic Review

    DEFF Research Database (Denmark)

    Larsen, Julie Brogaard; Hvas, Anne-Mette

    2017-01-01

    review of the existing literature assessing the ability of whole blood coagulation (thromboelastography [TEG]/thromboelastometry [ROTEM]/Sonoclot), platelet function tests, and standard plasma-based coagulation tests to predict bleeding in the perioperative setting. We searched PubMed and Embase...... value of testing in patients receiving antithrombotic medication. In general, studies reported low positive predictive values for perioperative testing, whereas negative predictive values were high. The studies yielded moderate areas under receiver operator characteristics (ROC) curve (for the majority...... recommend that both whole blood and plasma-based coagulation tests are primarily used in case of bleeding and not for screening in unselected patients prior to surgery....

  18. Influence of vegetable coagulant and ripening time on the lipolytic and sensory profile of cheeses made with raw goat milk from Canary breeds.

    Science.gov (United States)

    Rincón, Arturo A; Pino, Verónica; Fresno, María R; Jiménez-Abizanda, Ana I; Álvarez, Sergio; Ayala, Juan H; Afonso, Ana M

    2017-04-01

    Free fatty acids and sensory profiles were obtained for cheeses made with raw goat milk and vegetable coagulant, derived from the cardoon flower ( Cynara cardunculus), at different ripening times (7 and 20 days). A solid-liquid phase extraction method followed by solid-phase extraction and gas chromatography was used. Profiles were also obtained with cheeses made with commercial coagulant, traditional kid rennet paste, and mixture coagulant (vegetable coagulant-kid rennet). The use of vegetable coagulant and vegetable coagulant-kid rennet is common in traditional Protected Designation of Origin cheeses such as " Queso Flor de Guía" and " Queso Media Flor de Guía" (Spain). Contents of short-chain free fatty acids (7.5-22.5 mmol·kg -1 ), medium-chain free fatty acids (0.4-3.7 mmol·kg -1 ), and long-chain free fatty acids (0.2-2.1 mmol·kg -1 ) varied depending on the coagulant type and the ripening time. Vegetable coagulant cheeses present odour intensity and flavour intensity much higher than commercial coagulant cheeses in the sensory analysis for cheeses obtained with seven days of ripening, but the values decrease when increasing the ripening time. Multivariate analysis allowed us to differentiate cheese samples according to the ripening time when using lipolytic profile and according to the coagulant type using the sensory profile.

  19. Coagulation profiles of healthy Andalusian donkeys are different than those of healthy horses.

    Science.gov (United States)

    Mendoza, F J; Perez-Ecija, R A; Monreal, L; Estepa, J C

    2011-01-01

    Coagulation disorders are frequently diagnosed, especially in hospitalized equidae, and result in increased morbidity and mortality. However, hemostatic reference intervals have not been established for donkeys yet. To determine whether the most common coagulation parameters used in equine practice are different between healthy donkeys and horses. Thirty-eight healthy donkeys and 29 healthy horses. Blood samples were collected to assess both coagulation and fibrinolytic systems by determination of platelet count, fibrinogen concentration, clotting times (prothrombin time [PT] and activated partial thromboplastin time [aPTT]), fibrin degradation products (FDP) and D-Dimer concentrations. PT and aPTT in donkeys were significantly (P donkeys than in horses. The coagulation parameters most commonly determined in equine practice are different in donkeys compared with horses. Thus, the use of normal reference ranges reported previously for healthy horses in donkeys might lead to a misdiagnosis of coagulopathy in healthy donkeys, and unnecessary treatments in sick donkeys. This is the first report of normal coagulation profile results in donkeys, and further studies are warranted to elucidate the physiological mechanisms of the differences observed between donkeys and horses. Copyright © 2011 by the American College of Veterinary Internal Medicine.

  20. Evaluation of Coagulation Profiles in Dogs with Septic Shock

    OpenAIRE

    YILMAZ, Zeki; YALÇIN, Ebru

    2002-01-01

    The aim of the this study was to observe possible changes in coagulation profiles in dogs with septic shock. A total of 30 dogs (control group n=10, test group n=20) were used as materials in this study. Although different diseases leading to septic shock were diagnosed in dogs in the test group, dogs were selected on the basis of septic shock criteria such as fever or hypothermia, hypotension, leukopenia or leukocytosis and thrombocytopenia. In addition to the results of rutine clinical and...

  1. C-reactive protein in patients with acute coronary syndrome: association with coronary markers, lipid profile and markers of coagulation

    International Nuclear Information System (INIS)

    Munir, T.A.; Afzal, M.N.

    2010-01-01

    To determine levels of C-reactive protein (CRP) and its association with coronary markers, lipid profile and markers of coagulation in patients of acute coronary syndrome (ACS). The study was conducted at Shifa college of Medicine and Shifa international hospital for a period of one year (November 2005-December 2006). Patients and Methods: Sixty nine age matched controls and 133 consecutive patients of ACS were included in the study. CRP were measured by immunoturbidometric method, MB fraction of creatine kinase (CK-MB) and Troponin-1 by micro-particle enzyme immunoassay, lipid levels by Colorimetric Enzymatic methods, platelets by celldyn and coagulation markers were measured by CA-50 Sysmax. At admission mean CRP levels, cardiac biomarkers, lipid profile and coagulation markers were significantly increased in patients of ACS versus controls. Within the patients of ACS the mean levels of CRP, CK-MB, Trop I, prothrombin time (PT) and activated partial thromboplastin time (Am) were significantly raised in patients with ST - elevation myocardial infarction (STEMI) and non STEMI (NSTEMI) versus patients of unstable angina (VA). Association between CRP levels and coronary markers, coagulation markers and lipid profile was found to be non significant. The CRP levels were increased in patients with ACS as compared to controls. The CRP levels were insignificantly correlated with coronary markers (CK-MB, Trop I), coagulation markers (platelet count, PT, Am), and lipid profile (cholesterol, triglyceride, HDL and LDL cholesterol) in patients with ACS. (author)

  2. Coagulation profile in patients undergoing video-assisted thoracoscopic lobectomy: A randomized, controlled trial.

    Directory of Open Access Journals (Sweden)

    Thomas Decker Christensen

    Full Text Available Knowledge about the impact of Low-Molecular-Weight Heparin (LMWH on the coagulation system in patients undergoing minimal invasive lung cancer surgery is sparse. The aim of this study was to assess the effect of LMWH on the coagulation system in patients undergoing Video-Assisted Thoracoscopic Surgery (VATS lobectomy for primary lung cancer.Sixty-three patients diagnosed with primary lung cancer undergoing VATS lobectomy were randomized to either subcutaneous injection with dalteparin (Fragmin® 5000 IE once daily or no intervention. Coagulation was assessed pre-, peri-, and the first two days postoperatively by standard coagulation blood test, thromboelastometry (ROTEM® and thrombin generation.Patients undergoing potential curative surgery for lung cancer were not hypercoagulable preoperatively. There was no statistically significant difference in the majority of the assessed coagulation parameters after LMWH, except that the no intervention group had a higher peak thrombin and a shorter INTEM clotting time on the first postoperative day and a lower fibrinogen level on the second postoperative day. A lower level of fibrin d-dimer in the LMWH group was found on the 1. and 2.postoperative day, although not statistical significant. No differences were found between the two groups in the amount of bleeding or number of thromboembolic events.Use of LMWH administered once daily as thromboprophylaxis did not alter the coagulation profile per se. As the present study primarily evaluated biochemical endpoints, further studies using clinical endpoints are needed in regards of an optimized thromboprophylaxis approach.

  3. Hydroxyethyl Starch Reduces Coagulation Competence and Increases Blood Loss During Major Surgery

    DEFF Research Database (Denmark)

    Rasmussen, Kirsten C; Johansson, Pär I; Højskov, Michael

    2014-01-01

    OBJECTIVE: This study evaluated whether administration of hydroxyethyl starch (HES) 130/0.4 affects coagulation competence and influences the perioperative blood loss. BACKGROUND: Artificial colloids substitute blood volume during surgery; with the administration of HES 130/0.4 (Voluven, Fresenius...

  4. [Clinical research of minimal extracorporeal circulation in perioperative blood conservation of coronary artery bypass graft].

    Science.gov (United States)

    Liu, Yan; Cui, Hu-jun; Tao, Liang; Chen, Xu-fa

    2011-04-01

    To analyze the clinical effect of minimal extracorporeal circulation (MECC) in blood conservation perioperatively coronary artery bypass graft (CABG). The data of 120 cases received simple CABG since August 2006 to October 2009 was analyzed retrospectively. All the patients were divided to three groups according to the mode of circulation support in-operation: MECC, conventional extracorporeal circulation (cECC) or off-pump, 40 cases in each group. Jostra MECC system with normal temperature was used in MECC group, and common membrane oxygenator with moderate hypo-temperature was used in cECC group. Collect the data of coagulation and the blood cytological examination perioperatively, the draining volume during the first 24 h after operation, and consumption of blood products perioperatively. Standard and logistic EuroSCORE were higher in MECC group than the others (P blood products in cECC group, but no difference among the three groups. MECC could reduce the ruin to blood cell and interfere to coagulation function during the conventional ECC procedure, decrease the postoperative draining volume and requirement of blood products.

  5. Coagulation Profile as a Risk Factor for 30-Day Morbidity and Mortality Following Posterior Lumbar Fusion.

    Science.gov (United States)

    Bronheim, Rachel S; Oermann, Eric K; Cho, Samuel K; Caridi, John M

    2017-06-15

    A retrospective cohort study. The aim of this study was to identify associations between abnormal coagulation profile and postoperative morbidity and mortality in patients undergoing posterior lumbar fusion (PLF). The literature suggests that abnormal coagulation profile is associated with postoperative complications, notably the need for blood transfusion. However, there is little research that directly addresses the influence of coagulation profile on postoperative complications following PLF. The American College of Surgeons National Surgical Quality Improvement Program database (ACS-NSQIP) was utilized to identify patients undergoing PLF between 2006 and 2013. Nine thousand two hundred ninety-five patients met inclusion criteria. Multivariate analysis was utilized to identify associations between abnormal coagulation profile and postoperative complications. Low platelet count was an independent risk factor for organ space surgical site infections (SSIs) [odds ratio (OR) = 6.0, P 48 hours (OR = 4.5, P = 0.002), Acute renal failure (OR = 5.8, P = 0.007), transfusion (OR = 1.6, P risk factor for ventilation >48 hours (OR = 5.6, P = 0.002), cerebrovascular accident (CVA)/stroke with neurological deficit (OR = 5.1, P = 0.011), cardiac arrest (OR = 5.4, P = 0.030), transfusion (OR = 1.5, P = 0.020), and death (OR = 4.5, P = 0.050). High International Normalized Ration (INR) was an independent risk factor for pneumonia (OR = 8.7, P = 0.001), pulmonary embolism (OR = 5.6, P = 0.021), deep venous thrombosis/Thrombophlebitis (OR = 4.8, P = 0.011), septic shock (OR = 8.4, P = 0.048), and death (OR = 9.8, P = 0.034). Bleeding disorder was an independent risk factor for organ space SSI (OR = 5.4, P = 0.01), pneumonia (OR = 3.0, P = 0.023), and sepsis (OR = 4.4, P profile was an independent predictor of morbidity and mortality in patients

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

    DEFF Research Database (Denmark)

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

    2018-01-01

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

  7. Coagulation profile in patients undergoing video-assisted thoracoscopic lobectomy

    DEFF Research Database (Denmark)

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

    2017-01-01

    -, and the first two days postoperatively by standard coagulation blood test, thromboelastometry (ROTEM®) and thrombin generation. Results: Patients undergoing potential curative surgery for lung cancer were not hypercoagulable preoperatively. There was no statistically significant difference in the majority......Background: Knowledge about the impact of Low-Molecular-Weight Heparin (LMWH) on the coagulation system in patients undergoing minimal invasive lung cancer surgery is sparse. The aim of this study was to assess the effect of LMWH on the coagulation system in patients undergoing Video......-Assisted Thoracoscopic Surgery (VATS) lobectomy for primary lung cancer. Methods: Sixty-three patients diagnosed with primary lung cancer undergoing VATS lobectomy were randomized to either subcutaneous injection with dalteparin (Fragmin®) 5000 IE once daily or no intervention. Coagulation was assessed pre-, peri...

  8. Preoperative Detailed Coagulation Tests Are Required in Patients With Noonan Syndrome.

    Science.gov (United States)

    Morice, Anne; Harroche, Annie; Cairet, Pascale; Khonsari, Roman H

    2017-12-29

    Patients with Noonan syndrome often require surgery at young ages. They are at high risk of perioperative bleeding from coagulation defects that might not have been detected by routine screening. These risks are rarely described in the oral and maxillofacial surgery (OMS) literature. The aim of this study was to evaluate the perioperative bleeding risks associated with Noonan syndrome and to propose preoperative guidelines. This report describes a retrospective case series of patients with Noonan syndrome who underwent OMS procedures during a continuous observational period (2013 through 2016) in the authors' center. Clinical data, blood screening test results, and perioperative bleeding were analyzed. Five patients (age, 4 to 20 yr) with Noonan syndrome who underwent OMS procedures were included in this study. One patient presented a spontaneous bleeding tendency (epistaxis requiring cauterization). Blood screening showed clotting defects in 3 patients. One patient presented abnormal perioperative bleeding owing to a mild defect in factor XI. Patients with Noonan syndrome must be referred to a hematologist for specific preoperative investigations and for adapted perioperative management. Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  9. Perioperative complications in endovascular neurosurgery: Anesthesiologist's perspective

    Science.gov (United States)

    Sharma, Megha U.; Ganjoo, Pragati; Singh, Daljit; Tandon, Monica S.; Agarwal, Jyotsna; Sharma, Durga P.; Jagetia, Anita

    2017-01-01

    Background: Endovascular neurosurgery is known to be associated with potentially serious perioperative complications that can impact the course and outcome of anesthesia. We present here our institutional experience in the anesthetic management of various endovascular neurosurgical procedures and their related complications over a 10-year period. Methods: Data was obtained in 240 patients pertaining to their preoperative status, details of anesthesia and surgery, perioperative course and surgery-related complications. Information regarding hemodynamic alterations, temperature variability, fluid-electrolyte imbalance, coagulation abnormalities and alterations in the anesthesia course was specifically noted. Results: Among the important complications observed were aneurysm rupture (2.5%), vasospasm (6.67%), thromboembolism (4.16%), contrast reactions, hemodynamic alterations, electrolyte abnormalities, hypothermia, delayed emergence from anesthesia, groin hematomas and early postoperative mortality (5.14%). Conclusion: Awareness of the unique challenges of endovascular neurosurgery and prompt and appropriate management of the associated complications by an experienced neuroanesthesiologist is vital to the outcome of these procedures. PMID:28413524

  10. Severe antiphospholipid syndrome and cardiac surgery: Perioperative management.

    Science.gov (United States)

    Mishra, Pankaj Kumar; Khazi, Fayaz Mohammed; Yiu, Patrick; Billing, John Stephen

    2016-06-01

    Antiphospholipid syndrome is an antiphospholipid antibody-mediated prothrombotic state leading to arterial and venous thrombosis. This condition alters routine in-vitro coagulation tests, making results unreliable. Antiphospholipid syndrome patients requiring cardiac surgery with cardiopulmonary bypass present a unique challenge in perioperative anticoagulation management. We describe 3 patients with antiphospholipid syndrome who had successful heart valve surgery at our institution. We have devised an institutional protocol for antiphospholipid syndrome patients, and all 3 patients were managed according to this protocol. An algorithm-based approach is recommended because it improves team work, optimizes treatment, and improves patient outcome. © The Author(s) 2015.

  11. Risk factors associated with short-term outcome and development of perioperative complications in dogs undergoing surgery because of gastric dilatation-volvulus: 166 cases (1992-2003).

    Science.gov (United States)

    Beck, Jennifer J; Staatz, Andrew J; Pelsue, Davyd H; Kudnig, Simon T; MacPhail, Catriona M; Seim, Howard B; Monnet, Eric

    2006-12-15

    To evaluate risk factors associated with death and development of perioperative complications in dogs undergoing surgery for treatment of gastric dilatation-volvulus (GDV). Retrospective case series. 166 dogs. Records of dogs with confirmed GDV that underwent surgery were reviewed. Logistic regression was performed to identify factors associated with development of complications (ie, hypotension, arrhythmias, gastric necrosis necessitating gastrectomy, disseminated intravascular coagulation, peritonitis, sepsis, postoperative dilatation, postoperative vomiting, and incisional problems) and with short-term outcome (ie, died vs survived to the time of suture removal). Short-term mortality rate was 16.2% (27/166). Risk factors significantly associated with death prior to suture removal were clinical signs for > 6 hours prior to examination, combined splenectomy and partial gastrectomy, hypotension at any time during hospitalization, peritonitis, sepsis, and disseminated intravascular coagulation. Partial gastrectomy was not a significant risk factor for death but was for peritonitis, disseminated intravascular coagulation, sepsis, and arrhythmias. Age, gastrectomy, and disseminated intravascular coagulation were risk factors for development of hypotension. Use of a synthetic colloid or hypertonic saline solution was associated with a significantly decreased risk of hypotension. Results suggest that the prognosis for dogs undergoing surgery because of GDV is good but that certain factors are associated with an increased risk that dogs will develop perioperative complications or die.

  12. Coagulation competence for predicting perioperative hemorrhage in patients treated with lactated Ringer's vs. Dextran

    DEFF Research Database (Denmark)

    Rasmussen, Kirsten C; Højskov, Michael; Johansson, Per Ingemar

    2015-01-01

    to receive either lactated Ringer's solution or Dextran 70 (Macrodex ®) that affects coagulation competence. RESULTS: By thrombelastography evaluated coagulation competence, Dextran 70 reduced "maximal amplitude" (MA) by 25 % versus a 1 % reduction with the administration of lactated Ringer's solution (P ....001). Blinded evaluation of the blood loss was similar in the two groups of patients - 2339 ml with the use of Dextran 70 and 1822 ml in the lactated Ringer's group (P = 0.27). Yet, the blood loss was related to the reduction in MA (r = -0.427, P = 0.008) and by multiple regression analysis independently...... associated with MA (P = 0.01). Thus, 11 patients in the dextran group (58 %) developed a clinical significant blood loss (>1500 ml) compared to only four patients (22 %) in the lactated Ringer's group (P = 0.04). CONCLUSIONS: With the use of Dextran 70 vs. lactated Ringer's solution during cystectomy...

  13. COAGULATION PROFILE IN PATIENTS PRESENTING WITH MALIGNANCIES WITH SPECIAL REFERENCES TO HEAD AND NECK EPITHELIAL CANCERS, LEUKAEMIAS AND LYMPHOMAS

    Directory of Open Access Journals (Sweden)

    Kaberee Bhuyan

    2016-04-01

    Full Text Available BACKGROUND Cancer can cause activation of coagulation in many ways and there is definite evidence of abnormalities in haemostatic mechanism which is seen by the presence of one or more circulating markers of haemostatic activation & this is found to be potentiated by the release of tissue factors or procoagulants from normal tissue destructions during tumour development. OBJECTIVES • To evaluate the range of different types of haemostatic abnormalities in haematological and epithelial malignancies, especially the head and neck epithelial malignancies. • To look for the differences in the grades of these abnormalities in metastatic & non-metastatic malignancies. • To understand the prognostic value of routine tests of coagulation while predicting the outcome of the patient. • MATERIALS AND METHODS The study was conducted in the Department of Pathology, Gauhati Medical College & Hospital, Guwahati from July 2004 to June 2005. 70 cases comprising of head and neck epithelial malignancies, leukaemias and lymphomas without clinical presentation of haemorrhage or thrombosis were selected and coagulation profiles were seen. RESULTS AND OBSERVATION Out of 70 cases of both sexes & different age groups prior to therapeutic intervention, metastatic cases were 22, non-metastatic cases were 29, and 19 cases belonged to leukaemias and lymphomas. The commonest age group affected was 51–60 yrs. and male: female was 3.7: 1. The most frequent abnormality was 41 cases (58.57% of FDP positivity in the serum followed by 36 cases (51.43% of hyperfibrinogenaemia; 32 cases (45.71% shortened bleeding time, etc. DISCUSSION Activated coagulation in cancer leads to increased fibrin deposition stimulated by the destroyed tissues; increased FDPs being a strong marker of coagulation and fibrinolytic activation; increased platelet aggregation by the micro vesicles shed by tumour cells; prolonged PT & APTT being well known markers for disseminated intravascular

  14. [Perioperative fibrinogen concentrations in cardiac surgery with cardiopulmonary bypass].

    Science.gov (United States)

    Uji, Makiko; Terada, Yuki; Noguchi, Teruo; Nishida, Takaya; Hasuwa, Kyoko; Shinohara, Kozue; Kumano, Hotaka; Ishimura, Naoko; Nishiwada, Makoto

    2012-08-01

    Patients undergoing cardiac surgery with cardiopulmonary bypass (CPB) need many blood products due to deficiency of coagulation factors. Blood transfusion therapy in patients with excessive bleeding after CPB is generally empiric. We checked and studied the fibrinogen concentration and transfusion, as well as bleeding amount in the perioperative period. The study was approved by our institutional ethics committee. Thirty patients were studied. Blood samples were obtained at the induction of anesthesia (before CPB), at the end of CPB, at the end of operation, and on the next morning, or before the patient was given fresh frozen plasma in the intensive care unit. For all cases, fibrinogen concentration and platelet concentration were lowest at the end of CPB. Fibrinogen concentration rose up to before CPB level on the next morning. The group in which fibrinogen concentration was less than 150 mg x dl(-1) at the end of CPB consumed more blood products than the group with fibrinogen concentration of over 150 mg x dl(-1). Blood transfusion therapy based on fibrinogen concentration is needed to maintain adequacy of the perioperative blood transfusion and blood conservation in cardiac surgery.

  15. STUDY OF CHANGES IN COAGULATION PROFILE OF PATIENTS UNDERGOING LAPAROSCOPIC CHOLECYSTECTOMY USING CARBON DIOXIDE PNEUMOPERITONEUM

    Directory of Open Access Journals (Sweden)

    Vasuki Rajam

    2017-04-01

    Full Text Available BACKGROUND Laparoscopic cholecystectomy is now the gold standard procedure and with over 5,00,000 procedures being done annually, laparoscopic cholecystectomy assumes a great significance in general surgical specialty. This study aims to study the effects of carbon dioxide pneumoperitoneum on the coagulation system of patients undergoing laparoscopic cholecystectomy and make the surgeon aware of the detrimental effects. MATERIALS AND METHODS A prospective clinical observational study of 50 patients selected by systematic sampling method from January 2015 to September 2015 at our institution was conducted to determine the results of changes in coagulation profile of patients undergoing laparoscopic cholecystectomy using carbon dioxide pneumoperitoneum. RESULTS The mean prothrombin time of the patients before surgery is 11.83 seconds. The standard deviation was 1.008 and standard error of mean was 0.143. The mean of prothrombin time 6 hours after surgery was 11.7 seconds. The standard deviation was 0.898 and the standard error of mean being 0.127. The difference in the mean between the two groups was 0.130. The p-value was 0.0109 (<0.05. Hence, the value was statistically extremely significant. The values for D-dimer were analysed. The mean value of D-dimer before surgery is 129.78. The standard deviation was 21.01 and standard error of mean was at 2.97. In the D-dimer values after surgery, mean was calculated to be 350.22 with the standard deviation at 73.21 and standard error of mean at 10.35. CONCLUSION Our study concluded that there is activation of both coagulation and fibrinolytic systems post laparoscopic cholecystectomy.

  16. Effects of preoperative aspirin and clopidogrel therapy on perioperative blood loss and blood transfusion requirements in patients undergoing off-pump coronary artery bypass graft surgery.

    Science.gov (United States)

    Shim, Jae Kwang; Choi, Yong Seon; Oh, Young Jun; Bang, Sou Ouk; Yoo, Kyung Jong; Kwak, Young Lan

    2007-07-01

    Preoperative exposure to clopidogrel and aspirin significantly increases postoperative bleeding in patients undergoing on-pump coronary artery bypass graft surgery. Off-pump coronary bypass grafting has been proposed as an alternative technique to attenuate postoperative bleeding associated with clopidogrel. This study aimed to determine the effects of aspirin and clopidogrel therapy on perioperative blood loss and blood transfusion requirements in off-pump coronary artery bypass grafting. One hundred six patients scheduled for off-pump coronary artery bypass grafting were divided into three groups: aspirin and clopidogrel discontinued more than 6 days before surgery (group 1, n = 35), aspirin and clopidogrel continued until 3 to 5 days before surgery (group 2, n = 51), and both medications continued within 2 days of surgery (group 3, n = 20). Thromboelastographic tracings were analyzed before induction of anesthesia. Routine coagulation profiles were measured before and after surgery. A cell salvage device was used during surgery and salvaged blood was reinfused. Chest tube drainage and blood transfusion requirement were recorded postoperatively. Patient characteristics, operative data, and thromboelastographic tracings were similar among the groups. There were significant decreases in hematocrit level and platelet count and prolongation in prothrombin time postoperatively in all groups without any intergroup differences. The amounts of perioperative blood loss and blood transfusion required were all similar among the groups. Preoperative clopidogrel and aspirin exposure even within 2 days of surgery does not increase perioperative blood loss and blood transfusion requirements in patients undergoing elective off-pump coronary artery bypass grafting.

  17. Multipurpose HTS Coagulation Analysis: Assay Development and Assessment of Coagulopathic Snake Venoms

    Directory of Open Access Journals (Sweden)

    Kristina B. M. Still

    2017-11-01

    Full Text Available Coagulation assays currently employed are often low throughput, require specialized equipment and/or require large blood/plasma samples. This study describes the development, optimization and early application of a generic low-volume and high-throughput screening (HTS assay for coagulation activity. The assay is a time-course spectrophotometric measurement which kinetically measures the clotting profile of bovine or human plasma incubated with Ca2+ and a test compound. The HTS assay can be a valuable new tool for coagulation diagnostics in hospitals, for research in coagulation disorders, for drug discovery and for venom research. A major effect following envenomation by many venomous snakes is perturbation of blood coagulation caused by haemotoxic compounds present in the venom. These compounds, such as anticoagulants, are potential leads in drug discovery for cardiovascular diseases. The assay was implemented in an integrated analytical approach consisting of reversed-phase liquid chromatography (LC for separation of crude venom components in combination with parallel post-column coagulation screening and mass spectrometry (MS. The approach was applied for the rapid assessment and identification of profiles of haemotoxic compounds in snake venoms. Procoagulant and anticoagulant activities were correlated with accurate masses from the parallel MS measurements, facilitating the detection of peptides showing strong anticoagulant activity.

  18. Perioperative anaphylaxis

    Directory of Open Access Journals (Sweden)

    Marta Inés Berrío Valencia

    2015-08-01

    Full Text Available BACKGROUND AND OBJECTIVE: Anaphylaxis remains one of the potential causes of perioperative death, being generally unanticipated and quickly progress to a life threatening situation. A narrative review of perioperative anaphylaxis is performed.CONTENT: The diagnostic tests are primarily to avoid further major events. The mainstays of treatment are adrenaline and intravenous fluids.CONCLUSION: The anesthesiologist should be familiar with the proper diagnosis, management and monitoring of perioperative anaphylaxis.

  19. Characterization of the coagulation profile in children with liver disease and extrahepatic portal vein obstruction or shunt.

    Science.gov (United States)

    Beattie, William; Magnusson, Maria; Hardikar, Winita; Monagle, Paul; Ignjatovic, Vera

    2017-03-01

    Chronic liver disease causes a disruption of procoagulant and anticoagulant factors, resulting in a fragile state, prone to increased rates of both bleeding and thrombosis. Currently, there is limited literature describing the changes observed in pediatric liver disease and extrahepatic portal vein obstruction or shunt. This study aimed to describe the changes that occur in children with chronic liver disease and extrahepatic portal vein obstruction or shunt. We measured the concentration and activity of key procoagulant and anticoagulant factors in children with liver disease, children with extrahepatic portal vein obstruction or shunt, and healthy children. Children with severe liver disease had coagulopathic changes, including either decreased concentration or activity of factor II, factor V, and factor VII. Nineteen percent (8/42) of the cohort had significant bleeding. Thrombophilic changes were also observed, including decreased concentration or activity of protein C, protein S, and antithrombin and increased concentration and activity of factor VIII and Von Willebrand factor. Similar coagulation factor changes were observed in children with extrahepatic portal vein obstruction or shunt. There was a trend toward greater changes in coagulation factor activity compared to concentration. This study provides a detailed description of the changes in both the concentration and activity of coagulation factors in pediatric liver disease and extrahepatic portal vein obstruction or shunt. Interestingly, procoagulant and anticoagulant factors were deranged in portal vein obstruction or shunt to a similar degree as in liver disease. An improved understanding of the coagulation profile in the pediatric setting will contribute to the improved management of liver disease and extrahepatic portal obstruction or shunt. PELD: pediatric end-stage liver disease score; MELD: model for end-stage liver disease score; ELISA: enzyme-linked immunosorbent assay; MCRI: Murdoch Childrens

  20. Coagulation parameters as a guide for fresh frozen plasma transfusion practice: A tertiary hospital experience

    Directory of Open Access Journals (Sweden)

    Wan Haslindawani W

    2010-01-01

    Full Text Available Introduction: The appropriate use of blood and blood products means the transfusion of safe blood products only to treat a condition leading to significant morbidity or mortality, which cannot be prevented or managed effectively by other means. The safety and effectiveness of transfusion depend on the appropriate clinical use of blood and blood products. This study was conducted to review the practice of fresh frozen plasma usage (FFP for transfusion, based on the coagulation profile, requested by various departments in the Hospital Universiti Sains Malaysia (HUSM. Methodology: A retrospective review of blood bank records and coagulation profile results of the patients given FFP from October to December 2006, in Hospital USM was undertaken. The criteria set by the College of American Pathologists in 1994, were used as the guidelines. Results: One thousand six hundred and ninety-eight units of FFP were used during this study period. Only 806 (47.47% FFP units were deemed appropriate. 20.38% were based on studies without any coagulation tests prior to transfusion and 21.13% were transfused for mild prolongation of coagulation test results. About 6.41% requested FFP in the setting of normal coagulation results. Conclusion: Our results showed that a significant proportion of the FFP transfusion was not guided by the coagulation profile. We recommend that a continuous education on FFP transfusion may help to guide the appropriate request for FFP.

  1. Influence of multi-level anaesthesia care and patient profile on perioperative patient satisfaction in short-stay surgical inpatients: A preliminary study

    Directory of Open Access Journals (Sweden)

    Amarjeet Singh

    2007-01-01

    Full Text Available Background and goals of study: Patient satisfaction in relation to perioperative anesthesia care represents essential aspect of quality health-care management. We analyzed the influence of multi-level anesthesia care exposure and patient profile on perioperative patient satisfaction in short-stay surgical inpatients. Methods : 120 short-stay surgical inpatients who underwent laparoscopic surgery have been included in this prospective study. Pertaining to demographic parameters (age, gender, education, profession, duration of stay (preoperative room, recovery room, various patient problems and patient satisfaction (various levels, overall were recorded by an independent observer and analyzed. Overall, adults, male and uneducated patients experienced more problems. Conversely, elderly, females and educated patients were more dissatisfied. Female patients suffered more during immediate postoperative recovery room stay and were more dissatisfied than their male counterparts (p< 0.05. However, patient′s professional status had no bearing on the problems encountered and dissatisfaction levels. Preoperative and early postoperative period accounted for majority of the problems encountered among the study population. There was a positive correlation between problems faced and dissatisfaction experienced at respective levels of anesthesia care (p< 0.05. Conclusion(s : Patient′s demographic profile and problems faced during respective level of anesthesia care has a correlation with dissatisfaction. Interestingly, none of the above stated factors had any effect on overall satisfaction level.

  2. High Pressure Homogenization of Porcine Pepsin Protease: Effects on Enzyme Activity, Stability, Milk Coagulation Profile and Gel Development

    Science.gov (United States)

    Leite Júnior, Bruno Ricardo de Castro; Tribst, Alline Artigiani Lima; Cristianini, Marcelo

    2015-01-01

    This study investigated the effect of high pressure homogenization (HPH) (up to 190 MPa) on porcine pepsin (proteolytic and milk-clotting activities), and the consequences of using the processed enzyme in milk coagulation and gel formation (rheological profile, proteolysis, syneresis, and microstructure). Although the proteolytic activity (PA) was not altered immediately after the HPH process, it reduced during enzyme storage, with a 5% decrease after 60 days of storage for samples obtained with the enzyme processed at 50, 100 and 150 MPa. HPH increased the milk-clotting activity (MCA) of the enzyme processed at 150 MPa, being 15% higher than the MCA of non-processed samples after 60 days of storage. The enzyme processed at 150 MPa produced faster aggregation and a more consistent milk gel (G’ value 92% higher after 90 minutes) when compared with the non-processed enzyme. In addition, the gels produced with the enzyme processed at 150 MPa showed greater syneresis after 40 minutes of coagulation (forming a more compact protein network) and lower porosity (evidenced by confocal microscopy). These effects on the milk gel can be associated with the increment in MCA and reduction in PA caused by the effects of HPH on pepsin during storage. According to the results, HPH stands out as a process capable of changing the proteolytic characteristics of porcine pepsin, with improvements on the milk coagulation step and gel characteristics. Therefore, the porcine pepsin submitted to HPH process can be a suitable alternative for the production of cheese. PMID:25938823

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

    Directory of Open Access Journals (Sweden)

    Šćiban Marina B.

    2005-01-01

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

  4. A single-dose of oral nattokinase potentiates thrombolysis and anti-coagulation profiles.

    Science.gov (United States)

    Kurosawa, Yuko; Nirengi, Shinsuke; Homma, Toshiyuki; Esaki, Kazuki; Ohta, Mitsuhiro; Clark, Joseph F; Hamaoka, Takafumi

    2015-06-25

    Our aim was to determine the quantitative effects of a single-dose of Nattokinase (NK) administration on coagulation/fibrinolysis parameters comprehensively in healthy male subjects. A double-blind, placebo-controlled cross-over NK intervention study was carried out in 12 healthy young males. Following the baseline blood draw, each subject was randomized to receive either a single-dose of 2,000 FU NK (NSK-SD, Japan Bio Science Laboratory Co., Ltd) or placebo with subsequent cross-over of the groups. Subjects donated blood samples at 2, 4, 6 and 8 hours following administration for analysis of coagulation/fibrinolysis parameters. As a result, D-dimer concentrations at 6, and 8 hours, and blood fibrin/fibrinogen degradation products at 4 hours after NK administration elevated significantly (p < 0.05, respectively). Factor VIII activity declined at 4 and 6 hours (p < 0.05, respectively), blood antithrombin concentration was higher at 2 and 4 hours (p < 0.05, respectively), and the activated partial thromboplastin time prolonged significantly at 2 and 4 hours following NK administration (p < 0.05 and p < 0.01, respectively). All the changes, however, were within the normal range. In conclusion, thus, a single-dose of NK administration appears enhancing fibrinolysis and anti-coagulation via several different pathways simultaneously.

  5. Tracheostomy: current practice on timing, correction of coagulation disorders and peri-operative management - a postal survey in the Netherlands

    NARCIS (Netherlands)

    Veelo, D. P.; Dongelmans, D. A.; Phoa, K. N.; Spronk, P. E.; Schultz, M. J.

    2007-01-01

    BACKGROUND: Several factors may delay tracheostomy. As many critically ill patients either suffer from coagulation abnormalities or are being treated with anticoagulants, fear of bleeding complications during the procedure may also delay tracheostomy. It is unknown whether such (usually mild)

  6. Photoacoustic discrimination of viable and thermally coagulated blood using a two-wavelength method for burn injury monitoring

    International Nuclear Information System (INIS)

    Talbert, Robert J; Holan, Scott H; Viator, John A

    2007-01-01

    Discriminating viable from thermally coagulated blood in a burn wound can be used to profile burn depth, thus aiding the removal of necrotic tissue. In this study, we used a two-wavelength photoacoustic imaging method to discriminate coagulated and non-coagulated blood in a dermal burn phantom. Differences in the optical absorption spectra of coagulated and non-coagulated blood produce different values of the ratio of peak photoacoustic amplitude at 543 and 633 nm. The absorption values obtained from spectroscopic measurements indicate that the ratio of photoacoustic pressure for 543 and 633 nm for non-coagulated blood was 15.7:1 and 1.6:1 for coagulated blood. Using planar blood layers, we found the photoacoustic ratios to be 13.5:1 and 1.6:1, respectively. Using the differences in the ratios of coagulated and non-coagulated blood, we propose a scheme using statistical classification analysis to identify the different blood samples. Based upon these distinctly different ratios, we identified the planar blood samples with an error rate of 0%. Using a burn phantom with cylindrical vessels containing coagulated and non-coagulated blood, we achieved an error rate of 11.4%. These results have shown that photoacoustic imaging could prove to be a valuable tool in the diagnosis of burns

  7. Nanoparticles and the blood coagulation system. Part I: benefits of nanotechnology.

    Science.gov (United States)

    Ilinskaya, Anna N; Dobrovolskaia, Marina A

    2013-05-01

    Nanotechnology is proven to provide certain benefits in drug delivery by improving solubility, increasing uptake to target sites and changing pharmacokinetics profiles of traditional drugs. Since properties of many materials change tremendously at the nanoscale levels, nanotechnology is also being explored in various industrial applications. As such, nanoparticles are rapidly entering various areas of industry, biology and medicine. The benefits of using nanotechnology for industrial and biomedical applications are often tempered by concerns about the safety of these new materials. One such area of concern includes their effect on the immune system. While nanoparticle interactions with various constituents of the immune system have been reviewed before, little attention was given to nanoparticle effects on the blood coagulation system. Nanoparticle interface with the blood coagulation system may lead to either benefits to the host or adverse reactions. This article reviews recent advances in our understanding of nanoparticle interactions with plasma coagulation factors, platelets, endothelial cells and leukocytes. Part I is focused on desirable interactions between nanoparticles and the coagulation system, and discusses benefits of using nanotechnology to intervene in coagulation disorders. Undesirable interactions posing safety concerns are covered in part II, which will be published in the June issue of Nanomedicine.

  8. Perioperative Management of Neurological Conditions

    Directory of Open Access Journals (Sweden)

    Manjeet Singh Dhallu

    2017-06-01

    Full Text Available Perioperative care of the patients with neurological diseases can be challenging. Most important consideration is the management and understanding of pathophysiology of these disorders and evaluation of new neurological changes that occur perioperatively. Perioperative generally refers to 3 phases of surgery: preoperative, intraoperative, and postoperative. We have tried to address few commonly encountered neurological conditions in clinical practice, such as delirium, stroke, epilepsy, myasthenia gravis, and Parkinson disease. In this article, we emphasize on early diagnosis and management strategies of neurological disorders in the perioperative period to minimize morbidity and mortality of patients.

  9. Perioperative Management of a Child with Hypoplastic Left Heart Syndrome of the Jehovah's Witness Faith Presenting for Hybrid Comprehensive Stage II Procedure.

    Science.gov (United States)

    Karuppiah, Sathappan; Mckee, Christopher; Hodge, Ashley; Galantowicz, Mark; Tobias, Joseph; Naguib, Aymen

    2016-09-01

    Over the years, there has been a growing recognition of the potential negative sequelae of allogeneic blood products on postoperative outcomes following cardiac surgery. In addition, followers of the Jehovah's Witness (JW) faith have a religious restriction against receiving blood or blood components. Advances in perioperative care, cardiopulmonary bypass (CPB), and surgical technique have minimized the need for allogeneic blood products. Specific blood conservation strategies include maximizing the preoperative hematocrit and coagulation function as well as intraoperative strategies, such as acute normovolemic hemodilution and adjustments of the technique of CPB. We report a 7-month-old patient whose parents were of the JW faith who underwent a comprehensive stage II procedure for hypoplastic left heart syndrome without exposure to blood or blood products during his hospital stay. Perioperative techniques for blood avoidance are discussed with emphasis on their application to infants undergoing surgery for congenital heart disease.

  10. Perioperative anaesthetic adverse events in Thailand (PAAd THAI) study: Incident report of perioperative convulsion.

    Science.gov (United States)

    Eiamcharoenwit, Jatuporn; Akavipat, Phuping; Ariyanuchitkul, Thidarat; Wirachpisit, Nichawan; Pulnitiporn, Aksorn; Pongraweewan, Orawan

    2018-01-01

    The aim of this study was to identify the characteristics of perioperative convulsion and to suggest possible correcting strategies. The multi-centre study was conducted prospectively in 22 hospitals across Thailand in 2015. The occurrences of perioperative adverse events were collected. The data was collated by site manager and forwarded to the data management unit. All perioperative convulsion incidences were enrolled and analysed. The consensus was documented for the relevant factors and the corrective strategies. Descriptive statistics were used. From 2,000 incident reports, perioperative convulsions were found in 16 patients. Six episodes (37.5%) were related to anaesthesia, 31.3% to patients, 18.8% to surgery, and 12.5% to systemic processes. The contributing factor was an inexperienced anaesthesia performer (25%), while the corrective strategy was improvements to supervision (43.8%). Incidents of perioperative convulsion were found to be higher than during the last decade. The initiation and maintenance of safe anaesthesia should be continued.

  11. Danish Perioperative Nurses' Documentation

    DEFF Research Database (Denmark)

    Søndergaard, Susanne Friis; Lorentzen, Vibeke; Sørensen, Erik E

    2017-01-01

    of 2015 to 2016, six participants tested an EHR containing a Danish edition of a selected section of the Perioperative Nursing Data Set. This study relied on realistic evaluation and participant observations to generate data. We found that nursing leadership was essential for improving perioperative...

  12. [Evaluation of selected parameters of blood coagulation and fibrinolysis system in patients undergoing total hip replacement surgery with normovolemic hemodilution procedure and standard enoxaparine prophylaxis].

    Science.gov (United States)

    Piecuch, Wiesław; Sokołowska, Bozena; Dmoszyńska, Anna; Furmanik, Franciszek

    2003-01-01

    The aim of the study was to evaluate selected blood coagulation and fibrinolysis parameters in patients undergoing total hip replacement surgery with normovolemic hemodilution and standard enoksaparine profilaxis. The study included 66 patients undergoing hip replacement surgery. The group consisted of 51 women and 15 men, within the age range of 47-78, the mean age was 64. In 32 (subgroup II) patients the surgery was performed with the use of normovolemic hemodilution, in 34 (subgroup I) the hemodilution procedure was not applied. The enoksaparine as prophylaxis started 12 hours prior to surgery and continued during hospitalisation. The examination of the coagulation system was performed: on the day of the operation in the morning, on the day of the operation in the evening and on the first day after operation. We determined the concentrations of TAT and PAP complexes, prothrombin fragments 1 + 2 (F1 + 2) and d-dimers (DD). 1) during total hip replacement surgery and particularly in the period of the first 12 hours after the procedure marked activation of coagulation and fibrinolysis occurRed; 2) the application of the hemodilution procedure does not influence significantly the degree of coagulation and fibrinolysis disorders in the perioperative period, but could reduced incidence of thromboembolic complications in the postoperative period.

  13. Implementing a Perioperative Nursing Student Summer Internship.

    Science.gov (United States)

    Nash, Janice; Kamel, Teya C; Sherer, Joanne; Nauer, Kathleen

    2018-01-01

    Using qualitative research and a collaborative academic service partnership, we created an innovative 120-hour perioperative nursing summer internship for eight undergraduate nursing students in 2016. Recognizing that perioperative exposure is limited in the traditional baccalaureate program, this unpaid internship served to clarify student perceptions of perioperative nursing care and encourage graduates to meet perioperative workforce demands. We based the theoretical and practical student learning experiences on the AORN Periop 101 learning modules and included faculty-led discussions, student journaling, and onsite precepted clinical activities. Evaluation data revealed that students achieved an enhanced awareness of perioperative nursing, and a majority of the participants expressed a desire to enter the perioperative field after graduation. We suggest that stakeholders continue to strategize ways to maximize educational preparation to address the evolving health care market supply and demand. © AORN, Inc, 2018.

  14. Relative effects of plasma, fibrinogen concentrate, and factor XIII on ROTEM coagulation profiles in an in vitro model of massive transfusion in trauma.

    Science.gov (United States)

    Schmidt, David E; Halmin, Märit; Wikman, Agneta; Östlund, Anders; Ågren, Anna

    2017-10-01

    Massive traumatic haemorrhage is aggravated through the development of trauma-induced coagulopathy, which is managed by plasma transfusion and/or fibrinogen concentrate administration. It is yet unclear whether these treatments are equally potent in ensuring adequate haemostasis, and whether additional factor XIII (FXIII) administration provides further benefits. In this study, we compared ROTEM whole blood coagulation profiles after experimental massive transfusion with different transfusion regimens in an in vitro model of dilution- and transfusion-related coagulopathy. Healthy donor blood was mixed 1 + 1 with six different transfusion regimens. Each regimen contained RBC, platelet concentrate, and either fresh frozen plasma (FFP) or Ringer's acetate (RA). The regimens were further augmented through addition of a low- or medium-dose fibrinogen concentrate and FXIII. Transfusion with FFP alone was insufficient to maintain tissue-factor activated clot strength, coincidental with a deficiency in fibrin-based clot strength. Fibrinogen concentrate conserved, but did not improve coagulation kinetics and overall clot strength. Only combination therapy with FFP and low-dose fibrinogen concentrate improved both coagulation kinetics and fibrin-based clot strength. Administration of FXIII did not result in an improvement of clot strength. In conclusion, combination therapy with both FFP and low-dose fibrinogen concentrate improved clotting time and produced firm clots, representing a possible preferred first-line regimen to manage trauma-induced coagulopathy when RBC and platelets are also transfused. Further research is required to identify optimal first-line transfusion fluids for massive traumatic haemorrhage.

  15. TRAITEMENT DES EAUX USEES PAR COAGULATION-FLOCULATION EN UTILISANT LE SULFATE D’ALUMINIUM COMME COAGULANT

    OpenAIRE

    Nora SEGHAIRI; Leila MIMECHE; Adel BOUZID; Yassir AYACHI

    2017-01-01

    Domestic wastewater treatment by coagulation-flocculation is widely used internationally. This treatment reduces color and turbidity, indicating organic and inorganic contaminants, but at acceptable levels for treated waste water discharged into the receiving environment. The objective of this study is to optimize the treatment of wastewater by coagulation-flocculation using aluminum sulphate as a coagulant. Various reaction parameters are taken into account, such as the coagulant dose,...

  16. Blood coagulation factors as inflammatory mediators

    NARCIS (Netherlands)

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

    2005-01-01

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

  17. COAGULATION ACTIVITY IN LIVER DISEASE

    Directory of Open Access Journals (Sweden)

    Dr. Sheikh Sajjadieh Mohammad Reza

    2009-07-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2017-10-15

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

  19. Focused Review of Perioperative Care of Patients with Pulmonary Hypertension and Proposal of a Perioperative Pathway.

    Science.gov (United States)

    Steppan, Jochen; Diaz-Rodriguez, Natalia; Barodka, Viachaslau M; Nyhan, Daniel; Pullins, Erica; Housten, Traci; Damico, Rachel L; Mathai, Stephen C; Hassoun, Paul M; Berkowitz, Dan E; Maxwell, Bryan G; Kolb, Todd M

    2018-01-15

    Morbidity and mortality risk increase considerably for patients with pulmonary hypertension (PH) undergoing non-cardiac surgery. Unfortunately, there are no comprehensive, evidence-based guidelines for perioperative evaluation and management of these patients. We present a brief review of the literature on perioperative outcomes for patients with PH and describe the implementation of a collaborative perioperative management program for these high-risk patients at a tertiary academic center.

  20. Removal of Dye in Wastewater by Adsorption-Coagulation Combined System with Hibiscus sabdariffa as the Coagulant

    Directory of Open Access Journals (Sweden)

    Hoong Ho Nicholas Jian

    2018-01-01

    Full Text Available The conventional process to treat dye wastewater is the physicochemical treatment such as coagulation, flocculation and adsorption process. A new approach has been demonstrated to treat Congo red dye wastewater, which is the adsorption-coagulation hybrid process. Natural coagulant extracted from Hibiscus sabdariffa seeds is used as the coagulant while activated carbon is used as the adsorbent in this case study. The objective of this experiment is to study the significant factors that will affect the efficiency of dye removal. Then, the optimum conditions for the hybrid process is determined using Respond Surface Methodology (RSM. The variables are pH, initial dye concentration, coagulant dosage and adsorbent dosage while the response of experiment is the dye removal percentage. A three-level and four-variable Box-Behnken design (BBD is used for the RSM. A total of 27 sets of experimental results is required to determine the optimum conditions. Jar test is used to conduct the experiment with the addition of coagulant and adsorbent simultaneously. Based on the regression model analysis and ANOVA, the highly significant factors that contribute to the dye removal efficiency through adsorption-coagulation hybrid process are pH of solution and initial dye concentration. The RSM results shows that the optimised process parameters for adsorption-coagulation hybrid process with Hibiscus sabdariffa seeds as the coagulant and activated carbon as the adsorbent are pH 2, initial dye concentration of 385 ppm, coagulant dosage of 209 mg/L and adsorbent dosage of 150 mg/L. The dye removal reaches up to 96.67% under optimum parameters.

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

    Directory of Open Access Journals (Sweden)

    Šćiban Marina B.

    2010-01-01

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

  2. Refinement of Perioperative Feeding in a Mouse Model of Vertical Sleeve Gastrectomy.

    Science.gov (United States)

    Doerning, Carolyn M; Burlingame, Lisa A; Lewis, Alfor G; Myronovych, Andriy; Seeley, Randy J; Lester, Patrick A

    2018-05-01

    Provision of liquid enteral nutrition (LEN) during the perioperative period is standard practice for rodents undergoing bariatric surgery, yet these diets are associated with several challenges, including coagulation of the liquid diet within the delivery system and decreased postoperative consumption. We investigated the use of a commercially available high-calorie dietary gel supplement (DG) as an alternative food source for mice during the perioperative period. C57BL/6J male mice were fed high-fat diet for 8 to 10 wk prior to surgery. The study groups were: vertical sleeve gastrectomy (VSG) +DG, VSG+LEN, sham surgery+DG, and sham+LEN. Food and water intakes, body weight, and body fat composition was monitored throughout the study. Mice that received DG lost significantly more weight preoperatively than those fed LEN. However, during the postoperative period, body weight, body fat composition, and water and caloric intake were similar among all experimental diet groups. Three mice in the VSG+LEN group were euthanized due to clinical illness during the course of the study. In summary, feeding a high-calorie DG to mice undergoing VSG surgery is a viable alternative to LEN, given that DG does not significantly affect the surgical model of weight loss or result in adverse clinical outcomes. We recommend additional metabolic characterization of DG supplementation to ensure that this novel diet does not confound specific research goals in the murine VSG model.

  3. Total hip and knee joint replacement: perioperative clinical aspects

    Directory of Open Access Journals (Sweden)

    Luciana Pereira Almeida de Piano

    2010-09-01

    Full Text Available Objective: To understand the profile of patients undergoing hip and knee replacement during two years, and to compare the data obtained with the literature. Methods: A total of 323 medical records were reviewed to analyze the perioperative data of patients submitted to hip and knee replacement. Results: Osteoarthritis was the main indication for both procedures and male patients were heavier than females (p < 0.05. Hypertension was the prevalent disease among patients. Blood loss was more frequent in knee surgery than in the hip. Conclusions: The profile of patients undergoing total arthroplasty improved substantially over the past decade due to shorter hospital stay, lower risk of thromboembolic events and no infection as compared to previous reports.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-07-15

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

  5. Multicenter Experience with Nonischemic Multiport Laparoscopic and Laparoendoscopic Single-Site Partial Nephrectomy Utilizing Bipolar Radiofrequency Ablation Coagulator

    Directory of Open Access Journals (Sweden)

    Wassim M. Bazzi

    2011-01-01

    Full Text Available Objective. To investigate feasibility of multiport and laparoendoscopic single-site (LESS nonischemic laparoscopic partial nephrectomy (NI-LPN utilizing bipolar radiofrequency coagulator. Methods. Multicenter retrospective review of 60 patients (46 multiport/14 LESS undergoing NI-LPN between 4/2006 and 9/2009. Multiport and LESS NI-LPN utilized Habib 4X bipolar radiofrequency coagulator to form a hemostatic zone followed by nonischemic tumor excision and renorrhaphy. Demographics, tumor/perioperative characteristics, and outcomes were analyzed. Results. 59/60 (98.3% successfully underwent NI-LPN. Mean tumor size was 2.35 cm. Mean operative time was 160.0 minutes. Mean estimated blood loss was 131.4 mL. Preoperative/postoperative creatinine (mg/dL was 1.02/1.07 (=.471. All had negative margins. 12 (20% patients developed complications. 3 (5% developed urine leaks. No differences between multiport and LESS-PN were noted as regards demographics, tumor size, outcomes, and complications. Conclusion. Initial experience demonstrates that nonischemic multiport and LESS-PN is safe and efficacious, with excellent short-term preservation of renal function. Long-term data are needed to confirm oncological efficacy.

  6. Technological advances in perioperative monitoring: Current concepts and clinical perspectives.

    Science.gov (United States)

    Chilkoti, Geetanjali; Wadhwa, Rachna; Saxena, Ashok Kumar

    2015-01-01

    Minimal mandatory monitoring in the perioperative period recommended by Association of Anesthetists of Great Britain and Ireland and American Society of Anesthesiologists are universally acknowledged and has become an integral part of the anesthesia practice. The technologies in perioperative monitoring have advanced, and the availability and clinical applications have multiplied exponentially. Newer monitoring techniques include depth of anesthesia monitoring, goal-directed fluid therapy, transesophageal echocardiography, advanced neurological monitoring, improved alarm system and technological advancement in objective pain assessment. Various factors that need to be considered with the use of improved monitoring techniques are their validation data, patient outcome, safety profile, cost-effectiveness, awareness of the possible adverse events, knowledge of technical principle and ability of the convenient routine handling. In this review, we will discuss the new monitoring techniques in anesthesia, their advantages, deficiencies, limitations, their comparison to the conventional methods and their effect on patient outcome, if any.

  7. Enhanced coagulation for improving coagulation performance and reducing residual aluminum combining polyaluminum chloride with diatomite.

    Science.gov (United States)

    Hu, Wenchao; Wu, Chunde

    2016-01-01

    The feasibility of using enhanced coagulation, which combined polyaluminum chloride (PAC) with diatomite for improving coagulation performance and reducing the residual aluminum (Al), was discussed. The effects of PAC and diatomite dosage on the coagulation performance and residual Al were mainly investigated. Results demonstrated that the removal efficiencies of turbidity, dissolved organic carbon (DOC), and UV254 were significantly improved by the enhanced coagulation, compared with PAC coagulation alone. Meaningfully, the five forms of residual Al (total Al (TAl), total dissolved Al (TDAl), dissolved organic Al (DOAl), dissolved monomeric Al (DMAl), and dissolved organic monomeric Al (DOMAl)) all had different degrees of reduction in the presence of diatomite and achieved the lowest concentrations (0.185, 0.06, 0.053, 0.014, and 0 mg L(-1), respectively) at a PAC dose of 15 mg L(-1) and diatomite dose of 40 mg L(-1). In addition, when PAC was used as coagulant, the majority of residual Al existed in dissolved form (about 31.14-70.16%), and the content of DOMAl was small in the DMAl.

  8. Blood viscosity during coagulation at different shear rates

    Science.gov (United States)

    Ranucci, Marco; Laddomada, Tommaso; Ranucci, Matteo; Baryshnikova, Ekaterina

    2014-01-01

    Abstract During the coagulation process, blood changes from a liquid to a solid gel phase. These changes are reflected by changes in blood viscosity; however, blood viscosity at different shear rates (SR) has not been previously explored during the coagulation process. In this study, we investigated the viscosity changes of whole blood in 10 subjects with a normal coagulation profile, using a cone‐on‐plate viscosimeter. For each subject, three consecutive measurements were performed, at a SR of 20, 40, 80 sec−1. On the basis of the time‐dependent changes in blood viscosity, we identified the gel point (GP), the time‐to‐gel point (TGP), the maximum clot viscosity (MCV), and the clot lysis half‐time (CLH). The TGP significantly (P = 0.0023) shortened for increasing SR, and was significantly associated with the activated partial thromboplastin time at a SR of 20 sec−1 (P = 0.038) and 80 sec−1 (P = 0.019). The MCV was significantly lower at a SR of 80 sec−1 versus 40 sec−1 (P = 0.027) and the CLH significantly (P = 0.048) increased for increasing SR. These results demonstrate that measurement of blood viscosity during the coagulation process offers a number of potentially useful parameters. In particular, the association between the TGP and the activated partial thromboplastin time is an expression of the clotting time (intrinsic and common pathway), and its shortening for increasing SR may be interpreted the well‐known activating effects of SR on platelet activation and thrombin generation. Further studies focused on the TGP under conditions of hypo‐ or hypercoagulability are required to confirm its role in the clinical practice. PMID:24994896

  9. Theories of blood coagulation.

    Science.gov (United States)

    Riddel, James P; Aouizerat, Bradley E; Miaskowski, Christine; Lillicrap, David P

    2007-01-01

    Although the concept of the coagulation cascade represented a significant advance in the understanding of coagulation and served for many years as a useful model, more recent clinical and experimental observations demonstrate that the cascade/waterfall hypothesis does not fully and completely reflect the events of hemostasis in vivo. The goal of this article is to review the evolution of the theories of coagulation and their proposed models to serve as a tool when reviewing the research and practice literature that was published in the context of these different theories over time.

  10. Enhanced algae removal by Ti-based coagulant: comparison with conventional Al- and Fe-based coagulants.

    Science.gov (United States)

    Xu, Jie; Zhao, Yanxia; Gao, Baoyu; Zhao, Qian

    2018-05-01

    The water eutrophication caused by cyanobacteria seasonally proliferates, which is a hot potato to be resolved for water treatment plants. This study firstly investigated coagulation performance of titanium tetrachloride (TiCl 4 ) for Microcystis aeruginosa synthetic water treatment. Results show complete algal cell removal by TiCl 4 coagulation without damage to cell membrane integrity even under harsh conditions; 60 mg/L TiCl 4 was effective in removing the microcystins up to 85%. Furthermore, besides having stronger UV 254 removal capability and the higher removal of fluorescent substances over Al- and Fe-based coagulants, TiCl 4 coagulant required more compact coagulation and sedimentation tanks due to its significantly improved floc growth and sedimentation speed. Meanwhile, its' short hydraulic retention time avoided algal cell breakage and subsequent algal organic matter release. Microcystin concentrations were kept at a low level during sludge storage period, indicating that the TiCl 4 flocs could prevent algal cells from natural lysis. To facilitate water recycling without secondary contamination, the algae-containing sludge after TiCl 4 coagulation ought to be disposed within 12 days at 20 °C and 8 days at 35 °C.

  11. The interplay between platelets and coagulation

    NARCIS (Netherlands)

    Weeterings, C.

    2009-01-01

    Platelet activation and blood coagulation are two processes often studied separately, but which cannot be seen independently from each other. Platelets play a pivotal role in coagulation, not only by providing negatively charged phospholipids, but also in localizing the coagulation process from a

  12. Dust coagulation in ISM

    Science.gov (United States)

    Chokshi, Arati; Tielens, Alexander G. G. M.; Hollenbach, David

    1989-01-01

    Coagulation is an important mechanism in the growth of interstellar and interplanetary dust particles. The microphysics of the coagulation process was theoretically analyzed as a function of the physical properties of the coagulating grains, i.e., their size, relative velocities, temperature, elastic properties, and the van der Waal interaction. Numerical calculations of collisions between linear chains provide the wave energy in individual particles and the spectrum of the mechanical vibrations set up in colliding particles. Sticking probabilities are then calculated using simple estimates for elastic deformation energies and for the attenuation of the wave energy due to absorption and scattering processes.

  13. Effects on coagulation factor production following primary hepatomitogen-induced direct hyperplasia.

    Science.gov (United States)

    Tatsumi, Kohei; Ohashi, Kazuo; Taminishi, Sanae; Takagi, Soichi; Utoh, Rie; Yoshioka, Akira; Shima, Midori; Okano, Teruo

    2009-11-14

    To investigate the molecular mechanisms involved in coagulation factor expression and/or function during direct hyperplasia (DH)-mediated liver regeneration. Direct hyperplasia-mediated liver regeneration was induced in female C57BL/6 mice by administering 1,4-bis[2-(3,5-dichloropyridyloxy)] benzene (TCPOBOP), a representative hepatomitogen. Mice were weighed and sacrificed at various time points [Day 0 (D0: prior to injection), 3 h, D1, D2, D3, and D10] after TCPOBOP administration to obtain liver and blood samples. Using the RNA samples extracted from the liver, a comprehensive analysis was performed on the hepatic gene expression profiling of coagulation-related factors by real-time RT-PCR (fibrinogen, prothrombin, factors V, VII, VIII, IX, X, XI, XII, XIIIbeta, plasminogen, antithrombin, protein C, protein S, ADAMTS13, and VWF). The corresponding plasma levels of coagulation factors (fibrinogen, prothrombin, factors V, VII, VIII, IX, X, XI, XII, XIII, and VWF) were also analyzed and compared with their mRNA levels. Gavage administration of TCPOBOP (3 mg/kg body weight) resulted in a marked and gradual increase in the weight of the mouse livers relative to the total body weight to 220% by D10 relative to the D0 (control) ratios. At the peak of liver regeneration (D1 and D2), the gene expression levels for most of the coagulation-related factors (fibrinogen, prothrombin, factors V, VII, VIII, IX, XI, XII, XIIIbeta, plasminogen, antithrombin, protein C, ADAMTS13, VWF) were found to be down-regulated in a time-dependent manner, and gradually recovered by D10 to the basal levels. Only mRNA levels of factor X and protein S failed to show any decrease during the regenerative phase. As for the plasma levels, 5 clotting factors (prothrombin, factors VIII, IX, XI, and XII) demonstrated a significant decrease (Pfactors, factor IX and factor XI showed the most dramatic decline in their activities by about 50% at D2 compared to the basal levels, and these reductions in

  14. An updated concept of coagulation with clinical implications.

    Science.gov (United States)

    Romney, Gregory; Glick, Michael

    2009-05-01

    Over the past century, a series of models have been put forth to explain the coagulation mechanism. The coagulation cascade/waterfall model has gained the most widespread acceptance. This model, however, has problems when it is used in different clinical scenarios. A more recently proposed cell-based model better describes the coagulation process in vivo and provides oral health care professionals (OHCPs) with a better understanding of the clinical implications of providing dental care to patients with potentially increased bleeding tendencies. The authors conducted a literature search using the PubMed database. They searched for key words including "coagulation," "hemostasis," "bleeding," "coagulation factors," "models," "prothrombin time," "activated partial thromboplastin time," "international normalized ratio," "anticoagulation therapy" and "hemophilia" separately and in combination. The coagulation cascade/waterfall model is insufficient to explain coagulation in vivo, predict a patient's bleeding tendency, or correlate clinical outcomes with specific laboratory screening tests such as prothrombin time, activated partial thromboplastin time and international normalized ratio. However, the cell-based model of coagulation that reflects the in vivo process of coagulation provides insight into the clinical ramifications of treating dental patients with specific coagulation factor deficiencies. Understanding the in vivo coagulation process will help OHCPs better predict a patient's bleeding tendency. In addition, applying the theoretical concept of the cell-based model of coagulation to commonly used laboratory screening tests for coagulation and bleeding will result in safer and more appropriate dental care.

  15. Removal Natural Organic Matter (NOM in Peat Water from Wetland Area by Coagulation-Ultrafiltration Hybrid Process with Pretreatment Two-Stage Coagulation

    Directory of Open Access Journals (Sweden)

    Mahmud Mahmud

    2016-06-01

    Full Text Available The primary problem encountered in the application of membrane technology was membrane fouling. During this time, hybrid process by coagulation-ultrafiltration in drinking water treatment that has been conducted by some research, using by one-stage coagulation. The goal of this research was to investigate the effect of two-stage coagulation as a pretreatment towards performance of the coagulation-ultrafiltration hybrid process for removal NOM in the peat water. Coagulation process, either with the one-stage or two-stage coagulation was very good in removing charge hydrophilic fraction, i.e. more than 98%. NOM fractions of the peat water, from the most easily removed by the two-stage coagulation and one-stage coagulation process was charged hydrophilic>strongly hydrophobic>weakly hydrophobic>neutral hydrophilic. The two-stage coagulation process could removed UV254 and colors with a little better than the one-stage coagulation at the optimum coagulant dose. Neutral hydrophilic fraction of peat water NOM was the most influential fraction of UF membrane fouling. The two-stage coagulation process better in removing the neutral hidrophilic fraction, while removing of the charged hydrophilic, strongly hydrophobic and weakly hydrophobic similar to the one-stage coagulation. Hybrid process by pretreatment with two-stage coagulation, beside can increased removal efficiency of UV254 and color, also can reduced fouling rate of the ultrafiltration membraneIt must not exceed 250 words, contains a brief summary of the text, covering the whole manuscript without being too elaborate on every section. Avoid any abbreviation, unless it is a common knowledge or has been previously stated.

  16. Removal Natural Organic Matter (NOM in Peat Water from Wetland Area by Coagulation-Ultrafiltration Hybrid Process with Pretreatment Two-Stage Coagulation

    Directory of Open Access Journals (Sweden)

    Mahmud Mahmud

    2013-11-01

    Full Text Available The primary problem encountered in the application of membrane technology was membrane fouling. During this time, hybrid process by coagulation-ultrafiltration in drinking water treatment that has been conducted by some research, using by one-stage coagulation. The goal of this research was to investigate the effect of two-stage coagulation as a pretreatment towards performance of the coagulation-ultrafiltration hybrid process for removal NOM in the peat water. Coagulation process, either with the one-stage or two-stage coagulation was very good in removing charge hydrophilic fraction, i.e. more than 98%. NOM fractions of the peat water, from the most easily removed by the two-stage coagulation and one-stage coagulation process was charged hydrophilic>strongly hydrophobic>weakly hydrophobic>neutral hydrophilic. The two-stage coagulation process could removed UV254 and colors with a little better than the one-stage coagulation at the optimum coagulant dose. Neutral hydrophilic fraction of peat water NOM was the most influential fraction of UF membrane fouling. The two-stage coagulation process better in removing the neutral hidrophilic fraction, while removing of the charged hydrophilic, strongly hydrophobic and weakly hydrophobic similar to the one-stage coagulation. Hybrid process by pretreatment with two-stage coagulation, beside can increased removal efficiency of UV254 and color, also can reduced fouling rate of the ultrafiltration membraneIt must not exceed 250 words, contains a brief summary of the text, covering the whole manuscript without being too elaborate on every section. Avoid any abbreviation, unless it is a common knowledge or has been previously stated.

  17. Perioperative Management of Sickle Cell Disease.

    Science.gov (United States)

    Adjepong, Kwame Ofori; Otegbeye, Folashade; Adjepong, Yaw Amoateng

    2018-01-01

    Over 30 million people worldwide have sickle cell disease (SCD). Emergent and non-emergent surgical procedures in SCD have been associated with relatively increased risks of peri-operative mortality, vaso-occlusive (painful) crisis, acute chest syndrome, post-operative infections, congestive heart failure, cerebrovascular accident and acute kidney injury. Pre-operative assessment must include a careful review of the patient's known crisis triggers, baseline hematologic profile, usual transfusion requirements, pre-existing organ dysfunction and opioid use. Use of preoperative blood transfusions should be selective and decisions individualized based on the baseline hemoglobin, surgical procedure and anticipated volume of blood loss. Intra- and post-operative management should focus on minimizing hypoxia, hypothermia, acidosis, and intravascular volume depletion. Pre- and post-operative incentive spirometry use should be encouraged.

  18. Evidence for the perioperative care of mastectomized women

    Directory of Open Access Journals (Sweden)

    Carla Monique Lopes Mourão

    2014-01-01

    Full Text Available This study aimed to evaluate the evidence available in the literature about the perioperative care provided to women submitted to mastectomy. An integrative review of scientific literature conducted in MEDLINE, CINAHL, LILACS, and SciELO databases, published from 2000 to 2011, using the controlled descriptors: preoperative care; preoperative period; intraoperative care; intraoperative period; postoperative care; postoperative period; perioperative care; perioperative period; and mastectomy. The sample of this review consisted of seven articles. The evidence pointed as perioperative care of mastectomy the pharmacological management of pain in different surgical periods. Despite the difficulty in presenting a consensus of evidence for perioperative care of mastectomy, there was concern on the part of professionals to minimize/prevent pre-, intra- and post-operative pain. Nursing should be aware, both of the update of pharmacological treatments in pain management and the development of future research related to nursing care in the perioperative period of mastectomy.

  19. TRAITEMENT DES EAUX USEES PAR COAGULATION-FLOCULATION EN UTILISANT LE SULFATE D’ALUMINIUM COMME COAGULANT

    Directory of Open Access Journals (Sweden)

    Nora SEGHAIRI

    2017-12-01

    Full Text Available Domestic wastewater treatment by coagulation-flocculation is widely used internationally. This treatment reduces color and turbidity, indicating organic and inorganic contaminants, but at acceptable levels for treated waste water discharged into the receiving environment. The objective of this study is to optimize the treatment of wastewater by coagulation-flocculation using aluminum sulphate as a coagulant. Various reaction parameters are taken into account, such as the coagulant dose, the pH of the solutions, the conductivity, the BOD5, the nitrates, the ammonium and the phosphates. We found from the different results obtained the optimal dose of aluminum sulphate is 400 mg/l with a reduction of 96.31%, 82.44% 90.95% and 78.74% respectively for phosphates, nitrates, ammonium and BOD5. It is recognized that pH influences the abatement rates of pollution contained in wastewater. For each water, there is a pH range for which coagulation- flocculation takes place rapidly. For our study, the optimum pH for removal of BOD5 and ammonium is between 6 and 7.

  20. Perioperative registered nurses knowledge, attitudes, behaviors, and barriers regarding pressure ulcer prevention in perioperative patients.

    Science.gov (United States)

    Tallier, Peggy C; Reineke, Patricia R; Asadoorian, Kathy; Choonoo, John G; Campo, Marc; Malmgreen-Wallen, Christine

    2017-08-01

    Hospital acquired pressure ulcers have a detrimental effect on patient quality of life, morbidity, mortality, and cost to the healthcare industry. Little is known about pressure ulcer prevention in perioperative services. The objectives of this study were to describe perioperative registered nurses (RNs) knowledge, attitudes, behaviors, and barriers about pressure ulcer prevention and to determine if knowledge and the availability of a pressure ulcer staging tool are predictors of pressure ulcer prevention behavior. A cross-sectional descriptive pilot study was conducted. Sixty-two perioperative RNs from 10 acute care hospitals participated. Perioperative nurses believed carrying out pressure ulcer prevention strategies is essential to nursing practice but only two-thirds reported conducting pressure ulcer risk assessment on all patients and daily assessment on at risk patients. Results indicated a knowledge deficit regarding assessment and prevention of pressure ulcers as performance on the PUKT (72%) fell below the recommended score of 90%. Results of binary logistic regression indicated that knowledge as measured by the PUKT and availability of a pressure ulcer staging tool were statistically significant (p=0.03) predictors of pressure ulcer prevention behavior. The initial model without the predictor variables, indicated an overall success rate of correct predictions of 64% which increase to 73% when the predictor variables were added to the initial model. Although perioperative nurses believe that pressure ulcer prevention is important, a knowledge deficit exists and there is a need for pressure ulcer prevention education. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Perioperative outcomes of pancreaticoduodenectomy: Nepalese experience.

    Science.gov (United States)

    Lakhey, Paleswan Joshi; Bhandari, Ramesh Singh; Ghimire, Bikal; Khakurel, Mahesh

    2010-08-01

    Pancreaticodudenectomy (PD) is a high-risk, technically demanding operation associated with substantial perioperative morbidity and mortality. This review is intended to evaluate the perioperative outcomes of PD done in a single gastrointestinal surgery unit of a university teaching hospital. A retrospective review of medical records of patients who underwent PD from April 2005 through May 2009 was done. Perioperative morbidity was defined according to the standard of the International Study Group for Pancreatic Fistula (ISGPF). The patient demographics, type of surgery, and perioperative morbidity and mortality were evaluated. The factors associated with increased morbidity were analyzed. Twenty-four patients underwent PD, and there were no perioperative deaths. The overall morbidity was 58%, with a pancreatic fistula rate of 13%. None of the associated parameters, like increasing age, the presence of co-morbidity, preoperative biliary drainage, and duration of surgery, were found to increase the morbidity. These results of PD, though a small case series, are comparable to the international standard. Better outcomes can be achieved even in low- to medium-volume centers in developing countries where a dedicated team with special interest in pancreatic surgery is in place. Although there were no deaths after PD in our series, the morbidity was higher than that observed in other high-volume centers. To decrease the morbidity associated with PD, various factors must be streamlined, among them, the operative technique and the intensive perioperative management of the patient, as well as uniform definition of complications, use of a multidisciplinary approach, and identification of associated risk factors.

  2. Microwave tissue coagulation: effects of power and treatment time on coagulation size

    International Nuclear Information System (INIS)

    Kang, Seung Pyung; Kim, Young Hwan; Park, Dong Man; Kim, Jeong Seok; Park, Seo Young; Cha, Soon Joo; Hur, Gham

    1999-01-01

    To determine the effects of power and coagulation time on lesion size of ex-vivo bovine liver using microwaves. Six bovine livers were divided into two groups (first group : 30W output, second group : 60W output) and microwave coagulation was performed for 30, 60, and 120 sec. Thermal injury site was then observed by means of sonography, and the maximal transverse diameter of the echo-change portion after microwave coagulation was measured. On the section of specimen, maximal transverse diameters of the thermal injury site were measured by gross inspection and compared with the result of sonographic measurement. Maximal transverse diameters of hyperechoic lesions of the first group, as seen on sonography, were 8.3mm, 12.2mm, and 15.6mm, and the maximal transverse diameters of thermal injury sites on gross specimens were 9.1mm, 12.0mm, and 15.1mm, respectively. Maximal transverse diameters of hyperechoic lesions of the second group, as seen on sonography, were 12.1mm, 17.4mm, and 21.2mm and maximal transverse diameters of thermal injury sites on gross specimens were 13.2mm, 16.0mm, and 20.0mm, respectively. Statistically maximal transverse diameters of hyperechoic lesions, as seen on sonography, correlated closely with the gross findings of maximal transverse diameters of thermal injury sites (P < .05). Maximal transverse diameters of thermal injury sites were significantly increased as the output of the microwave coagulator and the duration of coagulation time increased (P < .05)

  3. Predicting the risk of perioperative transfusion for patients undergoing elective hepatectomy.

    Science.gov (United States)

    Sima, Camelia S; Jarnagin, William R; Fong, Yuman; Elkin, Elena; Fischer, Mary; Wuest, David; D'Angelica, Michael; DeMatteo, Ronald P; Blumgart, Leslie H; Gönen, Mithat

    2009-12-01

    To develop 2 instruments that predict the probability of perioperative red blood cell transfusion in patients undergoing elective liver resection for primary and secondary tumors. Hepatic resection is the most effective treatment for several benign and malign conditions, but may be accompanied by substantial blood loss and the need for perioperative transfusions. While blood conservation strategies such as autologous blood donation, acute normovolemic hemodilution, or cell saver systems are available, they are economically efficient only if directed toward patients with a high risk of transfusion. Using preoperative data from 1204 consecutive patients who underwent liver resection between 1995 and 2000 at Memorial Sloan- Kettering Cancer Center, we modeled the probability of perioperative red blood cell transfusion. We used the resulting model, validated on an independent dataset (n = 555 patients), to develop 2 prediction instruments, a nomogram and a transfusion score, which can be easily implemented into clinical practice. The planned number of liver segments resected, concomitant extrahepatic organ resection, a diagnosis of primary liver malignancy, as well as preoperative hemoglobin and platelets levels predicted the probability of perioperative red blood cell transfusion. The predictions of the model appeared accurate and with good discriminatory abilities, generating an area under the receiver operating characteristic curve of 0.71. Preoperative factors can be combined into risk profiles to predict the likelihood of transfusion during or after elective liver resection. These predictions, easy to calculate in the frame of a nomogram or of a transfusion score, can be used to identify patients who are at high risk for red cell transfusions and therefore most likely to benefit from blood conservation techniques.

  4. Emergent self-similarity of cluster coagulation

    Science.gov (United States)

    Pushkin, Dmtiri O.

    A wide variety of nonequilibrium processes, such as coagulation of colloidal particles, aggregation of bacteria into colonies, coalescence of rain drops, bond formation between polymerization sites, and formation of planetesimals, fall under the rubric of cluster coagulation. We predict emergence of self-similar behavior in such systems when they are 'forced' by an external source of the smallest particles. The corresponding self-similar coagulation spectra prove to be power laws. Starting from the classical Smoluchowski coagulation equation, we identify the conditions required for emergence of self-similarity and show that the power-law exponent value for a particular coagulation mechanism depends on the homogeneity index of the corresponding coagulation kernel only. Next, we consider the current wave of mergers of large American banks as an 'unorthodox' application of coagulation theory. We predict that the bank size distribution has propensity to become a power law, and verify our prediction in a statistical study of the available economical data. We conclude this chapter by discussing economically significant phenomenon of capital condensation and predicting emergence of power-law distributions in other economical and social data. Finally, we turn to apparent semblance between cluster coagulation and turbulence and conclude that it is not accidental: both of these processes are instances of nonlinear cascades. This class of processes also includes river network formation models, certain force-chain models in granular mechanics, fragmentation due to collisional cascades, percolation, and growing random networks. We characterize a particular cascade by three indicies and show that the resulting power-law spectrum exponent depends on the indicies values only. The ensuing algebraic formula is remarkable for its simplicity.

  5. Habits in perioperative nursing culture.

    Science.gov (United States)

    Lindwall, Lillemor; von Post, Iréne

    2008-09-01

    This study focuses on investigating habits in perioperative nursing culture, which are often simply accepted and not normally considered or discussed. A hermeneutical approach was chosen as the means of understanding perioperative nurses' experiences of and reflections on operating theatre culture. Focus group discussions were used to collect data, which was analysed using hermeneutical text analysis. The results revealed three main categories of habits present in perioperative nursing culture: habits that promote ethical values (by temporary friendship with patients, showing respect for each other, and spending time on reflection on ethics and caring); habits that hinder progress (by seeing the patient as a surgical case, not acknowledging colleagues, and not talking about ethics); and habits that set the cultural tone (the hidden power structure and achieving more in less time).

  6. Enhanced WWTP effluent organic matter removal in hybrid ozonation-coagulation (HOC) process catalyzed by Al-based coagulant

    Energy Technology Data Exchange (ETDEWEB)

    Jin, Xin [School of Environmental and Municipal Engineering, Xi’an University of Architecture and Technology, Xi’an, Shaanxi Province, 710055 (China); Jin, Pengkang, E-mail: pkjin@hotmail.com [School of Environmental and Municipal Engineering, Xi’an University of Architecture and Technology, Xi’an, Shaanxi Province, 710055 (China); Hou, Rui [School of Environmental and Municipal Engineering, Xi’an University of Architecture and Technology, Xi’an, Shaanxi Province, 710055 (China); Yang, Lei [Department of Materials Science and Engineering, Monash University, Clayton, VIC, 3800 (Australia); Wang, Xiaochang C., E-mail: xcwang@xauat.edu.cn [School of Environmental and Municipal Engineering, Xi’an University of Architecture and Technology, Xi’an, Shaanxi Province, 710055 (China)

    2017-04-05

    Highlights: • A novel HOC process was firstly put forward to apply in wastewater reclamation. • Interactions between ozone and Al-based coagulants was found in the HOC process. • Ozonation can be catalyzed and enhanced by Al-based coagulants in the HOC process. • HOC process showed better organics removal than pre-ozonation-coagulation process. - Abstract: A novel hybrid ozonation-coagulation (HOC) process was developed for application in wastewater reclamation. In this process, ozonation and coagulation occurred simultaneously within a single unit. Compared with the conventional pre-ozonation-coagulation process, the HOC process exhibited much better performance in removing dissolved organic matters. In particular, the maximal organic matters removal efficiency was obtained at the ozone dosage of 1 mgO{sub 3}/mg DOC at each pH value (pH 5, 7 and 9). In order to interpret the mechanism of the HOC process, ozone decomposition was monitored. The results indicated that ozone decomposed much faster in the HOC process. Moreover, by using the reagent of O{sub 3}-resistant hydroxyl radical (·OH) probe compound, para-chlorobenzoic acid (pCBA), and electron paramagnetic resonance (EPR) analysis, it was observed that the HOC process generated higher content of ·OH compared with pre-ozonation process. This indicates that the ·OH oxidation reaction as the key step can be catalyzed and enhanced by Al-based coagulants and their hydrolyzed products in this developed process. Thus, based on the catalytic effects of Al-based coagulants on ozonation, the HOC process provides a promising alternative to the conventional technology for wastewater reclamation in terms of higher efficiency.

  7. THE RATIONALIZATION OF THE PARAMETERS OF MILK PROTEINS’ THERMO ACID COAGULATION BY BERRY COAGULANTS

    Directory of Open Access Journals (Sweden)

    Olena GREK

    2017-03-01

    Full Text Available This paper presents the results related to the influence of berry coagulant amount, its proactive acidity and duration of thermo acid coagulation on the process of milk proteins’ sedimentation. In the present work, the regression equations and response surface analysis were used to design and optimize an industrial bioprocess. Increase in the berry coagulant amount to 11 % and reduction of active acidity to 2.4 units were determined. pH up to 3 minutes is characterized by the highest processes of destabilization. Moreover, it improves the organoleptic properties and has the biggest impact on the yield of protein-berry clot (to 25 % and active acidity.

  8. Magnetic particle imaging of blood coagulation

    Energy Technology Data Exchange (ETDEWEB)

    Murase, Kenya, E-mail: murase@sahs.med.osaka-u.ac.jp; Song, Ruixiao; Hiratsuka, Samu [Department of Medical Physics and Engineering, Division of Medical Technology and Science, Faculty of Health Science, Graduate School of Medicine, Osaka University, Osaka 565-0871 (Japan)

    2014-06-23

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

  9. Universal definition of perioperative bleeding in adult cardiac surgery

    NARCIS (Netherlands)

    Dyke, Cornelius; Aronson, Solomon; Dietrich, Wulf; Hofmann, Axel; Karkouti, Keyvan; Levi, Marcel; Murphy, Gavin J.; Sellke, Frank W.; Shore-Lesserson, Linda; von Heymann, Christian; Ranucci, Marco

    2014-01-01

    Perioperative bleeding is common among patients undergoing cardiac surgery; however, the definition of perioperative bleeding is variable and lacks standardization. We propose a universal definition for perioperative bleeding (UDPB) in adult cardiac surgery in an attempt to precisely describe and

  10. Rational and timely haemostatic interventions following cardiac surgery - coagulation factor concentrates or blood bank products.

    Science.gov (United States)

    Tang, Mariann; Fenger-Eriksen, Christian; Wierup, Per; Greisen, Jacob; Ingerslev, Jørgen; Hjortdal, Vibeke; Sørensen, Benny

    2017-06-01

    Cardiac surgery may cause a serious coagulopathy leading to increased risk of bleeding and transfusion demands. Blood bank products are commonly first line haemostatic intervention, but has been associated with hazardous side effect. Coagulation factor concentrates may be a more efficient, predictable, and potentially a safer treatment, although prospective clinical trials are needed to further explore these hypotheses. This study investigated the haemostatic potential of ex vivo supplementation of coagulation factor concentrates versus blood bank products on blood samples drawn from patients undergoing cardiac surgery. 30 adults were prospectively enrolled (mean age=63.9, females=27%). Ex vivo haemostatic interventions (monotherapy or combinations) were performed in whole blood taken immediately after surgery and two hours postoperatively. Fresh-frozen plasma, platelets, cryoprecipitate, fibrinogen concentrate, prothrombin complex concentrate (PCC), and recombinant FVIIa (rFVIIa) were investigated. The haemostatic effect was evaluated using whole blood thromboelastometry parameters, as well as by thrombin generation. Immediately after surgery the compromised maximum clot firmness was corrected by monotherapy with fibrinogen or platelets or combination therapy with fibrinogen. At two hours postoperatively the coagulation profile was further deranged as illustrated by a prolonged clotting time, a reduced maximum velocity and further diminished maximum clot firmness. The thrombin lagtime was progressively prolonged and both peak thrombin and endogenous thrombin potential were compromised. No monotherapy effectively corrected all haemostatic abnormalities. The most effective combinations were: fibrinogen+rFVIIa or fibrinogen+PCC. Blood bank products were not as effective in the correction of the coagulopathy. Coagulation factor concentrates appear to provide a more optimal haemostasis profile following cardiac surgery compared to blood bank products. Copyright © 2017

  11. Optimal glucose management in the perioperative period.

    Science.gov (United States)

    Evans, Charity H; Lee, Jane; Ruhlman, Melissa K

    2015-04-01

    Hyperglycemia is a common finding in surgical patients during the perioperative period. Factors contributing to poor glycemic control include counterregulatory hormones, hepatic insulin resistance, decreased insulin-stimulated glucose uptake, use of dextrose-containing intravenous fluids, and enteral and parenteral nutrition. Hyperglycemia in the perioperative period is associated with increased morbidity, decreased survival, and increased resource utilization. Optimal glucose management in the perioperative period contributes to reduced morbidity and mortality. To readily identify hyperglycemia, blood glucose monitoring should be instituted for all hospitalized patients. Published by Elsevier Inc.

  12. Hemorrhoidectomy: pedicle ligation vs pedicle coagulation

    International Nuclear Information System (INIS)

    Shaikh, B.S.; Balaoch, I.B.; Sohu, K.M.

    2015-01-01

    Objective: To compare the outcome of pedicle ligation vs pedicle coagulation haemorrhoidectomy. Methodology: This comparative prospective study was carried out at Department of Surgery, Ghulam Muhammad Maher Medcial College Hospital, Sukkur, Pakistan from January 2011 to January 2013 and included 300 patients of hemorrhoids. After routine workup, patients were randomly divided into two equal groups with one group receiving pedicle ligation and other pedicle coagulation for hemorrhoidectomy. Postoperatively they were followed for a period of 8 weeks for complications including pain, urinary retention, bleeding and anal stricture. Pain was recorded up to 10th postoperative day on the basis of visual analogue scale. Results: Mean age was 45 years and male to female ratio was 1.7:1. Mean operative time in pedicle ligation group was 15 min (range 14-20 min) and 17 min (15-25 min) in pedicle coagulation group. In Pedicle ligation group, pain was worst in 35 patients, moderate in 85 and mild in 30 patients; on the other hand in pedicle coagulation group, just 09 patients experienced worst pain. Urinary retention was observed in 44 patients in pedicle ligation group and 19 in pedicle coagulation group. Five patients in pedicle ligation group developed bleeding after their discharge from hospital; 7 patients in pedicle coagulation group reported secondary bleeding. Anal stricture was a rare complication and was found equally common in both the groups. Conclusion: Conventional hemorrhoidectomy with pedicle coagulation is an effective treatment modality for hemorrhoids and is associated with less chance of postoperative anal pain and urinary retention. (author)

  13. Perioperative Management of Patients with Rheumatic Diseases

    Science.gov (United States)

    Bissar, Lina; Almoallim, Hani; Albazli, Khaled; Alotaibi, Manal; Alwafi, Samar

    2013-01-01

    This paper aims to explore the assessment of patients with rheumatologic diseases, especially rheumatoid arthritis (RA), before undergoing orthopedic surgery. Perioperative assessment ensures an early diagnosis of the patient's medical condition, overall health, medical co-morbidities, and the assessment of the risk factors associated with the proposed procedures. Perioperative assessment allows for proper postoperative management of complications and of the management of drugs such as disease-modifying anti-rheumatic drugs (DMARD) and anti-platelets, and corticosteroids. The assessment also supports follow up plans, and patient education. Perioperative assessment enables the discussion of the proposed treatment plans and the factors associated with them in each case among the different specialists involved to facilitate an appropriate early decision-making about the assessment and treatment of patients with rheumatologic diseases. It also enables the discussion of both condition and procedure with the patient to ensure a good postoperative care. The article identifies the components of perioperative medical evaluation, discusses perioperative management of co-morbidities and the management of specific clinical problems related to RA, systemic lupus erythematosus, the management of DMARDs, like methotrexate (MTX) and biologic therapies, prophylactic antibiotics, and postoperative follow up, including patient education and rehabilitation PMID:24062860

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

    African Journals Online (AJOL)

    hope&shola

    2006-02-02

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

  15. Contact activation of blood-plasma coagulation

    Science.gov (United States)

    Golas, Avantika

    Surface engineering of biomaterials with improved hemocompatibility is an imperative, given the widespread global need for cardiovascular devices. Research summarized in this dissertation focuses on contact activation of FXII in buffer and blood plasma frequently referred to as autoactivation. The extant theory of contact activation imparts FXII autoactivation ability to negatively charged, hydrophilic surfaces. According to this theory, contact activation of plasma involves assembly of proteins comprising an "activation complex" on activating surfaces mediated by specific chemical interactions between complex proteins and the surface. This work has made key discoveries that significantly improve our core understanding of contact activation and unravel the existing paradigm of plasma coagulation. It is shown herein that contact activation of blood factor XII (FXII, Hageman factor) in neat-buffer solution exhibits a parabolic profile when scaled as a function of silanized-glass-particle activator surface energy (measured as advancing water adhesion tension t°a=g° Iv costheta in dyne/cm, where g°Iv is water interfacial tension in dyne/cm and theta is the advancing contact angle). Nearly equal activation is observed at the extremes of activator water-wetting properties --36 moderated by adsorption of plasma proteins unrelated to coagulation through an "adsorption-dilution" effect that blocks FXII contact with hydrophobic activator surfaces. The adsorption-dilution effect explains the apparent specificity for hydrophilic activators pursued by earlier investigators. Finally a comparison of FXII autoactivation in buffer, serum, protein cocktail, and plasma solutions is shown herein. Activation of blood plasma coagulation in vitro by contact with material surfaces is demonstrably dependent on plasma-volume-to-activator-surface-area ratio. However, activation of factor XII dissolved in buffer, protein cocktail, heat-denatured serum, and FXI deficient plasma does not

  16. Perioperative corticosteroids for intermittent and mild persistent asthma

    Directory of Open Access Journals (Sweden)

    Hiroto Matsuse

    2002-01-01

    Conclusions: Our results suggest that perioperative corticosteroids are effective in preventing perioperative bronchospasm in stable asthmatics during surgery under general anesthesia by suppressing airway hyperresponsiveness.

  17. Statins and perioperative myocardial infarction. | Levin | Southern ...

    African Journals Online (AJOL)

    The growing prevalence of atherosclerosis means that perioperative myocardial infarction (PMI) is of significant concern to anesthesiologists. Perioperative revascularization (if indicated medically), beta blockade (in high risk patients) and statin therapy are therapeutic modalities that are currently employed to reduce PMI.

  18. Perioperative death: Its implications and management

    Directory of Open Access Journals (Sweden)

    J P Attri

    2016-01-01

    Full Text Available Death to most people is a major life event. Nothing in this world prepares us to face and manage the perioperative death although the majority of anesthesiologists will be involved in an intraoperative death during the course of their careers. Whether death on the table was expected or occurred when least expected or may be even later, the anesthesiologist is most likely to be affected emotionally, physically in his personal life, and as well as will have an influence on his professional career. Anesthesiologists as perioperative physicians are likely to experience death on the operating table at some time in their careers. In case of perioperative death, meticulous record keeping including time of occurrence of event and methods and medications used during resuscitation, nature of the problem, and all sequence of events should be adopted to breaking bad news with relatives and blame game should be avoided. The anesthesiologist and the relatives of the patient should also be given emotional support to come out of this untoward event. In this article, we have highlighted the various factors and causes leading on to perioperative death and if in case such an event occurs, what are the protocols to be followed, including medicolegal aspects, giving emotional support to the concerned anesthesiologist, dealing with the relatives of the patient sympathetically, etc. We have also enumerated the various precautions to be taken to prevent perioperative mortality in this article.

  19. Coagulant recovery and reuse for drinking water treatment.

    Science.gov (United States)

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

    2016-01-01

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

  20. Perioperative nursing in public university hospitals

    DEFF Research Database (Denmark)

    Sørensen, Erik Elgaard; Olsen, Ida Østrup; Tewes, Marianne

    2014-01-01

    BACKGROUND: In recent years, perioperative nursing has received ongoing attention as part of an interprofessional collaboration. Perioperative nursing is constantly faced with new challenges and opportunities that necessitate continual updates of nursing knowledge and technical skills. In light...... of the longstanding relationship between nursing and technology, it is interesting that few studies with this focus have been performed. Therefore, our research question was: What is the content of perioperative nursing and how do nurses facilitate the interaction between nursing care and technology in highly...... specialized operating rooms in public university hospitals? METHODS: An ethnography involving participant observations and interviews was conducted during a 9-month study period. The participants comprised 24 nurses from 9 different operating wards at 2 university hospitals in different regions of Denmark...

  1. Management of severe perioperative bleeding

    DEFF Research Database (Denmark)

    Kozek-Langenecker, Sibylle A; Ahmed, Aamer B; Afshari, Arash

    2017-01-01

    : The management of perioperative bleeding involves multiple assessments and strategies to ensure appropriate patient care. Initially, it is important to identify those patients with an increased risk of perioperative bleeding. Next, strategies should be employed to correct preoperative anaemia...... and to stabilise macrocirculation and microcirculation to optimise the patient's tolerance to bleeding. Finally, targeted interventions should be used to reduce intraoperative and postoperative bleeding, and so prevent subsequent morbidity and mortality. The objective of these updated guidelines is to provide...

  2. Magnetic Resonance Mediated Radio Frequency Coagulation for Vascular Repair

    Science.gov (United States)

    Zhao, Ming

    Purpose. Magnetic Resonance Mediated Radiofrequency Coagulation employs the RF heating effect of MRI scanning to coagulate biomaterials for repair of vascular defects. Coagulation of a protein biomaterial by MR-induced RF heating is a novel means to effect repair of defects such as aneurysms or arteriovenous malformations. Our novel method is to coagulate a thermosetting material (such as egg white, which can be used for investigating heat coagulation behavior and MR relaxation properties) delivered endovascularly by catheter and coagulated by RF-induced heating of an intracatheter resonant wire antenna in the scanner. Methods. Experiments were performed on a Siemens 1.5 T MRI scanner and a Bruker 14T NMR spectrometer. Egg white was brought to equilibrium at seven temperatures (20, 30, 40, 50, 60, 70 and 37 °C) in sequence. Measurement of the water spin-lattice relaxation time Ti, spin-spin relaxation time T2, spin-lattice relaxation time in the rotating frame T1p, or full width at half maximum of the MT spectrum were performed at each temperature. Relaxation parameters of raw egg white and egg white after coagulation at 70 °C were measured in the scanner at 20 °C to determine optimum inversion time, echo time and offset frequency for good image contrast between coagulated and uncoagulated protein. Finally, coagulation of egg white within a glass aneurysm phantom by RF heating in the scanner was performed to demonstrate the MR coagulation methodology and the ability to achieve image contrast between coagulated and uncoagulated biomaterial. Results. Water T2, T1p and MT gave the most definitive indication of the change from uncoagulated at low temperature to fully coagulated at 60 °C, while water T1 showed only the expected gradual increase with temperature, and no response to coagulation. MT weighted imaging is expected to be the optimum method to establish the coagulation condition of the biomaterial.

  3. Perioperative beta blockers in patients having non-cardiac surgery

    DEFF Research Database (Denmark)

    Bangalore, Sripal; Wetterslev, Jørn; Pranesh, Shruthi

    2008-01-01

    American College of Cardiology and American Heart Association (ACC/AHA) guidelines on perioperative assessment recommend perioperative beta blockers for non-cardiac surgery, although results of some clinical trials seem not to support this recommendation. We aimed to critically review the evidence...... to assess the use of perioperative beta blockers in patients having non-cardiac surgery....

  4. Coagulation and Mental Disorders

    Directory of Open Access Journals (Sweden)

    Silvia Hoirisch-Clapauch

    2014-10-01

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

  5. COAGULATION PROFILE IN DIABETES MELLITUS AND ITS ASSOCIATION WITH MICROVASCULAR COMPLICATIONS

    Directory of Open Access Journals (Sweden)

    Uma Shankar Mishra

    2017-12-01

    Full Text Available BACKGROUND This study intends to assess the changes in the simple routine coagulation parameters in diabetes mellitus and to investigate whether any relationship exists among changes in these coagulation parameters and development of microvascular complication in diabetes mellitus. MATERIALS AND METHODS Period of study was from 2010-2012. It was done in M.K.C.G. Medical College with the approval from Berhampur University. It is a case control study. 50 diabetic patients and 50 age and sex matched non-diabetic patients were randomly selected. Simple coagulation parameters like Activated Partial Thromboplastin Time (aPTT, Prothrombin Time (PT, serum fibrinogen, platelet count and Plasminogen Activator Inhibitor-1 (PAI-1 were measured. Statistical study was done using unpaired t-test and analysis and calculations were done using GraphPad software. RESULTS Serum fibrinogen was found to be increased in diabetic patients when compared to non-diabetic patients (mean 278 ± 26.9 v/s 232.52 ± 16.5, P value - 0.009, significant. PAI-1 levels was found to be higher among the diabetics when compared to nondiabetics (47.64 ± 8.82 v/s 31.06 ± 7.12, the two-tailed P value is <0.0001, considered extremely significant. Platelet count through within normal limits. It was found to be decreased in diabetic patient when compared to non-diabetic (2.25 ± 0.18 v/s 2.33 ± 0.03, P value - 0.022. Prothrombin Time (PT (13.15 ± 0.52 v/s 13.04 ± 0.49, P value - 0.28 and PTT (33.04 ± 1.31 v/s 32.99 ± 1.29, P value 0.85, found to be statistically insignificant. Among 50 diabetic patients, 24 had neuropathy, 20 had nephropathy, 10 had retinopathy and 21 had none of these complications. On comparing diabetic patients with microvascular complications and without microvascular complications, significant age difference was observed (59.55 ± 5.06 v/s 51.00 ± 3.31, P=0.003. This probably was a reflection of increase in microvascular complications with increasing duration

  6. Removal of silver nanoparticles by coagulation processes

    International Nuclear Information System (INIS)

    Sun, Qian; Li, Yan; Tang, Ting; Yuan, Zhihua; Yu, Chang-Ping

    2013-01-01

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

  7. Perioperative nutritional support.

    Science.gov (United States)

    Morán López, Jesús Manuel; Piedra León, María; García Unzueta, María Teresa; Ortiz Espejo, María; Hernández González, Miriam; Morán López, Ruth; Amado Señaris, José Antonio

    2014-01-01

    The relationship between preoperative malnutrition and morbi-mortality has been documented for years. Despite the existence of tools that allow its detection, and therefore treat this entity, their introduction into clinical practice is not wide-spread. Both perioperative insulin resistance and hyperglycemia are associated with increased perioperative morbidity and length of hospital stay. The intake of carbohydrate-rich drinks 2-4h prior to surgery reduces insulin resistance. In the immediate postoperative period, the enteral route is safe and well tolerated and its early use reduces hospital stay and postoperative complications compared with parenteral nutritional support. Inmunonutrition has been proven effective to decrease postoperative complications and hospital stay. In view of these data we opted for the adoption of these measures replacing bowel rest and the indiscriminate use of postoperative parenteral nutrition. Copyright © 2013 AEC. Published by Elsevier Espana. All rights reserved.

  8. Perceptions of perioperative nursing competence: a cross-country comparison.

    Science.gov (United States)

    Gillespie, Brigid M; Harbeck, Emma B; Falk-Brynhildsen, Karin; Nilsson, Ulrica; Jaensson, Maria

    2018-01-01

    Throughout many countries, professional bodies rely on yearly self-assessment of competence for ongoing registration; therefore, nursing competence is pivotal to safe clinical practice. Our aim was to describe and compare perioperative nurses' perceptions of competence in four countries, while examining the effect of specialist education and years of experience in the operating room. We conducted a secondary analysis of cross-sectional surveys from four countries including; Australia, Canada, Scotland, and Sweden. The 40-item Perceived Perioperative Competence Scale-Revised (PPCS-R), was used with a total sample of 768 respondents. We used a factorial design to examine the influence of country, years of experience in the operating room and specialist education on nurses' reported perceived perioperative competence. Regardless of country origin, nurses with specialist qualifications reported higher perceived perioperative competence when compared to nurses without specialist education. However, cross-country differences were dependent on nurses' number of years of experience in the operating room. Nurses from Sweden with 6-10 years of experience in the operating room reported lower perceived perioperative competence when compared to Australian nurses. In comparing nurses with > 10 years of experience, Swedish nurses reported significantly lower perceived perioperative competence when compared to nurses from Australia, Canada and Scotland. Researchers need to consider educational level and years of experience in the perioperative context when examining constructs such as competence.

  9. Coagulation Profile Changes Due to Thromboprophylaxis and Platelets in Trauma Patients at High-Risk for Venous Thromboembolism.

    Science.gov (United States)

    Allen, Casey J; Murray, Clark R; Meizoso, Jonathan P; Ray, Juliet J; Teisch, Laura F; Ruiz, Xiomara D; Hanna, Mena M; Guarch, Gerardo A; Manning, Ronald J; Livingstone, Alan S; Ginzburg, Enrique; Schulman, Carl I; Namias, Nicholas; Proctor, Kenneth G

    2015-07-01

    We hypothesize there are coagulation profile changes associated both with initiation of thromboporphylaxis (TPX) and with change in platelet levels in trauma patients at high-risk for venous thromboembolism (VTE). A total of 1203 trauma intensive care unit patients were screened with a VTE risk assessment profile. In all, 302 high-risk patients (risk assessment profile score ≥ 10) were consented for weekly thromboelastography. TPX was initiated between initial and follow-up thromboelastography. Seventy-four patients were analyzed. Upon admission, 87 per cent were hypercoagulable, and 81 per cent remained hypercoagulable by Day 7 (P = 0.504). TPX was initiated 3.4 ± 1.4 days after admission; 68 per cent received unfractionated heparin and 32 per cent received low-molecular-weight heparin. The VTE rate was 18 per cent, length of stay 38 (25-37) days, and mortality of 17.6 per cent. In all, 76 per cent had a rapid clotting time at admission versus 39 per cent at Day 7 (P < 0.001); correcting from 7.75 (6.45-8.90) minutes to 10.45 (7.90-15.25) minutes (P < 0.001). At admission, 41 per cent had an elevated maximum clot formation (MCF) and 85 per cent had at Day 7 (P < 0.001); increasing from 61(55-65) mm to 75(69-80) mm (P < 0.001). Platelets positively correlated with MCF at admission (r = 0.308, R(2) = 0.095, P = 0.008) and at Day 7 (r = 0.516, R(2) = 0.266, P < 0.001). Change in platelet levels correlated with change in MCF (r = 0.332, R(2) = 0.110, P = 0.005). In conclusion, hypercoagulability persists despite the use of TPX. Although clotting time normalizes, MCF increases in correlation with platelet levels. As platelet function is a dominant contributor to sustained trauma-evoked hypercoagulability, antiplatelet therapy may be indicated in the management of severely injured trauma patients.

  10. Imaging of blood plasma coagulation at supported lipid membranes.

    Science.gov (United States)

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

    2011-12-15

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

  11. Prospective observational study for perioperative volume replacement with 6% HES 130/0,42, 4% gelatin and 6% HES 200/0,5 in cardiac surgery

    Directory of Open Access Journals (Sweden)

    Winterhalter M

    2010-09-01

    Full Text Available Abstract Background The constantly growing amount of different kinds of colloid fluids necessitates comparative investigations with regards to the safety and effectivity in clinical use of these preparations. Hence we compared three colloid fluids in an observational study. The objective was the exploration of the influence of these three colloids on blood coagulation, hemodynamics and renal function of the cardiac surgical patient. Methods We included 90 patients undergoing an elective open-heart surgery with the use of the heart-lung machine and observed them consecutively. Group 1 [gelatin 4% (n = 30], Group 2 [HES 200/0,5 (n = 30] and Group 3 [HES 130/0,42 (n = 30]. We measured the perioperative volume replacement, the administration of blood- and coagulation-products, the application of catecholamines, the renal function, blood gas and the platelet aggregation using multiplate electrode analyzer (Multiplate®, Dynabyte medical, Munich, Germany. Results The gelatin-group needed significantly more norepinephrine than the HES 130/0.42 group. The responsible surgeon considered the blood coagulation in the HES 200/0.5 group most frequently as impaired. Furthermore we saw a significant decrease in platelet function in the HES 200/0.5 group when performing the multiplate®-analysis (ADP-and COL-test. HES 130/0.4 as well as gelatin 4% showed no significant change in platelet function. The gelatin-group and the HES 200/0.5 needed significantly more aprotinine than the HES 130/0.4 group. We saw no significant difference with regards to administration of blood and coagulation products between the three groups. The urinary excretion during the intervention was significantly higher in the HES 200/0.5 group and in the gelatin group than in the HES 130/0.4 group. Conclusions Our results confirm the lower stabilizing effect of gelatin on circulation during fluid resuscitation. The blood coagulation was mostly impaired due to HES 200/0.5 confirmed by the

  12. Effect of nano-scale curvature on the intrinsic blood coagulation system

    Science.gov (United States)

    Kushida, Takashi; Saha, Krishnendu; Subramani, Chandramouleeswaran; Nandwana, Vikas; Rotello, Vincent M.

    2014-11-01

    The intrinsic coagulation activity of silica nanoparticles strongly depends on their surface curvature. Nanoparticles with higher surface curvature do not denature blood coagulation factor XII on its surface, providing a coagulation `silent' surface, while nanoparticles with lower surface curvature show denaturation and concomitant coagulation.The intrinsic coagulation activity of silica nanoparticles strongly depends on their surface curvature. Nanoparticles with higher surface curvature do not denature blood coagulation factor XII on its surface, providing a coagulation `silent' surface, while nanoparticles with lower surface curvature show denaturation and concomitant coagulation. Electronic supplementary information (ESI) available: Physical properties and scanning electron micrographs (SEM) of silica NPs, intrinsic coagulation activity after 3 h. See DOI: 10.1039/c4nr04128c

  13. Evolution and revision of the Perioperative Nursing Data Set.

    Science.gov (United States)

    Petersen, Carol; Kleiner, Cathy

    2011-01-01

    The Perioperative Nursing Data Set (PNDS) is a nursing language that provides standardized terminology to support perioperative nursing practice. The PNDS represents perioperative nursing knowledge and comprises data elements and definitions that demonstrate the nurse's influence on patient outcomes. Emerging issues and changes in practice associated with the PNDS standardized terminology require ongoing maintenance and periodic in-depth review of its content. Like each new edition of the Perioperative Nursing Data Set, the third edition, published in 2010, underwent content validation by numerous experts in clinical practice, vocabulary development, and informatics. The goal of this most recent edition is to enable the perioperative nurse to use the PNDS in a meaningful manner, as well as to promote standardization of PNDS implementation in practice, both in written documentation and the electronic health record. Copyright © 2011 AORN, Inc. Published by Elsevier Inc. All rights reserved.

  14. Real-time assessment of perioperative behaviors in children and parents: development and validation of the perioperative adult child behavioral interaction scale.

    Science.gov (United States)

    Sadhasivam, Senthilkumar; Cohen, Lindsey L; Hosu, Liana; Gorman, Kristin L; Wang, Yu; Nick, Todd G; Jou, Jing Fang; Samol, Nancy; Szabova, Alexandra; Hagerman, Nancy; Hein, Elizabeth; Boat, Anne; Varughese, Anna; Kurth, Charles Dean; Willging, J Paul; Gunter, Joel B

    2010-04-01

    Behavior in response to distressful events during outpatient pediatric surgery can contribute to postoperative maladaptive behaviors, such as temper tantrums, nightmares, bed-wetting, and attention seeking. Currently available perioperative behavioral assessment tools have limited utility in guiding interventions to ameliorate maladaptive behaviors because they cannot be used in real time, are only intended to be used during 1 phase of the experience (e.g., perioperative), or provide only a static assessment of the child (e.g., level of anxiety). A simple, reliable, real-time tool is needed to appropriately identify children and parents whose behaviors in response to distressful events at any point in the perioperative continuum could benefit from timely behavioral intervention. Our specific aims were to (1) refine the Perioperative Adult Child Behavioral Interaction Scale (PACBIS) to improve its reliability in identifying perioperative behaviors and (2) validate the refined PACBIS against several established instruments. The PACBIS was used to assess the perioperative behaviors of 89 children aged 3 to 12 years presenting for adenotonsillectomy and their parents. Assessments using the PACBIS were made during perioperative events likely to prove distressing to children and/or parents (perioperative measurement of blood pressure, induction of anesthesia, and removal of the IV catheter before discharge). Static measurements of perioperative anxiety and behavioral compliance during anesthetic induction were made using the modified Yale Preoperative Anxiety Scale and the Induction Compliance Checklist (ICC). Each event was videotaped for later scoring using the Child-Adult Medical Procedure Interaction Scale-Short Form (CAMPIS-SF) and Observational Scale of Behavioral Distress (OSBD). Interrater reliability using linear weighted kappa (kappa(w)) and multiple validations using Spearman correlation coefficients were analyzed. The PACBIS demonstrated good to excellent

  15. Introducing a music program in the perioperative area.

    Science.gov (United States)

    Cunningham, M F; Monson, B; Bookbinder, M

    1997-10-01

    Music can touch patients deeply and thus transform their anxiety and stress into relaxation and healing. Patients with cancer who undergo surgical procedures are highly stressed. To help alleviate these patients' stress and improve their comfort, perioperative nurses at Memorial Sloan-Kettering Cancer Center (MSKCC), New York, surveyed surgical patients and staff members about introducing a perioperative music program. This article reviews the literature on the use of music in perioperative care settings and describes MSKCC's decision to evaluate and then implement a music program.

  16. Perioperative Evaluation of Pregnant Surgical Patients: A Review

    Directory of Open Access Journals (Sweden)

    Manu Gupta

    2016-06-01

    Full Text Available Pregnant Females require special perioperative consideration as females react differently to treatment from physiologic and behavioural standpoints. Thus a standard perioperative assessment plays a crucial role for successful accomplishment of intraoperative and postoperative phase as well as to resist complications due to pregnancy. Each physiologic system is affected in such a way that may or may not have clinical significance for the surgeons. Thus affect of Pregnancy on cardiovascular, respiratory, gastrointestinal, renal and endocrinal system have been reviewed. Moreover to decrease the hazards to the developing child, impact of surgery/treatment on the fetus has also been discussed. It was concluded that the goal of the perioperative evaluation of pregnant females is to identify its physiological effects on various systems and provide for the best efficacious perioperative treatment algorithm that shall minimize the patient morbidity.

  17. Understanding Value as a Key Concept in Sustaining the Perioperative Nursing Workforce.

    Science.gov (United States)

    Kapaale, Chaluza C

    2018-03-01

    Perioperative nursing is faced with a staffing crisis attributed in part to minimal numbers of newly graduated nurses choosing a career in this specialty. This article analyzes and applies the concept of value to explore how to maintain an adequate perioperative nursing workforce; recruit newly graduated nurses; and encourage career professional, nurse educator, and student collaboration to generate meaningful value for perioperative nursing. This analysis revealed that value co-creation for perioperative nursing could lead to newly graduated nurses increasingly choosing perioperative nursing as a career, and enjoying satisfying perioperative nursing careers while providing high-quality patient care. © AORN, Inc, 2018.

  18. Comparison of Moringa stenopetala seed extract as a clean coagulant with Alum and Moringa stenopetala-Alum hybrid coagulant to remove direct dye from Textile Wastewater.

    Science.gov (United States)

    Dalvand, Arash; Gholibegloo, Elham; Ganjali, Mohammad Reza; Golchinpoor, Najmeh; Khazaei, Mohammad; Kamani, Hossein; Hosseini, Sara Sadat; Mahvi, Amir Hossein

    2016-08-01

    In this study, the efficiency of Moringa stenopetala seed extract was compared with alum and M. stenopetala-alum hybrid coagulant to remove Direct Red 23 azo dye from textile wastewater. The effects of parameters such as pH, coagulant dose, type of salt used for the extraction of coagulant and initial dye concentration on dye removal efficiency were investigated. Moreover, the existing functional groups on the structure of M. stenopetala coagulant (MSC) were determined by Fourier transform infrared spectroscopy, and the morphology of sludge produced by MSC, alum, and hybrid coagulant was characterized by scanning electron microscopy. Ninhydrin test was also used to determine the quantity of primary amines in the MSC and Moringa oleifera coagulant (MOC). According to the results, with increasing the coagulant dose and decreasing the initial dye concentration, dye removal efficiency has increased. The maximum dye removal of 98.5, 98.2, and 98.3 % were obtained by using 240, 120, and 80 mg/L MSC, alum and hybrid coagulant at pH 7, respectively. The results also showed MSC was much more effective than MOC for dye removal. The volume of sludge produced by MSC was one fourth and half of those produced by alum and hybrid coagulant, respectively. Based on the results, hybrid coagulant was the most efficient coagulant for direct dye removal from colored wastewater.

  19. A systematic review of peri-operative melatonin

    DEFF Research Database (Denmark)

    Andersen, L P H; Werner, M U; Rosenberg, J

    2014-01-01

    We systematically reviewed randomised controlled trials of peri-operative melatonin. We included 24 studies of 1794 participants that reported eight peri-operative outcomes: anxiety; analgesia; sleep quality; oxidative stress; emergence behaviour; anaesthetic requirements; steal induction......%, respectively. Qualitative reviews suggested the melatonin improved sleep quality and emergence behaviour, and might be capable of reducing oxidative stress and anaesthetic requirements....

  20. Polyferric sulphate: preparation, characterisation and application in coagulation experiments.

    Science.gov (United States)

    Zouboulis, A I; Moussas, P A; Vasilakou, F

    2008-07-15

    The process of coagulation is a core environmental protection technology, which is mainly used in the water or wastewater treatment facilities. Research is now focused on the development of inorganic pre-polymerised coagulants. A characteristic example is PFS (polyferric sulphate), a relatively new pre-polymerised inorganic coagulant with high cationic charge. In this paper, the role of major parameters, including temperature, types of chemical reagents, ratio r=[OH]/[Fe], rate of base addition in the preparation stages of PFS were investigated. Furthermore, the prepared PFS was characterised based on typical properties, such as the percentage of the polymerised iron present in the compound, z-potential, pH, etc. Moreover, dynamics of coagulation process were examined by means of the Photometric Dispersion Analyzer (PDA). Finally, the coagulation efficiency of PFS in treating kaolin suspension and biologically pre-treated wastewater was evaluated in comparison with the respective conventional coagulant agent. The results indicate that certain parameters, such as the r value, the rate of base addition and the duration and temperature of the polymerisation stage, significantly affected the properties of the PFS. Additionally, the prepared PFS polymerised coagulants exhibit a significantly better coagulation performance than the respective non-polymerised one, i.e. ferric sulphate.

  1. Does Lipid Profile Affect Thrombin Generation During Ramadan Fasting in Patients With Cardiovascular Risks?

    Science.gov (United States)

    Sassi, Mouna; Chakroun, Taher; Chouchène, Saoussen; Hellara, Ilhem; Boubaker, Hamdi; Grissa, Mohamed Habib; Khochtali, Ines; Hassine, Mohsen; Addad, Faouzi; Elalamy, Ismail; Nouira, Semir

    2017-11-01

    There is evidence that diet and variation in lipid metabolism can influence blood coagulation, but little is known about the effect of Ramadan fasting on plasmatic coagulation pattern. We investigated the effect of Ramadan fasting on thrombin generation (TG) in patients with cardiovascular disease (CVD) risks, and we aimed to assess the effect of lipid profile on TG parameters. The study was conducted in 36 adults having at least 2 CVD risks and in 30 healthy controls. Coagulation pattern was assessed by both classical clotting times and TG test. A complete lipid profile was performed simultaneously. Patients were invited 2 times: 1 week before Ramadan and during the last week of the Ramadan. The TG parameters were not different in patients with CVD risks compared to healthy controls. Fasting had no effect on plasmatic coagulation parameters and on TG profile. Individual analysis of the mean rate index (MRI) of TG revealed 3 groups: group 1 with no modification of MRI, group 2 with a significant increase in MRI (81.64 nM/min vs 136.07 nM/min; P fasting did not influence the global coagulation pattern in patients with CVD risks. Whereas, a significant increase in the propagation phase of TG was associated with a significant increase in cholesterol levels, which was not found with the other TG parameters.

  2. [Aspects of perioperative care in patients with diabetes].

    Science.gov (United States)

    Pestel, G; Closhen, D; Zimmermann, A; Werner, C; Weber, M M

    2013-01-01

    Diabetes is a common disease in Germany. Due to diabetes-associated end-organ disease, such as large and small vessel disease and neuropathy, diabetic patients require more intense anesthesia care during the perioperative phase. An in-depth and comprehensive medical history focusing on hemodynamic alterations, gastroparesis, neuropathy and stiff joint syndrome is a cornerstone of perioperative care and may affect outcome of diabetes patients more than specific anesthetic medications or the anesthetic procedure. Intraoperative anesthetic care needs to focus on preservation of hemodynamic stability, perioperative infection control and maintenance of glucose homeostasis. Whereas some years ago strict glucose control by aggressive insulin therapy was adamantly advocated, the results of recent studies have put the risk of such therapeutic algorithms into perspective. Therefore, optimized perioperative care of diabetic patients consists of setting a predefined targeted blood glucose level, evidence-based therapeutic approaches to reach that goal and finally adequate and continuous monitoring and amendment of the therapeutic approach if required.

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

    African Journals Online (AJOL)

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

  4. [Perioperative management of long-term medication].

    Science.gov (United States)

    Vogel Kahmann, I; Ruppen, W; Lurati Buse, G; Tsakiris, D A; Bruggisser, M

    2011-01-01

    Anesthesiologists and surgeons are increasingly faced with patients who are under long-term medication. Some of these drugs can interact with anaesthetics or anaesthesia and/or surgical interventions. As a result, patients may experience complications such as bleeding, ischemia, infection or severe circulatory reactions. On the other hand, perioperative discontinuation of medication is often more dangerous. The proportion of outpatient operations has increased dramatically in recent years and will probably continue to increase. Since the implementation of DRGs (pending in Switzerland, introduced in Germany for some time), the patient enters the hospital the day before operation. This means that the referring physician as well as anesthesiologists and surgeons at an early stage must deal with issues of perioperative pharmacotherapy. This review article is about the management of the major drug classes during the perioperative period. In addition to cardiac and centrally acting drugs and drugs that act on hemostasis and the endocrine system, special cases such as immunosuppressants and herbal remedies are mentioned.

  5. Ethics in perioperative practice--patient advocacy.

    Science.gov (United States)

    Schroeter, Kathryn

    2002-05-01

    Though often difficult, ethical decision making is necessary when caring for surgical patients. Perioperative nurses have to recognize ethical dilemmas and be prepared to take action based on the ethical code outlined in the American Nurses Association's (ANA's) Code of Ethics for Nurses with Interpretive Statements. In this second of a nine-part series that will help perioperative nurses relate the ANA code to their own area of practice, the author looks at the third provision statement, which addresses nurses' position as patient advocates.

  6. Coagulation and Adsorption Treatment of Printing Ink Wastewater

    OpenAIRE

    Klančnik, Maja

    2014-01-01

    The intention of the study was to improve the efficiency of total organic carbon (TOC) and colour removal from the wastewater samples polluted with flexographic printing ink following coagulation treatments with further adsorption onto activated carbons and ground orange peel. The treatment efficiencies were compared to those of further flocculation treatments and of coagulation and adsorption processes individually. Coagulation was a relatively effective single-treatment method, removing 99...

  7. [Hereditary heterozygous factor VII deficiency in patients undergoing surgery : Clinical relevance].

    Science.gov (United States)

    Woehrle, D; Martinez, M; Bolliger, D

    2016-10-01

    A hereditary deficiency in coagulation factor VII (FVII) may affect the international normalized ratio (INR) value. However, FVII deficiency is occasionally associated with a tendency to bleed spontaneously. We hypothesized that perioperative substitution with coagulation factor concentrates might not be indicated in most patients. In this retrospective data analysis, we included all patients with hereditary heterozygous FVII deficiency who underwent surgical procedures at the University Hospital Basel between December 2010 and November 2015. In addition, by searching the literature, we identified publications reporting patients with FVII deficiency undergoing surgical procedures without perioperative substitution. We identified 22 patients undergoing 46 surgical procedures, resulting in a prevalence of 1:1500-2000. Coagulation factor concentrates were administered during the perioperative period in 15 procedures (33 %), whereas in the other 31 procedures (66 %), FVII deficiency was not substituted. No postoperative bleeding or thromboembolic events were reported. In addition, we found no differences in pre- and postoperative hemoglobin and coagulation parameters, with the exception of an improved postoperative INR value in the substituted group. In the literature review, we identified five publications, including 125 patients with FVII deficiency, undergoing 213 surgical procedures with no perioperative substitution. Preoperative substitution using coagulation factor concentrates does not seem to be mandatory in patients with an FVII level ≥15 %. For decision-making on preoperative substitution, patient history of an increased tendency to bleed may be more important than the FVII level or increased INR value.

  8. Perioperative management of children with obstructive sleep apnea.

    Science.gov (United States)

    Schwengel, Deborah A; Sterni, Laura M; Tunkel, David E; Heitmiller, Eugenie S

    2009-07-01

    Obstructive sleep apnea syndrome (OSA) affects 1%-3% of children. Children with OSA can present for all types of surgical and diagnostic procedures requiring anesthesia, with adenotonsillectomy being the most common surgical treatment for OSA in the pediatric age group. Thus, it is imperative that the anesthesiologist be familiar with the potential anesthetic complications and immediate postoperative problems associated with OSA. The significant implications that the presence of OSA imposes on perioperative care have been recognized by national medical professional societies. The American Academy of Pediatrics published a clinical practice guideline for pediatric OSA in 2002, and cited an increased risk of anesthetic complications, though specific anesthetic issues were not addressed. In 2006, the American Society of Anesthesiologists published a practice guideline for perioperative management of patients with OSA that noted the pediatric-related risk factor of obesity, and the increased perioperative risk associated with adenotonsillectomy in children younger than 3 yr. However, management of OSA in children younger than 1 yr-of-age was excluded from the guideline, as were other issues related specifically to the pediatric patient. Hence, many questions remain regarding the perioperative care of the child with OSA. In this review, we examine the literature on pediatric OSA, discuss its pathophysiology, current treatment options, and recognized approaches to perioperative management of these young and potentially high-risk patients.

  9. Transitioning From Perioperative Staff Nurse to Perioperative Educator.

    Science.gov (United States)

    Mower, Juliana

    2017-08-01

    Perioperative nurses who enjoy teaching may wish to become staff development educators. The shift to this new role requires a transition period during which the new educator acquires the knowledge, skills, and attitudes integral to mastering the job. A systematic approach to achieving baseline competencies in the educator role helps to ensure a successful conversion from providing direct patient care to supporting the educational needs of staff members. Copyright © 2017 AORN, Inc. Published by Elsevier Inc. All rights reserved.

  10. Perioperative leadership: managing change with insights, priorities, and tools.

    Science.gov (United States)

    Taylor, David L

    2014-07-01

    The personal leadership of the perioperative director is a critical factor in the success of any change management initiative. This article presents an approach to perioperative nursing leadership that addresses obstacles that prevent surgical departments from achieving high performance in clinical and financial outcomes. This leadership approach consists of specific insights, priorities, and tools: key insights include self-understanding of personal barriers to leadership and accuracy at understanding economic and strategic considerations related to the OR environment; key priorities include creating a customer-centered organization, focusing on process improvement, and concentrating on culture change; and key tools include using techniques (e.g., direct engagement, collaborative leadership) to align surgical organizations with leadership priorities and mitigate specific perioperative management risks. Included in this article is a leadership development plan for perioperative directors. Copyright © 2014 AORN, Inc. Published by Elsevier Inc. All rights reserved.

  11. Effect of nano-scale curvature on the intrinsic blood coagulation system

    Science.gov (United States)

    Kushida, Takashi; Saha, Krishnendu; Subramani, Chandramouleeswaran; Nandwana, Vikas; Rotello, Vincent M.

    2014-01-01

    The intrinsic coagulation activity of silica nanoparticles strongly depends on their surface curvature. Nanoparticles with higher surface curvature do not denature blood coagulation factor XII on its surface, providing a coagulation ‘silent’ surface, while nanoparticles with lower surface curvature shows denaturation and concomitant coagulation. PMID:25341004

  12. Treatment of waste water by coagulation and flocculation using biomaterials

    Science.gov (United States)

    Muruganandam, L.; Saravana Kumar, M. P.; Jena, Amarjit; Gulla, Sudiv; Godhwani, Bhagesh

    2017-11-01

    The present study deals with the determination of physical and chemical parameters in the treatment process of waste water by flocculation and coagulation processes using natural coagulants and assessing their feasibility for water treatment by comparing the performance with each other and with a synthetic coagulant. Initial studies were done on the synthetic waste water to determine the optimal pH and dosage, the activity of natural coagulant, followed by the real effluent from tannery waste. The raw tannery effluent was bluish-black in colour, mildly basic in nature, with high COD 4000mg/l and turbidity in the range 700NTU, was diluted and dosed with organic coagulants, AloeVera, MoringaOleifera and Cactus (O.ficus-indica). The study observed that coagulant Moringa Oleifera of 15 mg/L dose at 6 pH gave the best reduction efficiencies for major physicochemical parameters followed by Aloe Vera and Cactus under identical conditions. The study reveals that the untreated tannery effluents can be treated with environmental confirmative naturally occurring coagulants.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-02-01

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

  14. Comparison of the Performance of Corn Starch Coagulant Aid Accompany with Alum, Polyaluminum Chloride and Ferric Chloride Coagulants in Turbidity Removal from Water

    Directory of Open Access Journals (Sweden)

    Leila Mosleh

    2014-09-01

    Full Text Available Background: The most important process in water treatment plant is coagulation and flocculation. Regular chemical coagulant which used in Iran are aluminum sulfate (Alum and ferric chloride. Chemical coagulants have hazardous effect on human health and their cost is high for developing country. The purpose of this study was to evaluate the comparison of chemical coagulants accompany with corn starch as a coagulant aid, for the turbidity removal from water. Methods: This study was accomplished in pilot-scale with synthetic turbid water using clay. In this research, initial turbidity of 250 and 500 NTU was experimented. Chemical coagulant dose during the experiment was 1, 2 and 5 ppm and natural coagulant dose was 0, 0.1, 0.3, 0.5 and 0.7 ppm. Results: The results showed that maximum removal efficiency of turbidity in initial turbidity of 250 NTU belonged to poly aluminum chloride with 5 ppm dosage and corn starch with 0.7 ppm dosage which removed and reduced the initial turbidity to 98.48% and 3.73 NTU, respectively. Moreover, in initial turbidity of 500 NTU the maximum removal efficiency was 98.52% which belonged to ferric chloride and corn starch (5 and 0.7 ppm respectively and reduced the initial turbidity to 7.4 NTU. Conclusions: The results of this study showed that using natural coagulant aid reduce the chemical coagulant consumption, and also does not have significant effect on pH range and reduce the health risks. While huge amount of required polyelectrolytes for water treatment plant imported to the country and the production of corn starch in our country is high, it is hope that the results of this project can be used in industrial scale.

  15. Critical Elements for the Pediatric Perioperative Anesthesia Environment.

    Science.gov (United States)

    Polaner, David M; Houck, Constance S

    2015-12-01

    The American Academy of Pediatrics proposes guidance for the pediatric perioperative anesthesia environment. Essential components are identified to optimize the perioperative environment for the anesthetic care of infants and children. Such an environment promotes the safety and well-being of infants and children by reducing the risk of adverse events. Copyright © 2015 by the American Academy of Pediatrics.

  16. Translation, adaptation and psychometric validation of the Good Perioperative Nursing Care Scale (GPNCS) with surgical patients in perioperative care

    DEFF Research Database (Denmark)

    Hertel-Joergensen, Michala; Abrahamsen, Charlotte; Jensen, Carsten

    2018-01-01

    patients were screened for eligibility; 215 were included. The full-scale model fit estimates were moderate. Factor loadings typically ranged from 0.65 to 0.97, except for the questions concerning Technical Skills (0.38-0.63) and Nursing Process (0.28). The Cronbach's alpha value for the total scale score......AIM: To test the psychometric validity of the Good Perioperative Nursing Care Scale (GPNCS), a self-administered questionnaire, following translation and adaptation. INTRODUCTION: Patients' satisfaction with and experience of nursing care in orthopaedic or perioperative settings are currently...... was 0.92, with subfactors ranging from 0.72 to 0.87. CONCLUSION: Providing evidence for quality, or lack thereof, the Danish version of the GPNCS is a valid tool for measuring surgical patients' experiences with perioperative nursing care. The electronic version proved practical. RELEVANCE TO CLINICAL...

  17. Perioperative nutrition: what do we know? | Kotze | South African ...

    African Journals Online (AJOL)

    Surgery patients are at risk for iatrogenic malnutrition and subsequent deleterious effects. The benefits of nutrition support on patient outcomes have been demonstrated and the possible benefit of perioperative nutrition support thus implied. Enhanced recovery after surgery (ERAS) protocols, including perioperative nutrition ...

  18. Coagulation and inflammation

    NARCIS (Netherlands)

    van der Poll, T.

    2001-01-01

    Severe infection induces both activation of the coagulation system and multiple other inflammatory mediator cascades. This concise review summarizes the current knowledge of mechanisms that are considered to contribute to the procoagulant response to sepsis. Furthermore, evidence is discussed that

  19. Perioperative nursing for patients with diabetic foot receiving endovascular interventional therapy

    International Nuclear Information System (INIS)

    Yang Yang; Wang Feng; Li Ke; Li Cheng; Ji Donghua

    2010-01-01

    Objective: To study the effect of perioperative nursing on the living quality of patients with diabetic foot who are treated with endovascular interventional therapy. Methods: Specific perioperative nursing care plan was accordingly designed for 43 patients with diabetic foot. Endovascular balloon angioplasty and stent implantation were formed in these patients to treat their diabetic foot. The clinical results were observed. Results: Perioperative nursing effectively improved patient's limb blood supply, enhanced the healing of diabetic foot ulceration and increased the possibility of limb preservation. Conclusion: Endovascular therapy combined with corresponding perioperative nursing care can benefit more patients with diabetic foot. (authors)

  20. Bio-responsive polymer hydrogels homeostatically regulate blood coagulation.

    Science.gov (United States)

    Maitz, Manfred F; Freudenberg, Uwe; Tsurkan, Mikhail V; Fischer, Marion; Beyrich, Theresa; Werner, Carsten

    2013-01-01

    Bio-responsive polymer architectures can empower medical therapies by engaging molecular feedback-response mechanisms resembling the homeostatic adaptation of living tissues to varying environmental constraints. Here we show that a blood coagulation-responsive hydrogel system can deliver heparin in amounts triggered by the environmental levels of thrombin, the key enzyme of the coagulation cascade, which--in turn--becomes inactivated due to released heparin. The bio-responsive hydrogel quantitatively quenches blood coagulation over several hours in the presence of pro-coagulant stimuli and during repeated incubation with fresh, non-anticoagulated blood. These features enable the introduced material to provide sustainable, autoregulated anticoagulation, addressing a key challenge of many medical therapies. Beyond that, the explored concept may facilitate the development of materials that allow the effective and controlled application of drugs and biomolecules.

  1. Postprandial triglycerides and blood coagulation.

    Science.gov (United States)

    Silveira, A

    2001-01-01

    Most of our lifetime we spend in the postprandial state. Postprandial triglyceridemia may represent a procoagulant state involving disturbances of both blood coagulation and fibrinolysis, in particular due to elevation of the plasma levels of activated factor VII (VIIa) and plasminogen activator inhibitor (PAI-1). Therefore, disturbances of the hemostatic system might, at least partly, account for by the link between hypertriglyceridemia and coronary heart disease (CHD). Factor VIIa is the first enzyme of the blood coagulation system and serves a priming function for triggering of the clotting cascade. The coagulant activity of factor VII (VIIc, total activity of factor VII in plasma) was identified as an independent predictor of myocardial infarction in initially healthy middle-aged men, and particularly of fatal coronary events, and both serum cholesterol and triglyceride concentrations correlated positively with the VIIc level. Addition of fat to diet has been consistently shown to cause a rapid conversion of the factor VII zymogen into its active form (VIIa) whereas the concentration of total protein is unaffected. Postprandial activation of factor VII is dependent on lipolytic activity and it is mainly supported by large triglyceride-rich lipoprotein of the VLDL class. Studies in vivo with specific coagulation factor-deficient patients indicate that factor IX is essential for the postprandial activation of factor VII. The basal generation of thrombin seems to be unaffected by increased plasma levels of VIIa. However, since VIIa-tissue factor complex is responsible for the initiation of the coagulation cascade, increased generation of VIIa in the postprandial state would increase the potential for thrombin production in the event of plaque rupture. Plasminogen activator inhibitor-1 (PAI-1) is the major physiological inhibitor of the plasminogen activators in the circulation and thereby the principal inhibitor of the fibrinolytic system. Postprandial

  2. Old, new and hidden causes of perioperative hypersensitivity

    DEFF Research Database (Denmark)

    Garvey, Lene Heise

    2016-01-01

    intravenously such as neuromuscular blocking agents (NMBA), induction agents and antibiotics have traditionally been reported to be implicated most commonly. It has recently become apparent that there are geographical differences in sensitization patterns related to variation in exposures, referral patterns...... and performance and interpretation of investigations. Differences in sensitization to NMBAs are partly explained by cross sensitization to pholcodine, an ingredient in cough-medicines available in some countries. While NMBAs are the most common causes of perioperative hypersensitivity in some countries, this may...... in causes of perioperative hypersensitivity emerging over time and to increase awareness about the “hidden allergens” in the perioperative setting. Some practical advice on how to approach the patient testing negative on all initial investigations is also included....

  3. The impact of acute preoperative beta-blockade on perioperative ...

    African Journals Online (AJOL)

    To determine the impact of acute preoperative β-blockade on the incidence of perioperative cardiovascular morbidity and all- ... Our findings suggest that acute preoperative β-blockade is associated with an increased risk of perioperative cardiac ..... Shammash JB, Trost JC, Gold JM, Berlin JA, Golden MA, Kimmel SE.

  4. Potential Use of Polyaluminium Chloride and Tobacco Leaf as Coagulant and Coagulant Aid in Post-Treatment of Landfill Leachate

    Directory of Open Access Journals (Sweden)

    Nurfarahim Rusdizal

    2015-12-01

    Full Text Available A study was conducted to treat stabilized leachate by applying polyaluminium chloride (PAC and tobacco leaf extract as a coagulant and coagulant aid. Experimental results indicated that the tobacco leaves were positively charged. The removal rate of the chemical oxygen demand, using 1500 mg/L PAC as a sole coagulant, was approximately 63% and increased to 91% when 1000 mg/L PAC was mixed with 1000 mg/L tobacco leaf. Additionally, 1500 mg/L PAC with 250 - 1000 mg/L tobacco leaf and 54% ammoniacal nitrogen was removed, compared with only 46% reduction using 1500 mg/L with only 46% reduction.

  5. Implementation of a microcontroller-based semi-automatic coagulator.

    Science.gov (United States)

    Chan, K; Kirumira, A; Elkateeb, A

    2001-01-01

    The coagulator is an instrument used in hospitals to detect clot formation as a function of time. Generally, these coagulators are very expensive and therefore not affordable by a doctors' office and small clinics. The objective of this project is to design and implement a low cost semi-automatic coagulator (SAC) prototype. The SAC is capable of assaying up to 12 samples and can perform the following tests: prothrombin time (PT), activated partial thromboplastin time (APTT), and PT/APTT combination. The prototype has been tested successfully.

  6. Anticipatory vigilance: A grounded theory study of minimising risk within the perioperative setting.

    Science.gov (United States)

    O'Brien, Brid; Andrews, Tom; Savage, Eileen

    2018-01-01

    To explore and explain how nurses minimise risk in the perioperative setting. Perioperative nurses care for patients who are having surgery or other invasive explorative procedures. Perioperative care is increasingly focused on how to improve patient safety. Safety and risk management is a global priority for health services in reducing risk. Many studies have explored safety within the healthcare settings. However, little is known about how nurses minimise risk in the perioperative setting. Classic grounded theory. Ethical approval was granted for all aspects of the study. Thirty-seven nurses working in 11 different perioperative settings in Ireland were interviewed and 33 hr of nonparticipant observation was undertaken. Concurrent data collection and analysis was undertaken using theoretical sampling. Constant comparative method, coding and memoing and were used to analyse the data. Participants' main concern was how to minimise risk. Participants resolved this through engaging in anticipatory vigilance (core category). This strategy consisted of orchestrating, routinising and momentary adapting. Understanding the strategies of anticipatory vigilance extends and provides an in-depth explanation of how nurses' behaviour ensures that risk is minimised in a complex high-risk perioperative setting. This is the first theory situated in the perioperative area for nurses. This theory provides a guide and understanding for nurses working in the perioperative setting on how to minimise risk. It makes perioperative nursing visible enabling positive patient outcomes. This research suggests the need for training and education in maintaining safety and minimising risk in the perioperative setting. © 2017 John Wiley & Sons Ltd.

  7. Perioperative nurses' attitudes toward the electronic health record.

    Science.gov (United States)

    Yontz, Laura S; Zinn, Jennifer L; Schumacher, Edward J

    2015-02-01

    The adoption of an electronic health record (EHR) is mandated under current health care legislation reform. The EHR provides data that are patient centered and improves patient safety. There are limited data; however, regarding the attitudes of perioperative nurses toward the use of the EHR. The purpose of this project was to identify perioperative nurses' attitudes toward the use of the EHR. Quantitative descriptive survey was used to determine attitudes toward the electronic health record. Perioperative nurses in a southeastern health system completed an online survey to determine their attitudes toward the EHR in providing patient care. Overall, respondents felt the EHR was beneficial, did not add to the workload, improved documentation, and would not eliminate any nursing jobs. Nursing acceptance and the utilization of the EHR are necessary for the successful integration of an EHR and to support the goal of patient-centered care. Identification of attitudes and potential barriers of perioperative nurses in using the EHR will improve patient safety, communication, reduce costs, and empower those who implement an EHR. Copyright © 2015 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.

  8. Coagulation mechanism of salt solution-extracted active component in Moringa oleifera seeds.

    Science.gov (United States)

    Okuda, T; Baes, A U; Nishijima, W; Okada, M

    2001-03-01

    This study focuses on the coagulation mechanism by the purified coagulant solution (MOC-SC-PC) with the coagulation active component extracted from M. oleifera seeds using salt solution. The addition of MOC-SC-PC tap water formed insoluble matters. This formation was responsible for kaolin coagulation. On the other hand, insoluble matters were not formed when the MOC-SC-PC was added into distilled water. The formation was affected by Ca2+ or other bivalent cations which may connect each molecule of the active coagulation component in MOC-SC-PC and form a net-like structure. The coagulation mechanism of MOC-SC-PC seemed to be an enmeshment of Kaolin by the insoluble matters with the net-like structure. In case of Ca2+ ion (bivalent cations), at least 0.2 mM was necessary for coagulation at 0.3 mgC l-1 dose of MOC-SC-PC. Other coagulation mechanisms like compression of double layer, interparticle bridging or charge neutralization were not responsible for the coagulation by MOC-SC-PC.

  9. Perioperative corticosteroids for intermittent and mild persistent asthma

    OpenAIRE

    Hiroto Matsuse; Terufumi Shimoda; Ikuko Machida; Yuki Kondo; Tetsuya Kawano; Sachiko Saeki; Shinya Tomari; Kazuko Mitsuta; Chizu Fukushima; Yasushi Obase; Shigeru Kohno

    2002-01-01

    Objectives: Asthmatics are considered to be at high risk for pulmonary complications during general anesthesia with tracheal intubation. The purpose of the present study was to determine the usefulness of perioperative corticosteroids for mild asthmatics in preventing perioperative exacerbation of asthma. Methods: Airway hyperresponsiveness to inhaled methacholine was determined in patients with intermittent (n = 27) and mild persistent (n = 48) asthma before general anesthesia who underwe...

  10. In vitro evaluation of the effect of haemodilution with dextran 40 on coagulation profile as measured by thromboelastometry and multiple electrode aggregometry.

    Science.gov (United States)

    Kam, Pca; Liou, Jpc; Yang, Kxf

    2017-09-01

    We evaluated the effects of haemodilution with either dextran 40 or 0.9% normal saline on coagulation in vitro using rotational thromboelastometry (ROTEM®, Pentapharm Co., Munich, Germany) and multiple electrode aggregometry (Multiplate® Platelet Function Analyser, Dynabyte, Munich, Germany). Venous blood samples obtained from 20 healthy volunteers were diluted in vitro with dextran 40 or normal saline by 5%, 10% and 15%. Fibrinogen concentration, ROTEM-EXTEM® (screening test for the extrinsic coagulation pathway), FIBTEM® (an EXTEM-based assay of the fibrin component of clot) parameters including coagulation time, clot formation time, alpha angle, maximum clot firmness and lysis index were measured in the undiluted sample and at each level of haemodilution. Dextran 40 at 15% haemodilution significantly prolonged coagulation time, clot formation time and significantly decreased the alpha angle and maximal clot firmness (EXTEM amplitude at five minutes [A5] and ten minutes [A10]) compared with normal saline. The FIBTEM assay (maximal clot firmness and FIBTEM A5 and A10) showed a marked decrease in maximal clot firmness at all dilutions suggesting impaired fibrinogen activity and a risk of bleeding. Multiple electrode aggregometry did not demonstrate any platelet dysfunction. Haemodilution with dextran 40 causes significant impairment in clot formation and strength compared to saline haemodilution and undiluted blood. At the levels of in vitro haemodilution designed to reflect the clinical use of dextran infusions, no significant fibrinolysis or platelet inhibition was observed.

  11. Infrared coagulation: a new treatment for hemorrhoids

    International Nuclear Information System (INIS)

    Leicester, R.J.; Nicholls, R.J.; Mann, C.V.

    1981-01-01

    Many methods, which have effectively reduced the number of patients requiring hospital admission, have been described for the outpatient treatment of hemorrhoids. However, complications have been reported, and the methods are often associated with unpleasant side effects. In 1977 Neiger et al. described a new method that used infrared coagulation, which produced minimal side effects. The authors have conducted a prospective, randomized trial to evaluate infrared coagulation compared with more traditional methods of treatment. The authors' results show that it may be more effective than injection sclerotherapy in treating non-prolapsing hemorrhoids and that it compares favorably with rubber band ligation in most prolapsing hemorrhoids. No complications occurred, and significantly fewer patients experienced pain after infrared coagulation

  12. Intraventricular hemorrhage in preterm infants: coagulation perspectives.

    Science.gov (United States)

    Kuperman, Amir A; Kenet, Gili; Papadakis, Emmanuel; Brenner, Benjamin

    2011-10-01

    It has long been considered that a severe coagulation deficiency in premature newborns could be a major contributing factor in the occurrence of intraventricular hemorrhage (IVH). High-grade IVH has also been shown to coincide with severe derangement of coagulation in extremely low birth weight infants. This review focuses on the relevance of the physiologically developing immature hemostatic system to IVH, and the potential benefit of agents affecting hemostasis for IVH therapy or prevention in preterm infants. The findings of small, open-label interventional studies on the effect of ethamsylate, vitamin K, fresh frozen plasma, recombinant activated factor VII, and prothrombin complex concentrate on the premature coagulation system will be reviewed. © Thieme Medical Publishers.

  13. Hip Resurfacing Arthroplasty and Perioperative Blood Testing

    Directory of Open Access Journals (Sweden)

    Andrew Cook

    2014-01-01

    Full Text Available It is standard practice in many institutions to routinely perform preoperative and postoperative haemoglobin level testing in association with hip joint arthroplasty procedures. It is our observation, however, that blood transfusion after uncomplicated primary hip arthroplasty in healthy patients is uncommon and that the decision to proceed with blood transfusion is typically made on clinical grounds. We therefore question the necessity and clinical value of routine perioperative blood testing about the time of hip resurfacing arthroplasty. We present analysis of perioperative blood tests and transfusion rates in 107 patients undertaking unilateral hybrid hip resurfacing arthroplasty by the senior author at a single institution over a three-year period. We conclude that routine perioperative testing of haemoglobin levels for hip resurfacing arthroplasty procedures does not assist in clinical management. We recommend that postoperative blood testing only be considered should the patient demonstrate clinical signs of symptomatic anaemia or if particular clinical circumstances necessitate.

  14. Nutrition in peri-operative esophageal cancer management.

    Science.gov (United States)

    Steenhagen, Elles; van Vulpen, Jonna K; van Hillegersberg, Richard; May, Anne M; Siersema, Peter D

    2017-07-01

    Nutritional status and dietary intake are increasingly recognized as essential areas in esophageal cancer management. Nutritional management of esophageal cancer is a continuously evolving field and comprises an interesting area for scientific research. Areas covered: This review encompasses the current literature on nutrition in the pre-operative, peri-operative, and post-operative phases of esophageal cancer. Both established interventions and potential novel targets for nutritional management are discussed. Expert commentary: To ensure an optimal pre-operative status and to reduce peri-operative complications, it is key to assess nutritional status in all pre-operative esophageal cancer patients and to apply nutritional interventions accordingly. Since esophagectomy results in a permanent anatomical change, a special focus on nutritional strategies is needed in the post-operative phase, including early initiation of enteral feeding, nutritional interventions for post-operative complications, and attention to long-term nutritional intake and status. Nutritional aspects of pre-optimization and peri-operative management should be incorporated in novel Enhanced Recovery After Surgery programs for esophageal cancer.

  15. The Coagulant Type Influence on Removal Efficiency of 5- and 6-Ring Pahs During Water Coagulation Process

    Directory of Open Access Journals (Sweden)

    Nowacka Anna

    2014-12-01

    Full Text Available The article presents results on investigation of the removal efficiency of selected 5- and 6-ring polycyclic aromatic hydrocarbons (benzo[a]pyrene, benzo[b]fluoranthene, benzo[k]fluoranthene, benzo[j]fluoranthene, benzo[g,h,i]perylene, indeno[1,2,3-cd]pyrene, dibenzo[a,h]anthracene from water during coagulation and sedimentation process. Two pre-hydrolyzed aluminum coagulants: PAX XL 19H and FLOKOR 105V were chosen for research. Process was carried out at optimum process parameters: rapid-mixing - 3 min at the rotational speed of 200 rpm, slow mixing - 10 min at 30 rpm, sedimentation - 60 min. The removal effectiveness was dependant on coagulant type and its composition. Better results in the removal of 5-and 6-ring PAHs were obtained after application of FLOKOR 105V (lower aluminum content than after using PAX XL 19H.

  16. PERIOPERATIVE MANAGEMENT OF SICKLE CELL DISEASE: A NARRATIVE REVIEW

    Directory of Open Access Journals (Sweden)

    Kwame Ofori Adjepong

    2018-05-01

    Full Text Available An estimated 30 million people worldwide have sickle cell disease (SCD.  Emergent and non-emergent surgical procedures in SCD have been associated with relatively increased risks of peri-operative mortality, vaso-occlussive (painful crisis, acute chest syndrome, post-operative infections, congestive heart failure, cerebrovascular accident and acute kidney injury.  Pre-operative assessment must include careful review of the patient’s known crisis triggers, baseline hematologic profile, usual transfusion requirements, pre-existing organ dysfunction and narcotic use. Use of preoperative blood transfusions should be selective and decisions individualized based on the baseline hemoglobin, surgical procedure and anticipated volume of blood loss.  Intra- and post-operative management should focus on minimizing hypoxia, hypothermia, acidosis, and intravascular volume depletion. Pre- and post-operative incentive spirometry use should be encouraged.

  17. Peri-operative care.

    Science.gov (United States)

    Baston, Helen

    2004-05-01

    This is the third 'midwifery basics' series aimed at student midwives, and focuses on midwifery care during labour. This article provides a summary of peri-operative care for women who experience caesarean birth. Students are encouraged to seek further information through a series of activities, and to link theory with practice by considering the issues relating to the care of the woman described in the short vignette.

  18. In vitro investigation of the effects of exogenous sugammadex on coagulation in orthopedic surgical patients.

    Science.gov (United States)

    Lee, Il Ok; Kim, Young Sung; Chang, Hae Wone; Kim, Heezoo; Lim, Byung Gun; Lee, Mido

    2018-05-24

    Previous studies have shown that sugammadex resulted in the prolongation of prothrombin time and activated partial thromboplastin time. In this study, we aimed to investigate the in vitro effects of exogenous sugammadex on the coagulation variables of whole blood in healthy patients who underwent orthopedic surgery. The effects of sugammadex on coagulations were assessed using thromboelastography (TEG) in kaolin-activated citrated blood samples taken from 14 healthy patients who underwent orthopedic surgery. The in vitro effects of three different concentrations of sugammadex (42, 193, and 301 μg mL - 1 ) on the TEG profiles were compared with those of the control (0 μg mL - 1 ). Previous studies indicated that these exogenous concentrations correspond to the approximate maximum plasma concentrations achieved after the administration of 4, 16, and 32 mg kg - 1 sugammadex to healthy subjects. Increased sugammadex concentrations were significantly associated with reduced coagulation, as evidenced by increases in reaction time (r), coagulation time, and time to maximum rate of thrombus generation (TMRTG), and decreases in the angle, maximum amplitude, and maximum rate of thrombus generation. Compared with the control, the median percentage change (interquartile range) in the TEG values of the samples treated with the highest exogenous sugammadex concentration was the greatest for r, 53% (26, 67.3%), and TMRTG, 48% (26, 59%). This in vitro study suggests that supratherapeutic doses of exogenous sugammadex might be associated with moderate hypocoagulation in the whole blood of healthy subjects. identifier:  UMIN000029081 , registered 11 September 2017.

  19. Optimum coagulant forecasting by modeling jar test experiments using ANNs

    Science.gov (United States)

    Haghiri, Sadaf; Daghighi, Amin; Moharramzadeh, Sina

    2018-01-01

    Currently, the proper utilization of water treatment plants and optimizing their use is of particular importance. Coagulation and flocculation in water treatment are the common ways through which the use of coagulants leads to instability of particles and the formation of larger and heavier particles, resulting in improvement of sedimentation and filtration processes. Determination of the optimum dose of such a coagulant is of particular significance. A high dose, in addition to adding costs, can cause the sediment to remain in the filtrate, a dangerous condition according to the standards, while a sub-adequate dose of coagulants can result in the reducing the required quality and acceptable performance of the coagulation process. Although jar tests are used for testing coagulants, such experiments face many constraints with respect to evaluating the results produced by sudden changes in input water because of their significant costs, long time requirements, and complex relationships among the many factors (turbidity, temperature, pH, alkalinity, etc.) that can influence the efficiency of coagulant and test results. Modeling can be used to overcome these limitations; in this research study, an artificial neural network (ANN) multi-layer perceptron (MLP) with one hidden layer has been used for modeling the jar test to determine the dosage level of used coagulant in water treatment processes. The data contained in this research have been obtained from the drinking water treatment plant located in Ardabil province in Iran. To evaluate the performance of the model, the mean squared error (MSE) and correlation coefficient (R2) parameters have been used. The obtained values are within an acceptable range that demonstrates the high accuracy of the models with respect to the estimation of water-quality characteristics and the optimal dosages of coagulants; so using these models will allow operators to not only reduce costs and time taken to perform experimental jar tests

  20. Service Dogs in the Perioperative Setting.

    Science.gov (United States)

    Levey, Janet A; Chappy, Sharon L

    2017-04-01

    Service dogs are critical for the independence of individuals with disabilities because they assist with daily living activities and help these individuals navigate society. Perioperative nurses need a working knowledge of disability laws pertaining to service dogs to provide patient-centered care for individuals using service dogs. This article provides information on the Americans With Disabilities Act regulations regarding service dogs, makes recommendations for the care of patients with service dogs across the perioperative continuum, and offers policy directives to ensure that safe, high-quality care is delivered to patients using service dogs. Copyright © 2017 AORN, Inc. Published by Elsevier Inc. All rights reserved.

  1. Disseminated intravascular coagulation in meningococcal sepsis. Case 7

    NARCIS (Netherlands)

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

    2003-01-01

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

  2. Interplay between coagulation and vascular inflammation in sickle cell disease

    Science.gov (United States)

    Sparkenbaugh, Erica; Pawlinski, Rafal

    2013-01-01

    Sickle cell disease is the most common inherited hematologic disorder that leads to the irreversible damage of multiple organs. Although sickling of red blood cells and vaso-occlusion are central to the pathophysiology of sickle cell disease the importance of hemolytic anemia and vasculopathy has been recently recognized. Hypercoagulation state is another prominent feature of sickle cell disease and is mediated by activation of both intrinsic and extrinsic coagulation pathways. Growing evidence demonstrates that coagulation may not only contribute to the thrombotic complications, but also to vascular inflammation associated with this disease. This article summarizes the role of vascular inflammation and coagulation activation, discusses potential mechanisms responsible for activation of coagulation and reviews recent data demonstrating the crosstalk between coagulation and vascular inflammation in sickle cell disease. PMID:23593937

  3. Validation of the TRUST tool in a Greek perioperative setting.

    Science.gov (United States)

    Chatzea, Vasiliki-Eirini; Sifaki-Pistolla, Dimitra; Dey, Nilanjan; Melidoniotis, Evangelos

    2017-06-01

    The aim of this study was to translate, culturally adapt and validate the TRUST questionnaire in a Greek perioperative setting. The TRUST questionnaire assesses the relationship between trust and performance. The study assessed the levels of trust and performance in the surgery and anaesthesiology department during a very stressful period for Greece (economic crisis) and offered a user friendly and robust assessment tool. The study concludes that the Greek version of the TRUST questionnaire is a reliable and valid instrument for measuring team performance among Greek perioperative teams. Copyright the Association for Perioperative Practice.

  4. Colloids removal from water resources using natural coagulant: Acacia auriculiformis

    Science.gov (United States)

    Abdullah, M.; Roslan, A.; Kamarulzaman, M. F. H.; Erat, M. M.

    2017-09-01

    All waters, especially surface waters contain dissolved, suspended particles and/or inorganic matter, as well as several biological organisms, such as bacteria, algae or viruses. This material must be removed because it can affect the water quality that can cause turbidity and colour. The objective of this study is to develop water treatment process from Seri Alam (Johor, Malaysia) lake water resources by using natural coagulant Acacia auriculiformis pods through a jar test experiment. Jar test is designed to show the effectiveness of the water treatment. This process is a laboratory procedure that will simulate coagulation/flocculation with several parameters selected namely contact time, coagulant dosage and agitation speed. The most optimum percentage of colloids removal for each parameter is determined at 0.2 g, 90 min and 80 rpm. FESEM (Field-emission Scanning Electron Microscope) observed the small structures of final floc particles for optimum parameter in this study to show that the colloids coagulated the coagulant. All result showed that the Acacia auriculiformis pods can be a very efficient coagulant in removing colloids from water.

  5. Tissue Factor Coagulant Activity is Regulated by the Plasma Membrane Microenvironment.

    Science.gov (United States)

    Yu, Yuanjie; Böing, Anita N; Hau, Chi M; Hajji, Najat; Ruf, Wolfram; Sturk, Auguste; Nieuwland, Rienk

    2018-06-01

     Tissue factor (TF) can be present in a non-coagulant and coagulant form. Whether the coagulant activity is affected by the plasma membrane microenvironment is unexplored.  This article studies the presence and coagulant activity of human TF in plasma membrane micro-domains.  Plasma membranes were isolated from human MIA PaCa2 cells, MDA-MB-231 cells and human vascular smooth muscle cells by Percoll gradient ultracentrifugation after cell disruption. Plasma membranes were fractionated by OptiPrep gradient ultracentrifugation, and the presence of TF, flotillin, caveolin, clathrin, protein disulphide isomerase (PDI), TF pathway inhibitor (TFPI) and phosphatidylserine (PS) were determined.  Plasma membranes contain two detergent-resistant membrane (DRM) compartments differing in density and biochemical composition. High-density DRMs (DRM-H) have a density ( ρ ) of 1.15 to 1.20 g/mL and contain clathrin, whereas low-density DRMs (DRM-L) have a density between 1.09 and 1.13 g/mL and do not contain clathrin. Both DRMs contain TF, flotillin and caveolin. PDI is detectable in DRM-H, TFPI is not detectable in either DMR-H or DRM-L and PS is detectable in DRM-L. The DRM-H-associated TF (> 95% of the TF antigen) lacks detectable coagulant activity, whereas the DRM-L-associated TF triggers coagulation. This coagulant activity is inhibited by lactadherin and thus PS-dependent, but seemed insensitive to 16F16, an inhibitor of PDI.  Non-coagulant and coagulant TF are present within different types of DRMs in the plasma membrane, and the composition of these DRMs may affect the TF coagulant activity. Schattauer GmbH Stuttgart.

  6. Correlation between thromboelastography and traditional coagulation test parameters in hospitalized dogs

    Directory of Open Access Journals (Sweden)

    Rubanick JV

    2017-02-01

    Full Text Available Jean V Rubanick, Medora B Pashmakova, Micah A Bishop, James W Barr Department of Veterinary Small Animal Clinical Sciences, Texas A&M University, College Station, TX, USA Abstract: A hospital-based, prospective cross-sectional study was used to compare kaolin-activated thromboelastography (TEG parameters with traditional coagulation tests in 29 hospitalized dogs. Cases were included if the attending clinician requested coagulation testing. Blood was obtained from each dog and coagulation (prothrombin time, partial thromboplastin time, antithrombin activity, d-dimer concentration, and fibrinogen concentration and TEG analyses were performed. Hematocrit (Hct was also measured. Traditional coagulation results were evaluated for correlation with those from kaolin-activated TEG. Spearman’s correlation was used to calculate correlation coefficients. Fibrinogen was positively correlated with maximum amplitude (Pearson r=0.72, P<0.001 and global clot strength (Pearson r=0.72, P<0.001. There was no correlation between any of the remaining coagulation variables, TEG parameters, or Hct. Results of kaolin-activated TEG and traditional coagulation tests are not interchangeable means of monitoring coagulation derangements in this intensive care unit patient population. Determination of a true outcome measure is necessary to establish TEG’s clinical relevance to veterinary medicine. Keywords: TEG, thromboelastography, coagulation, hemostasis

  7. Enhanced Coagulation-Flocculation Performance of Iron-Based Coagulants: Effects of PO4(3-) and SiO3(2-) Modifiers.

    Science.gov (United States)

    Chen, Wei; Zheng, Huaili; Teng, Houkai; Wang, Yili; Zhang, Yuxin; Zhao, Chuanliang; Liao, Yong

    2015-01-01

    PO4(3-) and SiO3(2-) are often used as modifier to improve stability and aggregating ability of the iron-base coagulants, however, there are few reports about their detailed comparison between the coagulation performance and mechanisms. In this study, three coagulants--polyferric phosphoric sulfate (PFPS), polysilicon ferric sulfate (PFSS), and polyferric sulfate (PFS) were synthesized; their structure and morphology were characterized by Fourier transformed infrared (FT-IR) spectroscopy, X-ray diffraction (XRD) and Scanning electron microscope (SEM). Alkali titration and Ferron species analysis were employed to investigate the hydrolysis performance and species distribution. Jar test was conducted to measure their coagulation behaviors at different dosage, pH, and temperatures in which the flocs properties were measured. The results showed that a number of new compounds were formed due to the presence of PO4(3-) and SiO3(2-). Moreover, PFPS and PFSS had similar level in Fea as well as Feb. Among them, PFPS produced more multi-core iron atoms polymer and content of Feb, and the formed flocs were larger and denser. It exhibited superior coagulation performance in terms of turbidity reduction, UV254 removal and residual ferric concentration. Jar test and floc breakage/regrowth experiments indicated other than charge neutrality, the dominated mechanism involved in PFSS was the adsorption between polysilicic acid and solution particle, while PFPS was sweeping, entrapment/adsorption resulting from larger polymer colloid of Fe-P chemistry bond.

  8. Enhanced Coagulation-Flocculation Performance of Iron-Based Coagulants: Effects of PO4(3- and SiO3(2- Modifiers.

    Directory of Open Access Journals (Sweden)

    Wei Chen

    Full Text Available PO4(3- and SiO3(2- are often used as modifier to improve stability and aggregating ability of the iron-base coagulants, however, there are few reports about their detailed comparison between the coagulation performance and mechanisms. In this study, three coagulants--polyferric phosphoric sulfate (PFPS, polysilicon ferric sulfate (PFSS, and polyferric sulfate (PFS were synthesized; their structure and morphology were characterized by Fourier transformed infrared (FT-IR spectroscopy, X-ray diffraction (XRD and Scanning electron microscope (SEM. Alkali titration and Ferron species analysis were employed to investigate the hydrolysis performance and species distribution. Jar test was conducted to measure their coagulation behaviors at different dosage, pH, and temperatures in which the flocs properties were measured. The results showed that a number of new compounds were formed due to the presence of PO4(3- and SiO3(2-. Moreover, PFPS and PFSS had similar level in Fea as well as Feb. Among them, PFPS produced more multi-core iron atoms polymer and content of Feb, and the formed flocs were larger and denser. It exhibited superior coagulation performance in terms of turbidity reduction, UV254 removal and residual ferric concentration. Jar test and floc breakage/regrowth experiments indicated other than charge neutrality, the dominated mechanism involved in PFSS was the adsorption between polysilicic acid and solution particle, while PFPS was sweeping, entrapment/adsorption resulting from larger polymer colloid of Fe-P chemistry bond.

  9. Characterization of coagulation factor synthesis in nine human primary cell types

    NARCIS (Netherlands)

    Dashty, Monireh; Akbarkhanzadeh, Vishtaseb; Zeebregts, Clark J.; Spek, C. Arnold; Sijbrands, Eric J.; Peppelenbosch, Maikel P.; Rezaee, Farhad

    2012-01-01

    The coagulation/fibrinolysis system is essential for wound healing after vascular injury. According to the standard paradigm, the synthesis of most coagulation factors is restricted to liver, platelets and endothelium. We challenged this interpretation by measuring coagulation factors in nine human

  10. Tranexamic Acid: From Trauma to Routine Perioperative Use

    Science.gov (United States)

    Simmons, Jeff; Sikorski, Robert A.; Pittet, Jean-Francois

    2015-01-01

    Purpose Of Review Optimizing hemostasis with antifibrinolytics is becoming a common surgical practice. Large clinical studies have demonstrated efficacy and safety of tranexamic acid (TXA) in the trauma population to reduce blood loss and transfusions. Its use in patients without preexisting coagulopathies is debated, as thromboembolic events are a concern. In this review, perioperative administration of TXA is examined in non-trauma surgical populations. Additionally, risk of thromboembolism, dosing regimens, and timing of dosing are assessed. Recent Findings Perioperative use of tranexamic acid is associated with reduced blood loss and transfusions. Thromboembolic effects do not appear to be increased. However, optimal dosing and timing of TXA administration is still under investigation for non-trauma surgical populations. Summary As part of a perioperative blood management program, tranexamic acid can be used to help reduce blood loss and mitigate exposure to blood transfusion. PMID:25635366

  11. In-Hospital Haloperidol Use and Perioperative Changes in QTc-Duration

    NARCIS (Netherlands)

    Blom, M T; de Jonghe, A; van Munster, B C; de Rooij, S E; Tan, H L; van der Velde, Nathalie; Jansen, S.

    2015-01-01

    OBJECTIVES: Haloperidol may prolong ECG QTc-duration but is often prescribed perioperatively to hip-fracture patients. We aimed to determine (1) how QTc-duration changes perioperatively, (2) whether low-dose haloperidol-use influences these changes, and (3) which clinical variables are associated

  12. Participation in paediatric perioperative care: 'what it means for parents'.

    Science.gov (United States)

    Sjöberg, Carina; Svedberg, Petra; Nygren, Jens M; Carlsson, Ing-Marie

    2017-12-01

    To explore what it means for parents to participate in their children's paediatric perioperative care. Allowing parents to participate in paediatric perioperative care can make a major difference for children in terms of their well-being, a decreased need for painkillers, fewer sleeping disorders and a more positive experience for both parties. The nurse anaesthetist should have a holistic view and develop a shared vision for the child, the parents and for themselves to perform successful paediatric perioperative care. Descriptive qualitative study. The study was conducted in 2014. Data were collected in 20 narrative interviews with 15 mothers and five fathers who had experience of participating in their child's paediatric perioperative day surgery. The analysis was carried out with qualitative content analysis to describe the variations, differences and similarities in the experiences. The analysis revealed a main category that describes that parental participation in the context of paediatric perioperative care in day surgery meant 'having strength to participate despite an increased vulnerability'. Three generic categories with additional subcategories explained what was essential for the parents to be able to preserve this strength and participate in their child's care despite their increased vulnerability. The generic categories were named, 'gaining information about what will happen', 'being seen as a resource' and 'gaining access to the environment'. Efforts should be made to improve parents' roles and opportunities to participate in paediatric perioperative care. Nurse anaesthetists have a crucial role in enabling parents' participation and need knowledge to develop strategies and nursing interventions that meet parents' needs. © 2017 John Wiley & Sons Ltd.

  13. Treatment of sugar beet thick juice spent wash by chemical and natural coagulants

    Directory of Open Access Journals (Sweden)

    Antov Mirjana G.

    2009-01-01

    Full Text Available The possibility of treatment of wastewater from bioethanol production by aluminium sulfate and natural coagulant extracted from common bean seed was studied. The highest coagulation activity at pH 6.5 is reached with analum dose of 1 g/l, but only a little lower coagulation activities were obtained by the dose of 0.05 and 0.10 g/l, which is more favorable for economic and environmental reasons. When natural coagulant from common bean was applied the highest coagulation activity, 14.3%, at pH 6.5 is reached with a dose of 0.5 ml/l. However, when common bean natural coagulant was used simultaneously with alum, the highest turbidity removal resulting in 24% coagulation activity was achieved and this was more efficient than when alum or natural coagulant were used.

  14. Prognostic impact of clinical course-specific mRNA expression profiles in the serum of perioperative patients with esophageal cancer in the ICU: a case control study

    Directory of Open Access Journals (Sweden)

    Oshima Yoshiaki

    2010-10-01

    Full Text Available Abstract Background We previously reported that measuring circulating serum mRNAs using quantitative one-step real-time RT-PCR was clinically useful for detecting malignancies and determining prognosis. The aim of our study was to find crucial serum mRNA biomarkers in esophageal cancer that would provide prognostic information for post-esophagectomy patients in the critical care setting. Methods We measured serum mRNA levels of 11 inflammatory-related genes in 27 post-esophagectomy patients admitted to the intensive care unit (ICU. We tracked these levels chronologically, perioperatively and postoperatively, until the two-week mark, investigating their clinical and prognostic significance as compared with clinical parameters. Furthermore, we investigated whether gene expression can accurately predict clinical outcome and prognosis. Results Circulating mRNAs in postoperative esophagectomy patients had gene-specific expression profiles that varied with the clinical phase of their treatment. Multivariate regression analysis showed that upregulation of IL-6, VWF and TGF-β1 mRNA in the intraoperative phase (p = 0.016, 0.0021 and 0.009 and NAMPT and MUC1 mRNA on postoperative day 3 (p ®, Ono Pharmaceutical Co., Ltd. significantly correlated with MUC1 and NAMPT mRNA expression (p = 0.048 and 0.045. IL-6 mRNA correlated with hypercytokinemia and recovery from hypercytokinemia (sensitivity 80.9% and was a significant biomarker in predicting the onset of severe inflammatory diseases. Conclusion Chronological tracking of postoperative mRNA levels of inflammatory-related genes in esophageal cancer patients may facilitate early institution of pharamacologic therapy, prediction of treatment response, and prognostication during ICU management in the perioperative period.

  15. Coagulation defects in experimental hepatic injury in the dog.

    Science.gov (United States)

    Osbaldiston, G W; Hoffman, M W

    1971-04-01

    Alteration in activity of blood coagulation factors in dogs with acute hepatic injury caused by oral carbon tetrachloride dosing was studied. Coagulation Factors II, VII and IX were dramatically reduced within 48 hours but recovered to normal in the next five days. Because surgery is rarely performed on dogs with hepatic necrosis, the use of fresh whole blood tranfusion to improve the coagulation defect in hepatic injury was also studied. Transfusion was found to have only a temporary beneficial effect.

  16. Detrimental effects of perioperative blood transfusion

    DEFF Research Database (Denmark)

    Nielsen, Hans Jørgen

    1995-01-01

    Evidence suggests that perioperative allogeneic blood transfusion increases the risk of infectious complications after major surgery and of cancer recurrence after curative operation. This has been attributed to immunosuppression. Several authors have suggested that filtered whole blood and/or red...... cell concentrate, or leucocyte- and buffy coat-reduced red cells in artificial medium or their own plasma, may reduce postoperative immunosuppression. It was also anticipated that the use of autologous blood might minimize the risk of perioperative transfusion, but studies have unexpectedly shown...... similar postoperative infectious complications and cancer recurrence and/or survival rates in patients receiving autologous blood donated before operation and those receiving allogeneic blood. Future studies should identify common risk factors associated with blood storage....

  17. Perioperative management of gastrostomy tube placement in Duchenne muscular dystrophy adolescent and young adult patients: A role for a perioperative surgical home.

    Science.gov (United States)

    Boivin, Ariane; Antonelli, Richard; Sethna, Navil F

    2018-02-01

    In past decades, Duchenne muscular dystrophy patients have been living longer and as the disease advances, patients experience multisystemic deterioration. Older patients often require gastrostomy tube placement for nutritional support. For optimizing the perioperative care, a practice of multidisciplinary team can better anticipate, prevent, and manage possible complications and reduce the overall perioperative morbidity and mortality. The aim of this study was to review our experience with perioperative care of adolescent and young adults with Duchenne muscular dystrophy undergoing gastrostomy by various surgical approaches in order to identify challenges and improve future perioperative care coordination to reduce morbidity. We retrospectively examined cases of gastrostomy tube placement in patients of ages 15 years and older between 2005 and 2016. We reviewed preoperative evaluation, anesthetic and surgical management, and postoperative complications. Twelve patients were identified; 1 had open gastrostomy, 3 laparoscopic gastrostomies, 5 percutaneous endoscopic guided, and 3 radiologically inserted gastrostomy tubes. All patients had preoperative cardiac evaluation with 6 patients demonstrating cardiomyopathy. Nine patients had preoperative pulmonary consultations and the pulmonary function tests reported forced vital capacity of ≤36% of predicted. Eight patients were noninvasive positive pressure ventilation dependent. General anesthesia with tracheal intubation was administered in 8 patients, and intravenous sedation in 4 patients; 1 received sedation supplemented with regional anesthesia and 3 received deep sedation. One patient had a difficult intubation that resulted in trauma and prolonged tracheal intubation. Three patients developed postoperative respiratory complications. Two patients' procedures were postponed due to inadequate preoperative evaluation and 1 because of disagreement between anesthesia and procedural services as to the optimal

  18. Vasopressin in perioperative management of congenital ...

    African Journals Online (AJOL)

    Annals of Pediatric Surgery ... Oxygenation failure, pulmonary hypertension and refractory systemic hypotension in infants with ... managing pulmonary and systemic perioperative haemodynamic instability in infants with diaphragmatic hernia.

  19. Musculoskeletal Problems Among Greek Perioperative Nurses in Regional Hospitals in Southern Peloponnese : Musculoskeletal Problems in Perioperative Nurses.

    Science.gov (United States)

    Bakola, Helen; Zyga, Sofia; Stergioulas, Apostolos; Kipreos, George; Panoutsopoulos, George

    2017-01-01

    The surgery unit is a particularly labor-intensive environment in the hospital. Studies reflect the correlation of labor risk factors for musculoskeletal injuries among nurses but few have investigated the relationship to perioperative nurses. The purpose of this study is the identification and definition of ergonomic risk factors in the operating room and their connection with musculoskeletal disorders in perioperative nurses in regional hospitals in Greece. Forty four Greek perioperative nurses working in regional hospitals in southern Peloponnese participated. Anonymous self-administered questionnaire was used to collect the data, which consisted of three parts (investigating musculoskeletal symptoms, description of work, psychometric evaluation). The analysis was done with the statistical program SPSS.19. Symptoms of musculoskeletal problems emerged. Specifically, 54.4% in the lumbar, 47.7% in the neck, 45.5% in the shoulder, followed by smaller percentages of the hip, knee, elbow and ankle. 6.8% of participants indicated no musculoskeletal symptoms in the last year while 74.9% of those who had symptoms presented them in two or more areas. Activities rated as a major problem among others were the manual handling, tools with weight and vibration etc. 100% of respondents agreed that the work in the surgery unit is demanding and has anxiety. The lack of support from the government (81.8%), combined with the low perioperative nurses (6.8%) having the opportunity to participate in administrative decisions concerning them were related to problems in the organization and management of work. Apart from engineers target factors, a main aim should be the organization of work within the framework of a national policy based on European directives on the protection and promotion of the health and safety of workers.

  20. Treatment of phosphate-containing oily wastewater by coagulation and microfiltration.

    Science.gov (United States)

    Zhang, Jin; Sun, Yu-xin; Huang, Zhi-feng; Liu, Xing-qin; Meng, Guang-yao

    2006-01-01

    The oily wastewater generated from pretreatment unit of electrocoating industry contains oils, phosphate, organic solvents, and surfactants. In order to improve the removal efficiencies of phosphate and oils, to mitigate the membrane fouling, coagulation for ceramic membrane microfiltration of oily wastewater was performed. The results of filtration tests show that the membrane fouling decreased and the permeate flux and quality increased with coagulation as pretreatment. At the coagulant Ca (OH)2 dosage of 900 mg/L, the removal efficiency of phosphate was increased from 46.4% without coagulation to 99.6%; the removal of COD and oils were 97.0% and 99.8%, respectively. And the permeate flux was about 70% greater than that when Ca(OH)2 was not used. The permeate obtained from coagulation and microfiltration can be reused as make-up water, and the recommended operation conditions for pilot and industrial application are transmembrane pressure of 0.10 MPa and cross-flow velocity of 5 m/s. The comparison results show that 0.2 microm ZrO2 microfilter with coagulation could be used to perform the filtration rather than conventional ultrafilter, with very substantial gain in flux and removal efficiency of phosphate.

  1. [Perioperative managment of laparoscopic sleeve gastrectomy].

    Science.gov (United States)

    Chang, Xu-sheng; Yin, Kai; Wang, Xin; Zhuo, Guang-zuan; Ding, Dan; Guo, Xiang; Zheng, Cheng-zhu

    2013-10-01

    To summarize the surgical technique and perioperative management of laparoscopic sleeve gastrectomy (LSG). A total of 57 morbid obesity patients undergoing LSG surgery from May 2010 to December 2012 were enrolled in the study, whose clinical data in perioperative period were analyzed retrospectively. These patients had more than 1 year of follow-up. All the patients received preoperative preparation and postoperative management, and postoperative excess weight loss(EWL%) and improvement of preoperative complications was evaluated. All the cases completed the operation under laparoscopy, except 1 case because of the abdominal extensive adhesion. The average operation time was(102.0±15.2) min and the mean intraoperative blood loss (132.3±45.6) ml. Of 2 postoperative hemorrhage patients, 1 case received conservative treatment, and another one underwent laparoscopic exploration. The EWL% at 3 months, 6 months and 1 year after procedure was (54.9±13.8)%, (79.0±23.6)% and (106.9±25.1)% respectively. The preoperative complications were improved in some degree. There were no operative death, and anastomotic leak, anastomotic stenosis, or surgical site infection occurred. LSG is a safe and effective surgical technique, whose safety and efficacy may be increased by improving the perioperative management.

  2. The peri-operative management of anti-platelet therapy in elective, non-cardiac surgery.

    Science.gov (United States)

    Alcock, Richard F; Naoum, Chris; Aliprandi-Costa, Bernadette; Hillis, Graham S; Brieger, David B

    2013-07-31

    Cardiovascular complications are important causes of morbidity and mortality in patients undergoing elective non-cardiac surgery, with adverse cardiac outcomes estimated to occur in approximately 4% of all patients. Anti-platelet therapy withdrawal may precede up to 10% of acute cardiovascular syndromes, with withdrawal in the peri-operative setting incompletely appraised. The aims of our study were to determine the proportion of patients undergoing elective non-cardiac surgery currently prescribed anti-platelet therapy, and identify current practice in peri-operative management. In addition, the relationship between management of anti-platelet therapy and peri-operative cardiac risk was assessed. We evaluated consecutive patients attending elective non-cardiac surgery at a major tertiary referral centre. Clinical and biochemical data were collected and analysed on patients currently prescribed anti-platelet therapy. Peri-operative management of anti-platelet therapy was compared with estimated peri-operative cardiac risk. Included were 2950 consecutive patients, with 516 (17%) prescribed anti-platelet therapy, primarily for ischaemic heart disease. Two hundred and eighty nine (56%) patients had all anti-platelet therapy ceased in the peri-operative period, including 49% of patients with ischaemic heart disease and 46% of patients with previous coronary stenting. Peri-operative cardiac risk score did not influence anti-platelet therapy management. Approximately 17% of patients undergoing elective non-cardiac surgery are prescribed anti-platelet therapy, the predominant indication being for ischaemic heart disease. Almost half of all patients with previous coronary stenting had no anti-platelet therapy during the peri-operative period. The decision to cease anti-platelet therapy, which occurred commonly, did not appear to be guided by peri-operative cardiac risk stratification. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  3. Reduce--recycle--reuse: guidelines for promoting perioperative waste management.

    Science.gov (United States)

    Laustsen, Gary

    2007-04-01

    The perioperative environment generates large amounts of waste, which negatively affects local and global ecosystems. To manage this waste health care facility leaders must focus on identifying correctable issues, work with relevant stakeholders to promote solutions, and adopt systematic procedural changes. Nurses and managers can moderate negative environmental effects by promoting reduction, recycling, and reuse of materials in the perioperative setting.

  4. A Novel Process Audit for Standardized Perioperative Handoff Protocols.

    Science.gov (United States)

    Pallekonda, Vinay; Scholl, Adam T; McKelvey, George M; Amhaz, Hassan; Essa, Deanna; Narreddy, Spurthy; Tan, Jens; Templonuevo, Mark; Ramirez, Sasha; Petrovic, Michelle A

    2017-11-01

    A perioperative handoff protocol provides a standardized delivery of communication during a handoff that occurs from the operating room to the postanestheisa care unit or ICU. The protocol's success is dependent, in part, on its continued proper use over time. A novel process audit was developed to help ensure that a perioperative handoff protocol is used accurately and appropriately over time. The Audit Observation Form is used for the Audit Phase of the process audit, while the Audit Averages Form is used for the Data Analysis Phase. Employing minimal resources and using quantitative methods, the process audit provides the necessary means to evaluate the proper execution of any perioperative handoff protocol. Copyright © 2017 The Joint Commission. Published by Elsevier Inc. All rights reserved.

  5. IMPROVEMENT OF COAGULATION PROCESS FOR THE PRUT RIVER WATER TREATMENT USING ALUMINUM SULPHATE

    Directory of Open Access Journals (Sweden)

    Larisa Postolachi

    2015-06-01

    Full Text Available The aim of presented research was to optimize the treatment process of the Prut River water. In order to realize the proposed goal, there were studied the following factors which can improve the process of coagulation: (i the influence of stirring speed during coagulation and (ii the influence of the concentration of the coagulant solution added in the process of coagulation. The optimal conditions of coagulation were established using the Jar-test method. Application of the recommended procedure contribute to the reduction of the coagulant dose, the contact time, the aluminum concentration in water and the expenses for water treatment.

  6. Disseminated intravascular coagulation (DIC)

    Science.gov (United States)

    ... Jr, Silberstein LE, et al, eds. Hematology: Basic Principles and Practice . 6th ed. Philadelphia, PA: Elsevier Saunders; 2013:chap 141. Thachil J, Toh CH. Current concepts in the management of disseminated intravascular coagulation. Thromb Res . 2012;129 ...

  7. Vitamin K: from coagulation to calcification.

    Science.gov (United States)

    Paakkari, Ilari

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

  8. WATER PURIFICATION BY COAGULATION UNDER THE INFLUENCE OF ULTRASONIC FIELD

    Directory of Open Access Journals (Sweden)

    Vikulina Vera Borisovna

    2016-03-01

    Full Text Available The authors carried out experiments on the in-fluence of ultrasound on the subsidence of suspended materials. The efficiency of coagulation process in wa-ter purification in ultrasound field is estimated. The influence of ultrasound on the water with suspended materials before introducing coagulant was a condition of the experiment. The magnetostriction method for obtaining ultrasound oscillations with the help of ultra-sound generator of batch production was applied. The samples were chosen and the coagulation process was controlled using standard procedures. The experimental data was obtained which estimate the efficiency in-crease in the subsidence of suspended materials de-pending on the duration of ultrasound processing. Dur-ing one minute of ultrasound processing the following results were obtained: the subsidence efficiency in-creased by 25.83 % in case of coagulant share Al2O3 2.5 mg/l; the subsidence efficiency increased by 23.70 % in case of coagulant share Al2O3 5.0 mg/l.

  9. Physiological levels of blood coagulation factors IX and X control coagulation kinetics in an in vitro model of circulating tissue factor

    International Nuclear Information System (INIS)

    Tormoen, Garth W; Khader, Ayesha; Gruber, András; McCarty, Owen J T

    2013-01-01

    Thrombosis significantly contributes to cancer morbidity and mortality. The mechanism behind thrombosis in cancer may be circulating tissue factor (TF), as levels of circulating TF are associated with thrombosis. However, circulating TF antigen level alone has failed to predict thrombosis in patients with cancer. We hypothesize that coagulation factor levels regulate the kinetics of circulating TF-induced thrombosis. Coagulation kinetics were measured as a function of individual coagulation factor levels and TF particle concentration. Clotting times increased when pooled plasma was mixed at or above a ratio of 4:6 with PBS. Clotting times increased when pooled plasma was mixed at or above a ratio of 8:2 with factor VII-depleted plasma, 7:3 with factor IX- or factor X-depleted plasmas, or 2:8 with factor II-, V- or VIII-depleted plasmas. Addition of coagulation factors VII, X, IX, V and II to depleted plasmas shortened clotting and enzyme initiation times, and increased enzyme generation rates in a concentration-dependent manner. Only additions of factors IX and X from low-normal to high-normal levels shortened clotting times and increased enzyme generation rates. Our results demonstrate that coagulation kinetics for TF particles are controlled by factor IX and X levels within the normal physiological range. We hypothesize that individual patient factor IX and X levels may be prognostic for susceptibility to circulating TF-induced thrombosis. (paper)

  10. Coagulation and flocculation of dissolved organic substances with organic polymers

    OpenAIRE

    Kvinnesland, Thomas

    2002-01-01

    Coagulation of natural organic matter (NOM) in water is a well-established process, enabling or enhancing the removal of these substances by different particle separation processes. The dominating coagulating agents used are, however, inorganic salts of iron (Fe3+) and aluminium (Al3+). The primary use of organic polymers is as flocculating agents for already coagulated aggregates. However, in recent years the use of cationic organic polymers have received increasing attent...

  11. Being altered by the unexpected: understanding the perioperative patient's experience: a case study.

    Science.gov (United States)

    Rudolfsson, Gudrun

    2014-08-01

    The present paper focuses on the process of understanding the patient in the context of perioperative caring and reports a story narrated by a perioperative nurse as well as her emerging understanding of the patient prior to surgery at an operating department. This qualitative case study had a dual purpose; firstly, to describe how the perioperative nurse's understanding of the patient emerged and, secondly, to establish how the researcher interpreted the situation. As a perioperative nurse and researcher, the author is both the narrator and interpreter. To date we have rarely discussed the fact that, in a perioperative context, the patient might feel ashamed of his/her body, even before arriving at the operating department. This new understanding emerged from the hermeneutical dialogue in the present study. © 2013 Wiley Publishing Asia Pty Ltd.

  12. Effects of perioperative briefing and debriefing on patient safety: a prospective intervention study.

    Science.gov (United States)

    Leong, Katharina Brigitte Margarethe Siew Lan; Hanskamp-Sebregts, Mirelle; van der Wal, Raymond A; Wolff, Andre P

    2017-12-14

    This study was carried out to improve patient safety in the operating theatre by the introduction of perioperative briefing and debriefing, which focused on an optimal collaboration between surgical team members. A prospective intervention study with one pretest and two post-test measurements: 1 month before and 4 months and 2.5 years after the implementation of perioperative briefing and debriefing, respectively. Operating theatres of a tertiary care hospital with 875 beds in the Netherlands. All members of five surgical teams participated in the perioperative briefing and debriefing. The implementation of perioperative briefing and debriefing from July 2012 to January 2014. The primary outcome was changes in the team climate, measured by the Team Climate Inventory. Secondary outcomes were the experiences of surgical teams with perioperative briefing and debriefing, measured with a structured questionnaire, and the duration of the briefings, measured by an independent observer. Two and a half years after the introduction of perioperative briefing and debriefing, the team climate increased statistically significant (p≤0.05). Members of the five surgical teams strongly agreed with the positive influence of perioperative briefing and debriefing on clear agreements and reminding one another of the agreements of the day. They perceived a higher efficiency of the surgical programme with more operations starting on time and less unexpectedly long operation time. The perioperative briefing took less than 4 min to conduct. Perioperative briefing and debriefing improved the team climate of surgical teams and the efficiency of their work within the operating theatre with acceptable duration per briefing. Surgical teams with alternating team compositions have the most benefit of briefing and debriefing. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise

  13. The performance of double layer structure membrane prepared from flowing coagulant

    Science.gov (United States)

    Mieow Kee, Chan; Xeng, Anthony Leong Chan; Regal, Sasiskala; Singh, Balvinder; Raoo, Preeshaath; Koon Eu, Yap; Sok Choo, Ng

    2017-12-01

    Membrane with double layer structure is favourable as it exhibits smooth surface and macrovoids free structure. However, its’ performance in terms of permeability, porosity and strength has not been studied thoroughly. Additionally, the effect of flowing coagulant on the formation of double layer membrane has not been reported. Thus, the objective of this study is to investigate the performance of double layer membranes, which were prepared using flowing coagulant. Results showed that when the coagulant flow changed from laminar to turbulent, the pure water permeation of the membrane increased. It was due to the higher porosity in the membrane, which prepared by turbulent flow (CA-Turbulent) compared to the membrane which fabricated under laminar condition (CA-Laminar). This can be explained by the rapid solvent-coagulant exchange rate between the polymer solution and the turbulent coagulant. In term of strength, the tensile strength of the CA-Turbulent was ~32 MPa, which was 100% higher compared to CA-Laminar. This may due to the presence of large amount of nodules on its surface, which reduced the surface integrity. In conclusion, flowing coagulant altered the membrane properties and adopting turbulent coagulant flow in membrane fabrication would improve the porosity, surface roughness and the strength of the membrane.

  14. Coagulation and Adsorption Treatment of Printing Ink Wastewater

    Directory of Open Access Journals (Sweden)

    Maja Klančnik

    2015-03-01

    Full Text Available The intention of the study was to improve the efficiency of total organic carbon (TOC and colour removal from the wastewater samples polluted with flexographic printing ink following coagulation treatments with further adsorption onto activated carbons and ground orange peel. The treatment efficiencies were compared to those of further flocculation treatments and of coagulation and adsorption processes individually. Coagulation was a relatively effective single-treatment method, removing 99.7% of the colour and 86.9% of the organic substances (TOC from the printing ink wastewater samples. Further flocculation did not further eliminate organic pollutants, whereas subsequent adsorption with 7 g/l of granular activated carbon further reduced organic substances by 35.1%, and adsorption with 7 g/l of powdered activated carbon further reduced organic substances by 59.3%. Orange peel was an inappropriate adsorbent for wastewater samples with low amounts of pollution, such as water that had been treated by coagulation. However, in highly polluted printing ink wastewater samples, the adsorption treatment with ground orange peel achieved efficiencies comparable to those of the granular activated carbon treatments.

  15. Novel approaches to the management of disseminated intravascular coagulation

    NARCIS (Netherlands)

    Levi, M. [=Marcel M.; de Jonge, E.; van der Poll, T.; ten Cate, H.

    2000-01-01

    Disseminated intravascular coagulation (DIC) is a syndrome characterized by systemic intravascular activation of coagulation, leading to widespread deposition of fibrin in the circulation. We addressed the issue of whether there is evidence that this fibrin deposition contributes to multiple organ

  16. Toyota production system quality improvement initiative improves perioperative antibiotic therapy.

    Science.gov (United States)

    Burkitt, Kelly H; Mor, Maria K; Jain, Rajiv; Kruszewski, Matthew S; McCray, Ellesha E; Moreland, Michael E; Muder, Robert R; Obrosky, David Scott; Sevick, Mary Ann; Wilson, Mark A; Fine, Michael J

    2009-09-01

    To assess the role of a Toyota production system (TPS) quality improvement (QI) intervention on appropriateness of perioperative antibiotic therapy and in length of hospital stay (LOS) among surgical patients. Pre-post quasi-experimental study using local and national retrospective cohorts. We used TPS methods to implement a multifaceted intervention to reduce nosocomial methicillin-resistant Staphylococcus aureus infections on a Veterans Affairs surgical unit, which led to a QI intervention targeting appropriate perioperative antibiotic prophylaxis. Appropriate perioperative antibiotic therapy was defined as selection of the recommended antibiotic agents for a duration not exceeding 24 hours from the time of the operation. The local computerized medical record system was used to identify patients undergoing the 25 most common surgical procedures and to examine changes in appropriate antibiotic therapy and LOS over time. Overall, 2550 surgical admissions were identified from the local computerized medical records. The proportion of surgical admissions receiving appropriate perioperative antibiotics was significantly higher (P <.01) in 2004 after initiation of the TPS intervention (44.0%) compared with the previous 4 years (range, 23.4%-29.8%) primarily because of improvements in compliance with antibiotic therapy duration rather than appropriate antibiotic selection. There was no statistically significant decrease in LOS over time. The use of TPS methods resulted in a QI intervention that was associated with an increase in appropriate perioperative antibiotic therapy among surgical patients, without affecting LOS.

  17. The role of perioperative warming in surgery: a systematic review

    Directory of Open Access Journals (Sweden)

    Muhammad Shafique Sajid

    Full Text Available OBJECTIVE: The objective of this review was to systematically analyze the trials on the effectiveness of perioperative warming in surgical patients. METHODS: A systematic review of the literature was undertaken. Clinical trials on perioperative warming were selected according to specific criteria and analyzed to generate summative data expressed as standardized mean difference (SMD. RESULTS: Twenty-five studies encompassing 3,599 patients in various surgical disciplines were retrieved from the electronic databases. Nineteen randomized trials on 1785 patients qualified for this review. The no-warming group developed statistically significant hypothermia. In the fixed effect model, the warming group had significantly less pain and lower incidence of wound infection, compared with the no-warming group. In the random effect model, the warming group was also associated with lower risk of post-anesthetic shivering. Both in the random and the fixed effect models, the warming group was associated with significantly less blood loss. However, there was significant heterogeneity among the trials. CONCLUSION: Perioperative warming of surgical patients is effective in reducing postoperative wound pain, wound infection and shivering. Systemic warming of the surgical patient is also associated with less perioperative blood loss through preventing hypothermia-induced coagulopathy. Perioperative warming may be given routinely to all patients of various surgical disciplines in order to counteract the consequences of hypothermia.

  18. A Pontential Agriculture Waste Material as Coagulant Aid: Cassava Peel

    Science.gov (United States)

    Othman, N.; Abd-Rahim, N.-S.; Tuan-Besar, S.-N.-F.; Mohd-Asharuddin, S.; Kumar, V.

    2018-02-01

    All A large amount of cassava peel waste is generated annually by small and medium scale industries. This has led to a new policy of complete utilization of raw materials so that there will be little or no residue left that could pose pollution problems. Conversion of these by-products into a material that poses an ability to remove toxic pollutant would increase the market value and ultimately benefits the producers. This study investigated the characteristics of cassava peel as a coagulant aid material and optimization process using the cassava peel was explored through coagulation and flocculation. This research had highlighted that the Cassava peels contain sugars in the form of polysaccharides such as starch and holocellulose. The FTIR results revealed that amino acids containing abundant of carboxyl, hydroxyl and amino groups which has significant capabilities in removing pollutants. Whereas analysis by XRF spectrometry indicated that the CP samples contain Fe2O3 and Al2O3 which might contribute to its coagulation ability. The optimum condition allowed Cassava peel and alum removed high turbidity up to 90. This natural coagulant from cassava peel is found to be an alternative coagulant aid to reduce the usage of chemical coagulants

  19. Evaluation of Impact of Coagulant Type on Operation Parameters in Direct Filtration

    Directory of Open Access Journals (Sweden)

    Ali Torabian

    2007-06-01

    Full Text Available Numerous advantages have been reported on PAC (poly aluminum chloride used as a coagulant over other coagulants such as alum and ferric chloride used in conventional water treatment process with medium and high turbidity levels. These include lower amounts of PACL required specially in removing turbidity, larger floc grain formation, reduced floc sedimentation time, lower sludge production, and relaxation of the need for pH adjustment by lime, among others. The present study aims to evaluate the effects of different coagulants such as ferric chloride and PACL on direct filtration and to identify the most effective material based on both turbidity and particle removal efficiencies. A perfectly experimental pilot system, including raw water preparation, coagulation, flocculation, distribution measurement, and filtration units, was designed and used. Raw water turbidity level in the experimental pilot was below 10 NTU. The effects of various parameters such as coagulant type, filtration rate, and coagulant dosage on the performance of the filter were investigated. The results obtained from several filtration cycles under different conditions indicated that average effluent turbidity level, effluent particle numbers, effluent turbidity variation graph, and effluent particle graph were lower throughout the filtration cycle when PACL was used compared to when ferric chloride was used as the coagulant. Increasing filtration rate led to increased turbidity and particle number. Addition of 2 mg/l of PACL (poor coagulation and flocculation scenario was compared with addition of 5 mg/l of ferric chloride (strong coagulation and flocculation scenario. The results indicated that higher average values of turbidity removal but lower turbidity and particle removal efficiencies obtained in the case of the poor coagulation and flocculation scenario.

  20. Treatment of sugar beet extraction juice stillage by natural coagulants extracted from common bean

    Directory of Open Access Journals (Sweden)

    Prodanović Jelena M.

    2015-01-01

    Full Text Available Distillery wastewaters have a great pollution potential, and pollution caused by them is one of the most critical environmental issues. This study is concerned with the coagulation efficiency of a new, environmental friendly, natural coagulant extracted from common bean seeds in the primary treatment of distillery wastewater in the bioethanol production from sugar beet juice. Active coagulation components were extracted from ground seeds of common bean with 0.5 mol/L NaCl. The obtained raw extract was used as a coagulant. The coagulation efficiency was measured by jar test at different pH values of wastewater, and a decrease in organic matter content was determined. The experiments confirmed that natural coagulant from common bean could be successfully used for the treatment of extraction juice distillery wastewater. The highest coagulation efficiencies were achieved at the pH 5.2 with a coagulant dose of 30 mL/L, and at the pH 8.5 with a coagulant dose of 5 mL/L, and they were 64.71% and 68.75% respectively. These encouraging results indicate that natural coagulant from common bean seeds is a potential alternative to conventional chemical coagulant/flocculant agents for treatment of wastewaters.[Projekat Ministarstva nauke Republike Srbije, br. III 43005

  1. Effect of perioperative insulin infusion on surgical morbidity and mortality

    DEFF Research Database (Denmark)

    Gandhi, Gunjan Y; Murad, M Hassan; Flynn, Errol David

    2008-01-01

    To conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the effect of perioperative insulin infusion on outcomes important to patients.......To conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the effect of perioperative insulin infusion on outcomes important to patients....

  2. A 10-year review of perioperative complications in pharyngeal flap surgery

    NARCIS (Netherlands)

    Hofer, SOP; Dhar, BK; Robinson, PH; Goorhuis-Brouwer, SM; Nicolai, JPA

    2002-01-01

    A 10-year retrospective study was undertaken to investigate perioperative complications in pharyngeal flap surgery in one institution using inferiorly and superiorly based flaps. In this fashion the current practice of surgical technique based on local findings and perioperative care, through

  3. Operating Conditions of Coagulation-Flocculation Process for High Turbidity Ceramic Wastewater

    Directory of Open Access Journals (Sweden)

    Sameer Al-Asheh

    2017-04-01

    Full Text Available This work attempted to determine the optimum conditions required for the coagulation and flocculation process as an essential stage of the ceramic wastewater treatment. Coagulation and flocculation is a very necessary step in industries as it lessens turbidity, color, and odor of wastewater. The experimental work was performed in several runs. The volume of wastewater used in each run was 200 mL and was kept at this value throughout. In certain runs, the speed of the mixer was varied while keeping the quantity of coagulant and flocculant constant in order to determine the optimum speed that resulted in the least turbidity. A speed of 5% was chosen as the ideal process speed according to the results obtained. Next, experiments were operated at this optimum speed while changing the dosage of coagulant and flocculant in order to decide the optimum dosage. Coagulant and flocculent amounts of 0.4 g (without booster and 0.2 g (with booster selected after the readings were taken. For all the readings, a turbidity meter was used providing results in Nephelometric Turbidity Units (NTU. Lowest turbidity was achieved when using 5% speed with 0.4 grams of coagulant and 0.4 grams of flocculant, or 5% speed with 0.2 grams of coagulant, 0.2 grams of flocculant and 0.25 g/L of booster coagulant. According to factorial design analysis, such as parameters as impeller speed and dosage have an influential impact on the turbidity; while the booster has insignificant influence and other interactions between parameters are important.

  4. Treatment of sugar beet thick juice spent wash by chemical and natural coagulants

    OpenAIRE

    Antov Mirjana G.; Klašnja Mile T.; Šćiban Marina B.

    2009-01-01

    The possibility of treatment of wastewater from bioethanol production by aluminium sulfate and natural coagulant extracted from common bean seed was studied. The highest coagulation activity at pH 6.5 is reached with analum dose of 1 g/l, but only a little lower coagulation activities were obtained by the dose of 0.05 and 0.10 g/l, which is more favorable for economic and environmental reasons. When natural coagulant from common bean was applied the highest coagulation activity, 14.3%, at pH ...

  5. Coagulation sensors based on magnetostrictive delay lines for biomedical and chemical engineering applications

    International Nuclear Information System (INIS)

    Maliaritsi, E.; Zoumpoulakis, L.; Simitzis, J.; Vassiliou, P.; Hristoforou, E.

    2006-01-01

    Coagulation sensors based on the magnetostrictive delay line technique are presented in this paper. They are based on magnetostrictive ribbons and are used for measuring the coagulation, curing or solidification time of different liquids. Experimental results indicate that the presented sensing elements can determine the blood coagulation with remarkable repeatability, thus allowing their use as blood coagulation sensors. Additionally, results indicate that they can also measure curing time of resins, solidification of fluids and coagulation of chemical substances, therefore allowing their implementation in chemical engineering applications

  6. Optimizing Perioperative Nutrition in Pediatric Populations.

    Science.gov (United States)

    Canada, Nicki L; Mullins, Lucille; Pearo, Brittany; Spoede, Elizabeth

    2016-02-01

    Nutrition status prior to surgery and nutrition rehabilitation after surgery can affect the morbidity and mortality of pediatric patients. A comprehensive approach to nutrition in pediatric surgical patients is important and includes preoperative assessment, perioperative nutrition considerations, and postoperative recovery. A thorough nutrition assessment to identify patients who are at nutrition risk prior to surgery is important so that the nutrition status can be optimized prior to the procedure to minimize suboptimal outcomes. Preoperative malnutrition is associated with increased complications and mean hospital days following surgery. Enteral and parenteral nutrition can be used in cases where food intake is inadequate to maintain and possibly improve nutrition status, especially in the 7-10 days prior to surgery. In the perioperative period, fasting should be limited to restricting solid foods and non-human milk 6 hours prior to the procedure and allowing clear liquids until 2 hours prior to the procedure. Postoperatively, early feeding has been shown to resolve postoperative ileus earlier, decrease infection rates, promote wound healing, and reduce length of hospital stay. If nutrition cannot be provided orally, then nutrition through either enteral or parenteral means should be initiated within 24-48 hours of surgery. Practitioners should identify those patients who are at the highest nutrition risk for postsurgical complications and provide guidance for optimal nutrition during the perioperative and postoperative period. © 2015 American Society for Parenteral and Enteral Nutrition.

  7. Perioperative Management of Diabetes: A Review

    Directory of Open Access Journals (Sweden)

    Md Nazmul Kayes

    2014-07-01

    Full Text Available Diabetes increases the requirements of surgery as well as perioperative morbidity and mortality. Careful preoperative evaluation and treatment of cardiac and renal diseases, intensive intraoperative and postoperative management are essential to optimize the best outcome. Stress hyperglycemia in response to surgery, osmotic diuresis and hypoinsulinemia can lead to life threatening complications like ketoacidosis or hyperglycemic hyperosmolar syndrome. Wound healing is impaired by hyperglycemia and chance of postoperative wound infection is more in diabetics. Therefore aseptic precautions must be taken. Adequate insulin, glucose, fluid and electrolytes should be provided for good metabolic control. Though some current study reveals that oral hypoglycemic agents can be used for the effective management of perioperative diabetes; the adverse effects of newly introduced agents need more clinical observations. Subcutaneous administration of insulin as in Sliding Scale may be a less preferable method, because of unreliable absorption and unpredictable blood glucose. Intravenous administration of rapid onset soluble (short acting insulin as in Alberti (GIK regimen, is safe and effective method controlling perioperative hyperglycemia. Patient with type 1 diabetes needs frequent monitoring of glucose, electrolytes and acid-base balance as chance of high hyperglycemia and ketoacidosis is more. In case of emergency surgery assessment for diabetic ketoacidosis (DKA and meticulous management is essential. Postoperative pain and hyperglycemia should be treated carefully to avoid complications.

  8. Superiority of ferric chloride as coagulant over alum and ferrous sulphate at controlled pH and cost comparison of these coagulant

    International Nuclear Information System (INIS)

    Irfan, M.

    2008-01-01

    This study was conducted by author as a member of Specialty Chemical Division of Sitara Chemical Industries which is the largest chlor -alkali manufacturing industry in Pakistan. Sitara is also producing FeCl/sub 3/ as a byproduct to consume its additional quantity of chlorine produced during electrolysis of brine solution for caustic soda preparation. Most of the industries are using Alum along with other polymers for treatment of effluent waste water. Treatment system is based on sand bed filters. For coagulation of unwanted materials present in the water, Alum is being used with Anionic Polymer (Accofloc-A2125) as flocculent. But the ferric chloride is not only functions as a reactants to remove water impurities but it also functions as a both coagulant and a Flocculent. This study was conducted for finding best alternative chemicals to improve treated water quality. For this purpose Ferric Chloride (FeCl/sub 3/) is used as best alternative of alum for better removal of turbidity, heavy metals and micro organisms to eradicate above said problems and for better removal of turbidity, heavy metals and micro, organisms to eradicate health problems. As per lab scale results quality of treated water with Ferric Chloride (FeCl/sub 3/) proved better than that of Alum. The main objective of this research is to investigate the efficiency of coagulation and flocculation processes for removing suspended solids, colour and COD which present in significant quantity. Three types of coagulants were examined using standard jar test apparatus, i.e., aluminum sulphate (alum), ferric chloride (FeCl/sub 3/) and ferrous sulphate (FeSO/sub 4/). The effects of agitation speed, settling time, pH, coagulant dosages and temperature were examined. At 300 rpm of rapid mixing and 50 rpm of slow mixing and 60 minutes settling time, higher removals of suspended solids (over 95%), colour (90%) and COD (43%) were achieved at pH 4 and 12. FeCl/sub 3/ was found to be superior compared with other

  9. Using Coagulation Process in Optimizing Natural Organic Matter Removal from Low Turbidity Waters

    Directory of Open Access Journals (Sweden)

    Alireza Mesdaghinia

    2006-03-01

    Full Text Available Optimization of coagulation process  for efficient removal of Natural Organic Matters (NOM has gained a lot of focus over the last years to meet the requirements of enhanced coagulation. NOM comprises both particulate and soluble components which the latter usually comprises the main portion. Removal of soluble NOM from low turbidity waters by coagulation is not a successful process unless enough attention is paid to stages of formation and development of both micro and macro-flocs. This study, which presents experimental results from pilot scale research studies aimed at optimizing coagulation process applied to synthetic raw waters supplemented by adding commercial humic acid with low turbidity levels, explains how pH and turbidity can be controlled to maximize soluble NOM removal. The removal of NOM at various coagulant doses and coagulation pHs has been assessed through raw and treated (coagulated-settled water measurements of total organic carbon (TOC. For low turbidity waters, essential floc nucleation sites can be provided by creating synthetic turbidities, for example by adding clay. Adjusting the initial pH at 5.5 or adding clay before coagulant addition allows the formation of micro-flocs as well as formation of the insoluble flocs at low coagulant doses.

  10. Charging and coagulation of radioactive and nonradioactive particles in the atmosphere

    International Nuclear Information System (INIS)

    Kim, Yong-ha; Yiacoumi, Sotira

    2016-01-01

    Charging and coagulation influence one another and impact the particle charge and size distributions in the atmosphere. However, few investigations to date have focused on the coagulation kinetics of atmospheric particles accumulating charge. This study presents three approaches to include mutual effects of charging and coagulation on the microphysical evolution of atmospheric particles such as radioactive particles. The first approach employs ion balance, charge balance, and a bivariate population balance model (PBM) to comprehensively calculate both charge accumulation and coagulation rates of particles. The second approach involves a much simpler description of charging, and uses a monovariate PBM and subsequent effects of charge on particle coagulation. The third approach is further simplified assuming that particles instantaneously reach their steady-state charge distributions. It is found that compared to the other two approaches, the first approach can accurately predict time-dependent changes in the size and charge distributions of particles over a wide size range covering from the free molecule to continuum regimes. The other two approaches can reliably predict both charge accumulation and coagulation rates for particles larger than about 0.04 micrometers and atmospherically relevant conditions. These approaches are applied to investigate coagulation kinetics of particles accumulating charge in a radioactive neutralizer, the urban atmosphere, and an atmospheric system containing radioactive particles. Limitations of the approaches are discussed.

  11. Simultaneous lactic acidification and coagulation by using recombinant Lactococcus lactis strain.

    Science.gov (United States)

    Raftari, M; Ghafourian, S; Abu Bakar, F

    2017-04-01

    This study was an attempt to create a novel milk clotting procedure using a recombinant bacterium capable of milk coagulation. The Rhizomucor pusillus proteinase (RPP) gene was sub-cloned into a pALF expression vector. The recombinant pALF-RPP vector was then electro-transferred into Lactococcus lactis. Finally, the milk coagulation ability of recombinant L. lactis carrying a RPP gene was evaluated. Nucleotide sequencing of DNA insertion from the clone revealed that the RPP activity corresponded to an open reading frame consisting of 1218 bp coding for a 43·45 kDa RPP protein. The RPP protein assay results indicated that the highest RPP enzyme expression with 870 Soxhlet units (SU) per ml and 7914 SU/OD were obtained for cultures which were incubated at pH 5·5 and 30°C. Interestingly, milk coagulation was observed after 205 min of inoculating milk with recombinant L. lactis carrying the RPP gene. The recombinant L. lactis carrying RPP gene has the ability to function as a starter culture for acidifying and subsequently coagulating milk by producing RPP as a milk coagulant agent. Creating a recombinant starter culture bacterium that is able to coagulate milk. It is significant because the recombinant L. lactis has the ability to work as a starter culture and milk coagulation agent. © 2016 The Society for Applied Microbiology.

  12. Rhinoplasty perioperative database using a personal digital assistant.

    Science.gov (United States)

    Kotler, Howard S

    2004-01-01

    To construct a reliable, accurate, and easy-to-use handheld computer database that facilitates the point-of-care acquisition of perioperative text and image data specific to rhinoplasty. A user-modified database (Pendragon Forms [v.3.2]; Pendragon Software Corporation, Libertyville, Ill) and graphic image program (Tealpaint [v.4.87]; Tealpaint Software, San Rafael, Calif) were used to capture text and image data, respectively, on a Palm OS (v.4.11) handheld operating with 8 megabytes of memory. The handheld and desktop databases were maintained secure using PDASecure (v.2.0) and GoldSecure (v.3.0) (Trust Digital LLC, Fairfax, Va). The handheld data were then uploaded to a desktop database of either FileMaker Pro 5.0 (v.1) (FileMaker Inc, Santa Clara, Calif) or Microsoft Access 2000 (Microsoft Corp, Redmond, Wash). Patient data were collected from 15 patients undergoing rhinoplasty in a private practice outpatient ambulatory setting. Data integrity was assessed after 6 months' disk and hard drive storage. The handheld database was able to facilitate data collection and accurately record, transfer, and reliably maintain perioperative rhinoplasty data. Query capability allowed rapid search using a multitude of keyword search terms specific to the operative maneuvers performed in rhinoplasty. Handheld computer technology provides a method of reliably recording and storing perioperative rhinoplasty information. The handheld computer facilitates the reliable and accurate storage and query of perioperative data, assisting the retrospective review of one's own results and enhancement of surgical skills.

  13. Perioperative Rosuvastatin in Cardiac Surgery.

    Science.gov (United States)

    Zheng, Zhe; Jayaram, Raja; Jiang, Lixin; Emberson, Jonathan; Zhao, Yan; Li, Qi; Du, Juan; Guarguagli, Silvia; Hill, Michael; Chen, Zhengming; Collins, Rory; Casadei, Barbara

    2016-05-05

    Complications after cardiac surgery are common and lead to substantial increases in morbidity and mortality. Meta-analyses of small randomized trials have suggested that perioperative statin therapy can prevent some of these complications. We randomly assigned 1922 patients in sinus rhythm who were scheduled for elective cardiac surgery to receive perioperative rosuvastatin (at a dose of 20 mg daily) or placebo. The primary outcomes were postoperative atrial fibrillation within 5 days after surgery, as assessed by Holter electrocardiographic monitoring, and myocardial injury within 120 hours after surgery, as assessed by serial measurements of the cardiac troponin I concentration. Secondary outcomes included major in-hospital adverse events, duration of stay in the hospital and intensive care unit, left ventricular and renal function, and blood biomarkers. The concentrations of low-density lipoprotein cholesterol and C-reactive protein after surgery were lower in patients assigned to rosuvastatin than in those assigned to placebo (PSTICS ClinicalTrials.gov number, NCT01573143.).

  14. Perioperative blood loss and diclofenac in major arthroplastic surgery

    Directory of Open Access Journals (Sweden)

    Ljiljana Gvozdenović

    2011-04-01

    Full Text Available Introduction: Contemporary literature indicates precaution over the perioperative use of non-steroidal anti-inflammatory drugs, since they can potentially increase perioperative blood loss related to their mechanism of action. The aim of this study was to assess the influence of non-steroidal anti-inflammatory drugs on perioperative blood loss undergoing hip arthroplasty and its correlation with general and regional anesthesia.Methods: This prospective study included 120 patients who had undergone elective unilateral total hip arthroplasty. Patients were allocated into four groups. Groups 1 and 2 were pretreated with diclofenac and operated in general and regional anesthesia. Group 3 and 4 weren’t pretreated with any non-steroidal anti-inflammatory drug and were, as well, operated in general and regional anesthesia. Diclofenac was administered orally two times a day 75 mg (total 150 mg and also as intramuscular injection (75 mg preoperatively and 12 hours later on a day of surgery.Results: The perioperative blood loss in the rst 24 hours showed an increase of 29.4% in the diclofenac group operated in general anesthesia and increase of 26.8% in patients operated in regional anesthesia (P < 0.05 compared to control group. Statistical data evaluation of patients operated in general anesthesia compared to regional anesthesia, the overall blood loss in the rst 24 h after surgery, showed an increase of 6.4% in the diclofenac group and increase of 3.6% in placebo group. This was not statistically significant.Conclusion: Pretreatment with non-steroidal anti-inflammatory drugs (diclofenac before elective unilateral total hip arthroplasty increases the perioperative blood loss signficantly. Early discontinuation of non-selective non-steroidal anti-inflammatory drugs is advised.

  15. Ambulatory anesthesia: optimal perioperative management of the diabetic patient

    Directory of Open Access Journals (Sweden)

    Polderman JAW

    2016-05-01

    Full Text Available Jorinde AW Polderman, Robert van Wilpe, Jan H Eshuis, Benedikt Preckel, Jeroen Hermanides Department of Anaesthesiology, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands Abstract: Given the growing number of patients with diabetes mellitus (DM and the growing number of surgical procedures performed in an ambulatory setting, DM is one of the most encountered comorbidities in patients undergoing ambulatory surgery. Perioperative management of ambulatory patients with DM requires a different approach than patients undergoing major surgery, as procedures are shorter and the stress response caused by surgery is minimal. However, DM is a risk factor for postoperative complications in ambulatory surgery, so should be managed carefully. Given the limited time ambulatory patients spend in the hospital, improvement in management has to be gained from the preanesthetic assessment. The purpose of this review is to summarize current literature regarding the anesthesiologic management of patients with DM in the ambulatory setting. We will discuss the risks of perioperative hyperglycemia together with the pre-, intra-, and postoperative considerations for these patients when encountered in an ambulatory setting. Furthermore, we provide recommendations for the optimal perioperative management of the diabetic patient undergoing ambulatory surgery. Keywords: diabetes mellitus, perioperative period, ambulatory surgery, insulin, complications, GLP-1 agonist, DPP-4 inhibitor

  16. Making the invisible visible--operating theatre nurses' perceptions of caring in perioperative practice.

    Science.gov (United States)

    Blomberg, Ann-Catrin; Bisholt, Birgitta; Nilsson, Jan; Lindwall, Lillemor

    2015-06-01

    The aim of this study was to describe operating theatre nurses' (OTNs') perceptions of caring in perioperative practice. A qualitative descriptive design was performed. Data were collected with interviews were carried out with fifteen strategically selected operating theatre nurses from different operating theatres in the middle of Sweden. A phenomenographic analysis was used to analyse the interviews. The findings show that operating theatre nurses' perceptions of caring in perioperative practice can be summarised in one main category: To follow the patient all the way. Two descriptive categories emerged: To ensure continuity of patient care and keeping a watchful eye. The operating theatre nurses got to know the patient and as a result became responsible for the patient. They protected the patient's body and preserved patient dignity in perioperative practice. The findings show different aspects of caring in perioperative practice. OTNs wanted to be more involved in patient care and follow the patient throughout the perioperative nursing process. Although OTNs have the ambition to make the care in perioperative practice visible, there is today a medical technical approach which promotes OTNs continuing to offer care in secret. © 2014 Nordic College of Caring Science.

  17. Critical assessment of chitosan as coagulant to remove cyanobacteria

    NARCIS (Netherlands)

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

    2017-01-01

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

  18. Critical assessment of chitosan as coagulant to remove cyanobacteria

    NARCIS (Netherlands)

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

    2017-01-01

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

  19. Coagulation mechanism of salt solution-extracted active component in Moringa oleifera seeds

    OpenAIRE

    Okuda, Tetsuji; Baes, Aloysius U.; Nishijima, Wataru; Okada, Mitsumasa

    2001-01-01

    This study focuses on the coagulation mechanism by the purified coagulant solution (MOC-SC-PC) with the coagulation active component extracted from M. oleifera seeds using salt solution. The addition of MOC-SC-PC into tap water formed insoluble matters. The formation was responsible for kaolin coagulation. On the other hand, insoluble matters were not formed when the MOC-SC-PC was added into distilled water. The formation was affected by Ca2+ or other bivalent cations which may connect each m...

  20. Improvement of extraction method of coagulation active components from Moringa oleifera seed

    OpenAIRE

    Okuda, Tetsuji; Baes, Aloysius U.; Nishijima, Wataru; Okada, Mitsumasa

    1999-01-01

    A new method for the extraction of the active coagulation component from Moringa oleifera seeds was developed and compared with the ordinary water extraction method (MOC–DW). In the new method, 1.0 mol l-1 solution of sodium chloride (MOC–SC) and other salts were used for extraction of the active coagulation component. Batch coagulation experiments were conducted using 500 ml of low turbid water (50 NTU). Coagulation efficiencies were evaluated based on the dosage required to remove kaolinite...

  1. Perioperative Management of a Patient with Cold Urticaria

    Directory of Open Access Journals (Sweden)

    Priscilla Agbenyefia

    2017-12-01

    Full Text Available Cold urticaria consists of an allergic immune response to cold temperatures with symptoms ranging from pruritic wheals to life-threatening angioedema, bronchospasm, or anaphylactic shock. Adequate planning to maintain normothermia perioperatively is vital due to impaired hypothalamic thermoregulation and overall depression of sympathetic outflow during deep sedation and general anesthesia. This case report describes the successful perioperative management of a 45-year-old female with a history of cold urticaria undergoing a laparoscopic Nissen fundoplication for refractory gastroesophageal reflux disease and discusses how to appropriately optimize the care of these patients.

  2. OPTIMISATION OF HIBISCUS SABDARIFFA AS A NATURAL COAGULANT TO TREAT CONGO RED IN WASTEWATER

    Directory of Open Access Journals (Sweden)

    MUN Y. YONG

    2016-02-01

    Full Text Available The process of coagulation is commonly practiced in water and wastewater treatment to reduce level of dissolved chemical, turbidity and so on with the usage of coagulant. Aluminium sulphate (alum is the most commonly used coagulant, however, recent studies show that residual aluminium in drinking water and sludge may induce Alzheimer’s disease and environmental issues. Natural coagulant which is environmental friendly and non-toxic is developed as an alternative to overcome these issues. In this work, Hibiscus Sabdariffa was studied as natural coagulant to treat dye wastewater containing Congo red. The seeds were extracted with different solvent such as distilled water, 0.5 M NaCl and 0.05 M NaOH to extract the coagulation agent. The working parameters were optimised using Response Surface Methodology (RSM. 0.5 M NaCl was found to have highest colour removal of 95.1 % among the solvents. In addition, Hibiscus Sabdariffa seed was found to be an effective coagulant that has 91.2 % colour removal at the optimal working condition of pH 2, 190 mg/L coagulant dosage at 400 ppm of dye concentration. It was also been identified that the performance of natural coagulant is comparable with conventional coagulant, aluminium sulphate with colour removal of 91.2 % and 92.3 % respectively.

  3. Removal of Arsenic from Drinking Water by Adsorption and Coagulation

    Science.gov (United States)

    Zhang, M.; Sugita, H.; Hara, J.; Takahashi, S.

    2013-12-01

    Removal of arsenic from drinking water has been an important issue worldwide, which has attracted greater attentions in recent years especially for supplying safe drinking water in developing countries. Although many kinds of treatment approaches that are available or applicable both in principle and practice, such as adsorption, coagulation, membrane filtration, ion exchange, biological process, electrocoagulation and so on, the first 2 approaches (i.e., adsorption and coagulation) are most promising due to the low-cost, high-efficiency, simplicity of treating systems, and thus can be practically used in developing countries. In this study, a literature survey on water quality in Bangladesh was performed to understand the ranges of arsenic concentration and pH of groundwater in Bangladesh. A series of tests were then organized and performed to investigate the effects of arsenic concentration, arsenic forms, pH, chemical compositions of the materials used for adsorption and coagulation, particle size distribution and treatment time on quality of treated water. The experimental results obtained in the study illustrated that both adsorption and coagulation can be used to effectively reduce the concentrations of either arsenic (V) or arsenic (III) from the contaminated water. Coagulation of arsenic with a magnesium-based material developed in this study can be very effective to remove arsenic, especially arsenic (V), from contaminated water with a concentration of 10 ppm to an undetectable level of 0.002 ppm by ICP analyses. Compared to arsenic (III), arsenic (V) is easier to be removed. The materials used for adsorption and coagulation in this study can remove arsenic (V) up to 9 mg/g and 6 mg/g, and arsenic (III) up to 4 mg/g and 3 mg/g, respectively, depending on test conditions and compositions of the materials being used. The control of pH during treatment can be a challenging technical issue for developing both adsorbent and coagulant. Keywords: Water Treatment

  4. Bladder perforation owing to a unipolar coagulating device.

    Science.gov (United States)

    Pakter, J; Budnick, L D

    1981-09-15

    A report on a patient who sustained a burn and perforation of the urinary bladder from visible sparks emanating from a unipolar coagulating device during the couse of laparoscopic sterilization is presented. It is the first report of urinary bladder burns using a unipolar coagulating device. A 24-year-old woman, gravida 10, para 3, abortus 7, underwent a laparoscopic sterilization with a unipolar coagulating device. As the physician was finishing the coagulation, a spark from the device caused a 1-2 cm burn with a central area of perforation into the urinary bladder. Conservative treatment was recommended, and consisted of Foley catheterization and drainage for 5 days. Initial urine culture revealed Klebsiella species, and oral ampicillin was prescribed. Hematuria was noted throughout the patient's hospitalization, and blood clots were present in the urine on Day 2 postoperation. The patient had no abdominal or flank pain, was afebrile, and had a stable hemoglobin level during the hospital stay. Cystography was performed on Day 5 postoperatively and demonstrated no perforation. Foley catheter was removed. Patient was discharged 2 days later and remains in good health 3 months postoperatively.

  5. Importance of Perioperative Glycemic Control in General Surgery

    Science.gov (United States)

    Kwon, Steve; Thompson, Rachel; Dellinger, Patchen; Yanez, David; Farrohki, Ellen; Flum, David

    2014-01-01

    Objective To determine the relationship of perioperative hyperglycemia and insulin administration on outcomes in elective colon/rectal and bariatric operations. Background There is limited evidence to characterize the impact of perioperative hyperglycemia and insulin on adverse outcomes in patients, with and without diabetes, undergoing general surgical procedures. Methods The Surgical Care and Outcomes Assessment Program is a Washington State quality improvement benchmarking-based initiative. We evaluated the relationship of perioperative hyperglycemia (>180 mg/dL) and insulin administration on mortality, reoperative interventions, and infections for patients undergoing elective colorectal and bariatric surgery at 47 participating hospitals between fourth quarter of 2005 and fourth quarter of 2010. Results Of the 11,633 patients (55.4 ± 15.3 years; 65.7% women) with a serum glucose determination on the day of surgery, postoperative day 1, or postoperative day 2, 29.1% of patients were hyperglycemic. After controlling for clinical factors, those with hyperglycemia had a significantly increased risk of infection [odds ratio (OR) 2.0; 95% confidence interval (CI), 1.63–2.44], reoperative interventions (OR, 1.8; 95% CI, 1.41–2.3), and death (OR, 2.71; 95% CI, 1.72–4.28). Increased risk of poor outcomes was observed both for patients with and without diabetes. Those with hyperglycemia on the day of surgery who received insulin had no significant increase in infections (OR, 1.01; 95% CI, 0.72–1.42), reoperative interventions (OR, 1.29; 95% CI, 0.89–1.89), or deaths (OR, 1.21; 95% CI, 0.61–2.42). A dose-effect relationship was found between the effectiveness of insulin-related glucose control (worst 180–250 mg/dL, best adverse outcomes. Conclusions Perioperative hyperglycemia was associated with adverse outcomes in general surgery patients with and without diabetes. However, patients with hyperglycemia who received insulin were at no greater risk than

  6. Quasi-static acoustic tweezing thromboelastometry.

    Science.gov (United States)

    Holt, R G; Luo, D; Gruver, N; Khismatullin, D B

    2017-07-01

    Essentials Blood coagulation measurement during contact with an artificial surface leads to unreliable data. Acoustic tweezing thromboelastometry is a novel non-contact method for coagulation monitoring. This method detects differences in the blood coagulation state within 10 min. Coagulation data were obtained using a much smaller sample volume (4 μL) than currently used. Background Thromboelastography is widely used as a tool to assess the coagulation status of critical care patients. It allows observation of changes in material properties of whole blood, beginning with early stages of clot formation and ending with clot lysis. However, the contact activation of the coagulation cascade at surfaces of thromboelastographic systems leads to inherent variability and unreliability in predicting bleeding or thrombosis risks. Objectives To develop acoustic tweezing thromboelastometry as a non-contact method for perioperative assessment of blood coagulation. Methods Acoustic tweezing is used to levitate microliter drops of biopolymer and human blood samples. By quasi-statically changing the acoustic pressure we control the sample drop location and deformation. Sample size, deformation and location are determined by digital imaging at each pressure. Results Simple Newtonian liquid solutions maintain a constant, reversible location vs. deformation curve. In contrast, the location/deformation curves for gelatin, alginate, whole blood and blood plasma uniquely change as the samples solidify. Increasing elasticity causes the sample to deform less, leading to steeper stress/strain curves. By extracting a linear regime slope, we show that whole blood or blood plasma exhibits a unique slope profile as it begins to clot. By exposing blood samples to pro- or antithrombotic agents, the slope profile changes, allowing detection of hyper- or hypocoagulable states. Conclusions We demonstrate that quasi-static acoustic tweezing can yield information about clotting onset, maturation

  7. Effects of Puff-Adder Venom on Coagulation, Fibrinolysis and ...

    African Journals Online (AJOL)

    The in vitro and in vivo haematological effects of puffadder (Bitis arietans) venom in the baboon (Papio ursinus) with regard to its effect on coagulation, fibrinolysis and platelet aggregation were studied. There is a delay in the intrinsic coagulation mechanism with fibrinolysis and in vitro fibrinogenolysis. Normal human ...

  8. Defining clinically important perioperative blood loss and transfusion for the Standardised Endpoints for Perioperative Medicine (StEP) collaborative: a protocol for a scoping review.

    Science.gov (United States)

    Bartoszko, Justyna; Vorobeichik, Leon; Jayarajah, Mohandas; Karkouti, Keyvan; Klein, Andrew A; Lamy, Andre; Mazer, C David; Murphy, Mike; Richards, Toby; Englesakis, Marina; Myles, Paul S; Wijeysundera, Duminda N

    2017-06-30

    'Standardised Endpoints for Perioperative Medicine' (StEP) is an international collaboration undertaking development of consensus-based consistent definitions for endpoints in perioperative clinical trials. Inconsistency in endpoint definitions can make interpretation of trial results more difficult, especially if conflicting evidence is present. Furthermore, this inconsistency impedes evidence synthesis and meta-analyses. The goals of StEP are to harmonise definitions for clinically meaningful endpoints and specify standards for endpoint reporting in clinical trials. To help inform this endeavour, we aim to conduct a scoping review to systematically characterise the definitions of clinically important endpoints in the existing published literature on perioperative blood loss and transfusion. The scoping review will be conducted using the widely adopted framework developed by Arksey and O'Malley, with modifications from Levac. We refined our methods with guidance from research librarians as well as researchers and clinicians with content expertise. The electronic literature search will involve several databases including Medline, PubMed-not-Medline and Embase. Our review has three objectives, namely to (1) identify definitions of significant blood loss and transfusion used in previously published large perioperative randomised trials; (2) identify previously developed consensus-based definitions for significant blood loss and transfusion in perioperative medicine and related fields; and (3) describe the association between different magnitudes of blood loss and transfusion with postoperative outcomes. The multistage review process for each question will involve two reviewers screening abstracts, reading full-text articles and performing data extraction. The abstracted data will be organised and subsequently analysed in an iterative process. This scoping review of the previously published literature does not require research ethics approval. The results will be used

  9. Distribution functions and moments in the theory of coagulation

    International Nuclear Information System (INIS)

    Pich, J.

    1990-04-01

    Different distribution functions and their moments used in the Theory of coagulation are summarized and analysed. Relations between the moments of these distribution functions are derived and the physical meaning of individual moments is briefly discussed. The time evolution of the moment of order zero (total number concentration) during the coagulation process is analysed for the general kernel of the Smoluchowski equation. On this basis the time evolution of certain physically important quantities related to this moment such as mean particle size, surface and volume as well as surface concentration is described. Equations for the half time of coagulation for the general collision frequency factor are derived. (orig.) [de

  10. Perioperative feedback in surgical training: A systematic review.

    Science.gov (United States)

    McKendy, Katherine M; Watanabe, Yusuke; Lee, Lawrence; Bilgic, Elif; Enani, Ghada; Feldman, Liane S; Fried, Gerald M; Vassiliou, Melina C

    2017-07-01

    Changes in surgical training have raised concerns about residents' operative exposure and preparedness for independent practice. One way of addressing this concern is by optimizing teaching and feedback in the operating room (OR). The objective of this study was to perform a systematic review on perioperative teaching and feedback. A systematic literature search identified articles from 1994 to 2014 that addressed teaching, feedback, guidance, or debriefing in the perioperative period. Data was extracted according to ENTREQ guidelines, and a qualitative analysis was performed. Thematic analysis of the 26 included studies identified four major topics. Observation of teaching behaviors in the OR described current teaching practices. Identification of effective teaching strategies analyzed teaching behaviors, differentiating positive and negative teaching strategies. Perceptions of teaching behaviors described resident and attending satisfaction with teaching in the OR. Finally models for delivering structured feedback cited examples of feedback strategies and measured their effectiveness. This study provides an overview of perioperative teaching and feedback for surgical trainees and identifies a need for improved quality and quantity of structured feedback. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. A quantitative comparison between electrocoagulation and chemical coagulation for boron removal from boron-containing solution

    International Nuclear Information System (INIS)

    Yilmaz, A. Erdem; Boncukcuoglu, Recep; Kocakerim, M. Muhtar

    2007-01-01

    This paper provides a quantitative comparison of electrocoagulation and chemical coagulation approaches based on boron removal. Electrocoagulation process delivers the coagulant in situ as the sacrificial anode corrodes, due to a fixed current density, while the simultaneous evolution of hydrogen at the cathode allows for pollutant removal by flotation. By comparison, conventional chemical coagulation typically adds a salt of the coagulant, with settling providing the primary pollutant removal path. Chemical coagulation was carried out via jar tests using aluminum chloride. Comparison was done with the same amount of coagulant between electrocoagulation and chemical coagulation processes. Boron removal obtained was higher with electrocoagulation process. In addition, it was seen that chemical coagulation has any effect for boron removal from boron-containing solution. At optimum conditions (e.g. pH 8.0 and aluminum dose of 7.45 g/L), boron removal efficiencies for electrocoagulation and chemical coagulation were 94.0% and 24.0%, respectively

  12. A quantitative comparison between electrocoagulation and chemical coagulation for boron removal from boron-containing solution

    Energy Technology Data Exchange (ETDEWEB)

    Yilmaz, A. Erdem [Atatuerk University, Faculty of Engineering, Department of Environmental Engineering, 25240 Erzurum (Turkey)], E-mail: aerdemy@atauni.edu.tr; Boncukcuoglu, Recep [Atatuerk University, Faculty of Engineering, Department of Environmental Engineering, 25240 Erzurum (Turkey); Kocakerim, M. Muhtar [Atatuerk University, Faculty of Engineering, Department of Chemical Engineering, 25240 Erzurum (Turkey)

    2007-10-22

    This paper provides a quantitative comparison of electrocoagulation and chemical coagulation approaches based on boron removal. Electrocoagulation process delivers the coagulant in situ as the sacrificial anode corrodes, due to a fixed current density, while the simultaneous evolution of hydrogen at the cathode allows for pollutant removal by flotation. By comparison, conventional chemical coagulation typically adds a salt of the coagulant, with settling providing the primary pollutant removal path. Chemical coagulation was carried out via jar tests using aluminum chloride. Comparison was done with the same amount of coagulant between electrocoagulation and chemical coagulation processes. Boron removal obtained was higher with electrocoagulation process. In addition, it was seen that chemical coagulation has any effect for boron removal from boron-containing solution. At optimum conditions (e.g. pH 8.0 and aluminum dose of 7.45 g/L), boron removal efficiencies for electrocoagulation and chemical coagulation were 94.0% and 24.0%, respectively.

  13. Effect of starters and ripening time on the physicochemical, nitrogen fraction and texture profile of goat's cheese coagulated with a vegetable coagulant (Cynara cardunculus).

    Science.gov (United States)

    García, Víctor; Rovira, Silvia; Boutoial, Khalid; Ferrandini, Eduardo; López Morales, María B

    2014-02-01

    The increase in the demand for goat's cheese throughout the world has encouraged research into the development of new related products with different textural characteristics. The aim of this work was to study the effect of three commercial starter cultures through the assessment of physicochemical and textural characteristics of goat's milk cheeses made with vegetable coagulant (Cynara cardunculus) during ripening. Use of the different starter cultures produced a significant effect (P starters ensures the correct acidification rate and produced cheeses with lower pH values and greater hardness. Use of thermophilic starter cultures produces cheeses with less instrumental hardness and the use of mixed cultures produced less proteolysis. These results are found useful for selecting the most suitable starter for the development of new goat's cheeses. © 2013 Society of Chemical Industry.

  14. Making the pediatric perioperative surgical home come to life by leveraging existing health information technology.

    Science.gov (United States)

    Leahy, Izabela C; Borczuk, Rachel; Ferrari, Lynne R

    2017-06-01

    To design a patient data dashboard for the Department of Anesthesiology, Perioperative and Pain Medicine at Boston Children's Hospital that supports care integration across the healthcare system as described by the pediatric perioperative surgical home (PPSH) initiative. By using 360 Technology, patient data was automatically pulled from all available Electronic Health Record sources from 2005 to the present. The PPSH dashboard described in this report provides a guide for implementation of PPSH Clinical Care Pathways. The dashboard integrates several databases to allow for visual longitudinal tracking of patient care, outcomes, and cost. The integration of electronic information provided the ability to display, compare, and analyze selected PPSH metrics in real time. By utilizing the PPSH dashboard format the use of an automated, integrated clinical, and financial health data profile for a specific patient population may improve clinicians' ability to have a comprehensive assessment of all care elements. This more global clinical thinking has the potential to produce bottom-up, evidence-based healthcare reform. The experience with the PPSH dashboard provides solid evidence for the use of integrated Electronic Health Record to improve patient outcomes and decrease cost.

  15. Arsenic removal in water by means of coagulation-flocculation processes

    International Nuclear Information System (INIS)

    Franco, M. F.; Carro P, M. E.

    2014-01-01

    Arsenic and arsenical compounds are considered as carcinogenic and risky for humans according to epidemiological evidence related with the ingestion of arsenical water during a long period. In many places the only source of drinking water contains arsenic and, therefore, removal strategies have to be investigated. This work shows experimental results of coagulation-flocculation processes implemented to evaluate the efficiency in the removal of arsenic from drinking water. The main objectives include the evaluation of the relevant aspect that controls the removal efficiency. Experimental tests were performed with coagulant concentrations from 5 to 500 mg/L, solid particle concentrations from 0 to 6000 mg/L, and initial arsenic concentrations from 0.5 to 5 mg/L. These variables were simultaneously varied in more than 100 experiments. The efficiency in remediation ranged from 0% to 95%. Removal efficiency near 95% was obtained when using ferric chloride as coagulant, and was close to 80% when using aluminium sulfate as coagulant in arsenate solutions. The remediation efficiency decreased significantly when the ferric chloride concentration was higher than 50 mg/L in relation to the obtained results for aluminum sulfate for different type and concentration of soil particles. The highest removal efficiency were obtained at ph between 3 and 5 in oxidized solutions. Obtained results simulated by means of multiple linear regression analysis (R>0.90) allow determining that the main parameters that control the removal of arsenic from drinking water are coagulant concentration, ph, and solid particles concentration. Conversely, particle mineralogy and coagulant type have less significant effect on the removal by means of coagulation-flocculation mechanisms. Obtained results are relevant for the removal of As in water treatment plants as well as for the development of small scale filters. The samples were studied by scanning electron microscopy and energy dispersive X

  16. Perioperative pharmacological management of pulmonary hypertensive crisis during congenital heart surgery.

    Science.gov (United States)

    Brunner, Nathan; de Jesus Perez, Vinicio A; Richter, Alice; Haddad, François; Denault, André; Rojas, Vanessa; Yuan, Ke; Orcholski, Mark; Liao, Xiaobo

    2014-03-01

    Pulmonary hypertensive crisis is an important cause of morbidity and mortality in patients with pulmonary arterial hypertension secondary to congenital heart disease (PAH-CHD) who require cardiac surgery. At present, prevention and management of perioperative pulmonary hypertensive crisis is aimed at optimizing cardiopulmonary interactions by targeting prostacyclin, endothelin, and nitric oxide signaling pathways within the pulmonary circulation with various pharmacological agents. This review is aimed at familiarizing the practitioner with the current pharmacological treatment for dealing with perioperative pulmonary hypertensive crisis in PAH-CHD patients. Given the life-threatening complications associated with pulmonary hypertensive crisis, proper perioperative planning can help anticipate cardiopulmonary complications and optimize surgical outcomes in this patient population.

  17. Post-surgical infections and perioperative antibiotics usage in pediatric genitourinary procedures.

    Science.gov (United States)

    Ellett, Justin; Prasad, Michaella M; Purves, J Todd; Stec, Andrew A

    2015-12-01

    Post-surgical infections (PSIs) are a source of preventable perioperative morbidity. No guidelines exist for the use of perioperative antibiotics in pediatric urologic procedures. This study reports the rate of PSIs in non-endoscopic pediatric genitourinary procedures at our institution. Secondary aims evaluate the association of PSI with other perioperative variables, including wound class (WC) and perioperative antibiotic administration. Data from consecutive non-endoscopic pediatric urologic procedures performed between August 2011 and April 2014 were examined retrospectively. The primary outcome was the rate of PSIs. PSIs were classified as superficial skin (SS) and deep/organ site (D/OS) according to Centers for Disease Control and Prevention guidelines, and urinary tract infection (UTI). PSIs were further stratified by WC1 and WC2 and perioperative antibiotic usage. A relative risk and chi-square analysis compared PSI rates between WC1 and WC2 procedures. A total of 1185 unique patients with 1384 surgical sites were reviewed; 1192 surgical sites had follow-up for inclusion into the study. Ten total PSIs were identified, for an overall infection rate of 0.83%. Of these, six were SS, one was D/OS, and three were UTIs. The PSI rate for WC1 (885 sites) and WC2 (307 sites) procedures was 0.34% and 2.28%, respectively, p antibiotics (0.35% vs. 0.33%). All WC2 procedures received antibiotics. Post-surgical infections are associated with significant perioperative morbidity. In some studies, PSI can double hospital costs, and contribute to hospital length of stay, admission to intensive care units, and impact patient mortality. Our study demonstrates that the rate of PSI in WC1 operations is low, irrespective of whether the patient received perioperative antibiotics (0.35%) or no antibiotics (0.33%). WC2 operations were the larger source of morbidity with an infection rate of 2.28% and a 6.7 fold higher increase in relative risk. WC1 procedures have a rate of

  18. [The standardized perioperative treatment of chronic rhinosinusitis with nasal polyps and asthma].

    Science.gov (United States)

    Li, Tingting; Ju, Jianbao; Yu, Hailing; Xie, Daoyu

    2015-04-01

    To discuss the perioperative treatment of chronic rhinosinusitis with nasal polyps (CRSwNP) and asthma. Retrospective analysis of perioperative clinical data of 43 cases with CRSwNP and asthma. The admitted and under endoscopic surgery. Patients with preventing perioperative asthma attacks and corresponding standardized treatment were Observed. Thirty-five cases were stable during perioperative period and without asthma. Seven patients diagnosed as mild and moderate asthma attacks because of low pulse oximetry (SpO2 92%-95%) and scattered wheeze heard in the lungs. So these patients were sent to ICU for the treatment. They went back to ward after their conditions turned to stable and no asthma during perioperative. One patient diagnosed as severe asthma attack, because irritability and suffocation happened, SpO2 decreased from 99% to 84%-81%, diffuse wheeze could be heard in the whole lung . So we give him tracheal intubation and sent him to ICU for advanced treatment after breathing smooth. Five days later the patient retuned to the ward in stable condition and with no asthma attack again. Before operation the patients should be give some corresponding standardized comprehensive treatment according to the nasal symptoms and the degree of asthma attack, such as the application of topical steroid and antiallergic medicine. And some special treatment should be given to reduce airway hyperresponsiveness mucosa during anesthesia. These methods can reduce the risk of the asthma attacks and improve perioperative safety, prevent serious complications.

  19. Effect of THI on milk coagulation properties of Holstein-Friesian dairy cattle

    Directory of Open Access Journals (Sweden)

    Simone Beux

    Full Text Available ABSTRACT The objective of this study was to evaluate the effect of temperature-humidity index (THI on the milk coagulation properties of Holstein-Friesian dairy cattle from northeast part of Italy. A total of 592 individual milk samples from six dairy herds were evaluated. The milk coagulation properties traits analysed were milk rennet coagulation time and curd firmness, as well as the fat, protein, and casein contents, pH, milk aptitude to coagulate (IAC, and the somatic cell count. The THI was determined during the periods of sample collection. The THI results showed that values of up to 75 did not significantly change the IAC values; however, when the THI values were above 75, the IAC decreased significantly. The control of THI can be used to guarantee appropriate milk coagulation properties.

  20. Application of Moringa Oleifera Seed Powder For Iron (III Coagulation on Local Water Resources

    Directory of Open Access Journals (Sweden)

    Fadillah Utami Prasetyaningtyas

    2013-07-01

    Full Text Available This research aims to know the effect of the use of powder moringa seed to coagulant mass and coagulation process, and its effectiveness to increase the quality of pure water. This research uses factorial research design and statistic test MANOVA. To analyse water quality, the researcher uses Fe parameter.  A graphic of coagulant mass and time for each parameter is used to analyse the data. Based on the research result, the uses of moringa seed as coagulant in each 300 mL mineral water gives a possitives result to the river water sample using 100 mg coagulant mass and sedimentations time for 60 minutes, well water sample using 500 mg coagulant mass and sedimentations time for 60 minutes, tap water sample using 300 mg  coagulant mass and sedimentations time for 90 minutes. The effective coagulant that increase the water quality on well water is 98,32% of moringa seed powder, on river water is 96,64%  and for tap water is 25,62%.

  1. Perioperative glycemic control in diabetic patients undergoing coronary artery bypass graft surgery

    Directory of Open Access Journals (Sweden)

    Ehab A. Wahby

    2016-08-01

    Conclusion: Tight glycemic control improved perioperative outcome in diabetic CABG patients. Maintaining perioperative blood glucose level between 110 and 149 mg/dl is safe and should be recommended as a routine practice in diabetic patients undergoing CABG surgery.

  2. Neoadjuvant Treatment Does Not Influence Perioperative Outcome in Rectal Cancer Surgery

    International Nuclear Information System (INIS)

    Ulrich, Alexis; Weitz, Juergen; Slodczyk, Matthias; Koch, Moritz; Jaeger, Dirk; Muenter, Marc; Buechler, Markus W.

    2009-01-01

    Purpose: To identify the risk factors for perioperative morbidity in patients undergoing resection of primary rectal cancer, with a specific focus on the effect of neoadjuvant therapy. Methods and Materials: This exploratory analysis of prospectively collected data included all patients who underwent anterior resection/low anterior resection or abdominoperineal resection for primary rectal cancer between October 2001 and October 2006. The study endpoints were perioperative surgical and medical morbidity. Univariate and multivariate analyses of potential risk factors were performed. Results: A total of 485 patients were included in this study; 425 patients (88%) underwent a sphincter-saving anterior resection/low anterior resection, 47 (10%) abdominoperineal resection, and 13 (2%) multivisceral resection. Neoadjuvant chemoradiotherapy was performed in 100 patients (21%), and 168 (35%) underwent neoadjuvant short-term radiotherapy (5 x 5 Gy). Patient age and operative time were independently associated with perioperative morbidity, and operative time, body mass index >27 kg/m 2 (overweight), and resection type were associated with surgical morbidity. Age and a history of smoking were confirmed as independent prognostic risk factors for medical complications. Neoadjuvant therapy was not associated with a worse outcome. Conclusion: The results of this prospective study have identified several risk factors associated with an adverse perioperative outcome after rectal cancer surgery. In addition, neoadjuvant therapy was not associated with increased perioperative complications.

  3. Influential factors of formation kinetics of flocs produced by water treatment coagulants.

    Science.gov (United States)

    Wu, Chunde; Wang, Lin; Hu, Bing; Ye, Jian

    2013-05-01

    The growth rate and size of floc formation is of great importance in water treatment especially in coagulation process. The floc formation kinetics and the coagulation efficiency of synthetic water were investigated by using an on-line continuous optical photometric dispersion analyze and the analysis of water quality. Experimental conditions such as alum dosage, pH value for coagulation, stirring intensity and initial turbidity were extensively examined. The photometric dispersion analyze results showed that coagulation of kaolin suspensions with two coagulants (alum and polyaluminium chloride) could be taken as a two-phase process: slow and rapid growth periods. Operating conditions with higher coagulant doses, appropriate pH and average shear rate might be particularly advantageous. The rate of overall floc growth was mainly determined by a combination of hydraulic and water quality conditions such as pH and turbidity. The measurement of zeta potential indicates that polyaluminium chloride exhibited higher charge-neutralizing ability than alum and achieved lower turbidities than alum for equivalent Al dosages. Under the same operating conditions, the alum showed a higher grow rate, but with smaller floc size.

  4. Coagulation-flocculation studies of laboratory wastewater using different combinations

    International Nuclear Information System (INIS)

    Butt, M. T.; Khan, R. A.; Khokar, A.; Iqbal, K.

    2013-01-01

    This study was conducted on the wastewater of PCSIR Laboratories complex Lahore. Both single as well as blended form was used in order to achieve maximum results and to reduce the cost. These experiments were conducted in Hudson Jars of one liter capacity using the coagulation technique for the removal of total suspended solids (TSS) and turbidity. The pH range was 6-8 and 4-10 for treatment. Four coagulants were used such as FeCl 3 , AlCl 3 . Alum and FeSO 4 , to remove the turbidity in single and blended form. Results of single coagulant are FeCl 3 from 39.7 to 11.51 NTU; AlCl 3 from 47.48 to 11.8 NTU. Alum 43 to 25.3NTU.FeSO 4 showed increasing trend in turbidity 53 to 120 NTU. The blended set of coagulants AlCl 3 +Alum turbidity from 45 to 18.55 NTU. The AlCl 3 and FeCl 3 showed almost similar results but after overnight settling results were excellent and alum showed also good results. The turbidity was removed from 54 to 27 NTU, 48 to 22 NTU, 44 to 17 NTU, and after overnight settling 33 to 4 NTU. The results of blended coagulants FeCl 3 +AlCl 3 after one, two and three hours settling were also studied and found best and blend AlCl3+Alum showed also similar trend and the blend of Alum+FeCl 3 after overnight settling was excellent. The same coagulants and its blended form were used for TSS removal and results are 278 to 7 mg/L, in blended form AlCl 3 +Alum show similar results but Alum + FeCl 3 showed excellent results. The TSS and turbidity removal was 87%, 97.5%. (author)

  5. Evaluation of Chitin as Natural Coagulant in Water Treatment

    Directory of Open Access Journals (Sweden)

    V. Saritha

    2012-04-01

    Full Text Available The use of synthetic coagulants is not regarded as suitable due to health and economic considerations. The present study was aimed to investigate the effects of alum as coagulant in conjunction with chitin as coagulant aid on the removal of turbidity, hardness and Escherichia coli from water. A conventional jar test apparatus was employed for the tests. The experiment was conducted at three different pH conditions of 6, 7 and 8. The dosages chosen were 0.5, 1, 1.5 and 2mg/l. The results showed that turbidity decrease provided also a primary Escherichia coli reduction. Hardness removal efficiency was observed to be 93% at pH 7 with 1mg/l concentration by alum whereas chitin was stable at all the pH ranges showing highest removal at 1 and 1.5mg/l with pH 7. At low concentration chitin showed marginally better performance on hardness. In conclusion, using natural coagulants results in considerable savings in chemicals and sludge handling cost may be achieved.

  6. Use of non-Conventional Material to Remove Cu+2 ions from Aqueous Solutions using Chemical Coagulation

    Directory of Open Access Journals (Sweden)

    Muna Yousif Abdul. Ahad

    2015-05-01

    Full Text Available Coagulation - flocculation are basic chemical engineering method in the treatment of metal-bearing industrial wastewater because it removes colloidal particles, some soluble compounds and very fine solid suspensions initially present in the wastewater by destabilization and formation of flocs. This research was conducted to study the feasibility of using natural coagulant such as okra and mallow and chemical coagulant such as alum for removing Cu and increase the removal efficiency and reduce the turbidity of treated water. Fourier transform Infrared (FTIR was carried out for okra and mallow before and after coagulant to determine their type of functional groups. Carbonyl and hydroxyl functional groups on the surface of okra and mallow were the major groups responsible for coagulation process. By using alum (conventional coagulants, okra and mallow (as a primary coagulant or in combination with the other two primary coagulants and by the jar testing, the optimum pH-value and dose of the coagulants were determined. The results indicated that the optimal pH values were 6.7, 8 and 6 for alum, okra and mallow, respectively. Mathematical modeling show significant results (sig.<0.05 for the % Cu removal (dependent variable with respect to coagulant dose (independent variable for the okra as a primary coagulant, alum with okra and alum with mallow as binary coagulants and alum, okra and mallow as ternary coagulants .

  7. Regional Differences in Case Mix and Peri-operative Outcome After Elective Abdominal Aortic Aneurysm Repair in the Vascunet Database.

    Science.gov (United States)

    Mani, K; Venermo, M; Beiles, B; Menyhei, G; Altreuther, M; Loftus, I; Björck, M

    2015-06-01

    National differences exist in the outcome of elective abdominal aortic aneurysm (AAA) repair. The role of case mix variation was assessed based on an international vascular registry collaboration. All elective AAA repairs with aneurysm size data in the Vascunet database in the period 2005-09 were included. AAA size and peri-operative outcome (crude and age adjusted mortality) were analysed overall and in risk cohorts, as well as per country. Glasgow Aneurysm Score (GAS) was calculated as risk score, and patients were stratified in three equal sized risk cohorts based on GAS. Predictors of peri-operative mortality were analysed with multiple regression. Missing data were handled with multiple imputation. Patients from Australia, Finland, Hungary, Norway, Sweden and the UK (n = 5,895) were analysed; mean age was 72.7 years and 54% had endovascular repair (EVAR). There were significant variations in GAS (lowest = Finland [75.7], highest = UK [79.4], p for comparison of all regions 82. Of those with a GAS >82, 8.4% of men and 20.8% of women had an AAA case selection for elective AAA repair, including variations in AAA size and patient risk profile. These differences partly explain the variations in peri-operative mortality. Further audit is warranted to assess the underlying reasons for the regional variation in case-mix. Copyright © 2015 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

  8. Blood coagulation factor VIII

    Indian Academy of Sciences (India)

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

  9. Removal of algal blooms from freshwater by the coagulation-magnetic separation method.

    Science.gov (United States)

    Liu, Dan; Wang, Peng; Wei, Guanran; Dong, Wenbo; Hui, Franck

    2013-01-01

    This research investigated the feasibility of changing waste into useful materials for water treatment and proposed a coagulation-magnetic separation technique. This technique was rapid and highly effective for clearing up harmful algal blooms in freshwater and mitigating lake eutrophication. A magnetic coagulant was synthesized by compounding acid-modified fly ash with magnetite (Fe(3)O(4)). Its removal effects on algal cells and dissolved organics in water were studied. After mixing, coagulation, and magnetic separation, the flocs obtained from the magnet surface were examined by SEM. Treated samples were withdrawn for the content determination of chlorophyll-a, turbidity, chemical oxygen demand (COD), total nitrogen, and total phosphorus. More than 99 % of algal cells were removed within 5 min after the addition of magnetic coagulant at optimal loadings (200 mg L(-1)). The removal efficiencies of COD, total nitrogen, and phosphorus were 93, 91, and 94 %, respectively. The mechanism of algal removal explored preliminarily showed that the magnetic coagulant played multiple roles in mesoporous adsorption, netting and bridging, as well as high magnetic responsiveness to a magnetic field. The magnetic-coagulation separation method can rapidly and effectively remove algae from water bodies and greatly mitigate eutrophication of freshwater using a new magnetic coagulant. The method has good performance, is low cost, can turn waste into something valuable, and provides reference and directions for future pilot and production scale-ups.

  10. PILOT PLANT STUDY ON NATURAL WATER COAGULANTS AS COAGULAN AIDS FOR WATER SUPPLY

    Directory of Open Access Journals (Sweden)

    B BINA

    2001-06-01

    Full Text Available Introduction: Natural plant coagulants have an important role to play in provision of portable water to rural communities in the developing world. The plant material that their coagulation properties have been confirmed in previous lab scale studies and can be found widely in Iran was selected as coagulant aids. Pilot plant study was done to evaluate the efficiency of natural material such as Starch/Gum Tragacanth, Fenugreek and Yeast as coagulant aids in conjunction with comercial alum. Methods: The pilot was placed in Isfahan Water Treatment Plant (IWTP and efficiency of these materials in removal of turbidity from raw water enters the IWTP was evaluated. The results indicated while these materials were used as coagulant aids in concentration of 1-5 mg/l conjunction with alum are able to reduced the turbidity and final residuals turbidity meets the standards limits. Results: The coagulation efficiency of these material were found to be effected by certain physico-chemical factors, namely, concentration of suspended solids, divalent cation metal and time of agitation. The relative importance of these variable was evaluated. The results of COD test proved that the natural coagulant aids in the optimum doses produce no any significant organic residual. Discussion: Economical considerations showed that using of these material as coagulant aids can cause reduction in alum consumption and in some cases are more econmical than synthetic polyelectrolyte.

  11. Intravenous sub-anesthetic ketamine for perioperative analgesia

    Directory of Open Access Journals (Sweden)

    Andrew W Gorlin

    2016-01-01

    Full Text Available Ketamine, an N-methyl-d-aspartate antagonist, blunts central pain sensitization at sub-anesthetic doses (0.3 mg/kg or less and has been studied extensively as an adjunct for perioperative analgesia. At sub-anesthetic doses, ketamine has a minimal physiologic impact though it is associated with a low incidence of mild psychomimetic symptoms as well as nystagmus and double vision. Contraindications to its use do exist and due to ketamine′s metabolism, caution should be exercised in patients with renal or hepatic dysfunction. Sub-anesthetic ketamine improves pain scores and reduces perioperative opioid consumption in a broad range of surgical procedures. In addition, there is evidence that ketamine may be useful in patients with opioid tolerance and for preventing chronic postsurgical pain.

  12. anaesthetic registrars' experiences of perioperative death

    African Journals Online (AJOL)

    Death on the table: anaesthetic registrars' experiences of perioperative ... aDepartment of Anaesthesiology and Critical Care, University of KwaZulu-Natal, Durban, South Africa ... Results: Themes expressed by participants fell into three broad categories: ... number (up to 70%) of anaesthetists report experiencing adverse.

  13. The clinical nurse leader in the perioperative setting: a preceptor experience.

    Science.gov (United States)

    Wesolowski, Michael S; Casey, Gwendolyn L; Berry, Shirley J; Gannon, Jane

    2014-07-01

    The U.S. Veterans Administration (VA) has implemented the clinical nurse leader (CNL) role nationwide. Nursing leaders at the Malcolm Randall VA Medical Center in Gainesville, Florida, implemented the development of the CNL role in the perioperative setting during the summer of 2012. The perioperative department developed the position in partnership with the University of Florida College of Nursing, Gainesville, Florida. The team developed a description of the roles and experiences of the preceptors, the clinical nurse leader resident, and the University of Florida faculty member. The clinical nurse leader resident's successes and the positive outcomes, such as improved patient outcomes, experienced by the perioperative department demonstrated the importance of the CNL role. Published by Elsevier Inc.

  14. Prophylactic Edaravone Prevents Transient Hypoxic-Ischemic Brain Injury: Implications for Perioperative Neuroprotection.

    Science.gov (United States)

    Sun, Yu-Yo; Li, Yikun; Wali, Bushra; Li, Yuancheng; Lee, Jolly; Heinmiller, Andrew; Abe, Koji; Stein, Donald G; Mao, Hui; Sayeed, Iqbal; Kuan, Chia-Yi

    2015-07-01

    Hypoperfusion-induced thrombosis is an important mechanism for postsurgery stroke and cognitive decline, but there are no perioperative neuroprotectants to date. This study investigated whether prophylactic application of Edaravone, a free radical scavenger already used in treating ischemic stroke in Japan, can prevent infarct and cognitive deficits in a murine model of transient cerebral hypoxia-ischemia. Adult male C57BL/6 mice were subjected to transient hypoxic-ischemic (tHI) insult that consists of 30-minute occlusion of the unilateral common carotid artery and exposure to 7.5% oxygen. Edaravone or saline was prophylactically applied to compare their effects on cortical oxygen saturation, blood flow, coagulation, oxidative stress, metabolites, and learning-memory using methods that include photoacoustic imaging, laser speckle contrast imaging, solid-state NMR, and Morris water maze. The effects on infarct size by Edaravone application at different time points after tHI were also compared. Prophylactic administration of Edaravone (4.5 mg/kg×2, IP, 1 hour before and 1 hour after tHI) improved vascular reperfusion, oxygen saturation, and the maintenance of brain metabolites, reducing oxidative stress, thrombosis, white-matter injury, and learning impairment after tHI insult. Delayed Edaravone treatment after 3 h post-tHI became unable to reduce infarct size. Acute application of Edaravone may be a useful strategy to prevent postsurgery stroke and cognitive impairment, especially in patients with severe carotid stenosis. © 2015 American Heart Association, Inc.

  15. A new inorganic-organic composite coagulant, consisting of polyferric sulphate (PFS) and polyacrylamide (PAA).

    Science.gov (United States)

    Moussas, P A; Zouboulis, A I

    2009-08-01

    Currently, research is focused on the synthesis of new composite coagulants, which are constituted of both inorganic and organic materials. In this paper, the development of relevant reagents was investigated, by combining the inorganic pre-polymerised iron-based coagulant Polyferric Sulphate (PFS) with an organic, non-ionic polymer (Polyacrylamide, PAA) under different PAA/Fe (mg/l) and OH/Fe molar ratios. Moreover, the new reagents were characterised in terms of typical properties, stability and morphological analysis (XRD, FTIR, SEM). Their coagulation performance, when treating low or high turbid kaolin-humic acid suspensions, was also investigated, whereas the applied coagulation mechanisms were discussed by using the Photometric Dispersion Analysis (PDA) analysis. The results show that the new coagulation reagents present improved properties, including increased effective polymer species concentration, and they exhibit very good stability. The respective tests using PDA confirmed that the predominant coagulation mechanism of PFS-PAA is the bridge formation mechanism. Coagulation experiments in low or high turbid kaolin-humic acid suspensions reveal that the novel composite reagent PFS-PAA exhibits better coagulation performance, when compared with simple PFS, in terms of zeta-potential reduction, turbidity and organic matter removal and residual iron concentration.

  16. Exact combinatorial approach to finite coagulating systems

    Science.gov (United States)

    Fronczak, Agata; Chmiel, Anna; Fronczak, Piotr

    2018-02-01

    This paper outlines an exact combinatorial approach to finite coagulating systems. In this approach, cluster sizes and time are discrete and the binary aggregation alone governs the time evolution of the systems. By considering the growth histories of all possible clusters, an exact expression is derived for the probability of a coagulating system with an arbitrary kernel being found in a given cluster configuration when monodisperse initial conditions are applied. Then this probability is used to calculate the time-dependent distribution for the number of clusters of a given size, the average number of such clusters, and that average's standard deviation. The correctness of our general expressions is proved based on the (analytical and numerical) results obtained for systems with the constant kernel. In addition, the results obtained are compared with the results arising from the solutions to the mean-field Smoluchowski coagulation equation, indicating its weak points. The paper closes with a brief discussion on the extensibility to other systems of the approach presented herein, emphasizing the issue of arbitrary initial conditions.

  17. Burnout in perioperative context

    OpenAIRE

    Galvão, Ana Maria; Gonçalves, Ana Rita Veloso; Certo, Ana

    2014-01-01

    Companies in a global context are going through moments of great development of information and technologies. In these environments Burnout is highly prevalent, this syndrome is considered as one of physical and emotional stress that leads to a lack of motivation to work, leading to a progressive sense of inadequacy and failure. Objectives: What level of stress Perioperative nurses for nurses in the Region of Tras-os-Montes and Alto Douro. Methods: Non-experimental study,...

  18. Vegetable coagulants as alternative for treatment of wastewater in Mexico

    Directory of Open Access Journals (Sweden)

    Servando López-León

    2017-11-01

    Full Text Available This review addresses the various properties of natural coagulants, water, the chemical substance essential for life and the ideal solvent for a large number of compounds, it is commonly used with domestic, commercial and industrial purposes. After its use, it presents sewage to be retired before use it once again. To remove pollutant, water is subject to different physical, chemical and biological processes. Here, the clarification process uses aluminum and iron materials to remove the solids present; these materials are reported as health hazardous and toxic. In Mexico, regulatory frame work stablish that treated wastewater should do not exceed 0.2 mg/L of aluminum even though has been reported an increased risk of Alzheimer's in populations when water exceeds 0.1 mg/L. Natural coagulants have showed coagulation properties when are used in the clarification process, proven its advantages over traditional ones; such as low cost, good coagulant properties and safe health and non-toxic properties. Here, we enlist some vegetable species as alternatives to the traditional based on aluminum and iron. Additionally, these species are known to have origins on Mexico or being present extensively in the territory, making possible to think about them as alternative coagulants in the clarification process of the wastewater treatment process.

  19. Peri-operative chemotherapy in the management of resectable colorectal cancer pulmonary metastases

    Directory of Open Access Journals (Sweden)

    Hawkes Eliza A

    2012-08-01

    Full Text Available Abstract Background Surgery is often advocated in patients with resectable pulmonary metastases from colorectal cancer (CRC. Our study aims to evaluate peri-operative chemotherapy in patients with metastastic CRC undergoing pulmonary metastasectomy. Methods Patients treated for CRC who underwent pulmonary metastasectomy by a single surgeon were identified. Outcome measures included survival, peri-operative complications, radiological and histological evidence of chemotherapy-induced lung toxicities. Results Between 1997 and 2009, 51 eligible patients were identified undergoing a total of 72 pulmonary resections. Thirty-eight patients received peri-operative chemotherapy, of whom 9 received an additional biological agent. Five-year overall survival rate was 72% in the whole cohort - 74% and 68% in those who received peri-operative chemotherapy (CS and those who underwent surgery alone (S respectively. Five-year relapse free survival rate was 31% in the whole cohort - 38% and ≤18% in CS and S groups respectively. Only 8% had disease progression during neoadjuvant chemotherapy. There were no post-operative deaths. Surgical complications occurred in only 4% of patients who received pre-operative chemotherapy. There was neither radiological nor histological evidence of lung toxicity in resected surgical specimens. Conclusions Peri-operative chemotherapy can be safely delivered to CRC patients undergoing pulmonary metastasectomy. Survival in this selected group of patients was favourable.

  20. Perioperative pharmacokinetics of methadone in adolescents.

    Science.gov (United States)

    Sharma, Anshuman; Tallchief, Danielle; Blood, Jane; Kim, Thomas; London, Amy; Kharasch, Evan D

    2011-12-01

    Methadone is frequently administered to adults experiencing anesthesia and receiving pain treatment. Methadone pharmacokinetics in adults are well characterized, including the perioperative period. Methadone is also used in children. There is, however, no information on methadone pharmacokinetics in children of any age. The purpose of this investigation was to determine the pharmacokinetics of intravenous methadone in children undergoing surgery. Perioperative opioid-sparing effects were also assessed. Eligible subjects were children 5-18 yr undergoing general anesthesia and surgery, with an anticipated postoperative inpatient stay exceeding 3 days. Three groups of 10 to 11 patients each received intravenous methadone hydrochloride after anesthetic induction in ascending dose groups of 0.1, 0.2, and 0.3 mg/kg (up to 20 mg). Anesthetic care was not otherwise changed. Venous blood was obtained for 4 days, for stereoselective determination of methadone and metabolites. Pain assessments were made each morning. Daily and total opioid consumption was determined. Perioperative opioid consumption and pain was determined in a second cohort, which was matched to age, sex, race, ethnicity, surgical procedure, and length of stay, but not receiving methadone. The final methadone study cohort was 31 adolescents (14 ± 2 yr, range 10-18) undergoing major spine surgery for a diagnosis of scoliosis. Methadone pharmacokinetics were linear over the dose range 0.1-0.3 mg/kg. Disposition was stereoselective. Methadone administration did not dose-dependently affect postoperative pain scores, and did not dose-dependently decrease daily or total postoperative opioid consumption in spinal fusion patients. Methadone enantiomer disposition in adolescents undergoing surgery was similar to that in healthy adults.

  1. Patient Education May Improve Perioperative Safety.

    NARCIS (Netherlands)

    de Haan, L.S.; Calsbeek, H; Wolff, André

    2016-01-01

    Importance: There is a growing interest in enabling ways for patients to participate in their own care to improve perioperative safety, but little is known about the effectiveness of interventions enhancing an active patient role. Objective: To evaluate the effect of patient participation on

  2. Perioperative care of the older patient

    NARCIS (Netherlands)

    E. Blommers; M. Klimek (Markus); K.A. Hartholt (Klaas); T.J.M. van der Cammen (Tischa); J. Klein (Jan); P. Noordzij (Peter)

    2011-01-01

    textabstractNearly 60% of the Dutch population undergoing surgery is aged 65 years and over. Older patients are at increased risk of developing perioperative complications (e.g., myocardial infarction, pneumonia, or delirium), which may lead to a prolonged hospital stay or death. Preoperative risk

  3. Vasopressin in perioperative management of congenital ...

    African Journals Online (AJOL)

    Perioperative care of infants with diaphragmatic hernias can be a challenge because of pulmonary hypertension and systemic hypotension. The objective of this study was to report the usefulness of vasopressin infusion in improving pulmonary and systemic haemodynamics in an infant with congenital diaphragmatic hernia.

  4. Reduction of Turbidity of Water Using Locally Available Natural Coagulants

    Science.gov (United States)

    Asrafuzzaman, Md.; Fakhruddin, A. N. M.; Hossain, Md. Alamgir

    2011-01-01

    Turbidity imparts a great problem in water treatment. Moringa oleifera, Cicer arietinum, and Dolichos lablab were used as locally available natural coagulants in this study to reduce turbidity of synthetic water. The tests were carried out, using artificial turbid water with conventional jar test apparatus. Optimum mixing intensity and duration were determined. After dosing water-soluble extracts of Moringa oleifera, Cicer arietinum, and Dolichos lablab reduced turbidity to 5.9, 3.9, and 11.1 nephelometric turbidity unit (NTU), respectively, from 100 NTU and 5, 3.3, and 9.5, NTU, respectively, after dosing and filtration. Natural coagulants worked better with high, turbid, water compare to medium, or low, turbid, water. Highest turbidity reduction efficiency (95.89%) was found with Cicer arietinum. About 89 to 96% total coliform reduction were also found with natural coagulant treatment of turbid water. Using locally available natural coagulants, suitable, easier, and environment friendly options for water treatment were observed. PMID:23724307

  5. Multiple roles of the coagulation protease cascade during virus infection.

    Science.gov (United States)

    Antoniak, Silvio; Mackman, Nigel

    2014-04-24

    The coagulation cascade is activated during viral infections. This response may be part of the host defense system to limit spread of the pathogen. However, excessive activation of the coagulation cascade can be deleterious. In fact, inhibition of the tissue factor/factor VIIa complex reduced mortality in a monkey model of Ebola hemorrhagic fever. Other studies showed that incorporation of tissue factor into the envelope of herpes simplex virus increases infection of endothelial cells and mice. Furthermore, binding of factor X to adenovirus serotype 5 enhances infection of hepatocytes but also increases the activation of the innate immune response to the virus. Coagulation proteases activate protease-activated receptors (PARs). Interestingly, we and others found that PAR1 and PAR2 modulate the immune response to viral infection. For instance, PAR1 positively regulates TLR3-dependent expression of the antiviral protein interferon β, whereas PAR2 negatively regulates expression during coxsackievirus group B infection. These studies indicate that the coagulation cascade plays multiple roles during viral infections.

  6. The perspective of children on factors influencing their participation in perioperative care.

    Science.gov (United States)

    Sjöberg, Carina; Amhliden, Helene; Nygren, Jens M; Arvidsson, Susann; Svedberg, Petra

    2015-10-01

    To describe the experiences of participation in perioperative care of 8- to 11-year-old children. All children have the right to participate in decisions that affect them and have the right to express their views in all matters that concern them. Allowing children to be involved in their perioperative care can make a major difference in terms of their well-being by decreasing fear and anxiety and having more positive experiences. Taking the views of children into account and facilitating their participation could thus increase the quality of care. Descriptive qualitative design. The study was conducted in 2013 and data were collected by narrative interviews with 10 children with experience from perioperative care in Sweden. Qualitative content analysis was chosen to describe the variations, differences and similarities in children's experiences of participation in perioperative care. The result showed that receiving preparatory information, lack of information regarding postoperative care and wanting to have detailed information are important factors for influencing children's participation. Interaction with healthcare professionals, in terms of being listened to, being a part of the decision-making and feeling trust, is important for children's participation in the decision-making process. Poor adaptation of the care environment to the children's needs, feeling uncomfortable while waiting and needs for distraction are examples of how the environment and the care in the operating theatre influence the children's experiences of participation. Efforts should be made to improve children's opportunities for participation in the context of perioperative care and further research is needed to establish international standards for information strategies and care environment that promotes children's participation in perioperative care. Nurse anaesthetists need to acquire knowledge and develop strategies for providing preparatory visits and information to children prior to

  7. Two-incision laparoscopic appendectomy for a severe hemophilia A child patient with coagulation factor VII deficiency: Case report and review of literature.

    Science.gov (United States)

    He, Jin Peng; Feng, Jie Xiong

    2017-10-01

    The main complication of patients with severe hemophilia is recurrent bleeding events that usually affected musculoskeletal contractures. And replacement therapy methods were continuously improved to minimize adverse impacts brought by those complications. However, only several cases reported about the appendectomy for hemophilia A. We report a case of acute appendicitis treated by two-incision laparoscopy in a boy with hemophilia A and coagulation factor VII deficiency for the first time. An 8y7m-old Chinese boy presented with half a day of right sided abdominal pain, fever, nausea, and vomiting. He received a computed tomography (CT) scan which revealed an enlarged appendix, thickened wall and appendiceal fecalith, and had received a conservative anti-bacterial treatment for his acute appendicitis but failed. He was diagnosed with hemophilia A and coagulation factor VII deficiency. Two-incision laparoscopic appendectomy was made in success with a careful management of perioperative period. We monitored the clotting factor FVIII level and gave him a replacement therapy. The patient had an uneventful recovery. It is important to exclude intraabdominal or retroperitoneal hemorrhage in patients suffering from hemophilia and acute abdominal pain. Pre-operative evaluation of validity of the FVIII replacement therapy is another effective strategy to assess the safety and feasibility of applying an operation procedure. The two-incision laparoscopic appendectomy is an effective treatment for this kind of patients for its minimal trauma and fast recovery characteristics. Our report shows that laparoscopic appendectomy is feasible in a child suffering from hemophilia after adequate blood clotting factor replacement treatment.

  8. Coagulation-flocculation studies of wastewaters

    NARCIS (Netherlands)

    Leentvaar, J.

    1982-01-01

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

  9. Cosmetic wastewater treatment by coagulation and advanced oxidation processes.

    Science.gov (United States)

    Naumczyk, Jeremi; Bogacki, Jan; Marcinowski, Piotr; Kowalik, Paweł

    2014-01-01

    In this study, the treatment process of three cosmetic wastewater types has been investigated. Coagulation allowed to achieve chemical oxygen demand (COD) removal of 74.6%, 37.7% and 74.0% for samples A (Al2(SO4)3), B (Brentafloc F3) and C (PAX 16), respectively. The Fenton process proved to be effective as well - COD removal was equal to 75.1%, 44.7% and 68.1%, respectively. Coagulation with FeCl3 and the subsequent photo-Fenton process resulted in the best values of final COD removal equal to 92.4%, 62.8% and 90.2%. In case of the Fenton process, after coagulation these values were equal to 74.9%, 50.1% and 84.8%, while in case of the H2O2/UV process, the obtained COD removal was 83.8%, 36.2% and 80.9%. High value of COD removal in the Fenton process carried out for A and C wastewater samples was caused by a significant contribution of the final neutralization/coagulation. Very small effect of the oxidation reaction in the Fenton process in case of sample A resulting from the presence of antioxidants, 'OH radical scavengers' in the wastewater.

  10. Treatment of melanoidin wastewater by anaerobic digestion and coagulation.

    Science.gov (United States)

    Arimi, Milton M; Zhang, Yongjun; Götz, Gesine; Geißen, Sven-Uwe

    2015-01-01

    Melanoidins are dark-coloured recalcitrant pollutants found in many industrial wastewaters including coffee-manufacturing effluent, molasses distillery wastewater (MDWW) and other wastewater with molasses as the raw material. The wastewaters are mostly treated with anaerobic digestion after some dilution to minimize the inhibition effect. However, the dark colour and recalcitrant dissolved organic carbon (DOC) mainly caused by melanoidin are not effectively removed. The aim of this study was to investigate the removal of colour and remnant DOC by different coagulants from anaerobically digested MDWW. From the six coagulants tested, ferric chloride had the highest melanoidin (48%), colour (92.7%) and DOC (63.3%) removal at pH 5 and a dosage of 1.6 g/l. Both polymer and inorganic salt coagulants tested had optimal colour, melanoidin and DOC removal at acidic pH. The molecular size distribution of synthetic melanoidins by liquid chromatography-organic carbon detection indicated a preferential removal of high-molecular-weight melanoidins over low weight melanoidins by the coagulation. Further studies should focus on how to improve biodegradability of the treated effluent for it to be reused as dilution water for anaerobic digestion.

  11. Removal of natural organic matter in drinking water treatment by coagulation: A comprehensive review.

    Science.gov (United States)

    Sillanpää, Mika; Ncibi, Mohamed Chaker; Matilainen, Anu; Vepsäläinen, Mikko

    2018-01-01

    Natural organic matter (NOM) is a complex matrix of organic substances produced in (or channeled to) aquatic ecosystems via various biological, geological and hydrological cycles. Such variability is posing a serious challenge to most water treatment technologies, especially the ones designed to treat drinking water supplies. Lately, in addition to the fluctuating composition of NOM, a substantial increase of its concentration in fresh waters, and also municipal wastewater effluents, has been reported worldwide, which justifies the urgent need to develop highly efficient and versatile water treatment processes. Coagulation is among the most applied processes for water and wastewater treatment. The application of coagulation to remove NOM from drinking water supplies has received a great deal of attention from researchers around the world because it was efficient and helped avoiding the formation of disinfection by products (DBPs). Nonetheless, with the increased fluctuation of NOM in water (concentration and composition), the efficiency of conventional coagulation was substantially reduced, hence the need to develop enhanced coagulation processes by optimizing the operating conditions (mainly the amount coagulants and pH), developing more efficient inorganic or organic coagulants, as well as coupling coagulation with other water treatment technologies. In the present review, recent research studies dealing with the application of coagulation for NOM removal from drinking water supplies are presented and compared. In addition, integration schemes combining coagulation and other water treatment processes are presented, including membrane filtration, oxidation, adsorption and others processes. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. Review of Coagulation Technology for Removal of Arsenic: Case of Chile

    OpenAIRE

    Sancha, Ana María

    2006-01-01

    Coagulation technology has been used since 1970 in northern Chile for removing arsenic from drinking-water. This experience suggests that coagulation is an effective technology for the removal of arsenic. It is currently possible to reduce arsenic from 400 μg/L to 10 μg/L at a rate of 500 L/sec, assuming pH, oxidizing and coagulation agents are strictly controlled. The Chilean experience with the removal of arsenic demonstrates that the water matrix dictates the selection of the arsenic-remov...

  13. Coagulation-Adsorption Hybrid Process for the Treatment of Dyes and Pigments Wastewater

    Directory of Open Access Journals (Sweden)

    Abdul Karim Shah

    2013-10-01

    Full Text Available The study aimed to improve the effectiveness of dyes and pigments wastewater treatment. Hybrid system of adsorption and coagulation was applied for the reduction of COD, color, turbidity and TSS. Activated carbon adsorbent was prepared from a waste of sugar industry boiler. It was processed through physicochemical treatment with sulfuric acid following grinding, sieving, washing and drying unit operations. Combined wastewater of dyes and pigments manufacturing plant was treated with a hybrid process of coagulation and adsorption. FeCl 3, FeSO 4and Alum coagulants were tested individually and found them less effective. It was revealed that FeCl 3 coagulation, adsorption and hybrid process reduced COD (41, 51 and 54%, Color (67, 70 and 89%, turbidity (69, 71 and 90% and TSS (82, 93 and 97% respectively. Combination of FeCl3 -SBFA (Sugarcane Bagasse Fly Ash proved 90% efficient in removal than coagulation as an individual process. 4g adsorbent dose was optimized for this hybrid process

  14. Using YouTube in perioperative nursing education.

    Science.gov (United States)

    Logan, Rebecca

    2012-04-01

    Educators today need innovative teaching strategies to meet the learning needs of the multigenerational population of perioperative nurses. Emerging technologies, such as YouTube, the world's largest video-sharing web site, can be used as a component of an active learning strategy that can appeal to a broad group of nurses along the novice-to-expert proficiency continuum. Using video clips can be a useful method to engage learners and promote critical thinking, decision making, and creativity. YouTube videos can be used to teach skills or as a platform for discussion. Learners also can create and upload their own videos to educate others. Increased engagement and active learning can lead the perioperative nurse to a deeper understanding of the educational material. Copyright © 2012 AORN, Inc. Published by Elsevier Inc. All rights reserved.

  15. Modelling of the Blood Coagulation Cascade in an In Vitro Flow System

    DEFF Research Database (Denmark)

    Andersen, Nina Marianne; Sørensen, Mads Peter; Efendiev, Messoud A.

    2010-01-01

    We derive a mathematical model of a part of the blood coagulation cascade set up in a perfusion experiment. Our purpose is to simulate the influence of blood flow and diffusion on the blood coagulation pathway. The resulting model consists of a system of partial differential equations taking...... and flow equations, which guarantee non negative concentrations at all times. The criteria is applied to the model of the blood coagulation cascade....

  16. REMOVAL OF ORGANIC MATTER FROM SURFACE WATER USING COAGULANTS WITH VARIOUS BASICITY

    Directory of Open Access Journals (Sweden)

    Lidia Dąbrowska

    2016-07-01

    Full Text Available Humic substances are a natural admixture of surface water and determine the level of organic pollution of water and colour intensity. Application of coagulation process in surface water treatment allows for decrease turbidity and colour of water, as well as organic matter content. In Poland most drinking water treatment plants use aluminium sulphate as a coagulant. Research works on pre-hydrolysed coagulants, e.g. polyaluminium chlorides (general formula Aln(OHmCl3n-m are also carried out. The aim of this study was to evaluate the effectiveness of the coagulation process using polyaluminium chlorides with different basicity, in reducing the level of pollution of surface water with organic substances. Apart from the typical indicators used to evaluate the content of organic compounds, the potential for trihalomethanes formation THM-FP was also determined. The influence of the type of coagulant (low, medium, highly alkaline on the efficiency of organic compound removal, determined as total organic carbon TOC, oxidisability OXI, absorbance UV254, was stated. Under the conditions of the coagulation (pH 7.2-7.4, temperature of 19-21°C, the best results were obtained using highly alkaline polyaluminium chlorides PAX-XL19F, PAX-XL1905 and PAX-XL1910S, decrease in TOC and OXI by 43-46%, slightly worse - 40-41% using low alkaline PAX18. Using the medium alkaline coagulants PAX-XL61 and PAXX-XL69, 30-35% removal of organic matter was obtained. Despite various effects of dissolved organic carbon removal, depending on the used coagulant, THM-FP in purified water did not differ significantly and ranged from 10.0 to 10.9 mgCHCl3 m-3. It was by 37-42% lower than in surface water.

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

    NARCIS (Netherlands)

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

    2004-01-01

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

  18. Does training of fellows affect peri-operative outcomes of robot-assisted partial nephrectomy?

    Science.gov (United States)

    Khene, Zine-Eddine; Peyronnet, Benoit; Bosquet, Elise; Pradère, Benjamin; Robert, Corentin; Fardoun, Tarek; Kammerer-Jacquet, Solène-Florence; Verhoest, Grégory; Rioux-Leclercq, Nathalie; Mathieu, Romain; Bensalah, Karim

    2017-10-01

    To evaluate the impact of fellows' involvement on the peri-operative outcomes of robot-assisted partial nephrectomy (RAPN). We analysed 216 patients who underwent RAPN for a small renal tumour. We stratified our cohort into two groups according to the involvement of a fellow surgeon during the procedure: expert surgeon operating alone (expert group) and fellow operating under the supervision of the expert surgeon (fellow group). Peri-operative data were compared between the two groups. Linear and logistic regression analyses were performed to assess the impact of fellows' involvement on peri-operative and postoperative outcomes. Trifecta and margins ischaemia complications (MIC) score achievement rates were used to assess the quality of surgery in both the expert and fellow groups. Trifecta was defined as a combination of warm ischaemia time negative surgical margins and no peri-operative complications. MIC score was defined as negative surgical margins, ischaemia time Training fellows to perform RAPN is associated with longer operating time and WIT but does not appear to compromise other peri-operative outcomes. © 2017 The Authors BJU International © 2017 BJU International Published by John Wiley & Sons Ltd.

  19. A protocol for a systematic review for perioperative pregabalin use

    Directory of Open Access Journals (Sweden)

    Eipe Naveen

    2012-09-01

    Full Text Available Abstract Background Perioperative pain management has recently been revolutionized with the recognition of novel mechanisms and introduction of newer drugs. Many randomized trials have studied the use of the gabapentinoid anti-epileptic, pregabalin, in acute pain. Published systematic reviews suggest that using pregabalin for perioperative pain management may decrease analgesic requirements and pain scores, at the expense of troublesome side effects. A major limitation of the extant reviews is the lack of rigorous investigation of clinical characteristics that would maximize the benefit harms ratio in favor of surgical patients. We posit that effects of pregabalin for perioperative pain management vary by the type of surgical pain model and propose this systematic review protocol to update previous systematic reviews and investigate the heterogeneity in findings across subgroups of surgical pain models. Methods/Design Using a peer-reviewed search strategy, we will search key databases for clinical trials on perioperative pregabalin use in adults. The electronic searches will be supplemented by scanning the reference lists of included studies. No limits of language, country or year will be imposed. Outcomes will include pain; use of co-analgesia, particularly opioids; enhanced recovery; and drug-related harms. We will focus on the identification of surgical models and patient characteristics that have shown benefit and adverse effects from pregabalin. Two clinical experts will independently screen the studies for inclusion using eligibility criteria established a priori. Data extracted by the reviewers will then be verified. Publication bias will be assessed, as will risk of bias using the Cochrane Risk of Bias tool. Meta-analysis and meta-regression are planned if the studies are deemed statistically, methodologically and clinically homogenous. Evidence will be graded for its strength for a select number of outcomes. Discussion We will explore

  20. [Coagulation factor VII levels in uremic patients and theirs influence factors].

    Science.gov (United States)

    Fang, Jun; Xia, Ling-Hui; Wei, Wen-Ning; Song, Shan-Jun

    2004-12-01

    This study was aimed to investigate coagulation factor VII level in uremic patients with chronic renal failure and to explore theirs influence factors. The plasma levels of coagulation factor VII were detected in 30 uremic patients with chronic renal failure before and after hemodialysis for 1 month, the factor VII activity (FVII:C) was determined by one-stage coagulation method, while activated factor VII (FVIIa) was measured by one-stage coagulation method using recombinant soluble tissue factor, and factor VII antigen was detected by ELISA. The results showed that: (1) The FVIIa, FVII:C and FVIIAg levels in chronic uremic patients before hemodialysis were 4.00 +/- 0.86 microg/L, (148.5 +/- 40.4)% and (99.8 +/- 21.1)% respectively, which were significantly increased, as compared with healthy controls [2.77 +/- 1.02 microg/L, (113.1 +/- 33.0)% and (73.7 +/- 18.3)% respectively, P factor VII was positively correlated with levels of blood uria nitrogen and serum creatinine before hemodialysis but not after hemodialysis. It is concluded that the enhanced levels of coagulation factor VII in chronic uremic patients suggested abnormal activated state, herperactivity and elevated production of factor VII which correlated with renal functional injury. The abnormality of factor VII in uremia may be aggravated by hemodialysis. Coagulation factor (FVII) may be a risk factor for cardiovascular events in uremic patients who especially had been accepted long-term hemodialysis.

  1. I need to know! Timely accessing of perioperative user manuals.

    Science.gov (United States)

    Landreneau, Raphael

    2010-12-01

    Ready access to equipment or product information is essential for the safe operation of the many items that a perioperative nurse is asked to use, troubleshoot, or maintain. One institution's solution for making manufacturer information available in the practice setting was to create a facility intranet site dedicated to OR equipment manuals. This site provides information access to perioperative nurses and support staff members and, ultimately, helps improve patient care. Published by Elsevier Inc. All rights reserved.

  2. Removal of total suspended solid by natural coagulant derived from cassava peel waste

    Science.gov (United States)

    Mohd-Asharuddin, S.; Othman, N.; Mohd-Zin, N. S.; Tajarudin, H. A.

    2018-04-01

    The present study was aimed to investigate the performance of starch derived from cassava peel waste as primary coagulant and coagulant aid. Comparable study was also conducted using commercially used aluminium sulfate (alum) as primary coagulant. A series of Jar tests were performed using raw water from Sembrong Barat water treatment plant. It was observed that coagulation test using cassava peel starch (CPS) alone had unappreciable removing ability. However, it was found that combination of alum-CPS successfully achieve up to 90.48% of total suspended solid (TSS) removal under optimized working conditions (pH 9, 7.5mg/L : 100 mg/L of alum : CPS dosage, rapid mixing of 200 rpm for 1 minute; 100 rpm for 2 minutes, slow mixing of 25 rpm for 30 minutes and 30 minutes settling time). This remarks the reduction in alum dosage up to 50% compared to coagulation test using alum alone. Therefore this finding suggesting that CPS can be considered as potential source of sustainable and effective coagulant aid for water treatment especially in developing countries.

  3. Optimizing perioperative decision making: improved information for clinical workflow planning.

    Science.gov (United States)

    Doebbeling, Bradley N; Burton, Matthew M; Wiebke, Eric A; Miller, Spencer; Baxter, Laurence; Miller, Donald; Alvarez, Jorge; Pekny, Joseph

    2012-01-01

    Perioperative care is complex and involves multiple interconnected subsystems. Delayed starts, prolonged cases and overtime are common. Surgical procedures account for 40-70% of hospital revenues and 30-40% of total costs. Most planning and scheduling in healthcare is done without modern planning tools, which have potential for improving access by assisting in operations planning support. We identified key planning scenarios of interest to perioperative leaders, in order to examine the feasibility of applying combinatorial optimization software solving some of those planning issues in the operative setting. Perioperative leaders desire a broad range of tools for planning and assessing alternate solutions. Our modeled solutions generated feasible solutions that varied as expected, based on resource and policy assumptions and found better utilization of scarce resources. Combinatorial optimization modeling can effectively evaluate alternatives to support key decisions for planning clinical workflow and improving care efficiency and satisfaction.

  4. Effects of pentastarch and albumin infusion on cardiorespiratory function and coagulation in patients with severe sepsis and systemic hypoperfusion.

    Science.gov (United States)

    Rackow, E C; Mecher, C; Astiz, M E; Griffel, M; Falk, J L; Weil, M H

    1989-05-01

    Twenty consecutive patients with severe sepsis were randomized to fluid challenge with 5% albumin or 10% low MW hydroxyethyl starch (pentastarch) solutions. Fluid challenge was administered iv as 250 ml of test colloid every 15 min until the pulmonary artery wedge pressure (WP) was greater than or equal to 15 mm Hg or a maximum dose of 2000 ml was infused. Hemodynamic, respiratory, and coagulation profiles were measured before and after fluid infusion. The amount of colloid required to achieve a WP of 15 mm Hg was comparable between groups. Both colloid infusions resulted in similar increases in cardiac output, stroke output, and stroke work. The effect of fluid infusion with pentastarch on coagulation was not significantly different from albumin, although pentastarch was associated with a 45% decrease in factor VIII:c. We conclude that pentastarch is equivalent to albumin for fluid resuscitation of patients with severe sepsis.

  5. Molecular cloning, characterization and expression analysis of coagulation factor VII gene in grass carp (Ctenopharyngodon idella).

    Science.gov (United States)

    Liu, Qiaolin; Xu, Baohong; Xiao, Tiaoyi; Su, Jianming; Zhong, Lei

    2013-08-01

    Coagulation factor VII has been studied in several species but, to date, not in grass carp (Ctenopharyngodon idella), a commercially important freshwater fish found in China. In this study, the full-length cDNA of grass carp coagulation factor VII (GcCFVII) was cloned using a RACE-Ready cDNA Kit, grass carp were challenged with a hemorrhagic virus, and temporal expression profiles of GcCFVII in the thymus, gills, liver, spleen, and head kidney were examined at 0 h, 24 h, 48 h, 72 h, 96 h, and 138 h using fluorescence quantitative PCR. The results showed the 1480 bp GcCFVII to contain three conservative motifs: Gla, EGF-CA, and Tryp-SPc, similar to other species. Phylogenetic analysis showed the evolution of GcCFVII gene to be consistent with the evolution of the species. After viral challenge, GcCFVII expression in five tissues of grass carp showed different patterns of fluctuation. These results provide a solid basis for further investigation of GcCFVII and its relationship with grass carp hemorrhage. Copyright © 2013 Elsevier Ltd. All rights reserved.

  6. In-Hospital Haloperidol Use and Perioperative Changes in QTc-Duration.

    Science.gov (United States)

    Blom, M T; Jansen, S; de Jonghe, A; van Munster, B C; de Boer, A; de Rooij, S E; Tan, H L; van der Velde, N

    2015-05-01

    Haloperidol may prolong ECG QTc-duration but is often prescribed perioperatively to hip-fracture patients. We aimed to determine (1) how QTc-duration changes perioperatively, (2) whether low-dose haloperidol-use influences these changes, and (3) which clinical variables are associated with potentially dangerous perioperative QTc-prolongation (PD-QTc; increase >50 ms or to >500 ms). Prospective cohort study. Tertiary university teaching-hospital. Patients enrolled in a randomized controlled clinical trial of melatonin versus placebo on occurrence of delirium in hip-fracture patients. Data from ECGs made before and after hip surgery (1-3 days and/or 4-6 days post-surgery) were analyzed. QTc-duration was measured by hand, blinded for haloperidol and pre/post-surgery status. Clinical variables were measured at baseline. Mixed model analysis was used to estimate changes in QTc-duration. Risk-factors for PD-QTc were estimated by logistic regression analysis. We included 89 patients (mean age 84 years, 24% male); 39 were treated with haloperidol. Patients with normal pre-surgery QTc-duration (male ≤430 ms, female ≤450 ms) had a significant increase (mean 12 ms, SD 28) in QTc-duration. A significant decrease (mean 19 ms, SD 34) occurred in patients with prolonged pre-surgery QTc-duration (male >450ms, female >470 ms). Haloperidol-use did not influence the perioperative course of the QTc-interval (p=0.351). PD-QTc (n=8) was not associated with any of the measured risk-factors. QTc-duration changed differentially, increasing in patients with normal, but decreasing in patients with abnormal baseline QTc-duration. PD-QTc was not associated with haloperidol-use or other risk-factors. Low-dose oral haloperidol did not affect perioperative QTc-interval.

  7. Causes and consequences of coagulation activation in sepsis: an evolutionary medicine perspective.

    Science.gov (United States)

    Fiusa, Maiara Marx Luz; Carvalho-Filho, Marco Antonio; Annichino-Bizzacchi, Joyce M; De Paula, Erich V

    2015-05-06

    Coagulation and innate immunity have been linked together for at least 450 million years of evolution. Sepsis, one of the world's leading causes of death, is probably the condition in which this evolutionary link is more evident. However, the biological and the clinical relevance of this association have only recently gained the attention of the scientific community. During sepsis, the host response to a pathogen is invariably associated with coagulation activation. For several years, coagulation activation has been solely regarded as a mechanism of tissue damage, a concept that led to several clinical trials of anticoagulant agents for sepsis. More recently, this paradigm has been challenged by the failure of these clinical trials, and by a growing bulk of evidence supporting the concept that coagulation activation is beneficial for pathogen clearance. In this article we discuss recent basic and clinical data that point to a more balanced view of the detrimental and beneficial consequences of coagulation activation in sepsis. Reappraisal of the association between coagulation and immune activation from an evolutionary medicine perspective offers a unique opportunity to gain new insights about the pathogenesis of sepsis, paving the way to more successful approaches in both basic and clinical research in this field.

  8. Pretreatment of wastewater: Optimal coagulant selection using Partial Order Scaling Analysis (POSA)

    International Nuclear Information System (INIS)

    Tzfati, Eran; Sein, Maya; Rubinov, Angelika; Raveh, Adi; Bick, Amos

    2011-01-01

    Jar-test is a well-known tool for chemical selection for physical-chemical wastewater treatment. Jar test results show the treatment efficiency in terms of suspended matter and organic matter removal. However, in spite of having all these results, coagulant selection is not an easy task because one coagulant can remove efficiently the suspended solids but at the same time increase the conductivity. This makes the final selection of coagulants very dependent on the relative importance assigned to each measured parameter. In this paper, the use of Partial Order Scaling Analysis (POSA) and multi-criteria decision analysis is proposed to help the selection of the coagulant and its concentration in a sequencing batch reactor (SBR). Therefore, starting from the parameters fixed by the jar-test results, these techniques will allow to weight these parameters, according to the judgments of wastewater experts, and to establish priorities among coagulants. An evaluation of two commonly used coagulation/flocculation aids (Alum and Ferric Chloride) was conducted and based on jar tests and POSA model, Ferric Chloride (100 ppm) was the best choice. The results obtained show that POSA and multi-criteria techniques are useful tools to select the optimal chemicals for the physical-technical treatment.

  9. Prehospital resuscitation with hypertonic saline-dextran modulates inflammatory, coagulation and endothelial activation marker profiles in severe traumatic brain injured patients

    Directory of Open Access Journals (Sweden)

    Morrison Laurie J

    2010-01-01

    Full Text Available Abstract Background Traumatic brain injury (TBI initiates interrelated inflammatory and coagulation cascades characterized by wide-spread cellular activation, induction of leukocyte and endothelial cell adhesion molecules and release of soluble pro/antiinflammatory cytokines and thrombotic mediators. Resuscitative care is focused on optimizing cerebral perfusion and reducing secondary injury processes. Hypertonic saline is an effective osmotherapeutic agent for the treatment of intracranial hypertension and has immunomodulatory properties that may confer neuroprotection. This study examined the impact of hypertonic fluids on inflammatory/coagulation cascades in isolated head injury. Methods Using a prospective, randomized controlled trial we investigated the impact of prehospital resuscitation of severe TBI (GCS vs 0.9% normal saline (NS, on selected cellular and soluble inflammatory/coagulation markers. Serial blood samples were drawn from 65 patients (30 HSD, 35 NS at the time of hospital admission and at 12, 24, and 48-h post-resuscitation. Flow cytometry was used to analyze leukocyte cell-surface adhesion (CD62L, CD11b and degranulation (CD63, CD66b molecules. Circulating concentrations of soluble (sL- and sE-selectins (sL-, sE-selectins, vascular and intercellular adhesion molecules (sVCAM-1, sICAM-1, pro/antiinflammatory cytokines [tumor necrosis factor (TNF-α and interleukin (IL-10], tissue factor (sTF, thrombomodulin (sTM and D-dimers (D-D were assessed by enzyme immunoassay. Twenty-five healthy subjects were studied as a control group. Results TBI provoked marked alterations in a majority of the inflammatory/coagulation markers assessed in all patients. Relative to control, NS patients showed up to a 2-fold higher surface expression of CD62L, CD11b and CD66b on polymorphonuclear neutrophils (PMNs and monocytes that persisted for 48-h. HSD blunted the expression of these cell-surface activation/adhesion molecules at all time-points to

  10. Arsenic removal by coagulation using ferric chloride and chitosan from water

    Directory of Open Access Journals (Sweden)

    Farid Hesami

    2013-01-01

    Conclusions: Chitosan as natural coagulant aid improved arsenic removal efficiency by coagulation process using FeCl 3 . This method can be used for regions with drinking water contaminated with initial arsenic concentration less than 1 000 μg/l.

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

    African Journals Online (AJOL)

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

  12. Coagulation of sheep intestinal and prefemoral lymph.

    Science.gov (United States)

    Hanley, C A; Johnston, M G; Nelson, W

    1988-06-01

    We have determined the most suitable method for the automated analysis of the clotting parameters in sheep intestinal and prefemoral lymph as defined by the Activated Partial Thromboplastin Times (APTT; measure of intrinsic coagulation pathway) and the Prothrombin Times (PT; measure of extrinsic coagulation pathway). As opposed to optical density systems, the use of a Fibro-System Fibrometer was found to provide the most consistent assessment of coagulation with the endpoint being the time to fibrin strand formation. We measured APTT in sheep intestinal and prefemoral lymph of 59.78 +/- 7.69 seconds and 51.03 +/- 10.49 seconds respectively. These values were more prolonged than those obtained from sheep blood plasma but only in the case of intestinal lymph were the differences significant (p less than 0.025). Human blood APTT values were significantly less than both sheep blood (p less than 0.05) and sheep intestinal (p less than 0.001) and prefemoral lymph (p less than 0.01). PT values were found to be 21.56 +/- 1.14 seconds in intestinal and 22.00 +/- 1.88 seconds in prefemoral lymph. These values were also significantly greater than those obtained from sheep blood (both p less than 0.001). Human blood PTs were significantly less than both sheep blood (p less than 0.001) and intestinal and prefemoral lymph (both p less than 0.001). Measurement of APTT and PT values in intestinal lymph and PT determinations in prefemoral lymph were not affected by storage in the refrigerator or freezer. There was some indication that APTT values in prefemoral samples were susceptible to storage artifacts; however, the differences in coagulation times were not significant.

  13. Approaches and perioperative management in periacetabular osteotomy surgery

    DEFF Research Database (Denmark)

    Søballe, Kjeld; Troelsen, Anders

    2012-01-01

    .9 to 8.1 years) of 209 PAOs performed using this approach have shown Kaplan-Meier survivorship rates of 94.7% at 5 years and 88.6% at 8.1 years, with conversion to total hip arthroplasty as the end point. Perioperative management includes a patient education program, optimized pain treatment strategies...... (local infiltration analgesia), and a progressive mobilization and exercise program. The transsartorial approach coupled with a specific perioperative management program has proved successful for PAO surgery.......In the early days of periacetabular osteotomy (PAO), surgical approaches were characterized by extensive soft-tissue dissection. The Smith-Petersen approach (and iliofemoral modifications) and the ilioinguinal approach have traditionally been used for PAO. The optimal surgical approach for PAO...

  14. Low-cost multi-stage filtration enhanced by coagulation-flocculation in upflow gravel filtration

    Directory of Open Access Journals (Sweden)

    L. D. Sánchez

    2012-12-01

    Full Text Available This paper assesses the operational and design aspects of coagulation and flocculation in upflow gravel filters (CF-UGF in a multi-stage filtration (MSF plant. This study shows that CF-UGF units improve the performance of MSF considerably, when the system operates with turbidity above 30 NTU. It strongly reduces the load of particulate material before the water enters in the slow sand filters (SSF and therewith avoids short filter runs and prevents early interruption in SSF operations. The removal efficiency of turbidity in the CF-UGF with coagulant was between 85 and 96%, whereas the average efficiency without coagulant dosing was 46% (range: 21–76%. Operating with coagulant also improves the removal efficiency for total coliforms, E-coli and HPC. No reduction was observed in the microbial activity of the SSF, no obstruction of the SSF bed was demonstrated and SSF runs were maintained between 50 and 70 days for a maximum head loss of 0.70 m. The most important advantage is the flexibility of the system to operate with and without coagulant according to the influent turbidity. It was only necessary for 20% of the time to operate with the coagulant. The CF-UGF unit represented 7% of total construction costs and the O&M cost for the use of coagulant represented only 0.3%.

  15. Performance optimization of coagulant/flocculant in the treatment of wastewater from a beverage industry.

    Science.gov (United States)

    Amuda, O S; Amoo, I A; Ajayi, O O

    2006-02-28

    This study investigated the effect of coagulation/flocculation treatment process on wastewater of Fumman Beverage Industry, Ibadan, Nigeria. The study also compared different dosages of coagulant, polyelectrolyte (non-ionic polyacrylamide) and different pH values of the coagulation processes. The effect of different dosages of polyelectrolyte in combination with coagulant was also studied. The results reveal that low pH values (3-8), enhance removal efficiency of the contaminants. Percentage removal of 78, 74 and 75 of COD, TSS and TP, respectively, were achieved by the addition of 500 mg/L Fe2(SO4)3.3H2O and 93, 94 and 96% removal of COD, TSS and TP, respectively, were achieved with the addition of 25 mg/L polyelectrolyte to the coagulation process. The volume of sludge produced, when coagulant was used solely, was higher compared to the use of polyelectrolyte combined with Fe2(SO4)3.3H2O. This may be as a result of non-ionic nature of the polyelectrolyte; hence, it does not chemically react with solids of the wastewater. Coagulation/flocculation may be useful as a pre-treatment process for beverage industrial wastewater prior to biological treatment.

  16. Perioperative lung protective ventilation in obese patients

    NARCIS (Netherlands)

    Fernandez-Bustamante, Ana; Hashimoto, Soshi; Serpa Neto, Ary; Moine, Pierre; Vidal Melo, Marcos F.; Repine, John E.

    2015-01-01

    The perioperative use and relevance of protective ventilation in surgical patients is being increasingly recognized. Obesity poses particular challenges to adequate mechanical ventilation in addition to surgical constraints, primarily by restricted lung mechanics due to excessive adiposity, frequent

  17. Inhibitory Effect of Triterpenoids from Panax ginseng on Coagulation Factor X

    Directory of Open Access Journals (Sweden)

    Lingxin Xiong

    2017-04-01

    Full Text Available Enzymes involved in the coagulation process have received great attention as potential targets for the development of oral anti-coagulants. Among these enzymes, coagulation factor Xa (FXa has remained the center of attention in the last decade. In this study, 16 ginsenosides and two sapogenins were isolated, identified and quantified. To determine the inhibitory potential on FXa, the chromogenic substrates method was used. The assay suggested that compounds 5, 13 and 18 were mainly responsible for the anti-coagulant effect. Furthermore, these three compounds also possessed high thrombin selectivity in the thrombin inhibition assay. Furthermore, Glide XP from Schrödinger was employed for molecular docking to clarify the interaction between the bioactive compounds and FXa. Therefore, the chemical and biological results indicate that compounds 5 (ginsenoside Rg2, 13 (ginsenoside Rg3 and 18 (protopanaxtriol, PPT are potential natural inhibitors against FXa.

  18. Interpretation of coagulation test results using a web-based reporting system.

    Science.gov (United States)

    Quesada, Andres E; Jabcuga, Christine E; Nguyen, Alex; Wahed, Amer; Nedelcu, Elena; Nguyen, Andy N D

    2014-01-01

    Web-based synoptic reporting has been successfully integrated into diverse fields of pathology, improving efficiency and reducing typographic errors. Coagulation is a challenging field for practicing pathologists and pathologists-in-training alike. To develop a Web-based program that can expedite the generation of a individualized interpretive report for a variety of coagulation tests. We developed a Web-based synoptic reporting system composed of 119 coagulation report templates and 38 thromboelastography (TEG) report templates covering a wide range of findings. Our institution implemented this reporting system in July 2011; it is currently used by pathology residents and attending pathologists. Feedback from the users of these reports have been overwhelmingly positive. Surveys note the time saved and reduced errors. Our easily accessible, user-friendly, Web-based synoptic reporting system for coagulation is a valuable asset to our laboratory services. Copyright© by the American Society for Clinical Pathology (ASCP).

  19. Perioperative Vision Loss in Cervical Spinal Surgery.

    Science.gov (United States)

    Gabel, Brandon C; Lam, Arthur; Chapman, Jens R; Oskouian, Rod J; Nassr, Ahmad; Currier, Bradford L; Sebastian, Arjun S; Arnold, Paul M; Hamilton, Steven R; Fehlings, Michael G; Mroz, Thomas E; Riew, K Daniel

    2017-04-01

    Retrospective multicenter case series. To assess the rate of perioperative vision loss following cervical spinal surgery. Medical records for 17 625 patients from 21 high-volume surgical centers from the AOSpine North America Clinical Research Network who received cervical spine surgery (levels from C2 to C7) between January 1, 2005, and December 31, 2011, inclusive, were reviewed to identify occurrences of vision loss following surgery. Of the 17 625 patients in the registry, there were 13 946 patients assessed for the complication of blindness. There were 9591 cases that involved only anterior surgical approaches; the remaining 4355 cases were posterior and/or circumferential fusions. There were no cases of blindness or vision loss in the postoperative period reported during the sampling period. Perioperative vision loss following cervical spinal surgery is exceedingly rare.

  20. Using games to provide interactive perioperative education.

    Science.gov (United States)

    Carifa, Linda; Janiszewski Goodin, Heather

    2011-10-01

    Perioperative nurses must use critical thinking and sound clinical judgment to meet their patients' needs safely and effectively. This requires the integration and continual updating of large amounts of detailed clinical information. Innovative education strategies are designed to make teaching and learning more interesting and interactive, especially for the presentation of complex subject material. One interactive educational strategy is the use of games. Educational games can foster collaboration and critical thinking among peers and associates. An example of this was the Perioperative QuizBowl: Evidence-Based Practice presented at the annual AORN Congress from 2003 to 2010, which was used to teach and reinforce evidence-based practice in a fun, competitive way. Although AORN no longer presents this offering, the QuizBowl format demonstrates how educational games can support clinical practice. Copyright © 2011 AORN, Inc. Published by Elsevier Inc. All rights reserved.

  1. Characterisation of landfill leachate by EEM-PARAFAC-SOM during physical-chemical treatment by coagulation-flocculation, activated carbon adsorption and ion exchange.

    Science.gov (United States)

    Oloibiri, Violet; De Coninck, Sam; Chys, Michael; Demeestere, Kristof; Van Hulle, Stijn W H

    2017-11-01

    The combination of fluorescence excitation-emission matrices (EEM), parallel factor analysis (PARAFAC) and self-organizing maps (SOM) is shown to be a powerful tool in the follow up of dissolved organic matter (DOM) removal from landfill leachate by physical-chemical treatment consisting of coagulation, granular activated carbon (GAC) and ion exchange. Using PARAFAC, three DOM components were identified: C1 representing humic/fulvic-like compounds; C2 representing tryptophan-like compounds; and C3 representing humic-like compounds. Coagulation with ferric chloride (FeCl 3 ) at a dose of 7 g/L reduced the maximum fluorescence of C1, C2 and C3 by 52%, 17% and 15% respectively, while polyaluminium chloride (PACl) reduced C1 only by 7% at the same dose. DOM removal during GAC and ion exchange treatment of raw and coagulated leachate exhibited different profiles. At less than 2 bed volumes (BV) of treatment, the humic components C1 and C3 were rapidly removed, whereas at BV ≥ 2 the tryptophan-like component C2 was preferentially removed. Overall, leachate treated with coagulation +10.6 BV GAC +10.6 BV ion exchange showed the highest removal of C1 (39% - FeCl 3 , 8% - PACl), C2 (74% - FeCl 3 , 68% - PACl) and no C3 removal; whereas only 52% C2 and no C1 and C3 removal was observed in raw leachate treated with 10.6 BV GAC + 10.6 BV ion exchange only. Analysis of PARAFAC-derived components with SOM revealed that coagulation, GAC and ion exchange can treat leachate at least 50% longer than only GAC and ion exchange before the fluorescence composition of leachate remains unchanged. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. The challenge of perioperative pain management in opioid-tolerant patients

    Science.gov (United States)

    Coluzzi, Flaminia; Bifulco, Francesca; Cuomo, Arturo; Dauri, Mario; Leonardi, Claudio; Melotti, Rita Maria; Natoli, Silvia; Romualdi, Patrizia; Savoia, Gennaro; Corcione, Antonio

    2017-01-01

    The increasing number of opioid users among chronic pain patients, and opioid abusers among the general population, makes perioperative pain management challenging for health care professionals. Anesthesiologists, surgeons, and nurses should be familiar with some pharmacological phenomena which are typical of opioid users and abusers, such as tolerance, physical dependence, hyperalgesia, and addiction. Inadequate pain management is very common in these patients, due to common prejudices and fears. The target of preoperative evaluation is to identify comorbidities and risk factors and recognize signs and symptoms of opioid abuse and opioid withdrawal. Clinicians are encouraged to plan perioperative pain medications and to refer these patients to psychiatrists and addiction specialists for their evaluation. The aim of this review was to give practical suggestions for perioperative management of surgical opioid-tolerant patients, together with schemes of opioid conversion for chronic pain patients assuming oral or transdermal opioids, and patients under maintenance programs with methadone, buprenorphine, or naltrexone. PMID:28919771

  3. The use of cold coagulation for the treatment of cervical intraepithelial neoplasia

    LENUS (Irish Health Repository)

    Wyse, A

    2017-05-01

    In 2015, Cold Coagulation was introduced as a treatment for cervical intraepithelial neoplasia (CIN) at our colposcopy clinic. We reviewed the 6-month follow up data of the first 200 women who underwent Cold Coagulation using cytology and HPV status as tests of cure (TOC). A random sample of 200 patients treated by Large Loop Excision of the Transformation Zone (LLETZ) during the same period was used to compare treatment outcome. Six months following treatment,173 (86.5%) of the women treated by CC and 167 (83.5%) treated by LLETZ had negative cytology. (x2= P>0.05). 148 (74%) treated by Cold Coagulation and 166 (83%) treated by LLETZ were HPV negative (x2= P<0.05). One hundred and thirty-nine (70%) women treated by Cold Coagulation and 152 (76%) treated with LLETZ had normal cytology and were HPV negative. This audit of our initial experience supports the observation that Cold Coagulation is as effective as LLETZ in the management of CIN when cervical cytology is used as a test of cure.

  4. Comparison of the level of residual coagulant activity in different cheese varieties.

    Science.gov (United States)

    Bansal, Nidhi; Fox, Patrick F; McSweeney, Paul L H

    2009-08-01

    The coagulant retained in cheese curd is a major contributor to proteolysis during ripening. The objective of this study was to quantify residual coagulant in 9 cheese varieties by measuring its activity on a synthetic heptapeptide (Pro-Thr-Glu-Phe-[NO2-Phe]-Arg-Leu) assayed using reversed-phase HPLC. The level of residual coagulant activity was highest in Camembert cheese, probably due to its low pH at whey drainage and the high moisture content of the cheese, followed in order by Feta=Port du Salut=Cheddar>Gouda>Emmental=Parmigiano Reggiano=low-moisture part-skim Mozzarella=Mozzarella di Bufala Campana. The high cooking temperature (50-54 degrees C) used during the manufacture of Emmental and Parmigiano Reggiano cheeses and the cooking and stretching step in hot water during the manufacture of Mozzarella cheese may be the reasons for the lowest residual coagulant activity in these cheeses. The level of residual coagulant activity was higher in Feta cheese made from milk concentrated by ultrafiltration than in conventional Feta.

  5. Evidence utilisation project: Management of inadvertent perioperative hypothermia. The challenges of implementing best practice recommendations in the perioperative environment.

    Science.gov (United States)

    Munday, Judy; Hines, Sonia Jane; Chang, Anne M

    2013-12-01

    The prevention of inadvertent perioperative hypothermia (IPH) remains an important issue in perioperative healthcare. The aims of this project were to: (i) assess current clinical practice in the management of IPH and (ii) promote best practice in the management of IPH in adult operating theatres. This project from August 2010 to March 2012 utilised a system of audit and feedback to implement best practice recommendations. Data were collected via chart audits against criteria developed from best practice recommendations for managing IPH. Evidence-based best practices, such as consistent temperature monitoring and patient warming, were implemented using multifaceted interventions. Perioperative records for 73 patients (baseline) and 72 patients (post-implementation) were audited. Post-implementation audit showed an increase in patients with temperatures >36°C admitted to the post-anaesthetic care unit (PACU) (8%) and discharged from PACU (28%). The percentage of patients receiving preoperative temperature monitoring increased (38%); however, low levels of intraoperative monitoring remained (31% of patients with surgery of 30 min or longer duration). Small increases were found in patient warming of 5% intraoperatively and 8% postoperatively. Preoperative warming was not successfully implemented during this phase of the project. Temperature monitoring, warming and rates of normothermia improved; however, barriers to best practice of IPH management were experienced, which negatively impacted on the project. Further stages of implementation and audit were added to further address IPH management in this department. © 2013 The Authors. International Journal of Evidence-Based Healthcare © 2013 The Joanna Briggs Institute.

  6. Characteristics of BPA removal from water by PACl-Al13 in coagulation process.

    Science.gov (United States)

    Xiaoying, Ma; Guangming, Zeng; Chang, Zhang; Zisong, Wang; Jian, Yu; Jianbing, Li; Guohe, Huang; Hongliang, Liu

    2009-09-15

    This paper discussed the coagulation characteristics of BPA with polyaluminum chloride (PACl-Al(13)) as coagulant, examined the impact of coagulation pH, PACl-Al(13) dosage, TOC (total organic carbon) and turbidity on BPA removal, and analyzed the possible dominant mechanisms in water coagulation process. Formation and performance of flocs during coagulation processes were monitored using photometric dispersion analyzer (PDA). When the concentration of humic acid matters and turbidity was low in the solution, the experimental results showed that the removal of BPA experienced increase and subsequently decrease with the PACl-Al(13) dosage increasing. The optimal PACl-Al(13) dosage was found at BPA/PACl-Al(13)=1:2.6(M/M) under our experiment conditions. Results show that the maximum BPA removal efficiency occurred at pH 9.0 due to the adsorption by Al(13) aggregates onto BPA rather than charge neutralization mechanism by polynuclear aluminous salts in the solution. The humic acid matters and kaolin in the solution have significant effect on BPA removal with PACl-Al(13) in the coagulation. The BPA removal will be weakened at high humic matters. The removal rate of BPA increased and subsequently decreased with the turbidity increasing.

  7. Effects of storage conditions of Moringa oleifera seeds on its performance in coagulation.

    Science.gov (United States)

    Katayon, S; Noor, M J Megat Mohd; Asma, M; Ghani, L A Abdul; Thamer, A M; Azni, I; Ahmad, J; Khor, B C; Suleyman, A M

    2006-09-01

    Moringa oleifera is a plant whose seeds have coagulation properties for treating water and wastewater. In this study the coagulation efficiency of Moringa oleifera kept in different storage conditions were studied. The Moringa oleifera seeds were stored at different conditions and durations; open container and closed container at room temperature (28 degrees C) and refrigerator (3 degrees C) for durations of 1, 3 and 5 months. Comparison between turbidity removal efficiency of Moringa oleifera kept in refrigerator and room temperature revealed that there was no significant difference between them. The Moringa oleifera kept in refrigerator and room temperature for one month showed higher turbidity removal efficiency, compared to those kept for 3 and 5 months, at both containers. The coagulation efficiency of Moringa oleifera was found to be dependent on initial turbidity of water samples. Highest turbidity removals were obtained for water with very high initial turbidity. In summary coagulation efficiency of Moringa oleifera was found independent of storage temperature and container, however coagulation efficiency of Moringa oleifera decreased as storage duration increased. In addition, Moringa oleifera can be used as a potential coagulant especially for very high turbidity water.

  8. Application of Moringa Oleifera Seed Powder for Iron (III) Coagulation on Local Water Resources

    OpenAIRE

    Prasetyaningtyas, Fadillah Utami; Rumhayati, Barlah; Masruri, Masruri

    2013-01-01

    This research aims to know the effect of the use of powder moringa seed to coagulant mass and coagulation process, and its effectiveness to increase the quality of pure water. This research uses factorial research design and statistic test MANOVA. To analyse water quality, the researcher uses Fe parameter.  A graphic of coagulant mass and time for each parameter is used to analyse the data. Based on the research result, the uses of moringa seed as coagulant in each 300 mL mineral water gives ...

  9. Diffusion mediated coagulation and fragmentation based study of domain formation in lipid bilayer membrane

    Energy Technology Data Exchange (ETDEWEB)

    Rao, Laxminarsimha V., E-mail: laxman@iitk.ac.in [Mechanics and Applied Mathematics Group, Department of Mechanical Engineering, Indian Institute of Technology Kanpur, Kanpur 208016 (India); Roy, Subhradeep [Department of Biomedical Engineering and Mechanics (MC 0219), Virginia Tech, 495 Old Turner Street, Blacksburg, VA 24061 (United States); Das, Sovan Lal [Mechanics and Applied Mathematics Group, Department of Mechanical Engineering, Indian Institute of Technology Kanpur, Kanpur 208016 (India)

    2017-01-15

    We estimate the equilibrium size distribution of cholesterol rich micro-domains on a lipid bilayer by solving Smoluchowski equation for coagulation and fragmentation. Towards this aim, we first derive the coagulation kernels based on the diffusion behaviour of domains moving in a two dimensional membrane sheet, as this represents the reality better. We incorporate three different diffusion scenarios of domain diffusion into our coagulation kernel. Subsequently, we investigate the influence of the parameters in our model on the coagulation and fragmentation behaviour. The observed behaviours of the coagulation and fragmentation kernels are also manifested in the equilibrium domain size distribution and its first moment. Finally, considering the liquid domains diffusing in a supported lipid bilayer, we fit the equilibrium domain size distribution to a benchmark solution.

  10. Blood coagulation and fibrinolysis of the whole-body irradiated rabbits

    International Nuclear Information System (INIS)

    Hishikawa-Itoh, Youko; Ayakawa, Yoshio; Miyata, Nobuki

    1984-01-01

    To study the effects of irradiation on blood coagulation and fibrinolysis, rabbits were irradiated with 60 Co γ-rays (whole-body: 0, 100, 400, 800, 1200 rads). Clotting time, activity of plasmin and plasminogen, and fibrinogen contents of irradiated rabbit plasma were measured at 4 days before, immediately after, and at 1, 3, 7, 10, and 14 days after irradiation. Both clotting times obtained by addition of (kaolin+phospholipid) which expressed effects on the total intrinsic coagulation system, and by addition of (Ca 2+ ) which expressed effects on the total extrinsic coagulation system, were prolonged with small dose irradiation (100 rads) immediately and 3 days after irradiation. However, with high dose irradiation (400-1200 rads), these clotting times were prolonged 1 day after irradiation. The times of manifestation of irradiation effects on clotting time were different in small and high dose irradiation. Plasmin activity was decreased immediately, 1 day after and recovered 3 days after irradiation. Plasminogen activity was markedly increased in 800 and 1200 rads irradiated groups from 3 days after irradiation. Conversion of plasminogen into plasmin was impaired by irradiation. Fibrinogen contents increased rapidly in all irradiated rabbits except for 100 rads from 1 day after irradiation. These results revealed decreased coagulation and fibrinolysis activities in rabbit blood, irradiation injury of both coagulation and fibrinolysis activation systems, and accumulation of the precursors of fibrin and plasmin (i.e., fibrinogen and plasminogen). (author)

  11. Effect of fibrinogen on blood coagulation detected by optical coherence tomography

    International Nuclear Information System (INIS)

    Xu, Xiangqun; Teng, Xiangshuai

    2015-01-01

    Our previous work demonstrated that an optical coherence tomography (OCT) technique and the parameter 1/e light penetration depth (d 1/e ) were able to characterize the whole blood coagulation process in contrast to existing optical tests that are performed on plasma samples. To evaluate the feasibility of the technique for quantifying the effect of fibrinogen (Fbg) on blood coagulation, a dynamic study of d 1/e of blood in various Fbg concentrations was performed in static state. Two groups of blood samples of hematocrit (HCT) in 35, 45, and 55% were reconstituted of red blood cells with: 1) treated plasma with its intrinsic Fbg removed and commercial Fbg added (0–8 g L −1 ); and 2) native plasma with commercial Fbg added (0–8 g L −1 ). The results revealed a typical behavior due to coagulation induced by calcium ions and the clotting time is Fbg concentration-dependent. The clotting time was decreased by the increasing amount of Fbg in both groups. Besides, the blood of lower HCT with various levels of Fbg took shorter time to coagulate than that of higher HCT. Consequently, the OCT method is a useful and promising tool for the detection of blood-coagulation processes induced with different Fbg levels. (paper)

  12. Chemical coagulants and Moringa oleifera seed extract for treating concrete wastewater

    Directory of Open Access Journals (Sweden)

    Heber Martins de Paula

    2016-01-01

    Full Text Available Wastewater from concrete plants has a high pH and a high concentration of suspended solids, necessitating treatment before reuse or discharge into the environment. The objective of this study is to evaluate the efficiency of two chemical coagulants, aluminum sulfate (Al2(SO43 and iron chloride (FeCl3, and a natural coagulant, Moringa oleifera (MO, all in their soluble forms, in the treatment of wastewater from concrete plants. To this end, the efficiencies of the three coagulants, in combinations with different proportions, were tested. The quality parameters of the wastewater obtained after the treatments were compared to the limit values for non-potable water. The use of coagulants in their soluble form potentiates their effect, especially when preparing the MO extract, i.e., greater amounts of the protein responsible for the coagulation is extracted. A mixture with MO and Al2(SO43 in a 20:80 proportion showed the best results, with 97.5% of the turbidity removed at 60 min. of sedimentation, allowing the treated water to be used for washing vehicles and flushing toilets. The FeCl3 treatment produced a high concentration of chlorides, which could cause corrosion problems, and is therefore not recommended for concrete wastewater treatment.

  13. Aqueous arsenite removal by simultaneous ultraviolet photocatalytic oxidation-coagulation of titanium sulfate

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Yuxia [Key Laboratory of Northwest Water Resources, Environment and Ecology, MOE, School of Environmental & Municipal Engineering, Xi’an University of Architecture and Technology (China); Duan, Jinming, E-mail: jinmingduan@xauat.edu.cn [Key Laboratory of Northwest Water Resources, Environment and Ecology, MOE, School of Environmental & Municipal Engineering, Xi’an University of Architecture and Technology (China); Centre for Water Management and Reuse, School of Natural and Built Environments, University of South Australia, Mawson Lakes Campus, South Australia (Australia); Li, Wei [Key Laboratory of Northwest Water Resources, Environment and Ecology, MOE, School of Environmental & Municipal Engineering, Xi’an University of Architecture and Technology (China); Beecham, Simon; Mulcahy, Dennis [Centre for Water Management and Reuse, School of Natural and Built Environments, University of South Australia, Mawson Lakes Campus, South Australia (Australia)

    2016-02-13

    Highlights: • A simultaneous UV catalysed oxidation–coagulation for As(III) removal is proposed. • As(III) was effectively oxidised to As(V) by the UV catalysed coagulation. • >99% removal for As(III) in pH 4–6 at low doses of Ti(SO{sub 4}){sub 2} was achieved. • Concurrent UV radiation in massive small crystal formation facilitate the effects. • Reaction mechanisms involve both hydroxyl radicals and superoxide radicals. - Abstract: This study explored the efficacy and efficiency of a simultaneous UV-catalyzed oxidation–coagulation process of titanium sulfate (UV/Ti(SO{sub 4}){sub 2}) for efficient removal of As(III) from water. It revealed that, As(III) could be oxidized to As(V) during the UV catalyzed coagulation of Ti(SO{sub 4}){sub 2} with highly efficient As(III) removal in the pH range 4–6{sub .} The UV catalyzed oxidation–coagulation showed surprisingly effective oxidation of As(III) to As(V) within a short time. XPS indicated that 84.7% of arsenic on the coagulated precipitate was in the oxidized form of As(V) after the UV/Ti(SO{sub 4}){sub 2} treatment of As(III) aqueous solutions at pH 5. Arsenic remaining in solution at high pH was in the oxidized form As(V). Removal efficiencies of As(III) were investigated as a function of pH, Ti(SO{sub 4}){sub 2} dosage, initial As(III) concentration and irradiation energy. As(III) could almost completely be removed (>99%) by the photocatalytic oxidation–coagulation process with a moderate dose of Ti(SO{sub 4}){sub 2} in the pH range 4–6 at an initial arsenic concentration of 200 μg/L. The mechanisms of the photocatalytic coagulation oxidation of Ti(SO{sub 4}){sub 2} are similar to those of UV/crystalline TiO{sub 2} particles, involving the formation and reactions of the hydroxyl radical OH· and superoxide HO{sub 2}·/O{sub 2}{sup ·−}.

  14. [Current status and prospect of perioperative thrombus management in gastrointestinal cancer].

    Science.gov (United States)

    Qin, X Y

    2016-03-01

    Thanks to the progress of surgical theory and skills, as well as the application of modern medical devices in general surgery, both the occurrence of perioperative complications and mortality of gastrointestinal surgery have significantly reduced recently. However, it is still far from optimal in terms of the perioperative venous thromboembolism (VTE) management in gastrointestinal cancer, and what is responsible for that? This paper aims at finding out the reasons contributing to the current status, giving suggestions for how to make improvement at both disease level and hospital management level. At the same time, while paying attention for the prophylaxis of VTE, there have been more and more patients receiving antithrombotic treatment require elective or emergent surgery in clinical practice, due to aging and increased incidence of cardiovascular disease year by year. How to balance the bleeding and thrombosis risk for these patients during perioperative periods is also a question we are going to discuss. In conclusion, as to the issue of the management of perioperative thrombosis, there will be a long way for Chinese doctors to go. Our peers should pay more attention to this problem and take more efforts, so that the thrombotic complications in surgical patients can be reduced.

  15. Quinine-induced disseminated intravascular coagulation.

    Science.gov (United States)

    Spearing, R L; Hickton, C M; Sizeland, P; Hannah, A; Bailey, R R

    Recurrent disseminated intravascular coagulation occurred in 3 women after ingestion of quinine tablets for cramp. All had circulating quinine-dependent antibodies to platelets and in 2 there was initial evidence of antibody consumption, with low titres that rose steeply over the next few days and remained high for many months.

  16. A natural coagulant protein from Moringa oleifera: isolation, characterization, and potential use for water treatment

    Science.gov (United States)

    Choudhary, Manisha; Neogi, Sudarsan

    2017-10-01

    In developing countries pond water is still widely used for drinking and household purposes, which develops higher turbidity during rainy seasons and requires a large amount of chemical coagulants, and this leads to high cost of treatment. To mitigate this, it is important to find an economical and natural coagulant to treat turbid water. The present study is focused on using a plant based component as a natural coagulant that is sustainable and environment-friendly. This work focuses on the extraction, isolation and purification of a natural coagulant from seed kernels of Moringa oleifera to enhance its turbidity removal efficiency. The determination of themolecular weight of the purified proteins was done using sodium dodecyl sulfate polyacrylamide gel electrophoresis. The active coagulant proteins were isolated using 30-60% and 60-80% saturation of ammonium sulfate. It was observed that proteins with molecular weight less than 36 kDa have superior coagulation activity. Turbidity removal efficiency of these active coagulant proteins was compared with alum. The possibility of using Moringa oleifera seeds as a natural antimicrobial agent was also investigated.

  17. Comparative study of perioperative complication rates of cervical laminoplasty performed by residents and teaching neurosurgeons.

    Science.gov (United States)

    Niimura, Manabu; Takai, Keisuke; Taniguchi, Makoto

    2017-11-01

    Early surgical education is required for neurosurgical residents to learn many surgical procedures. However, the participation of less experienced residents may increase perioperative complication rates. Perioperative complication studies in the field of neurosurgery are being increasingly published; however, studies have not yet focused on cervical laminoplasty. The study population included 193 consecutive patients who underwent cervical laminoplasty in Tokyo Metropolitan Neurological Hospital between 2008 and 2014. Patient and surgeon background factors, as well as perioperative complication rates were retrospectively compared between resident and board-certified spine neurosurgeon groups. Deteriorated or newly developed neurological deficits and surgical site complications within 30days of cervical laminoplasty were defined as perioperative complications. Out of 193 patients, 123 (64%) were operated on by residents as the first operator and 70 (36%) by board-certified spine neurosurgeons. No significant differences were observed in patient and surgeon factors between the two groups, except for hyperlipidemia (13 vs 17, p=0.02). Furthermore, no significant differences were noted in perioperative complication rates between the two groups (7 [5.7%] vs 4 [5.7%], p=1). Cervical laminoplasty performed in a standardized manner by residents who received their surgical training in our hospital did not increase perioperative complication rates, and ensured the safety of patients. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. Hibiscus rosa- sinensis leaf extract as coagulant aid in leachate treatment

    Science.gov (United States)

    Awang, Nik Azimatolakma; Aziz, Hamidi Abdul

    2012-12-01

    Hibiscus rosa- sinensis is a biodegradable material that has remained untested for flocculating properties. The objective of this study is to examine the efficiency of coagulation-flocculation processes for the removal of color, iron (Fe3+), suspended solids, turbidity and ammonia nitrogen(NH3-N), from landfill leachate using 4,000 mg/L alum in conjunction with H. rosa- sinensis leaf extract (HBaqs). Hydroxyl (O-H) and (carboxyl) C=O functional groups along the HBaqs chain help to indulge flocculating efficiency of HBaqs via bridging. The experiments confirm the positive coagulation properties of HBaqs. The Fe3+ removal rate using 4,000 mg/L alum as sole coagulant was approximately 60 %, and increased to 100 % when 4,000 mg/L alum was mixed with 500 mg/L HBaqs. By mixing, 4,000 mg/L alum with 100-500 mg/L HBaqs, 72 % of SS was removed as compared with only 45 % reduction using 4,000 mg/L alum as sole coagulant.

  19. Ontology-based specification, identification and analysis of perioperative risks.

    Science.gov (United States)

    Uciteli, Alexandr; Neumann, Juliane; Tahar, Kais; Saleh, Kutaiba; Stucke, Stephan; Faulbrück-Röhr, Sebastian; Kaeding, André; Specht, Martin; Schmidt, Tobias; Neumuth, Thomas; Besting, Andreas; Stegemann, Dominik; Portheine, Frank; Herre, Heinrich

    2017-09-06

    Medical personnel in hospitals often works under great physical and mental strain. In medical decision-making, errors can never be completely ruled out. Several studies have shown that between 50 and 60% of adverse events could have been avoided through better organization, more attention or more effective security procedures. Critical situations especially arise during interdisciplinary collaboration and the use of complex medical technology, for example during surgical interventions and in perioperative settings (the period of time before, during and after surgical intervention). In this paper, we present an ontology and an ontology-based software system, which can identify risks across medical processes and supports the avoidance of errors in particular in the perioperative setting. We developed a practicable definition of the risk notion, which is easily understandable by the medical staff and is usable for the software tools. Based on this definition, we developed a Risk Identification Ontology (RIO) and used it for the specification and the identification of perioperative risks. An agent system was developed, which gathers risk-relevant data during the whole perioperative treatment process from various sources and provides it for risk identification and analysis in a centralized fashion. The results of such an analysis are provided to the medical personnel in form of context-sensitive hints and alerts. For the identification of the ontologically specified risks, we developed an ontology-based software module, called Ontology-based Risk Detector (OntoRiDe). About 20 risks relating to cochlear implantation (CI) have already been implemented. Comprehensive testing has indicated the correctness of the data acquisition, risk identification and analysis components, as well as the web-based visualization of results.

  20. Potential of Hibiscus Sabdariffa and Jatropha Curcas as Natural Coagulants in the Treatment of Pharmaceutical Wastewater

    Directory of Open Access Journals (Sweden)

    Sibartie Sheena

    2018-01-01

    Full Text Available Pharmaceutical wastewater is one of the most difficult wastewater to treat due to the presence of pharmaceutical compounds resulting in high concentration of organic matter, high turbidity and Chemical Oxygen Demand (COD. Chemical-based coagulation is a common method used to treat wastewater. However, the issue that has been raised with the use of chemical coagulants is their presence in water after treatment that can cause risks to the human health such as Alzheimer and cancer. Natural coagulants can be used as a safe alternative to these chemicals instead. Therefore, the objective of this experiment was to study the effect of H. Sabdariffa and J. Curcas as natural coagulants, separately and as a combination, on the treatment of pharmaceutical wastewater. Jar test experiment were carried out where beakers of 0.5L wastewater were mixed with the coagulants. The pH of the wastewater was varied from 2 to 12 while the coagulant dosage was varied from 40 to 200 mg/L. It was found that H. Sabdariffa works best at pH 4 and at a coagulant dosage of 190 mg/L with a highest turbidity removal of 35.8% and a decrease of COD by 29%. J. Curcas was found to perform best at pH 3 and with a coagulant dosage of 200 mg/L with a highest turbidity removal of 51% and a decrease of COD by 32%. When J. Curcas and H. Sabdariffa were used in combination, the optimum composition was found to be 80% J. Curcas and 20% H. Sabdariffa by weight with a maximum turbidity removal of 46.8% and a decrease in COD by 46%. In comparison between the two natural coagulants, J. Curcas is found to be a better and more suited coagulative agent for the treatment of pharmaceutical wastewater. The same experiment was carried with alum at pH 6 and coagulant dosage of 750 mg/L and a turbidity removal of 48% and a decrease in COD by 38% were recorded. In comparison with alum, J. Curcas was a better coagulant in treating the pharmaceutical wastewater. This shows that natural coagulants can be

  1. Exact results for the Boltzmann equation and Smoluchowski's coagulation equation

    International Nuclear Information System (INIS)

    Hendriks, E.M.

    1983-01-01

    Almost no analytical solutions have been found for realistic intermolecular forces, largely due to the complicated structure of the collision term which calls for the construction of simplified models, in which as many physical properties are maintained as possible. In the first three chapters of this thesis such model Boltzmann equations are studied. Only spatially homogeneous gases with isotropic distribution functions are considered. Chapter I considers transition kernels, chapter II persistent scattering models and chapter III very hard particles. The second part of this dissertation deals with Smoluchowski's coagulation equation for the size distribution function in a coagulating system, with chapters devoted to the following topics: kinetics of gelation and universality, coagulation equations with gelation and exactly soluble models of nucleation. (Auth./C.F.)

  2. Evidence or eminence in abdominal surgery: Recent improvements in perioperative care

    OpenAIRE

    Segelman, Josefin; Nygren, Jonas

    2014-01-01

    Repeated surveys from Europe, the United States, Australia, and New Zealand have shown that adherence to an evidence-based perioperative care protocol, such as Enhanced Recovery After Surgery (ERAS), has been generally low. It is of great importance to support the implementation of the ERAS protocol as it has been shown to improve outcomes after a number of surgical procedures, including major abdominal surgery. However, despite an increasing awareness of the importance of structured perioper...

  3. Multidisciplinary perioperative protocol in patients undergoing acute high-risk abdominal surgery

    DEFF Research Database (Denmark)

    Tengberg, L. T.; Bay-Nielsen, M.; Bisgaard, T.

    2017-01-01

    Background: Acute high-risk abdominal (AHA) surgery carries a very high risk of morbidity and mortality and represents a massive healthcare burden. The aim of the present study was to evaluate the effect of a standardized multidisciplinary perioperative protocol in patients undergoing AHA surgery...... = 0·004). Conclusion: The introduction of a multidisciplinary perioperative protocol was associated with a significant reduction in postoperative mortality in patients undergoing AHA surgery. NCT01899885 (http://www.clinicaltrials.gov)....

  4. Disseminated intravascular coagulation in solid tumors

    International Nuclear Information System (INIS)

    Terzieff, V.; Alonso, I.; Vázquez, A.

    2004-01-01

    It is estimated that 20-25% of cases of disseminated intravascular coagulation (DIC) relate to an underlying neoplasia primarily hematologic. It is estimated that about 5% of patients with solid tumors have CID clinic, although the incidence of subclinical alterations is much higher. The CID is not limited to the activation of the coagulation cascade, which leads to bleeding micro thrombosis and consumption of coagulation factors. Solid tumors are frequently associated adenocarcinomas producers mucin (especially gastric), usually in the context of a disseminated disease. The mucin may act as a promoter of the cascade, but probably it is a multi-event. High levels of TNF to produced by the tumor mass and chemotherapy-induced cell lysis have Also linked. Although the bleeding is usually oriented diagnosis, the most frequent cause of death is thrombosis. There are no specific tests for diagnosis. Elevated levels of D-dimer and products oriented fibrinogen degradation diagnosis. No reduction fibrinogen and almost always, one thrombocytopenia consumption. Treatment is complex and there is no consensus on many points. To recover the lost factors for consumption, it is recommended to use fresh frozen plasma and / or washed red blood cells. the heparin anticoagulation low dose is indicated since the disease causal can not be controlled quickly, but should not be initiated if there thrombocytopenia 50.000.El under profuse bleeding can require the use of tranexamic acid or EACA. Acute DIC, the case of our patient, is rare and very serious

  5. Benefits and harms of perioperative beta-blockade

    DEFF Research Database (Denmark)

    Wetterslev, Jørn; Juul, Anne Benedicte

    2006-01-01

    randomized trials. However, confidence intervals of the intervention effects in the meta-analyses are wide, leaving room for both benefits and harms. The largest observational study performed suggests that perioperative beta-blockade is associated with higher mortality in patients with low cardiac risk...

  6. Strategier til begraensning af det perioperative forbrug af allogent blod

    DEFF Research Database (Denmark)

    Jørgensen, B G; Qvist, N

    2001-01-01

    Allogenic blood transfusion carries the risk of immunological and non-immunological adverse effects. Consequently, blood transfusion should be limited to situations where alternatives are not available. This article reviews current by available alternative strategies that reduce the need...... for perioperative allogenic blood transfusion. The effectiveness of a number of these alternatives needs to be documented and potential adverse effects clarified. The acceptance of a lower haemoglobin level as the transfusion trigger value is perhaps the most important factor in reducing the need for peri......-operative allogenic blood transfusion...

  7. Enhanced coagulation for turbidity and Total Organic Carbon (TOC) removal from river Kansawati water.

    Science.gov (United States)

    Narayan, Sumit; Goel, Sudha

    2011-01-01

    The objective of this study was to determine optimum coagulant doses for turbidity and Total Organic Carbon (TOC) removal and evaluate the extent to which TOC can be removed by enhanced coagulation. Jar tests were conducted in the laboratory to determine optimum doses of alum for the removal of turbidity and Natural Organic Matter (NOM) from river water. Various other water quality parameters were measured before and after thejar tests and included: UV Absorbance (UVA) at 254 nm, microbial concentrations, TDS, conductivity, hardness, alkalinity, and pH. The optimum alum dose for removal of turbidity and TOC was 20 mg/L for the sample collected in November 2009 and 100 mg/L for the sample collected in March 2010. In both cases, the dose for enhanced coagulation was significantly higher than that for conventional coagulation. The gain in TOC removal was insignificant compared to the increase in coagulant dose required. This is usual for low TOC (TOC need to be tested to demonstrate the effectiveness of enhanced coagulation.

  8. A simple purification and activity assay of the coagulant protein from Moringa oleifera seed.

    Science.gov (United States)

    Ghebremichael, Kebreab A; Gunaratna, K R; Henriksson, Hongbin; Brumer, Harry; Dalhammar, Gunnel

    2005-06-01

    Use of extracts from Moringa oleifera (MO) is of great interest for low-cost water treatment. This paper discusses water and salt extraction of a coagulant protein from the seed, purification using ion exchange, its chemical characteristics, coagulation and antimicrobial properties. The coagulant from both extracts is a cationic protein with pI greater than 9.6 and molecular mass less than 6.5 kDa. Mass spectrometric analysis of the purified water extract indicated that it contained at least four homologous proteins, based on MS/MS peptide sequence data. The protein is thermoresistant and remained active after 5h heat treatment at 95 degrees C. The coagulant protein showed both flocculating and antibacterial effects of 1.1--4 log reduction. With samples of high turbidity, the MO extract showed similar coagulation activity as alum. Cecropin A and MO extract were found to have similar flocculation effects for clay and microorganisms. Simple methods for both the purification and assay of MO coagulating proteins are presented, which are necessary for large-scale water treatment applications.

  9. OPTIMIZATION OF FLOCCULATION PROCESS BY MICROBIAL COAGULANT IN RIVER WATER

    Directory of Open Access Journals (Sweden)

    Fatin Nabilah Murad

    2017-12-01

    Full Text Available The existing process of coagulation and flocculation are using chemicals that known as cationic coagulant such as alum, ferric sulfate, calcium oxide, and organic polymers.  Thus, this study concentrates on optimizing of flocculation process by microbial coagulant in river water. Turbidity and suspended solids are the main constraints of river water quality in Malaysia. Hence, a study is proposed to produce microbial coagulants isolated locally for river water treatment. The chosen microbe used as the bioflocculant producer is Aspergillus niger. The parameters to optimization in the flocculation process were pH, bioflocculant dosage and effluent concentration. The research was done in the jar test process and the process parameters for maximum turbidity removal was validated. The highest flocculating activity was obtained on day seven of cultivation in the supernatant. The optimum pH and bioflocculant dosage for an optimize sedimentation process were between 4-5 and 2-3 mL for 0.3 g/L of effluent concentration respectively. The model was validated by using a river water sample from Sg. Pusu and the result showed that the model was acceptable to evaluate the bioflocculation process.

  10. Blood coagulation in lead poisoning and the influence of specific treatment

    Energy Technology Data Exchange (ETDEWEB)

    Levantovskaya, O M; Lyubcenko, P N; Dayhin, I S; Sorkina, N S

    1974-07-01

    Results of blood coagulation studies in 104 workers with long-term exposure in a storage-battery plant. Over-all coagulation activity is unchanged in cases of mild lead poisoning, but long-term exposure gives rise to increased fibrinogen levels, activated fibrinolysis, and reduced serum accelerator globulin and prothrombin activities. 13 workers were given D-penicillamine (oral doses of 450 mg daily). All coagulation indices had become normal after 10 days' treatment. The changes observed are thought to be due to protein synthesis disturbances in the liver and to inhibition of enzymes by lead which combines with their sulfhydryl and disulfide groups. (CIS Abstr. Vol. 2)

  11. Perioperative lung protective ventilation in obese patients.

    Science.gov (United States)

    Fernandez-Bustamante, Ana; Hashimoto, Soshi; Serpa Neto, Ary; Moine, Pierre; Vidal Melo, Marcos F; Repine, John E

    2015-05-06

    The perioperative use and relevance of protective ventilation in surgical patients is being increasingly recognized. Obesity poses particular challenges to adequate mechanical ventilation in addition to surgical constraints, primarily by restricted lung mechanics due to excessive adiposity, frequent respiratory comorbidities (i.e. sleep apnea, asthma), and concerns of postoperative respiratory depression and other pulmonary complications. The number of surgical patients with obesity is increasing, and facing these challenges is common in the operating rooms and critical care units worldwide. In this review we summarize the existing literature which supports the following recommendations for the perioperative ventilation in obese patients: (1) the use of protective ventilation with low tidal volumes (approximately 8 mL/kg, calculated based on predicted -not actual- body weight) to avoid volutrauma; (2) a focus on lung recruitment by utilizing PEEP (8-15 cmH2O) in addition to recruitment maneuvers during the intraoperative period, as well as incentivized deep breathing and noninvasive ventilation early in the postoperative period, to avoid atelectasis, hypoxemia and atelectrauma; and (3) a judicious oxygen use (ideally less than 0.8) to avoid hypoxemia but also possible reabsorption atelectasis. Obesity poses an additional challenge for achieving adequate protective ventilation during one-lung ventilation, but different lung isolation techniques have been adequately performed in obese patients by experienced providers. Postoperative efforts should be directed to avoid hypoventilation, atelectasis and hypoxemia. Further studies are needed to better define optimum protective ventilation strategies and analyze their impact on the perioperative outcomes of surgical patients with obesity.

  12. Perioperative Prophylaxis for Total Artificial Heart Transplantation.

    Science.gov (United States)

    Chambers, H E; Pelish, P; Qiu, F; Florescu, D F

    2017-11-01

    Practice variation regarding perioperative antimicrobial prophylaxis in total artificial heart transplantations (TAH-t) across institutions is unknown. The aim of our survey was to assess the current practices for prevention of infection in TAH-t recipients among different programs. An electronic survey was sent to programs that implant Syncardia TAH (Syncardia Systems, Tuscon, Ariz, USA). Proportions were analyzed for categorical variables; means and SDs were analyzed for continuous variables. The majority of centers (80.8%) had a formal surgical infection prophylaxis protocol. For non-penicillin-allergic patients, five (20.1%) institutions reported using a 4-drug regimen, seven (29.2%) used a 3-drug regimen, five (20.1%) used a 2-drug regimen, and seven (29.2%) used a cephalosporin alone. Similar data was seen in the penicillin-allergic patients. Infections were reported to occur postoperatively in 52.2% centers. During the first month after TAH-t, bacteremia represented 27.3%, driveline infections 27.2%, pulmonary infections 9%, and mediastinal infections 18.2%. The most common organisms seen within the first month were Candida spp., Escherichia coli, and Pseudomonas aeruginosa (21.4%). In 65% of centers, the mean rate of death post-TAH-t due to infection was 14.5% (SD, 22.3%). The mean rate of patients surviving until orthotopic heart transplantation was 58.6% (SD, 27.7%). Preventing infections post-TAH-t is key to decreasing morbidity and mortality. All institutions administered perioperative prophylaxis for TAH-t with significant variation among the centers. The majority of the centers have a formal perioperative prophylactic protocol. Copyright © 2017. Published by Elsevier Inc.

  13. Nitrous oxide and perioperative outcomes.

    Science.gov (United States)

    Ko, Hanjo; Kaye, Alan David; Urman, Richard D

    2014-06-01

    There is emerging evidence related to the effects of nitrous oxide on important perioperative patient outcomes. Proposed mechanisms include metabolic effects linked to elevated homocysteine levels and endothelial dysfunction, inhibition of deoxyribonucleic acid and protein formation, and depression of chemotactic migration by monocytes. Newer large studies point to possible risks associated with the use of nitrous oxide, although data are often equivocal and inconclusive. Cardiovascular outcomes such as stroke or myocardial infarction were shown to be unchanged in previous studies, but the more recent Evaluation of Nitrous Oxide in the Gas Mixture for Anesthesia I trial shows possible associations between nitrous oxide and increased cardiovascular and pulmonary complications. There are also possible effects on postoperative wound infections and neuropsychological function, although the multifactorial nature of these complications should be considered. Teratogenicity linked to nitrous oxide use has not been firmly established. The use of nitrous oxide for routine anesthetic care may be associated with significant costs if complications such as nausea, vomiting, and wound infections are taken into consideration. Overall, definitive data regarding the effect of nitrous oxide on major perioperative outcomes are lacking. There are ongoing prospective studies that may further elucidate its role. The use of nitrous oxide in daily practice should be individualized to each patient's medical conditions and risk factors.

  14. Removal of chemical oxygen demand from textile wastewater using a natural coagulant

    Energy Technology Data Exchange (ETDEWEB)

    Ramavandi, Bahman [Bushehr University of Medical Sciences, Bushehr (Iran, Islamic Republic of); Farjadfard, Sima [Islamic Azad University, Tehran (Iran, Islamic Republic of)

    2014-01-15

    A biomaterial was successfully synthesized from Plantago ovata by using an FeCl{sub 3}-induced crude extract (FCE). The potential of FCE to act as a natural coagulant was tested for the pretreatment of real textile wastewater. Tests were performed to evaluate the effects of FCE quantity, salt concentration, and wastewater pH on chemical oxygen demand (COD) reduction during a coagulation/flocculation process. Experimental results indicated that the wastewater could be effectively treated by using a coagulation/flocculation process, where the BOD{sub 5}/COD ratio of the effluent was improved to 0.48. A low coagulant dose, 1.5mg/L, achieved a high COD removal percentage, 89%, at operational conditions of neutral pH and room temperature. The experimental data revealed that the maximum COD removal occurred at water pH<8. Increasing the salt promoted the COD removal. The settling and filterability characteristics of the sludge were also studied. Scanning electron microscopy and energy dispersive spectroscopy studies were conducted to determine the sludge structure and composition, respectively. Overall, FCE as an eco-friendly biomaterial was revealed to be a very efficient coagulant and a promising option for the removal of COD from wastewaters.

  15. Reincarnation of ancient links between coagulation and complement.

    Science.gov (United States)

    Conway, E M

    2015-06-01

    Throughout evolution, organisms have developed means to contain wounds by simultaneously limiting bleeding and eliminating pathogens and damaged host cells via the recruitment of innate defense mechanisms. Disease emerges when there is unchecked activation of innate immune and/or coagulation responses. A key component of innate immunity is the complement system. Concurrent excess activation of coagulation and complement - two major blood-borne proteolytic pathways - is evident in numerous diseases, including atherosclerosis, diabetes, venous thromboembolic disease, thrombotic microangiopathies, arthritis, cancer, and infectious diseases. Delineating the cross-talk between these two cascades will uncover novel therapeutic insights. © 2015 International Society on Thrombosis and Haemostasis.

  16. Surface Potential and Particle Size Effect on the Rate of Perikinetic Coagulation

    International Nuclear Information System (INIS)

    Molina-Bolivar, J. A.; Galisteo-Gonzalez, F.; Cabrerizo-Vilchez, M.; Hidalgo-alvarez, R.

    1998-01-01

    The diffusion-controlled rapid coagulation rate of monodisperse polystyrene particles in aqueous solutions has been measured with a low angle scattering apparatus (nephelometer). We have refined this technique by using a narrow scattering flow cell and a pneumatic addicting-mixing device to introduce the salt solution and the latex sample in the cell. Coagulation rate constants were determined from analysis of the scattered light intensity dependence with time at an angle of 4.5 degree centigrade ± 1 degree centigrade. Experiments were designed to check the effects of particle size, surface potential and counterion valency on rapid coagulation constant. The particle ranged in diameter from 151 nm to 530 nm. The results are compared with the predictions of Smoluchowski's theory. Experiments to obtain the stability diagrams and the critical coagulation concentration of latexes have been performed. (Author) 31 refs

  17. The treatment of perioperative myocardial infarctions following ...

    African Journals Online (AJOL)

    Background: Perioperative myocardial infarction (PMI) is a common complication following noncardiac surgery, with a 30-day mortality of 10-20%. Effective therapeutic interventions are of public health importance. Method: This is a systematic review, aimed to determine the evidence for therapies following PMI. Results: A ...

  18. Comparison of single-step and two-step purified coagulants from Moringa oleifera seed for turbidity and DOC removal.

    Science.gov (United States)

    Sánchez-Martín, J; Ghebremichael, K; Beltrán-Heredia, J

    2010-08-01

    The coagulant proteins from Moringa oleifera purified with single-step and two-step ion-exchange processes were used for the coagulation of surface water from Meuse river in The Netherlands. The performances of the two purified coagulants and the crude extract were assessed in terms of turbidity and DOC removal. The results indicated that the optimum dosage of the single-step purified coagulant was more than two times higher compared to the two-step purified coagulant in terms of turbidity removal. And the residual DOC in the two-step purified coagulant was lower than in single-step purified coagulant or crude extract. (c) 2010 Elsevier Ltd. All rights reserved.

  19. Performance of alum and assorted coagulants in turbidity removal of muddy water

    Science.gov (United States)

    Malik, Qasim H.

    2018-03-01

    Coagulation is a primary and cost effective process in water treatment plants. Under optimum conditions, not only it effectively removes turbidity but also results in reduced sludge volume and subsequently minimizes sludge management costs. Highly turbid water from streams, canals, rivers and rain run offs was run through jar test for turbidity removal. The brown water with 250NTU turbidity when coagulated with alum and assorted coagulants proved that maximum turbidity removal was witnessed using alum dose of 0.25 g/l at ph 6 with a sedimentation time of 30 min.

  20. Early markers of blood coagulation and fibrinolysis activation in Argentine hemorrhagic fever

    NARCIS (Netherlands)

    Heller, M. V.; Marta, R. F.; Sturk, A.; Maiztegui, J. I.; Hack, C. E.; Cate, J. W.; Molinas, F. C.

    1995-01-01

    Junin virus, an arenaviridae, is the etiological agent of Argentine hemorrhagic fever. In addition to thrombocytopenia, patients present several alterations in both the blood coagulation and the fibrinolytic system, but diffuse intravascular coagulation could not be demonstrated. To investigate

  1. Matriptase activation connects tissue factor-dependent coagulation initiation to epithelial proteolysis and signaling.

    Science.gov (United States)

    Le Gall, Sylvain M; Szabo, Roman; Lee, Melody; Kirchhofer, Daniel; Craik, Charles S; Bugge, Thomas H; Camerer, Eric

    2016-06-23

    The coagulation cascade is designed to sense tissue injury by physical separation of the membrane-anchored cofactor tissue factor (TF) from inactive precursors of coagulation proteases circulating in plasma. Once TF on epithelial and other extravascular cells is exposed to plasma, sequential activation of coagulation proteases coordinates hemostasis and contributes to host defense and tissue repair. Membrane-anchored serine proteases (MASPs) play critical roles in the development and homeostasis of epithelial barrier tissues; how MASPs are activated in mature epithelia is unknown. We here report that proteases of the extrinsic pathway of blood coagulation transactivate the MASP matriptase, thus connecting coagulation initiation to epithelial proteolysis and signaling. Exposure of TF-expressing cells to factors (F) VIIa and Xa triggered the conversion of latent pro-matriptase to an active protease, which in turn cleaved the pericellular substrates protease-activated receptor-2 (PAR2) and pro-urokinase. An activation pathway-selective PAR2 mutant resistant to direct cleavage by TF:FVIIa and FXa was activated by these proteases when cells co-expressed pro-matriptase, and matriptase transactivation was necessary for efficient cleavage and activation of wild-type PAR2 by physiological concentrations of TF:FVIIa and FXa. The coagulation initiation complex induced rapid and prolonged enhancement of the barrier function of epithelial monolayers that was dependent on matriptase transactivation and PAR2 signaling. These observations suggest that the coagulation cascade engages matriptase to help coordinate epithelial defense and repair programs after injury or infection, and that matriptase may contribute to TF-driven pathogenesis in cancer and inflammation.

  2. An assessment of the utility of unselected coagulation screening in general hospital practice.

    LENUS (Irish Health Repository)

    McHugh, Johnny

    2011-03-01

    Coagulation screening using prothrombin time (PT) and activated partial thromboplastin time (APTT) is widely used. We performed an audit of coagulation screening in an Irish teaching hospital. We analysed PT and\\/or APTT results received during normal working hours during a 1-week period in our hospital. Abnormal results due to anticoagulants were excluded from further study. In samples with PT longer than 15.5 s and\\/or APTT longer than 42 s, we proceeded to 1: 1 mixing studies if the PT was prolonged and 1: 1 mixing studies, factor XII assay and lupus screen if the APTT was prolonged. We also obtained referral source for all samples and clinical details for abnormal samples. Six hundred and seventy-one coagulation requests were received during the study period. Three hundred and eighteen of 671 (47.4%) coagulation requests were for monitoring of anticoagulation. Three hundred and fifty-three of 671 (52.6%) requests were for coagulation screening rather than anticoagulant monitoring. In the coagulation screens received, PT was prolonged in 19 of 353 (5.4%). PT was longer than 20 s in four of 353 cases (1.1%). APTT was prolonged in 19 of 353 (5.4%). APTT was longer than 50 s in four of 353 (1.1%). No patients with abnormal PT or APTT had any bleeding sequelae during the study period. Unregulated coagulation screening has a low yield of abnormal results; the majority of these abnormal results show mild prolongation of PT or APTT with no evidence that they are associated with an increased bleeding risk.

  3. Perioperative Variables Contributing to the Rupture of Intracranial Aneurysm: An Update

    Directory of Open Access Journals (Sweden)

    Tumul Chowdhury

    2013-01-01

    Full Text Available Background. Perioperative aneurysm rupture (PAR is one of the most dreaded complications of intracranial aneurysms, and approximately 80% of nontraumatic SAHs are related to such PAR aneurysms. The literature is currently scant and even controversial regarding the issues of various contributory factors on different phases of perioperative period. Thus this paper highlights the current understanding of various risk factors, variables, and outcomes in relation to PAR and try to summarize the current knowledge. Method. We have performed a PubMed search (1 January 1991–31 December 2012 using search terms including “cerebral aneurysm,” “intracranial aneurysm,” and “intraoperative/perioperative rupture.” Results. Various risk factors are summarized in relation to different phases of perioperative period and their relationship with outcome is also highlighted. There exist many well-known preoperative variables which are responsible for the highest percentage of PAR. The role of other variables in the intraoperative/postoperative period is not well known; however, these factors may have important contributory roles in aneurysm rupture. Preoperative variables mainly include natural course (age, gender, and familial history as well as the pathophysiological factors (size, type, location, comorbidities, and procedure. Previously ruptured aneurysm is associated with rupture in all the phases of perioperative period. On the other hand intraoperative/postoperative variables usually depend upon anesthesia and surgery related factors. Intraoperative rupture during predissection phase is associated with poor outcome while intraoperative rupture at any step during embolization procedure imposes poor outcome. Conclusion. We have tried to create such an initial categorization but know that we cannot scale according to its clinical importance. Thorough understanding of various risk factors and other variables associated with PAR will assist in better

  4. Development of a magnetic coagulant based on Moringa oleifera seed extract for water treatment.

    Science.gov (United States)

    Santos, Tássia R T; Silva, Marcela F; Nishi, Leticia; Vieira, Angélica M S; Fagundes-Klen, Márcia R; Andrade, Murilo B; Vieira, Marcelo F; Bergamasco, Rosângela

    2016-04-01

    In this work, to evaluate the effectiveness of the coagulation/flocculation using a natural coagulant, using Moringa oleifera Lam functionalized with magnetic iron oxide nanoparticles, producing flakes that are attracted by an external magnetic field, thereby allowing a fast settling and separation of the clarified liquid, is proposed. The removal efficiency of the parameters, apparent color, turbidity, and compounds with UV254nm absorption, was evaluated. The magnetic functionalized M. oleifera Lam coagulant could effectively remove 90 % of turbidity, 85 % of apparent color, and 50 % for the compounds with absorption at UV254nm, in surface waters under the influence of an external magnetic field within 30 min. It was found that the coagulation/flocculation treatment using magnetic functionalized M. oleifera Lam coagulant was able to reduce the values of the physico-chemical parameters evaluated with reduced settling time.

  5. Initiator Systems Effect on Particle Coagulation and Particle Size Distribution in One-Step Emulsion Polymerization of Styrene

    Directory of Open Access Journals (Sweden)

    Baijun Liu

    2016-02-01

    Full Text Available Particle coagulation is a facile approach to produce large-scale polymer latex particles. This approach has been widely used in academic and industrial research owing to its higher polymerization rate and one-step polymerization process. Our work was motivated to control the extent (or time of particle coagulation. Depending on reaction parameters, particle coagulation is also able to produce narrowly dispersed latex particles. In this study, a series of experiments were performed to investigate the role of the initiator system in determining particle coagulation and particle size distribution. Under the optimal initiation conditions, such as cationic initiator systems or higher reaction temperature, the time of particle coagulation would be advanced to particle nucleation period, leading to the narrowly dispersed polymer latex particles. By using a combination of the Smoluchowski equation and the electrostatic stability theory, the relationship between the particle size distribution and particle coagulation was established: the earlier the particle coagulation, the narrower the particle size distribution, while the larger the extent of particle coagulation, the larger the average particle size. Combined with the results of previous studies, a systematic method controlling the particle size distribution in the presence of particle coagulation was developed.

  6. Moringa oleifera-mediated coagulation of textile wastewater and its biodegradation using novel consortium-BBA grown on agricultural waste substratum.

    Science.gov (United States)

    Bedekar, Priyanka A; Bhalkar, Bhumika N; Patil, Swapnil M; Govindwar, Sanjay P

    2016-10-01

    Generation of secondary sludge is a major concern of textile dye removal by coagulation process. Combinatorial coagulation-biodegradation treatment system has been found efficient in degradation of coagulated textile dye sludge. Moringa oleifera seed powder (700 mg L -1 ) was able to coagulate textile dyestuff from real textile wastewater with 98 % color removal. Novel consortium-BBA was found to decolorize coagulated dye sludge. Parameters that significantly affect coagulation process were optimized using response surface methodology. The bench-scale stirred tank reactor (50-L capacity) designed with optimized parameters for coagulation process could efficiently remove 98, 89, 78, and 67 % of American Dye Manufacturer's Institute (ADMI) in four repetitive cycles, respectively. Solid-state fermentation composting reactor designed to treat coagulated dye sludge showed 96 % removal of dye within 10 days. Coagulation of dyes from textile wastewater and degradation of coagulated dye sludge were confirmed by Fourier transform infrared spectroscopy (FTIR) analysis. Cell morphology assay, comet assay, and phytotoxicity confirmed the formation of less toxic products after coagulation and degradation mechanism.

  7. The effects of chemical coagulants on the decolorization of dyes by electrocoagulation using response surface methodology (RSM)

    Science.gov (United States)

    Butler, Erick B.; Hung, Yung-Tse; Mulamba, Oliver

    2017-09-01

    This study assessed the efficiency of electrocoagulation (ECF) coupled with an addition of chemical coagulant to decolorize textile dye. Tests were conducted using Box Behnken methodology to vary six parameters: dye type, weight, coagulant type, dose, initial pH and current density. The combination of electrocoagulation and chemical coagulation was able to decolorize dye up to 99.42 % in 30 min of treatment time which is remarkably shorter in comparison with using conventional chemical coagulation. High color removal was found to be contingent upon the dye type and current density, along with the interactions between the current density and the coagulant dose. The addition of chemical coagulants did enhanced treatment efficiency.

  8. Perioperative effect of epidural dexmedetomidine with intrathecal ...

    African Journals Online (AJOL)

    2011-06-10

    Jun 10, 2011 ... coagulation or neurological disorders, spine deformity, or skin infection, were ... expressed in the tables as mean ± standard deviation. The parametric .... The analgesic effect of dexmedetomidine is produced by the stimulation ...

  9. Guideline-oriented perioperative management of patients with bronchial asthma and chronic obstructive pulmonary disease.

    Science.gov (United States)

    Yamakage, Michiaki; Iwasaki, Sohshi; Namiki, Akiyoshi

    2008-01-01

    Increased airway hyperresponsiveness is a major concern in the perioperative management of patients with bronchial asthma and chronic obstructive pulmonary disease. Guidelines using evidence-based medicine are continually being updated and published regarding the diagnosis, treatment, and prevention of these respiratory disorders. Perioperative management in these patients involves: (1) adequate control of airway hyperresponsiveness, including detection of purulent sputum and infection before surgery; (2) evidence-based control of anesthesia; and (3) the aggressive use of beta-2 adrenergic stimulants and the systemic administration of steroids for the treatment of acute attacks. Good preoperative control, including the use of leukotriene antagonists, can reduce the incidence of life-threatening perioperative complications. Awareness of recent guidelines is thus important in the management of patients with airway hyperresponsiveness. This review covers the most recent guidelines for the perioperative management of patients with bronchial asthma and chronic obstructive pulmonary disease.

  10. Chronic sleep deprivation markedly reduces coagulation factor VII expression

    Science.gov (United States)

    Pinotti, Mirko; Bertolucci, Cristiano; Frigato, Elena; Branchini, Alessio; Cavallari, Nicola; Baba, Kenkichi; Contreras-Alcantara, Susana; Ehlen, J. Christopher; Bernardi, Francesco; Paul, Ketema N.; Tosini, Gianluca

    2010-01-01

    Chronic sleep loss, a common feature of human life in industrialized countries, is associated to cardiovascular disorders. Variations in functional parameters of coagulation might contribute to explain this relationship. By exploiting the mouse model and a specifically designed protocol, we demonstrated that seven days of partial sleep deprivation significantly decreases (−30.5%) the thrombin generation potential in plasma evaluated upon extrinsic (TF/FVIIa pathway) but not intrinsic activation of coagulation. This variation was consistent with a decrease (−49.8%) in the plasma activity levels of factor VII (FVII), the crucial physiologicalal trigger of coagulation, which was even more pronounced at the liver mRNA level (−85.7%). The recovery in normal sleep conditions for three days completely restored thrombin generation and FVII activity in plasma. For the first time, we demonstrate that chronic sleep deprivation on its own reduces, in a reversible manner, the FVII expression levels, thus influencing the TF/FVIIa activation pathway efficiency. PMID:20418241

  11. Oral surgery in patients under antithrombotic therapy: perioperative bleeding as a significant risk factor for postoperative hemorrhage.

    Science.gov (United States)

    Rocha, Amanda L; Souza, Alessandra F; Martins, Maria A P; Fraga, Marina G; Travassos, Denise V; Oliveira, Ana C B; Ribeiro, Daniel D; Silva, Tarcília A

    2018-01-01

    : To investigate perioperative and postoperative bleeding, complications in patients under therapy with anticoagulant or antiplatelet drugs submitted to oral surgery. To evaluate the risk of bleeding and safety for dental surgery, a retrospective chart review was performed. Medical and dental records of patients taking oral antithrombotic drugs undergoing dental surgery between 2010 and 2015 were reviewed. Results were statistically analyzed using Fisher's exact test, t test or the χ test. One hundred and seventy-nine patients underwent 293 surgical procedures. A total of eight cases of perioperative and 12 episodes of postoperative bleeding were documented. The complications were generally managed with local measures and did not require hospitalization. We found significant association of postoperative hemorrhage with increased perioperative bleeding (P = 0.043) and combination of anticoagulant and antiplatelet therapy (P bleeding is 8.8 times bigger than procedures without perioperative bleeding. Dental surgery in patients under antithrombotic therapy might be carried out without altering the regimen because of low risk of perioperative and postoperative bleeding. However, patients with increased perioperative bleeding should be closely followed up because of postoperative complications risk.

  12. Perioperative management of haemophilia B: A critical appraisal of the evidence and current practices.

    Science.gov (United States)

    Neufeld, E J; Solimeno, L; Quon, D; Walsh, C; Seremetis, S; Cooper, D; Iyer, N N; Hoxer, C S; Giangrande, P

    2017-11-01

    While there is substantial literature addressing the principles of general management of haemophilia, literature on perioperative management of haemostasis is scarce. The aim of this study was to better understand perioperative management among congenital haemophilia B patients (without inhibitors) and to gain insights into real-world surgical practices. A systematic literature review, with an emphasis on haemophilia B, was conducted using EMBASE ® , Medline ® and the Cochrane Library. Studies from 1974 to June 2015 were accessed, and 132 studies were eligible for the full-study review. An international expert panel with five haematologists and one surgeon reviewed the resulting literature and provided further insights. The literature review revealed that documented experience in the perioperative management of bleeding risk in haemophilia B patients is relatively scarce. Therefore, the review was amended to provide a comprehensive overview of the perioperative management for haemophilia A and B patients; the expert panel applied a particular focus to haemophilia B. Several gaps were identified in the literature including the lack of consensus on defining surgery in terms of bleeding risk, optimal factor levels during surgery and lack of robust evidence on surgical outcomes. The ensuing discussions with the expert panel provided validation of some of the results from the systematic literature review and proposed future directions for perioperative management. Suggestions included collaboration with haemophilia treatment centres (HTCs) to collect real-world data on perioperative management, establishing the need for optimal factor level monitoring practice, and the appropriate adoption of extended half-life products in clinical settings. © 2017 John Wiley & Sons Ltd.

  13. Ventricular metastasis resulting in disseminated intravascular coagulation

    Directory of Open Access Journals (Sweden)

    Davis Ian D

    2005-05-01

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

  14. Comparison of postoperative coagulation profiles and outcome for sugammadex versus pyridostigmine in 992 living donors after living-donor hepatectomy.

    Science.gov (United States)

    Moon, Young-Jin; Kim, Sung-Hoon; Kim, Jae-Won; Lee, Yoon-Kyung; Jun, In-Gu; Hwang, Gyu-Sam

    2018-03-01

    Donor safety is the major concern in living donor liver transplantation, although hepatic resection may be associated with postoperative coagulopathy. Recently, the use of sugammadex has been gradually increased, but sugammadex is known to prolong prothrombin time (PT) and activated partial thromboplastin time (aPTT). We compared the postoperative coagulation profiles and outcomes of sugammadex versus pyridostigmine group in donors receiving living donor hepatectomy.Consecutive donor hepatectomy performed between September 2013 and August 2016 was retrospectively analyzed. For reversal of rocuronium-induced neuromuscular blockade, donors received sugammadex 4 mg/kg or pyridostigmine 0.25 mg/kg. The primary end-points were laboratory findings (PT, aPTT, hemoglobin, platelet count) and clinically evaluated postoperative bleeding (relaparotomy for bleeding, cumulative volume collected in drains). Secondary outcomes were anesthesia time, postoperative hospital day.Of 992 donors, 383 treated with sugammadex and 609 treated with pyridostigmine for the reversal of neuromuscular blockade. There were no significant differences between both groups for drop in hemoglobin and platelet, prolongation in PT, aPTT, and the amount of 24-h drain volume. Bleeding events within 24 h were reported in 2 (0.3%) for pyridostigmine group and 0 (0%) for sugammadex group (P = .262). Anesthesia time was significantly longer in pyridostigmine group than that in sugammadex group (438.8 ± 71.4 vs. 421.3 ± 62.3, P sugammadex group (P = .002).Sugammadex 4 mg/kg was not associated with increased bleeding tendency, but associated with reduced anesthesia time and hospital stay. Therefore, sugammadex may be safely used and will decrease morbidity in donor undergoing living-donor hepatectomy.

  15. EFFECTIVENESS OF CHITOSAN AS NATURAL COAGULANT AID IN TREATING TURBID WATERS

    Directory of Open Access Journals (Sweden)

    B. Bina ، M. H. Mehdinejad ، M. Nikaeen ، H. Movahedian Attar

    2009-10-01

    Full Text Available During the last decade, there has been a concern about the relation between aluminum residuals in treated water and Alzheimer disease, and more interest has been considered on the development of natural coagulants such as chitosan. Chitosan, a natural linear biopolyaminosaccharide, is obtained by alkaline deacetylation of chitin. The present study was aimed to investigate the effects of alum as coagulant in conjunction with chitosan as coagulant aid on the removal of turbidity, hardness and Escherichia coli from water. A conventional jar test apparatus was employed for the tests. The optimum pH was observed between 7 to 7.5 for all turbidities. The optimum doses of alum and chitosan when used in conjunction, were 10mg/L and 1mg/L, 5mg/L and 0.5mg/L, and 5mg/L and 0.5mg/L in low, medium and high turbidities, respectively. Turbidity removal efficiency was resulted between %74.3 to %98.2 by alum in conjunction with chitosan. Residual Al+3 in treated water was less than 0.2 mg/L, meeting the international guidelines. The results showed that turbidity decrease provided also a primary Escherichia coli reduction of 2-4 log units within the first 1 to 2 hr of treatment. Hardness removal efficiency decreased when the total hardness increased from 102 to 476mg/L as CaCO3. At low initial turbidity, chitosan showed marginally better performance on hardness, especially at the ranges of 100 to 210 mg/L as CaCO3. In conclusion, coagulant aid showed a useful method for coagulation process. By using natural coagulants, considerable savings in chemicals and sludge handling cost may be achieved.

  16. Self-production of tissue factor-coagulation factor VII complex by ovarian cancer cells

    OpenAIRE

    Yokota, N; Koizume, S; Miyagi, E; Hirahara, F; Nakamura, Y; Kikuchi, K; Ruf, W; Sakuma, Y; Tsuchiya, E; Miyagi, Y

    2009-01-01

    Background: Thromboembolic events are a major complication in ovarian cancer patients. Tissue factor (TF) is frequently overexpressed in ovarian cancer tissue and correlates with intravascular thrombosis. TF binds to coagulation factor VII (fVII), changing it to its active form, fVIIa. This leads to activation of the extrinsic coagulation cascade. fVII is produced by the liver and believed to be supplied from blood plasma at the site of coagulation. However, we recently showed that ovarian ca...

  17. Identification of coagulation gene 3′UTR variants that are potentially regulated by microRNAs

    NARCIS (Netherlands)

    Vossen, Carla Y.; van Hylckama Vlieg, Astrid; Teruel-Montoya, Raúl; Salloum-Asfar, Salam; de Haan, Hugoline G.; Corral, Javier; Reitsma, Pieter H.; Koeleman, Bobby P.C.; Martínez, Constantino

    2017-01-01

    MicroRNAs have been recognized as critical regulators of gene expression and might affect the risk of venous thrombosis. We aimed to identify 3′ untranslated region (UTR) variants in coagulation genes that influence coagulation factor levels and venous thrombosis risk. The 3′UTR of coagulation genes

  18. The hydrophilic/hydrophobic ratio vs. dissolved organics removal by coagulation – A review

    Directory of Open Access Journals (Sweden)

    Djamel Ghernaout

    2014-07-01

    Full Text Available This review discusses the hydrophilic/hydrophobic ratio as a function of the hydrophilic and hydrophobic contents removal by coagulation process. It is well established that coagulation process could bring a reduction in dissolved organic carbon of around 30–60% by increasing the coagulant dose and optimising reaction pH, in which large organic molecules with hydrophobic property was removed preferentially. Furthermore, the literature affirmed that the greater removal of UV-absorbing substances indicates that alum coagulation preferentially removed the hydrophobic fraction of the total organic carbon. For the hydrophobic fraction, it needs to be removed entirely without its transformation into hydrophilic fractions by coagulation process avoiding pre-chlorination/pre-oxidation due to the risk of organic molecules fragmentation. Determining the exact numerical values of the hydrophilic/hydrophobic ratio for raw water and treated water at different stages of the treatment processes in a water treatment plant, as for the DCO/DBO5 ratio in the case of wastewater treatment, would help on more focusing on OM control and removal.

  19. Study on Coagulant Dosing Control System of Micro Vortex Water Treatment

    Science.gov (United States)

    Fengping, Hu; Qi, Fan; Wenjie, Hu; Xizhen, He; Hongling, Dai

    2018-03-01

    In view of the characteristics of nonlinearity, large time delay and multi disturbance in the process of coagulant dosing in water treatment, it is difficult to control the dosage of coagulant. According to the four indexes of raw water quality parameters (raw water flow, turbidity, pH value) and turbidity of sedimentation tank, the micro vortex coagulation dosing control model is constructed based on BP neural network and GA. The forecast results of BP neural network model are ideal, and after the optimization of GA, the prediction accuracy of the model is partly improved. The prediction error of the optimized network is ±0.5 mg/L, and has a better performance than non-optimized network.

  20. Inhaled therapy for the management of perioperative pulmonary hypertension

    Directory of Open Access Journals (Sweden)

    C A Thunberg

    2015-01-01

    Full Text Available Patients with pulmonary hypertension (PH are at high risk for complications in the perioperative setting and often receive vasodilators to control elevated pulmonary artery pressure (PAP. Administration of vasodilators via inhalation is an effective strategy for reducing PAP while avoiding systemic side effects, chiefly hypotension. The prototypical inhaled pulmonary-specific vasodilator, nitric oxide (NO, has a proven track record but is expensive and cumbersome to implement. Alternatives to NO, including prostanoids (such as epoprostenol, iloprost, and treprostinil, NO-donating drugs (sodium nitroprusside, nitroglycerin, and nitrite, and phosphodiesterase inhibitors (milrinone, sildenafil may be given via inhalation for the purpose of treating elevated PAP. This review will focus on the perioperative therapy of PH using inhaled vasodilators.

  1. Coagulation and electrocoagulation for co-treatment of stabilized landfill leachate and municipal wastewater

    Directory of Open Access Journals (Sweden)

    Mohini Verma

    2018-04-01

    Full Text Available Landfill leachate and municipal wastewater at various ratios (1:20, 1:10, 1:7 and 1:5 were subjected to coagulation and electrocoagulation (EC. Alum was used in conventional coagulation at pH 6 and aluminum plate as electrode was used in EC at a current density of 386 A/m2 with 5 cm inter electrode spacing. Treatment efficiency was assessed from removal of chemical oxygen demand (COD, total suspended solids (TSS, turbidity, ammonia, nitrate and phosphate. At 1:5 ratio of landfill leachate to municipal wastewater, highest COD removal was with 3.8 g/L alum whereas highest turbidity removal was with 3.3 g/L alum during coagulation. EC exhibited almost similar removal efficiency for all the parameters at different ratios tested except for COD which was considerably higher at 1:20 ratio. Aluminum consumption from electrode was 0.7 g/L following EC as compared to 3.8 g/L alum used in coagulation. The amount of sludge produced was found to be higher with EC as compared to coagulation which could be due to the fact that the electrochemical method was performed for a longer duration than conventional coagulation. For minimal sludge generation, EC reaction time should be ∼30 min. Further studies with EC process on costing and sludge generation will help to advance the technology for wastewater treatment.

  2. Perioperative care of an adolescent with postural orthostatic tachycardia syndrome

    Directory of Open Access Journals (Sweden)

    Kernan Scott

    2010-01-01

    Full Text Available Postural orthostatic tachycardia syndrome (POTS is a disorder characterized by postural tachycardia in combination with orthostatic symptoms without associated hypotension. Symptoms include light-headedness, palpitations, fatigue, confusion, and anxiety, which are brought on by assuming the upright position and usually relieved by sitting or lying down. Given the associated autonomic dysfunction that occurs with POTS, various perioperative concerns must be considered when providing anesthetic care for such patients. We present an adolescent with POTS who required anesthetic care during posterior spinal fusion for the treatment of scoliosis. The potential perioperative implications of this syndrome are discussed.

  3. Treatment of sugar beet extraction juice stillage by natural coagulants extracted from common bean

    OpenAIRE

    Prodanović Jelena M.; Šćiban Marina B.; Antov Mirjana G.; Kukić Dragana V.; Vasić Vesna M.

    2015-01-01

    Distillery wastewaters have a great pollution potential, and pollution caused by them is one of the most critical environmental issues. This study is concerned with the coagulation efficiency of a new, environmental friendly, natural coagulant extracted from common bean seeds in the primary treatment of distillery wastewater in the bioethanol production from sugar beet juice. Active coagulation components were extracted from ground seeds of common bean with...

  4. Effect of Centrifuge Temperature on Routine Coagulation Tests.

    Science.gov (United States)

    Yazar, Hayrullah; Özdemir, Fatma; Köse, Elif

    2018-01-01

    This study investigated the effects of cooled and standard centrifuges on the results of coagulation tests to examine the effects of centrifugation temperature. Equal-volume blood samples from each patient were collected at the same time intervals and subjected to standard (25°C) and cooled centrifugation (2-4°C). Subsequently, the prothrombin time (PT), international normalized ratio (INR), activated partial thromboplastin time (aPTT), fibrinogen, and D-dimer values were determined in runs with the same lot numbers in the same coagulation device using the Dia-PT R (PT and INR), Dia-PTT-liquid (aPTT), Dia-FIB (fibrinogen), and Dia-D-dimer kits, respectively. The study enrolled 771 participants. The PT was significantly (p centrifuges were as follows: PT 10.30 versus 10.50 s; PT (INR) 1.04 versus 1.09 s; APTT 28.90 versus 29.40 s; fibrinogen 321.5 versus 322.1 mg/dL; and D-dimer 179.5 versus 168.7 µg FEU/mL. There were significant differences (p centrifuges. Centrifuge temperature can have a significant effect on the results of coagulation tests. However, broad and specific disease-based studies are needed. © 2018 S. Karger AG, Basel.

  5. Numerical Simulation of the Coagulation Dynamics of Blood

    Directory of Open Access Journals (Sweden)

    T. Bodnár

    2008-01-01

    Full Text Available The process of platelet activation and blood coagulation is quite complex and not yet completely understood. Recently, a phenomenological meaningful model of blood coagulation and clot formation in flowing blood that extends existing models to integrate biochemical, physiological and rheological factors, has been developed. The aim of this paper is to present results from a computational study of a simplified version of this coupled fluid-biochemistry model. A generalized Newtonian model with shear-thinning viscosity has been adopted to describe the flow of blood. To simulate the biochemical changes and transport of various enzymes, proteins and platelets involved in the coagulation process, a set of coupled advection–diffusion–reaction equations is used. Three-dimensional numerical simulations are carried out for the whole model in a straight vessel with circular cross-section, using a finite volume semi-discretization in space, on structured grids, and a multistage scheme for time integration. Clot formation and growth are investigated in the vicinity of an injured region of the vessel wall. These are preliminary results aimed at showing the validation of the model and of the numerical code.

  6. Coagulation competence and fluid recruitment after moderate blood loss in young men

    DEFF Research Database (Denmark)

    Zaar, Morten; Mørkeberg, Jakob; Pott, Frank C

    2014-01-01

    The coagulation system is activated by a reduction of the central blood volume during orthostatic stress and lower body negative pressure suggesting that also a blood loss enhances coagulation. During bleeding, however, the central blood volume is supported by fluid recruitment to the circulation...

  7. Brownian coagulation at high particle concentrations

    NARCIS (Netherlands)

    Trzeciak, T.M.

    2012-01-01

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

  8. Quantifying interspecific coagulation efficiency of phytoplankton

    DEFF Research Database (Denmark)

    Hansen, J.L.S.; Kiørboe, Thomas

    1997-01-01

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

  9. Performance Evaluation of the Sysmex CS-5100 Automated Coagulation Analyzer.

    Science.gov (United States)

    Chen, Liming; Chen, Yu

    2015-01-01

    Coagulation testing is widely applied clinically, and laboratories increasingly demand automated coagulation analyzers with short turn-around times and high-throughput. The purpose of this study was to evaluate the performance of the Sysmex CS-5100 automated coagulation analyzer for routine use in a clinical laboratory. The prothrombin time (PT), international normalized ratio (INR), activated partial thromboplastin time (APTT), fibrinogen (Fbg), and D-dimer were compared between the Sysmex CS-5100 and Sysmex CA-7000 analyzers, and the imprecision, comparison, throughput, STAT function, and performance for abnormal samples were measured in each. The within-run and between-run coefficients of variation (CV) for the PT, APTT, INR, and D-dimer analyses showed excellent results both in the normal and pathologic ranges. The correlation coefficients between the Sysmex CS-5100 and Sysmex CA-7000 were highly correlated. The throughput of the Sysmex CS-5100 was faster than that of the Sysmex CA-7000. There was no interference at all by total bilirubin concentrations and triglyceride concentrations in the Sysmex CS-5100 analyzer. We demonstrated that the Sysmex CS-5100 performs with satisfactory imprecision and is well suited for coagulation analysis in laboratories processing large sample numbers and icteric and lipemic samples.

  10. The Inflammatory Actions of Coagulant and Fibrinolytic Proteases in Disease

    Directory of Open Access Journals (Sweden)

    Michael Schuliga

    2015-01-01

    Full Text Available Aside from their role in hemostasis, coagulant and fibrinolytic proteases are important mediators of inflammation in diseases such as asthma, atherosclerosis, rheumatoid arthritis, and cancer. The blood circulating zymogens of these proteases enter damaged tissue as a consequence of vascular leak or rupture to become activated and contribute to extravascular coagulation or fibrinolysis. The coagulants, factor Xa (FXa, factor VIIa (FVIIa, tissue factor, and thrombin, also evoke cell-mediated actions on structural cells (e.g., fibroblasts and smooth muscle cells or inflammatory cells (e.g., macrophages via the proteolytic activation of protease-activated receptors (PARs. Plasmin, the principle enzymatic mediator of fibrinolysis, also forms toll-like receptor-4 (TLR-4 activating fibrin degradation products (FDPs and can release latent-matrix bound growth factors such as transforming growth factor-β (TGF-β. Furthermore, the proteases that convert plasminogen into plasmin (e.g., urokinase plasminogen activator evoke plasmin-independent proinflammatory actions involving coreceptor activation. Selectively targeting the receptor-mediated actions of hemostatic proteases is a strategy that may be used to treat inflammatory disease without the bleeding complications of conventional anticoagulant therapies. The mechanisms by which proteases of the coagulant and fibrinolytic systems contribute to extravascular inflammation in disease will be considered in this review.

  11. A parametric comparative study of electrocoagulation and coagulation using ultrafine quartz suspensions.

    Science.gov (United States)

    Kiliç, Mehtap Gülsün; Hoşten, Cetin; Demirci, Sahinde

    2009-11-15

    This paper attempts to compare electrocoagulation using aluminum anodes and stainless steel cathodes with conventional coagulation by aluminum sulfate dosing on aqueous suspensions of ultrafine quartz. Several key parameters affecting the efficiency of electrocoagulation and coagulation were investigated with laboratory scale experiments in search of optimal parameter values. Optimal values of the parameters were determined on the basis of the efficiency of turbidity removal from ultrafine quartz suspensions. The parameters investigated in the study were suspension pH, electrical potential, current density, electrocoagulation time, and aluminum dosage. A comparison between electrocoagulation and coagulation was made on the basis of total dissolved aluminum, revealing that electrocoagulation and coagulation were equally effective at the same aluminum dosage for the removal of quartz particles from suspensions. Coagulation, however, was more effective in a wider pH range (pH 6-9) than electrocoagulation which yielded optimum effectiveness in a relatively narrower pH range around 9, where, in both methods, these pH values corresponded to near-zero zeta potentials of quartz particles. Furthermore, experimental results confirmed that electrocoagulation could display some pH buffering capacity. The kinetics of electrocoagulation was very fast (<10 min) in approaching a residual turbidity, which could be modeled with a second-order rate equation.

  12. Improvement of NOM Removal from Water Resources by Modifying the Coagulation Process

    Directory of Open Access Journals (Sweden)

    F Vaezi, A Mohagheghian, J Nouri, MR Eshraghian, A Ghasri

    2005-01-01

    Full Text Available As a result of the regulations on DBPs, interest in NOM removal is increasing and many water treatment plants in developed countries have started to measure the concentration of TOC in their finished waters. Promulgation of the rules will substantially increase these efforts in other countries too. Since the cost of TOC (and DBPs determination was high, it was decided to study the traditional analysis of COD as a surrogate measure to detect the organic constituents in raw water and the extent to which optimized coagulation with ferric chloride can increase COD removal. The two water samples studied belonged to Karaj and Jajrood Rivers. For both samples the observed values of COD removal by coagulation at lower pH (about 1-1.5 pH values less than the regular pH were about 85-95 percent without making water turbidity unacceptable. In order to determine the effects of organic content on coagulation, synthetic samples were also prepared with much higher COD values. Again, considerable increases in COD removal have been observed for most of these samples only by decreasing 0.5-2 pH value. The results indicated that a modified coagulation process without need to much increasing the amount of coagulant can be developed for these water samples.

  13. Comparison of electrocoagulation and chemical coagulation for heavy metal removal

    Energy Technology Data Exchange (ETDEWEB)

    Akbal, F.; Camci, S. [Ondokuz Mayis University, Engineering Faculty, Environmental Engineering Department, Kurupelit, Samsun (Turkey)

    2010-10-15

    Copper (Cu), chromium (Cr), and nickel (Ni) removal from metal plating wastewater by electrocoagulation and chemical coagulation was investigated. Chemical coagulation was performed using either aluminum sulfate or ferric chloride, whereas electrocoagulation was done in an electrolytic cell using aluminum or iron electrodes. By chemical coagulation, Cu-, Cr-, and Ni-removal of 99.9 % was achieved with aluminum sulfate and ferric chloride dosages of 500, 1000, and 2000 mg L{sup -1}, respectively. Removal of metals by electrocoagulation was affected by the electrode material, wastewater pH, current density, number of electrodes, and electrocoagulation time. Electrocoagulation with iron electrodes at a current density of 10 mA cm{sup -2}, electrocoagulation time of 20 min, and pH 3.0 resulted in 99.9 % Cu-, 99.9 % Cr-, and 98 % Ni-removal. (Abstract Copyright [2010], Wiley Periodicals, Inc.)

  14. Perioperative Endocrine Therapy for Patients with Cushing's Syndrome Undergoing Retroperitoneal Laparoscopic Adrenalectomy

    Directory of Open Access Journals (Sweden)

    Xiaobo Cui

    2012-01-01

    Full Text Available Objectives. To investigate the efficacy and safety of perioperative endocrine therapy (PET for patients with Cushing’s syndrome (CS undergoing retroperitoneal laparoscopic adrenalectomy (RLA. Methods. The novel, simplified PET modality of 82 patients who underwent RLA procedures for CS were studied. Clinical manifestations were observed for all patients on days 1 and 5 postoperatively, and clinical data, such as blood pressure (BP, levels of serum cortisol, adrenocorticotropin (ACTH, blood glucose, and electrolytes, were acquired and analyzed. Results. Supraphysiological doses of glucocorticoid were administered during the perioperative period, and the dosage was reduced gradually. In all 82 cases, the RLAs were performed successfully without any perioperative complication, such as steroid withdrawal symptoms. The patient’s symptoms and signs were improved quickly and safely during the hospital days. The serum cortisol and potassium levels were rather stable on days 1 and 5 postoperatively, and most were within the normal range. The clinical manifestations, serum levels of cortisol, ACTH, and potassium in most patients restored to normal gradually after several months (mean, 6.7 ± 1.2 months, except for one patient undergoing bilateral adrenalectomy. Conclusions. This perioperative endocrine therapy for patients with Cushing’s syndrome (mainly for adrenocortical adenoma undergoing retro-laparoscopic adrenalectomy is both effective and safe.

  15. Adverse effects of perioperative paracetamol, NSAIDs, glucocorticoids, gabapentinoids and their combinations

    DEFF Research Database (Denmark)

    Mathiesen, O; Wetterslev, Jørn; Kontinen, V K

    2014-01-01

    with the most common perioperative non-opioid analgesics: paracetamol, non-steroidal anti-inflammatory drugs (NSAIDs), glucocorticoids (GCCs), gabapentinoids and their combinations. The review is based on data from systematic reviews with meta-analyses of analgesic efficacy and/or adverse effects...... of perioperative non-opioid analgesics, and randomised trials and cohort/retrospective studies. Generally, data on AE are sparse and related to the immediate post-operative period. For paracetamol, the incidence of AEs appears trivial. Data are inconclusive regarding an association of NSAIDs with mortality...

  16. Coagulation-flocculation process applied to wastewaters generated in hydrocarbon-contaminated soil washing: Interactions among coagulant and flocculant concentrations and pH value.

    Science.gov (United States)

    Torres, Luis G; Belloc, Claudia; Vaca, Mabel; Iturbe, Rosario; Bandala, Erick R

    2009-11-01

    Wastewater produced in the contaminated soil washing was treated by means of coagulation-flocculation (CF) process. The wastewater contained petroleum hydrocarbons, a surfactant, i.e., sodium dodecyl sulfate (SDS) as well as salts, brownish organic matter and other constituents that were lixiviated from the soil during the washing process. The main goal of this work was to develop a process for treating the wastewaters generated when washing hydrocarbon-contaminated soils in such a way that it could be recycled to the washing process, and also be disposed at the end of the process properly. A second objective was to study the relationship among the coagulant and flocculant doses and the pH at which the CF process is developed, for systems where methylene blue active substances (MBAS) as well as oil and greases were present. The results for the selection of the right coagulant and flocculant type and dose, the optimum pH value for the CF process and the interactions among the three parameters are detailed along this work. The best coagulant and flocculant were FeCl(3) and Tecnifloc 998 at doses of 4,000 and 1 mg/L, correspondingly at pH of 5. These conditions gave color, turbidity, chemical oxygen demand (COD) and conductivity removals of 99.8, 99.6, 97.1 and 35%, respectively. It was concluded that it is feasible to treat the wastewaters generated in the contaminated soil washing process through CF process, and therefore, wastewaters could be recycled to the washing process or disposed to drainage.

  17. Perioperative thirst: an analysis from the perspective of the Symptom Management Theory

    Directory of Open Access Journals (Sweden)

    Marilia Ferrari Conchon

    2015-02-01

    Full Text Available A theoretical study aimed to analyze the existing knowledge in the literature on the perioperative thirst symptom from the perspective of Symptom Management Theory, and supplemented with the experience of the study group and thirst research. Thirst is described as a very intense symptom occurring in the perioperative period, and for this reason it cannot be ignored. The Symptom Management Theory is adequate for understanding the thirst symptom and is a deductive theory, focused on the domains of the Person, Environment and Health / Illness Status, as well as on the dimensions of Experience, Management Strategies and Symptom Outcomes. Using the theory leads us to consider perioperative thirst in its multifactorial aspects, analyzing the interrelation of its domains and dimensions in order to draw attention to this symptom that has been insufficiently valued, recorded and treated in clinical practice.

  18. REMOVAL OF PHENOL AND SURFACTANT FROM LANDFILL LEACHATE BY COAGULATION-FLOCCULATION PROCESS

    Directory of Open Access Journals (Sweden)

    H. BAKRAOUY

    2016-02-01

    Full Text Available Following the action of rainfall and natural fermentation, the stored waste produces a liquid fraction called leachate. This leachate is rich in organic matter (biodegradable but also refractory and trace elements. There are many techniques of treating the leachate, in particular, biological, physicochemical, membrane processes. The choice of a technique instead of another depends on several parameters including: the age of the leachate, composition... In this work we applied a coagulation-flocculation process to treat intermediate landfill leachate of Rabat city with a combined ferric chloride coagulant and a polymer flocculant. We were inspired by full factorial design, including twenty five experiments, to determine optimal dosages of coagulant and flocculant. We operate at pH 8.4, the best removal efficiencies obtained were 88 % for Turbidity, 98 % for Phenol and 82 % for surfactant. The optimum dosages values determined by this study were 13.2 g∙L-1 of coagulant, 62 mL∙L-1 of flocculant.

  19. Demonstration of the Coagulation and Diffusion of Homemade Slime Prepared under Acidic Conditions without Borate

    Science.gov (United States)

    Isokawa, Naho; Fueda, Kazuki; Miyagawa, Korin; Kanno, Kenichi

    2015-01-01

    Poly(vinyl alcohol) (PVA) precipitates in many kinds of aqueous salt solutions. While sodium sulfate, a coagulant for PVA fiber, precipitates PVA to yield a white rigid gel, coagulation of PVA with aluminum sulfate, a coagulant for water treatment, yields a slime-like viscoelastic fluid. One type of homemade slime is prepared under basic…

  20. Validation of computerized sniffer for monitoring perioperative normothermia.

    Science.gov (United States)

    Giri, Jyothsna; Li, Man; Pickering, Brian; Subramanian, Arun; Kor, Daryl J; Herasevich, Vitaly

    2013-01-01

    The World Health Organization sets a standard to maintain patient core temperature greater than 36°C throughout the perioperative period. Normothermia (defined as >36°C) in the Operating Room (OR) is an important factor to preventing complications in patients (MI, infection, coagulopathy). Randomized studies suggests that maintaining at higher temperatures may further reduce complications in surgery (less complications for group at 36.4°C than the control group at 36.0°C) [1,2]. Perioperative normothermia is an important but often unrecognized element during anesthesia. Early recognition of hypothermia would allow for appropriate interventions and prevent complications. Manual validation of the diagnostic performance a clinical tool (alert) that would automatically measure changes in core temperature to identify patients who fail to be in range of normothermia during surgery. The clinical tool (alert) was found to be 97 % sensitive.

  1. Removal of congo red and methylene blue from waste water using coagulation

    International Nuclear Information System (INIS)

    Ghaffar, S.; Nosheen, S.; Ahmad, N.

    2011-01-01

    The textile industry has been condemned as being one of the world's worst offenders in terms of pollution Because of increasing population and industrial developments, a huge amount of wastewater is discharged to the environment above the level that the nature can eliminate. Many techniques like oxidation, reduction, physical treatment and biological method are available for removal of colored dyes from wastewater. The work presented here involved the decolorisation of wastewater containing congo red and methylene blue using various coagulants such as alum, bentonite and lime. The effect of various experimental factors such as dosage of coagulants, contact time between coagulant and dye and concentration of dyes and working environment like shaking and static was studied. Under static condition alum give almost 43% removal of congo red while with 10 minutes shaking 74 % removal of 80 dye was achieved with same coagulant. The highest removal of congo red was found to be 99.5 % by using alum after 30 minutes of shaking but in case of methylene blue it intensified the color and gave negative results. Lime gave only 33 % color removal of congo red under static conditions while 57% color was removed under shaking conditions. Maximum color removal achieved by lime was 89% at 40 minutes with shaking condition. Lime gave 60% removal of methylene blue in static condition and 90% removal in shaking condition and maximum absorbance at 80 ppm was 90%. Bentonite also used for the removal of methylene blue and gave 89% removal in shaking condition. By increasing shaking time %age removal increased to 100% at 40 min. And amount of coagulant increased the removal efficiency it attained 100% in both lime and bentonite coagulant for methylene blue Overall alum was found to be better coagulant for the removal of congo red from its aqueous solution. Lime and bentonite both proved better and economical for removal of methylene blue from aqueous solution at lab scale. (author)

  2. Comprehensive reuse of drinking water treatment residuals in coagulation and adsorption processes.

    Science.gov (United States)

    Jung, Kyung-Won; Hwang, Min-Jin; Park, Dae-Seon; Ahn, Kyu-Hong

    2016-10-01

    While drinking water treatment residuals (DWTRs) inevitably lead to serious problems due to their huge amount of generation and limitation of landfill sites, their unique properties of containing Al or Fe contents make it possible to reuse them as a beneficial material for coagulant recovery and adsorbent. Hence, in the present study, to comprehensively handle and recycle DWTRs, coagulant recovery from DWTRs and reuse of coagulant recovered residuals (CRs) were investigated. In the first step, coagulant recovery from DWTRs was conducted using response surface methodology (RSM) for statistical optimization of independent variables (pH, solid content, and reaction time) on response variable (Al recovery). As a result, a highly acceptable Al recovery of 97.5 ± 0.4% was recorded, which corresponds to 99.5% of the predicted Al recovery. Comparison study of recovered and commercial coagulant from textile wastewater treatment indicated that recovered coagulant has reasonable potential for use in wastewater treatment, in which the performance efficiencies were 68.5 ± 2.1% COD, 97.2 ± 1.9% turbidity, and 64.3 ± 1.0% color removals at 50 mg Al/L. Subsequently, in a similar manner, RSM was also applied to optimize coagulation conditions (Al dosage, initial pH, and reaction time) for the maximization of real cotton textile wastewater treatment in terms of COD, turbidity, and color removal. Overall performance revealed that the initial pH had a remarkable effect on the removal performance compared to the effects of other independent variables. This is mainly due to the transformation of metal species form with increasing or decreasing pH conditions. Finally, a feasibility test of CRs as adsorbent for phosphate adsorption from aqueous solution was conducted. Adsorption equilibrium of phosphate at different temperatures (10-30 °C) and initial levels of pH (3-11) indicated that the main mechanisms of phosphate adsorption onto CRs are endothermic and chemical

  3. 21 CFR 864.5400 - Coagulation instrument.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Coagulation instrument. 864.5400 Section 864.5400 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Automated and Semi-Automated Hematology Devices § 864...

  4. In silico modeling and experimental evidence of coagulant protein interaction with precursors for nanoparticle functionalization.

    Science.gov (United States)

    Okoli, Chuka; Sengottaiyan, Selvaraj; Arul Murugan, N; Pavankumar, Asalapuram R; Agren, Hans; Kuttuva Rajarao, Gunaratna

    2013-10-01

    The design of novel protein-nanoparticle hybrid systems has applications in many fields of science ranging from biomedicine, catalysis, water treatment, etc. The main barrier in devising such tool is lack of adequate information or poor understanding of protein-ligand chemistry. Here, we establish a new strategy based on computational modeling for protein and precursor linkers that can decorate the nanoparticles. Moringa oleifera (MO2.1) seed protein that has coagulation and antimicrobial properties was used. Superparamagnetic nanoparticles (SPION) with precursor ligands were used for the protein-ligand interaction studies. The molecular docking studies reveal that there are two binding sites, one is located at the core binding site; tetraethoxysilane (TEOS) or 3-aminopropyl trimethoxysilane (APTES) binds to this site while the other one is located at the side chain residues where trisodium citrate (TSC) or Si60 binds to this site. The protein-ligand distance profile analysis explains the differences in functional activity of the decorated SPION. Experimentally, TSC-coated nanoparticles showed higher coagulation activity as compared to TEOS- and APTES-coated SPION. To our knowledge, this is the first report on in vitro experimental data, which endorses the computational modeling studies as a powerful tool to design novel precursors for functionalization of nanomaterials; and develop interface hybrid systems for various applications.

  5. Optical coherence tomography-guided laser microsurgery for blood coagulation with continuous-wave laser diode.

    Science.gov (United States)

    Chang, Feng-Yu; Tsai, Meng-Tsan; Wang, Zu-Yi; Chi, Chun-Kai; Lee, Cheng-Kuang; Yang, Chih-Hsun; Chan, Ming-Che; Lee, Ya-Ju

    2015-11-16

    Blood coagulation is the clotting and subsequent dissolution of the clot following repair to the damaged tissue. However, inducing blood coagulation is difficult for some patients with homeostasis dysfunction or during surgery. In this study, we proposed a method to develop an integrated system that combines optical coherence tomography (OCT) and laser microsurgery for blood coagulation. Also, an algorithm for positioning of the treatment location from OCT images was developed. With OCT scanning, 2D/3D OCT images and angiography of tissue can be obtained simultaneously, enabling to noninvasively reconstruct the morphological and microvascular structures for real-time monitoring of changes in biological tissues during laser microsurgery. Instead of high-cost pulsed lasers, continuous-wave laser diodes (CW-LDs) with the central wavelengths of 450 nm and 532 nm are used for blood coagulation, corresponding to higher absorption coefficients of oxyhemoglobin and deoxyhemoglobin. Experimental results showed that the location of laser exposure can be accurately controlled with the proposed approach of imaging-based feedback positioning. Moreover, blood coagulation can be efficiently induced by CW-LDs and the coagulation process can be monitored in real-time with OCT. This technology enables to potentially provide accurate positioning for laser microsurgery and control the laser exposure to avoid extra damage by real-time OCT imaging.

  6. Influence of micellar calcium and phosphorus on rennet coagulation properties of cows milk.

    Science.gov (United States)

    Malacarne, Massimo; Franceschi, Piero; Formaggioni, Paolo; Sandri, Sandro; Mariani, Primo; Summer, Andrea

    2014-05-01

    The main requirement for milk processed in most cheese typologies is its rennet coagulation ability. Despite the increasing number of studies, the causes for abnormal coagulation of milk are not fully understood. The aim of this study was to ascertain relationships between milk characteristics and its rennet coagulation ability, focusing on the influence of calcium (Ca) and phosphorus (P). Ca and P are essential constituents of the micelles. Micellar P can be present as part of colloidal calcium phosphate (inorganic-P) or covalently bound to caseins as phosphate groups (casein-P). Eighty one herd milk samples (SCCproperties. Optimal milk was characterised by the highest contents of major constituents, protein fractions and minerals, lowest content of chloride and highest values of titratable acidity. Non-coagulating milk was characterised by the highest values of pH and the lowest of titratable acidity. At micellar level, Optimal milk showed the highest values of colloidal Ca, casein-P and colloidal Mg (g/100 g casein), while Non-coagulating milk showed the lowest values. Interestingly, there was no statistical difference regarding the content of colloidal inorganic-P (g/100 g casein) between Optimal and Non-coagulating milks. Overall, high mineralisation of the micelle (expressed as g inorganic-P/100 g casein) positively affect its rennetability. However, excessive mineralisation could lead to a reduction of the phosphate groups (g casein-P/100 g casein) available for curd formation.

  7. Fluid therapy in the perioperative setting-a clinical review

    DEFF Research Database (Denmark)

    Voldby, Anders Winther; Brandstrup, Birgitte

    2016-01-01

    BACKGROUND: Perioperative hypovolemia and fluid overload have effects on both complications following surgery and on patient survival. Therefore, the administration of intravenous fluids before, during, and after surgery at the right time and in the right amounts is of great importance. This review...... aims to analyze the literature concerning perioperative fluid therapy in abdominal surgery and to provide evidence-based recommendations for clinical practice. RESULTS: Preoperative oral or intravenous administration of carbohydrate containing fluids has been shown to improve postoperative well...... for most patients. It is less expensive and simpler than the zero-balance GDT approach and therefore recommended in this review. In outpatient surgery, 1-2 L of balanced crystalloids reduces postoperative nausea and vomiting and improves well-being....

  8. Development of Coagulation Factor Probes for the Identification of Procoagulant Circulating Tumor Cells

    Energy Technology Data Exchange (ETDEWEB)

    Tormoen, Garth W.; Cianchetti, Flor A. [Department of Biomedical Engineering, Oregon Health and Science University, Portland, OR (United States); Bock, Paul E. [Department of Pathology, Microbiology and Immunology, Vanderbilt University School of Medicine, Nashville, TN (United States); McCarty, Owen J. T., E-mail: tormoeng@ohsu.edu [Department of Biomedical Engineering, Oregon Health and Science University, Portland, OR (United States); Department of Cell and Developmental Biology, Oregon Health and Science University, Portland, OR (United States); Division of Hematology and Medical Oncology, Department of Medicine, Oregon Health and Science University, Portland, OR (United States)

    2012-09-06

    Metastatic cancer is associated with a hypercoagulable state, and pathological venous thromboembolic disease is a significant source of morbidity and the second leading cause of death in patients with cancer. Here we aimed to develop a novel labeling strategy to detect and quantify procoagulant circulating tumor cells (CTCs) from patients with metastatic cancer. We hypothesize that the enumeration of procoagulant CTCs may be prognostic for the development of venous thrombosis in patients with cancer. Our approach is based on the observation that cancer cells are capable of initiating and facilitating cell-mediated coagulation in vitro, whereby activated coagulation factor complexes assemble upon cancer cell membrane surfaces. Binding of fluorescently labeled, active site-inhibited coagulation factors VIIa, Xa, and IIa to the metastatic breast cancer cell line, MDA-MB-231, non-metastatic colorectal cell line, SW480, or metastatic colorectal cell line, SW620, was characterized in a purified system, in anticoagulated blood and plasma, and in plasma under conditions of coagulation. We conclude that a CTC labeling strategy that utilizes coagulation factor-based fluorescent probes may provide a functional assessment of the procoagulant potential of CTCs, and that this strategy is amenable to current CTC detection platforms.

  9. Isolation and characterization of coagulant extracted from Moringa oleifera seed by salt solution.

    Science.gov (United States)

    Okuda, T; Baes, A U; Nishijima, W; Okada, M

    2001-02-01

    It is known that M. oleifera contains a natural coagulant in the seeds. In our previous research, the method using salt water to extract the active coagulation component from M. oleifera seeds was developed and compared with the conventional method using water. In this research, the active coagulation component was purified from a NaCl solution crude extract of Moringa oleifera seeds. The active component was isolated and purified from the crude extract through a sequence of steps that included salting-out by dialysis, removal of lipids and carbohydrates by homogenization with acetone, and anion exchange. Specific coagulation activity of the active material increased up to 34 times more than the crude extract after the ion exchange. The active component was not the same as that of water extract. The molecular weight was about 3000 Da. The Lowry method and the phenol-sulfuric acid method indicated that the active component was neither protein nor polysaccharide. The optimum pH of the purified active component for coagulation of turbidity was pH 8 and above. Different from the conventional water extracts, the active component can be used for waters with low turbidity without increase in the dissolved organic carbon concentration.

  10. Real-time electrical impedimetric monitoring of blood coagulation process under temperature and hematocrit variations conducted in a microfluidic chip.

    Directory of Open Access Journals (Sweden)

    Kin Fong Lei

    Full Text Available Blood coagulation is an extremely complicated and dynamic physiological process. Monitoring of blood coagulation is essential to predict the risk of hemorrhage and thrombosis during cardiac surgical procedures. In this study, a high throughput microfluidic chip has been developed for the investigation of the blood coagulation process under temperature and hematocrit variations. Electrical impedance of the whole blood was continuously recorded by on-chip electrodes in contact with the blood sample during coagulation. Analysis of the impedance change of the blood was conducted to investigate the characteristics of blood coagulation process and the starting time of blood coagulation was defined. The study of blood coagulation time under temperature and hematocrit variations was shown a good agreement with results in the previous clinical reports. The electrical impedance measurement for the definition of blood coagulation process provides a fast and easy measurement technique. The microfluidic chip was shown to be a sensitive and promising device for monitoring blood coagulation process even in a variety of conditions. It is found valuable for the development of point-of-care coagulation testing devices that utilizes whole blood sample in microliter quantity.

  11. Comparative thermometric coagulation studies of plasmas from normal outbred Swiss Webster mice and persons.

    Science.gov (United States)

    Tsang, V C; Wyatt, C R; Damian, R T

    1979-06-01

    The functional capabilities of a thermometric clot-timer have been demonstrated in a comparative study of human and mouse plasma coagulation. The influence of some variables on coagulation times of mouse and human plasmas were examined in activated partial thromboplastin time, one-stage prothrombin time, and Russell's viper venom time assays. Mouse plasma coagulation times were generally shorter and more reproducible than those of human plasma. Optimal assay conditions are also described.

  12. Exploration by radioactive fibrinogen of intrarenal coagulation phenomena. Preliminary results

    International Nuclear Information System (INIS)

    Simon, Jacques.

    1974-01-01

    The participation of fibrin deposits in kidney pathology was studied by the use of a radioactive tracer involved in the coagulation phenomenon: iodine 131-labelled fibrinogen. The isotopic exploration consists of a fibrinogen kinetics study combined with external counting over the kidney regions. The different stages of the procedure are described: separation, purification and labelling of fibrinogen; characteristics of the radioactive fibrinogen used; practical details of the examination itself; data analysis method. A chapter devoted to verifications and discussions of the procedure is followed by a report on the exploration of intrarenal coagulation phenomena in 30 kidney disease patients. In conclusion, the study of fibrinogen kinetics is considered as the most suitable method to detect local or slight intravascular coagulation phenomena. The sensitivity of the isotopic exploration is very satisfactory. The main criticism directed against this method is that the exploration is general and therefore blind [fr

  13. Comparison of electrocoagulation and chemical coagulation ...

    African Journals Online (AJOL)

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

  14. Enhancement of sedimentation and coagulation with static magnetic field

    Science.gov (United States)

    Zieliński, Marcin; Dębowski, Marcin; Hajduk, Anna; Rusanowska, Paulina

    2017-11-01

    The static magnetic field can be an alternative method for wastewater treatment. It has been proved that this physical factor, accelerates the biochemical processes, catalyzes advanced oxidation, intensifies anaerobic and aerobic processes or reduces swelling of activated sludge. There are also reports proving the positive impact of the static magnetic field on the coagulation and sedimentation, as well as the conditioning and dewatering of sludge. In order to be applied in larger scale the published results should be verified and confirmed. In the studies, the enhancement of sedimentation by the static magnetic field was observed. The best sedimentation was noted in the experiment, where magnetizers were placed on activated sludge bioreactor and secondary settling tank. No effect of the static magnetic field on coagulation with the utilization of PIX 113 was observed. However, the static magnetic field enhanced coagulation with the utilization of PAX-XL9. The results suggest that increased sedimentation of colloids and activated sludge, can in practice mean a reduction in the size of the necessary equipment for sedimentation with an unchanged efficiency of the process.

  15. Composite wastewater treatment by aerated electrocoagulation and modified peroxi-coagulation processes.

    Science.gov (United States)

    Kumar, Abhijeet; Nidheesh, P V; Suresh Kumar, M

    2018-08-01

    Treatment of composite wastewater generating from the industrial estates is a great challenge. The present study examines the applicability of aerated electrocoagulation and modified peroxi-coagulation processes for removing color and COD from composite wastewater. Iron plates were used as anodes and cathodes in both electrochemical processes and experiments were carried out in a working volume of 2 L. Aeration enhanced the efficiency of electrocoagulation process significantly. More than 50% of COD and 60% of color were removed after 1 h of electrocoagulation process operated at pH 3 and applied voltage of 1 V. Efficiency of the modified peroxi-coagulation process was significantly higher than that of aerated electrocoagulation. COD and color removal efficiencies of the modified peroxi-coagulation process were found as 77.7% and 97%, respectively after 1 h of electrolysis operated at 1 V, solution pH 3 and 50 mM hydrogen peroxide addition. This improved efficiency of modified peroxi-coagulation compared to aerated electrocoagulation is mainly due to the attack of in-situ generated hydroxyl radicals. Copyright © 2018 Elsevier Ltd. All rights reserved.

  16. Monte Carlo simulation of aggregate morphology for simultaneous coagulation and sintering

    International Nuclear Information System (INIS)

    Schmid, Hans-Joachim; Tejwani, Saurabh; Artelt, Christian; Peukert, Wolfgang

    2004-01-01

    A model for simulation of the three-dimensional morphology of nano-structured aggregates formed by concurrent coagulation and sintering is presented. Diffusion controlled cluster-cluster aggregation is assumed to be the prevailing coagulation mechanism which is implemented using a Monte-Carlo algorithm. Sintering is modeled as a successive overlapping of spherical primary particles, which are allowed to grow as to preserve overall mass. Simulations are characterized by individual ratios τ of characteristic collision to fusion time. A number of resulting aggregate-structures is displayed and reveals structure formation by coagulation and sintering for different values of τ. These aggregates are described qualitatively and quantitatively by their mass fractal dimension D f and radius of gyration. The fractal dimension increases from 1.86 for pure aggregation to ∼ 2.75 for equal characteristic time scales. As sintering turns out to be more and more relevant, increasingly compact aggregates start to form and the radius of gyration decreases significantly. The simulation results clearly reveal a strong dependence of the fractal dimension on the kinetics of the concurrent coagulation and sintering processes. Considering appropriate values of D f in aerosol process simulations may therefore be important in many cases

  17. Disseminated intravascular coagulation caused by moojenactivase, a procoagulant snake venom metalloprotease.

    Science.gov (United States)

    Sartim, Marco A; Cezarette, Gabriel N; Jacob-Ferreira, Anna L; Frantz, Fabiani G; Faccioli, Lucia H; Sampaio, Suely V

    2017-10-01

    Snake venom toxins that activate coagulation factors are key players in the process of venom-induced coagulopathy, and account for severe clinical manifestations. The present study applies a variety of biochemical, hematological, and histopathological approaches to broadly investigate the intravascular and systemic effects of moojenactivase (MooA), the first described PIIId subclass metalloprotease isolated from Bothrops sp. venom that activates coagulation factors. MooA induced consumption coagulopathy with high toxic potency, characterized by prolongation of prothrombin and activated partial thromboplastin time, consumption of fibrinogen and the plasma coagulation factors X and II, and thrombocytopenia. MooA promoted leukocytosis and expression of the proinflammatory cytokines interleukin-6 and tumor necrosis factor-α, accompanied by tissue factor-dependent procoagulant activity in peripheral blood mononuclear cells. This metalloprotease also caused intravascular hemolysis, elevated plasma levels of creatine kinase-MB, aspartate transaminase, and urea/creatinine, and induced morphopathological alterations in erythrocytes, heart, kidney, and lungs associated with thrombosis and hemorrhage. Diagnosis of MooA-induced disseminated intravascular coagulation represents an important approach to better understand the pathophysiology of Bothrops envenomation and develop novel therapeutic strategies targeting hemostatic disturbances. Copyright © 2017. Published by Elsevier B.V.

  18. Enhanced Coagulation Efficiency of Moringa Oleifera Seeds Through Selective Oil Extraction

    Directory of Open Access Journals (Sweden)

    Suleyman A. Muyibi

    2012-10-01

    Full Text Available In this laboratory based study, varying quantities of oil, corresponding to 20 % w/w, 25 % w/w and 30 % w/w kernel weight extracted from Moringa oleifera seeds ( S1, S2, S3 respectively  were applied in the coagulation of model turbid water (kaolin suspension and turbid river water samples from River Batang Kali and River Selangor in Malaysia to determine the percentage oil removed which gave the best coagulation efficiency. For model turbid water (kaolin suspension coagulation of low turbidity of 35 NTU, medium turbidity of 100 NTU and high turbidity of 300 NTU, sample S2  gave the best turbidity removal corresponding to 91.7%, 95.5% and 99% respectively. Application of sample S2 to River Batang Kali with low initial turbidity of 32 NTU and high initial turbidity of 502 NTU gave a highest turbidity removal of 69% and 99% respectively. Application to River Selangor with medium initial turbidity- of 87 NTU and high initial turbidity of 466 NTU gave a highest residual turbidity' of 94% and 98.9%,  respectively.Key words: Moringa oleifera seed, selective oil extraction, coagulation, model turbid water (kaolin suspension, river water, turbidity removal.

  19. Simple and rapid methods for purification and characterization of active coagulants from the seeds of Vigna unguiculata and Parkinsonia aculeata.

    Science.gov (United States)

    Marobhe, N J; Dalhammar, G; Gunaratna, K R

    2007-06-01

    The coagulating properties of aqueous crude extracts and purified proteins of Vigna unguiculata and Parkinsonia aculeata seeds, which are traditional water coagulants in rural areas of Tanzania, were studied. The coagulation activity assays were done using one millilitre (ml) of kaolin water samples. Coagulating proteins were purified in two-step ion exchange chromatography. The properties of coagulant protein were compared with Moringa oleifera. Coagulating components eluted by 0.6 M NaCl in both coagulants are cationic proteins that have the molecular mass of about 6 kDa, which is very similar to that of M. oleifera. The proteins of V. unguiculata and P. aculeata eluted by 0.3 M NaCl also harbour coagulation activity but proteins eluted with 0.6 M NaCl have higher activity. The dosage for coagulation using purified proteins of both coagulants is about 5 to 10 times lower than that of crude seed extracts. The optimum floc settling time of water treated by crude seed extracts and purified proteins ranged between two and two and half hours. Coagulating proteins of both coagulants eluted by 0.6 M NaCl are thermoresistant and retained coagulation activity of 87% to 92% after boiling for two hours at 80 degrees C and one hour at 95 degrees C. Thermotolerant proteins of V. unguiculata eluted by 0.6 M NaCl and P. aculeata have wider pH range of 5.5 to 8.5 for coagulation activity than those of M. oleifera proteins. The present investigation reveals the possibility of using purified natural coagulants for water treatment to produce safe drinking water.

  20. Systematic review and consensus definitions for the Standardised Endpoints in Perioperative Medicine (StEP) initiative

    DEFF Research Database (Denmark)

    Myles, P S; Boney, O; Botti, M

    2018-01-01

    Medicine initiative was established to derive a set of standardised endpoints for use in perioperative clinical trials. METHODS: We undertook a systematic review to identify measures of patient comfort used in the anaesthetic, surgical, and other perioperative literature. A multi-round Delphi consensus...

  1. Optimization of peri-operative care in colorectal surgery

    NARCIS (Netherlands)

    Kornmann, V.N.N.

    2016-01-01

    Colorectal cancer is an important health issue, and colorectal surgery is increasingly being performed. During the last years, quality and safety of care, new surgical techniques and attention for peri-operative risks resulted in reduction of postoperative morbidity and mortality. Despite these

  2. Preliminary assessment of the importance of turbulent coagulation in the Kuwaiti oil fires. Final report, April 1992-June 1993

    Energy Technology Data Exchange (ETDEWEB)

    Kohlberg, I.

    1993-06-01

    This study provides a mathematical determination of the spatial distribution of aerosols due to turbulent shear coagulation and turbulent inertial coagulation, as applied to the conditions of the Kuwaiti Oil Fires (KOF) of 1991. Using an approximation from a forest fire for the normalized size distribution of aerosols, the downstream particle concentration is found by the concurrent solution of the coagulations' kinetics combined with turbulent atmospheric diffusion. The result shows the explicit dependence of the concentration on the following principal parameters: turbulent energy dissipation rate, turbulent diffusion constant, average wind speed, mass ejection from a well, Kolmorogov time scale for turbulence, and Kolmorogov length scale for turbulence. For very large values of turbulent energy dissipation rate, turbulent inertial coagulation is more effective than turbulent shear coagulation in particle growth. The spatial dependence of concentration attributed to turbulent coagulation may vary considerably. Depending on the choice of parameters, the importance of turbulent coagulation in particle transport processes may extend from less than a kilometer to tens of kilometers. Kuwaiti Oil Fires (KOF), Particle transport, Turbulent inertial coagulation, Turbulent shear coagulation.

  3. Levosimendan for Perioperative Cardioprotection: Myth or Reality?

    Science.gov (United States)

    Santillo, Elpidio; Migale, Monica; Massini, Carlo; Incalzi, Raffaele Antonelli

    2018-03-21

    Levosimendan is a calcium sensitizer drug causing increased contractility in the myocardium and vasodilation in the vascular system. It is mainly used for the therapy of acute decompensated heart failure. Several studies on animals and humans provided evidence of the cardioprotective properties of levosimendan including preconditioning and anti-apoptotic. In view of these favorable effects, levosimendan has been tested in patients undergoing cardiac surgery for the prevention or treatment of low cardiac output syndrome. However, initial positive results from small studies have not been confirmed in three recent large trials. To summarize levosimendan mechanisms of action and clinical use and to review available evidence on its perioperative use in cardiac surgery setting. We searched two electronic medical databases for randomized controlled trials studying levosimendan in cardiac surgery patients, ranging from January 2000 to August 2017. Meta-analyses, consensus documents and retrospective studies were also reviewed. In the selected interval of time, 54 studies on the use of levosimendan in heart surgery have been performed. Early small size studies and meta-analyses have suggested that perioperative levosimendan infusion could diminish mortality and other adverse outcomes (i.e. intensive care unit stay and need for inotropic support). Instead, three recent large randomized controlled trials (LEVO-CTS, CHEETAH and LICORN) showed no significant survival benefits from levosimendan. However, in LEVO-CTS trial, prophylactic levosimendan administration significantly reduced the incidence of low cardiac output syndrome. Based on most recent randomized controlled trials, levosimendan, although effective for the treatment of acute heart failure, can't be recommended as standard therapy for the management of heart surgery patients. Further studies are needed to clarify whether selected subgroups of heart surgery patients may benefit from perioperative levosimendan

  4. Perioperative interstitial brachytherapy for recurrent keloid scars

    International Nuclear Information System (INIS)

    Rio, E.; Bardet, E.; Peuvrel, P.; Martinet, L.; Perrot, P.; Baraer, F.; Loirat, Y.; Sartre, J.Y.; Malard, O.; Ferron, C.; Dreno, B.

    2010-01-01

    Purpose: Evaluation of the results of perioperative interstitial brachytherapy with low dose-rate (L.D.R.) Ir-192 in the treatment of keloid scars. Patients and methods: We performed a retrospective analysis of 73 histologically confirmed keloids (from 58 patients) resistant to medico surgical treated by surgical excision plus early perioperative brachytherapy. All lesions were initially symptomatic. Local control was evaluated by clinical evaluation. Functional and cosmetic results were assessed in terms of patient responses to a self-administered questionnaire. Results: Median age was 28 years (range 13-71 years). Scars were located as follows: 37% on the face, 32% on the trunk or abdomen, 16% on the neck, and 15% on the arms or legs. The mean delay before loading was four hours (range, 1-6 h). The median dose was 20 Gy (range, 15-40 Gy). Sixty-four scars (from 53 patients) were evaluated. Local control was 86% (follow-up, 44.5 months; range, 14-150 months). All relapses occurred early within 2 years posttreatment. At 20 months, survival without recurrence was significantly lower when treated lengths were more than 6 cm long. The rate was 100% for treated scars below 4.5 cm in length, 95% (95% CI: 55-96) for those 4.5-6 cm long, and 75% (95% CI: 56-88) beyond 6 cm (p = 0.038). Of the 35 scars (28 patients) whose results were reassessed, six remained symptomatic and the esthetic results were considered to be good in 51% (18/35) and average in 37% (13/35) (median follow-up, 70 months; range, 16-181 months). Conclusion: Early perioperative L.D.R. brachytherapy delivering 20 Gy at 5 mm reduced the rate of recurrent keloids resistant to other treatments and gave good functional results. (authors)

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

    Science.gov (United States)

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

    2014-01-01

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

  6. Moojenactivase, a novel pro-coagulant PIIId metalloprotease isolated from Bothrops moojeni snake venom, activates coagulation factors II and X and induces tissue factor up-regulation in leukocytes.

    Science.gov (United States)

    Sartim, Marco A; Costa, Tassia R; Laure, Helen J; Espíndola, Milena S; Frantz, Fabiani G; Sorgi, Carlos A; Cintra, Adélia C O; Arantes, Eliane C; Faccioli, Lucia H; Rosa, José C; Sampaio, Suely V

    2016-05-01

    Coagulopathies following snakebite are triggered by pro-coagulant venom toxins, in which metalloproteases play a major role in envenomation-induced coagulation disorders by acting on coagulation cascade, platelet function and fibrinolysis. Considering this relevance, here we describe the isolation and biochemical characterization of moojenactivase (MooA), a metalloprotease from Bothrops moojeni snake venom, and investigate its involvement in hemostasis in vitro. MooA is a glycoprotein of 85,746.22 Da, member of the PIIId group of snake venom metalloproteases, composed of three linked disulfide-bonded chains: an N-glycosylated heavy chain, and two light chains. The venom protease induced human plasma clotting in vitro by activating on both blood coagulation factors II (prothrombin) and X, which in turn generated α-thrombin and factor Xa, respectively. Additionally, MooA induced expression of tissue factor (TF) on the membrane surface of peripheral blood mononuclear cells (PBMC), which led these cells to adopt pro-coagulant characteristics. MooA was also shown to be involved with production of the inflammatory mediators TNF-α, IL-8 and MCP-1, suggesting an association between MooA pro-inflammatory stimulation of PBMC and TF up-regulation. We also observed aggregation of washed platelets when in presence of MooA; however, the protease had no effect on fibrinolysis. Our findings show that MooA is a novel hemostatically active metalloprotease, which may lead to the development of coagulopathies during B. moojeni envenomation. Moreover, the metalloprotease may contribute to the development of new diagnostic tools and pharmacological approaches applied to hemostatic disorders.

  7. [A survey of perioperative asthmatic attack among patients with bronchial asthma underwent general anesthesia].

    Science.gov (United States)

    Ie, Kenya; Yoshizawa, Atsuto; Hirano, Satoru; Izumi, Sinyuu; Hojo, Masaaki; Sugiyama, Haruhito; Kobayasi, Nobuyuki; Kudou, Kouichirou; Maehara, Yasuhiro; Kawachi, Masaharu; Miyakoshi, Kouichi

    2010-07-01

    We investigated the risk factor of perioperative asthmatic attack and effectiveness of preventing treatment for asthmatic attack before operation. We performed retrospective chart review of one hundred eleven patients with asthma underwent general anesthesia and surgical intervention from January 2006 to October 2007 in our hospital. The rate of perioperative asthmatic attack were as follows; 10.2% (5 in 49 cases) in no pretreatment group, 7.5% (3 in 40 cases) in any pretreatments except for systemic steroid, and 4.5% (1 in 22 cases) in systemic steroid pretreatment group. Neither preoperative asthma severity nor duration from the last attack had significant relevancy to perioperative attack rate. The otolaryngological surgery, especially those have nasal polyp and oral surgery had high perioperative asthma attack rate, although there was no significant difference. We recommend the systemic steroid pretreatment for asthmatic patients, especially when they have known risk factor such as administration of the systemic steroid within 6 months, or possibly new risk factor such as nasal polyp, otolaryngological and oral surgery.

  8. EFFECTS OF ORAL CONTRACEPTIVES ON COAGULATING FACTORS

    Directory of Open Access Journals (Sweden)

    H.R. Sadeghipour Roudsari.

    1997-06-01

    Full Text Available Thirty young, healthy, nonsmoking women (mean age approximately 28 years taking low-dose oral contraceptive pills were recruited for the study of the effects of these pills on coagulating factors. Twenty subjects were taking LD pill (Ethinyl estradiol 0.03 mg, levonorgestrel 0.15 mg and 10 others were taking Cilest (Ethinyl estradiol 0.035 mg, Norgestimate 0.25 mg for six months. The control subjects did not receive any oral contraceptives or other medications. Our results showed that:"n1. There is no significant difference between the effects of LD and Cilest (with a different progestin content on coagulating factors."n2. No significant changes were observed between both LD users and controls in PT, APTT, and fibrinogen levels."n3. No significant changes were observed between both Cilest users and controls in PT, APTT, and fibrinogen levels."n

  9. Implementation of the Vocera Communication System in a Quaternary Perioperative Environment.

    Science.gov (United States)

    Friend, Tynan H; Jennings, Samantha J; Copenhaver, Martin S; Levine, Wilton C

    2017-01-01

    In the hospital, fast and efficient communication among clinicians and other employees is paramount to ensure optimal patient care, workflow efficiency, patient safety and patient comfort. The implementation of the wireless Vocera® Badge, a hands-free wearable device distributed to perioperative team members, has increased communication efficiency across the perioperative environment at Massachusetts General Hospital (MGH). This quality improvement project, based upon identical pre- and post-implementation surveys, used qualitative and quantitative analysis to determine if and how the Vocera system affected the timeliness of information flow, ease of communication, and operating room noise levels throughout the perioperative environment. Overall, the system increased the speed of information flow and eased communication between coworkers yet was perceived to have raised the overall noise level in and around the operating rooms (ORs). The perceived increase in noise was outweighed by the closed-loop communication between clinicians. Further education of the system's features in regard to speech recognition and privacy along with expected conversation protocol are necessary to ensure hassle-free communication for all staff.

  10. Enrichment of trace metals in water utilizing the coagulation of soybean protein

    International Nuclear Information System (INIS)

    Musha, Soichiro; Takahashi, Yoshihisa.

    1975-01-01

    An enrichment of trace metals in water with a coagulated soybean protein and the complex-forming character of heavy metal ions with the soybean protein were investigated by means of emission spectrography. Fixed amounts of soybean milk (collector) and delta-gluconic lactone (coagulant) were added to a sample solution containing various metal ions, and then the mixture was heated to boiling in order to coagulate the protein. The coagulum (soybean curd) separated from the suspension with a centrifuge was burned to ashes with a low temperature plasma asher. Then metals enriched in the soybean curd were determined by means of emission spectrography. The pH of the solution was adjusted to 4.4--5.0 by adding suitable amounts of delta-gluconic lactone for the complete coagulation of the soybean protein. The proposed method can be applied to the collection and enrichment of various metal ions such as gold, silver, mercury, platinum, cadmium, beryllium, palladium, antimony, gallium, indium, cerium, lanthanum, thorium, yttrium, zirconium, etc. Those metals are not detectable in the original soybean. (auth.)

  11. Characterization of Natural Organic Matter by FeCl3 Coagulation

    Science.gov (United States)

    Cahyonugroho, O. H.; Hidayah, E. N.

    2018-01-01

    Natural organic matter (NOM) is heterogenous mixture of organic compounds that enter the water from various decomposition and metabolic reactions, including animal, plant, domestic and industrial wastes. NOM refers to group of carbon-based compounds that are found in surface water and ground water. The aim of the study is to assess organic matter characteristics in Jagir River as drinking water source and to characterize the organic components that could be removed during coagulation. Coagulation is the common water treatment process can be used to remove NOM with FeCl3 coagulant in various dosage. NOM surrogates, including total organic carbon (TOC), ultraviolet absorbance at 254 nm (UV254) and specific UV absorbance (SUVA) were chosen to assess the organic removal. Results of jar test experiments showed that NOM can be removed about 40% of NOM surrogates with 200 mg/L FeCl3. About 60% removal of total organic fraction, which is mainly humic substances, as detected by size exclusion chromatography (SEC).

  12. Changes in Chara hispida L. morphology in response to phosphate aluminium coagulant application

    Directory of Open Access Journals (Sweden)

    Rybak Michał

    2018-03-01

    Full Text Available Progressing eutrophication of waterbodies requires measures to be undertaken that aim at halting or reversing negative changes in the environment. Chemical restoration is one of the most common methods used for lake treatment, where iron or aluminium phosphate coagulants are applied. However, their chemical qualities pose the risk of acidification and aluminium ion release, which become toxic in acidic conditions. The influence of coagulants on aquatic plants, including charophytes that are very valuable from the ecological perspective, is little recognised. For this reason, the aim of the research was to define changes in the growth pattern of the charophyte Chara hispida under the influence of an aluminium coagulant. The research was carried out in mesocosms (0.8 m3 located in situ in a lake. Polyaluminium chloride was applied once to each chamber in doses of 50.0, 100.0 and 200.0 ml m−3. Coagulant concentrations reflected aggressive restoration aimed at precipitation of phosphates, suspension and water colour at the same time. It was proved that the coagulant had inhibited the growth and slightly reduced the length of branchlets, and simultaneously elongated internode cells. Changes in the total length as well as the length of branchlets were caused by a strong pH decrease of the environment which simultaneously induced higher aluminium solubility and toxicity. Elongation of internode cells was caused by reduced light availability, resulting from high water turbidity in the first stage of coagulant’s application, and then from the charophytes’ thallus being covered by a coagulated suspension precipitated from water.

  13. Peri-operative Blood Transfusion in open Suprapubic Transvesical ...

    African Journals Online (AJOL)

    INTRODUCTION: Open simple prostatectomy is the most effective and the most durable method of controlling symptoms associated with benign prostatic hyperplasia, especially in sub- Saharan Africa, where TURP set and expertise are unavailable in most health institutions. The risk of perioperative heterologous blood ...

  14. Perioperative Management of Patients with Inflammatory Rheumatic Diseases Undergoing Major Orthopaedic Surgery: A Practical Overview.

    Science.gov (United States)

    Gualtierotti, Roberta; Parisi, Marco; Ingegnoli, Francesca

    2018-04-01

    Patients with inflammatory rheumatic diseases often need orthopaedic surgery due to joint involvement. Total hip replacement and total knee replacement are frequent surgical procedures in these patients. Due to the complexity of the inflammatory rheumatic diseases, the perioperative management of these patients must envisage a multidisciplinary approach. The frequent association with extraarticular comorbidities must be considered when evaluating perioperative risk of the patient and should guide the clinician in the decision-making process. However, guidelines of different medical societies may vary and are sometimes contradictory. Orthopaedics should collaborate with rheumatologists, anaesthesiologists and, when needed, cardiologists and haematologists with the common aim of minimising perioperative risk in patients with inflammatory rheumatic diseases. The aim of this review is to provide the reader with simple practical recommendations regarding perioperative management of drugs such as disease-modifying anti-rheumatic drugs, corticosteroids, non-steroidal anti-inflammatory drugs and tools for a risk stratification for cardiovascular and thromboembolic risk based on current evidence for patients with inflammatory rheumatic diseases.

  15. The Role of Emotional Intelligence in Perioperative Nursing and Leadership: Developing Skills for Improved Performance.

    Science.gov (United States)

    Beydler, Kathy Williams

    2017-10-01

    Many responsibilities of perioperative professionals involve concrete tasks that require high technical competence. Emotional intelligence, referred to as EQ, which involves the ability to relate to and influence others, may also be important for perioperative professionals. High EQ has been linked to higher performance in the workplace, higher job satisfaction, lower turnover intentions, and less burnout. Perioperative professionals who demonstrate a combination of technical skills and EQ could be more attuned to the humanity of health care (ie, providing more holistic care for the patient). Perioperative nurses who value providing holistic care for their patients may possess many of the elements of EQ. Leaders who recognize the importance of their own EQ and actively assist staff members to enhance and develop their EQ competency may help to create a competitive advantage by establishing a workforce of nurses who possess strong technical skills and high EQ. Copyright © 2017 AORN, Inc. Published by Elsevier Inc. All rights reserved.

  16. Coagulation Factor Tests: MedlinePlus Lab Test Information

    Science.gov (United States)

    ... K. Brunner & Suddarth's Handbook of Laboratory and Diagnostic Tests. 2nd Ed, Kindle. Philadelphia: Wolters Kluwer Health, Lippincott Williams & Wilkins; c2014. Coagulation Factor Assay; 156–7 p. ...

  17. Pattern of perioperative cardiac arrests at University of Maiduguri Teaching Hospital.

    Science.gov (United States)

    Kwari, Y D; Bello, M R; Eni, U E

    2010-01-01

    Perioperative cardiac arrests and death on the table represent the most serious complications of surgery and anaesthesia. This paper was designed to study their pattern, causes and outcomes following cardiopulmonary resuscitation (CPR) and intensive care unit (ICU) management in our institution. Three year retrospective review of perioperative cardiac arrests and death on operating table following surgical procedure under anaesthesia. For each cardiac arrest or death on the table the sequence of events leading to the arrest was evaluated using case notes, anaesthetic chart and ICU records. Study variables which include demographic data, ASA score, anaesthetic technique, causes and outcome were analysed and discussed. Fourteen perioperative cardiac arrests were encountered following 4051 anaesthetics administered over the three year study period. Twelve out of the fourteen cardiac arrests occurred following general anaesthesia, while the remaining two occurred following spinal anaesthesia. There was no cardiac arrest following local anaesthesia. Children suffered more cardiac arrest than adults. ASA class III and IV risk status suffered more arrests than ASA I and II. Hypoxia from airway problems was the commonest cause of cardiac arrest followed by septic shock. Monitoring with pulse oximeter was done in only 4 out of the 14 cardiac arrests. Only 2 (14%) out of 14 cardiac arrests recovered to home discharge, one of them with significant neurological deficit. Majority of arrests were due to hypoxia from airway problems that were not detected early There is need to improve on patient monitoring, knowledge of CPR and intensive care so as to improve the outcome of perioperative cardiac arrest.

  18. Plasma concentrations of blood coagulation factor VII measured by immunochemical and amidolytic methods

    DEFF Research Database (Denmark)

    Bladbjerg, E-M; Gram, J; Jespersen, J

    2000-01-01

    Ever since the coagulant activity of blood coagulation factor VII (FVII:C) was identified as a risk indicator of cardiac death, a large number of studies have measured FVII protein concentrations in plasma. FVII protein concentrations are either measured immunologically with an ELISA method (FVII...

  19. Coagulation and flocculation in the preparation of drinking water in a pilot plant

    Directory of Open Access Journals (Sweden)

    Iličić Gordana

    2005-01-01

    Full Text Available The objective of the practical part in this article was to explore the influence of different parameters on coagulation and flocculation processes as well as the influence of this stage on other stages in water purification. Analysis of the water samples was conducted in the chemical laboratory of Banja Luka Municipal Waterworks using standard methods for analyzing drinking water. The results are presented as diagrams that show the dependence of different parameters as a function of the residual turbidity and the content of natural organic matters in water. The following conclusions were drawn It is necessary to conduct the chemical treatment of raw water with the aim to satisfy chemical and bacteriological standards for drinking water. The best results were achieved with Al2(SO4s as coagulant,. Counterrecoil sludge in an amount of 2-3% in relation with the total quantity of water has a positive impacts on coagulation-flocculation processes. 4. For effective purification, all the conditions for coagulation-flocculation must be adjusted for the filter to have a longer useful life. One of example is correction of the pH to pH=7, coagulant dose 20 mg/L Al2(SO4s, flocculant dose 0.1 mg/L PE, counterrecoil sludge dose 90 L/h PM.

  20. Transparent exopolymer particles (TEP) removal efficiency by a combination of coagulation and ultrafiltration to minimize SWRO membrane fouling

    KAUST Repository

    Li, Sheng; Lee, Shang-Tse; Sinha, Shahnawaz; Leiknes, TorOve; Amy, Gary L.; Ghaffour, NorEddine

    2016-01-01

    This study investigated the impact of coagulation on the transformation between colloidal and particulate transparent exopolymer particles (TEP) in seawater; and the effectiveness of a combined pretreatment consisting of coagulation and UF on minimizing TEP fouling of seawater reverse osmosis (SWRO) membranes. Coagulation with ferric chloride at pH 5 substantially transformed colloidal TEP (0.1–0.4) into particulate TEP (>0.4) leading to a better membrane fouling control. Both 50 and 100 kDa molecular weight cut-off (MWCO) UF membranes removed most of particulate and colloidal TEP without the assistance of coagulation, but coagulation is still necessary for better UF fouling control. The improvement of combined SWRO pretreatment with coagulation and 50 kDa UF membranes was not that much significant compared to UF pretreatment with 50 KDa alone. Therefore, the minimal coagulant dosage for seawater containing TEP should be based on the UF fouling control requirements rather than removal efficiency. © 2016 Elsevier Ltd

  1. Transparent exopolymer particles (TEP) removal efficiency by a combination of coagulation and ultrafiltration to minimize SWRO membrane fouling

    KAUST Repository

    Li, Sheng

    2016-07-02

    This study investigated the impact of coagulation on the transformation between colloidal and particulate transparent exopolymer particles (TEP) in seawater; and the effectiveness of a combined pretreatment consisting of coagulation and UF on minimizing TEP fouling of seawater reverse osmosis (SWRO) membranes. Coagulation with ferric chloride at pH 5 substantially transformed colloidal TEP (0.1–0.4) into particulate TEP (>0.4) leading to a better membrane fouling control. Both 50 and 100 kDa molecular weight cut-off (MWCO) UF membranes removed most of particulate and colloidal TEP without the assistance of coagulation, but coagulation is still necessary for better UF fouling control. The improvement of combined SWRO pretreatment with coagulation and 50 kDa UF membranes was not that much significant compared to UF pretreatment with 50 KDa alone. Therefore, the minimal coagulant dosage for seawater containing TEP should be based on the UF fouling control requirements rather than removal efficiency. © 2016 Elsevier Ltd

  2. Change of particle size distribution during Brownian coagulation

    International Nuclear Information System (INIS)

    Lee, K.W.

    1984-01-01

    Change in particle size distribution due to Brownian coagulation in the continuum regime has been stuied analytically. A simple analytic solution for the size distribution of an initially lognormal distribution is obtained based on the assumption that the size distribution during the coagulation process attains or can, at least, be represented by a time dependent lognormal function. The results are found to be in a form that corrects Smoluchowski's solution for both polydispersity and size-dependent kernel. It is further shown that regardless of whether the initial distribution is narrow or broad, the spread of the distribution is characterized by approaching a fixed value of the geometric standard deviation. This result has been compared with the self-preserving distribution obtained by similarity theory. (Author)

  3. The effects of nanomaterials on blood coagulation in hemostasis and thrombosis.

    Science.gov (United States)

    Simak, Jan; De Paoli, Silvia

    2017-09-01

    The blood coagulation balance in the organism is achieved by the interaction of the blood platelets (PLTs) with the plasma coagulation system (PCS) and the vascular endothelial cells. In healthy organism, these systems prevent thrombosis and, in events of vascular damage, enable blood clotting to stop bleeding. The dysregulation of hemostasis may cause serious thrombotic and/or hemorrhagic pathologies. Numerous engineered nanomaterials are being investigated for biomedical purposes and are unavoidably exposed to the blood. Also, nanomaterials may access vascular system after occupational, environmental, or other types of exposure. Thus, it is essential to evaluate the effects of engineered nanomaterials on hemostasis. This review focuses on investigations of nanomaterial interactions with the blood components involved in blood coagulation: the PCS and PLTs. Particular emphases include the pathophysiology of effects of nanomaterials on the PCS, including the kallikrein-kinin system, and on PLTs. Methods for investigating these interactions are briefly described, and a review of the most important studies on the interactions of nanomaterials with plasma coagulation and platelets is provided. WIREs Nanomed Nanobiotechnol 2017, 9:e1448. doi: 10.1002/wnan.1448 For further resources related to this article, please visit the WIREs website. © Published 2017. This article is a U.S. Government work and is in the public domain in the USA.

  4. Patient satisfaction with the perioperative surgical services and ...

    African Journals Online (AJOL)

    Introduction: Globally, increasing consideration has been given to the assessment of patient satisfaction as a method of monitor of the quality of health care provision in the health institutions. Perioperative patient satisfaction has been contemplated to be related with the level of postoperative pain intensity, patients' ...

  5. Design and Implementation of a Perioperative Surgical Home at a Veterans Affairs Hospital.

    Science.gov (United States)

    Walters, Tessa L; Howard, Steven K; Kou, Alex; Bertaccini, Edward J; Harrison, T Kyle; Kim, T Edward; Shafer, Audrey; Brun, Carlos; Funck, Natasha; Siegel, Lawrence C; Stary, Erica; Mariano, Edward R

    2016-06-01

    The innovative Perioperative Surgical Home model aims to optimize the outcomes of surgical patients by leveraging the expertise and leadership of physician anesthesiologists, but there is a paucity of practical examples to follow. Veterans Affairs health care, the largest integrated system in the United States, may be the ideal environment in which to explore this model. We present our experience implementing Perioperative Surgical Home at one tertiary care university-affiliated Veterans Affairs hospital. This process involved initiating consistent postoperative patient follow-up beyond the postanesthesia care unit, a focus on improving in-hospital acute pain management, creation of an accessible database to track outcomes, developing new clinical pathways, and recruiting additional staff. Today, our Perioperative Surgical Home facilitates communication between various services involved in the care of surgical patients, monitoring of patient outcomes, and continuous process improvement. © The Author(s) 2015.

  6. Perioperative care following complex laryngotracheal reconstruction in infants and children

    Directory of Open Access Journals (Sweden)

    Gupta Punkaj

    2010-01-01

    Full Text Available Laryngotracheal reconstruction (LTR involves surgical correction of a stenotic airway with cartilage interpositional grafting, followed by either placement of a tracheostomy and an intraluminal stent (two-stage LTR or placement of an endotracheal tube with postoperative sedation and mechanical ventilation for an extended period of time (single-stage LTR. With single-stage repair, there may be several perioperative challenges including the provision of adequate sedation, avoidance of the development of tolerance to sedative and analgesia agents, the need to use neuromuscular blocking agents, the maintenance of adequate pulmonary toilet to avoid perioperative nosocomial infections, and optimization of postoperative respiratory function to facilitate successful tracheal extubation. We review the perioperative management of these patients, discuss the challenges during the postoperative period, and propose recommendations for the prevention of reversible causes of extubation failure in this article. Optimization to ensure a timely tracheal extubation and successful weaning of mechanical ventilator, remains the primary key to success in these surgeries as extubation failure or the need for prolonged postoperative mechanical ventilation can lead to failure of the graft site, the need for prolonged Pediatric Intensive Care Unit care, and in some cases, the need for a tracheostomy to maintain an adequate airway.

  7. A Systematic Approach to Creation of a Perioperative Data Warehouse.

    Science.gov (United States)

    Hofer, Ira S; Gabel, Eilon; Pfeffer, Michael; Mahbouba, Mohammed; Mahajan, Aman

    2016-06-01

    Extraction of data from the electronic medical record is becoming increasingly important for quality improvement initiatives such as the American Society of Anesthesiologists Perioperative Surgical Home. To meet this need, the authors have built a robust and scalable data mart based on their implementation of EPIC containing data from across the perioperative period. The data mart is structured in such a way so as to first simplify the overall EPIC reporting structure into a series of Base Tables and then create several Reporting Schemas each around a specific concept (operating room cases, obstetrics, hospital admission, etc.), which contain all of the data required for reporting on various metrics. This structure allows centralized definitions with simplified reporting by a large number of individuals who access only the Reporting Schemas. In creating the database, the authors were able to significantly reduce the number of required table identifiers from >10 to 3, as well as to correct errors in linkages affecting up to 18.4% of cases. In addition, the data mart greatly simplified the code required to extract data, making the data accessible to individuals who lacked a strong coding background. Overall, this infrastructure represents a scalable way to successfully report on perioperative EPIC data while standardizing the definitions and improving access for end users.

  8. Effects of coagulating enzyme types (commercial calf rennet ...

    African Journals Online (AJOL)

    Effects of coagulating enzyme types (commercial calf rennet, Aspergillus niger var. awamori as recombinant chymosin and rhizomucor miehei as microbial rennet) on the chemical and sensory characteristics of white pickled cheese.

  9. Effect of perioperative blood transfusions on long term graft outcomes in renal transplant patients.

    LENUS (Irish Health Repository)

    O'Brien, Frank J

    2012-06-01

    It is established that blood transfusions will promote sensitization to human leucocyte antigen (HLA) antigens, increase time spent waiting for transplantation and may lead to higher rates of rejection. Less is known about how perioperative blood transfusion influence patient and graft outcome. This study aims to establish if there is an association between perioperative blood transfusion and graft or patient survival.

  10. The impact of pre-oxidation with potassium permanganate on cyanobacterial organic matter removal by coagulation.

    Science.gov (United States)

    Naceradska, Jana; Pivokonsky, Martin; Pivokonska, Lenka; Baresova, Magdalena; Henderson, Rita K; Zamyadi, Arash; Janda, Vaclav

    2017-05-01

    The study investigates the effect of permanganate pre-oxidation on the coagulation of peptides/proteins of Microcystis aeruginosa which comprise a major proportion of the organic matter during cyanobacterial bloom decay. Four different permanganate dosages (0.1, 0.2, 0.4 and 0.6 mg KMnO 4 mg -1 DOC) were applied prior to coagulation by ferric sulphate. Moreover, changes in sample characteristics, such as UV 254 , DOC content and molecular weight distribution, after pre-oxidation were monitored. The results showed that permanganate pre-oxidation led to a reduction in coagulant dose, increased organic matter removals by coagulation (by 5-12% depending on permanganate dose), microcystin removal (with reductions of 91-96%) and a shift of the optimum pH range from 4.3 to 6 without to 5.5-7.3 with pre-oxidation. Degradation of organic matter into inorganic carbon and adsorption of organic matter onto hydrous MnO 2 are suggested as the main processes responsible for coagulation improvement. Moreover, permanganate prevented the formation of Fe-peptide/protein complexes that inhibit coagulation at pH about 6.2 without pre-oxidation. The study showed that carefully optimized dosing of permanganate improves cyanobacterial peptide/protein removal, with the benefit of microcystin elimination. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. A preliminary study of opuntia stricta as a coagulant for turbidity removal in surface waters

    International Nuclear Information System (INIS)

    Mukhtar, A.

    2015-01-01

    Natural polymers, extracted from plants, can be used as coagulants for water treatment in addition to metal salts and synthetic polymers. Natural materials may offer benefits such as local production, lesser health hazards and affordability for developing world. Opuntia stricta plant, a cactus specie native to Mexico, has been explored in this study for its efficacy as coagulant. Efficiency of Opuntia stricta was assessed on the basis of turbidity removal from lab prepared and surface water samples. The effect of water pH on its performance was also analyzed. The study results revealed that removal efficiency of Opuntia stricta for turbidity removal remains consistent within a wide pH range (pH 5 to 10), in contrast to other coagulants which are pH dependent. Furthermore, pH of the water remains constant during coagulation and pH adjustment may not be required for subsequent treatment processes, which is often needed in case metal coagulants are used. Residual turbidity below 20 NTU is conveniently achieved by using Opuntia stricta even when it is used at very low doses. Formation of exceptionally large flocs and their linear configuration reveals the possibility that mechanism of coagulation by Opuntia stricta is adsorption and inter-particle bridging. (author)

  12. The mechanism and properties of acid-coagulated milk gels

    Directory of Open Access Journals (Sweden)

    Chanokphat Phadungath

    2005-03-01

    Full Text Available Acid-coagulated milk products such as fresh acid-coagulated cheese varieties and yogurt areimportant dairy food products. However, little is known regarding the mechanisms involved in gel formation, physical properties of acid gels, and the effects of processing variables such as heat treatment and gelation temperature on the important physical properties of acid milk gels. This paper reviews the modern concepts of possible mechanisms involved in the formation of particle milk gel aggregation, along with recent developments including the use of techniques such as dynamic low amplitude oscillatory rheology to observe the gel formation process, and confocal laser scanning microscopy to monitor gel microstructure.

  13. Perioperative blood transfusion as a poor prognostic factor after aggressive surgical resection for hilar cholangiocarcinoma.

    Science.gov (United States)

    Kimura, Norihisa; Toyoki, Yoshikazu; Ishido, Keinosuke; Kudo, Daisuke; Yakoshi, Yuta; Tsutsumi, Shinji; Miura, Takuya; Wakiya, Taiichi; Hakamada, Kenichi

    2015-05-01

    Blood transfusion is linked to a negative outcome for malignant tumors. The aim of this study was to evaluate aggressive surgical resection for hilar cholangiocarcinoma (HCCA) and assess the impact of perioperative blood transfusion on long-term survival. Sixty-six consecutive major hepatectomies with en bloc resection of the caudate lobe and extrahepatic bile duct for HCCA were performed using macroscopically curative resection at our institute from 2002 to 2012. Clinicopathologic factors for recurrence and survival were retrospectively assessed. Overall survival rates at 1, 3, and 5 years were 86.7, 47.3, and 35.7 %, respectively. In univariate analysis, perioperative blood transfusion and a histological positive margin were two of several variables found to be significant prognostic factors for recurrence or survival (Pblood transfusion was independently associated with recurrence (hazard ratio (HR)=2.839 (95 % confidence interval (CI), 1.370-5.884), P=0.005), while perioperative blood transfusion (HR=3.383 (95 % CI, 1.499-7.637), P=0.003) and R1 resection (HR=3.125 (95 % CI, 1.025-9.530), P=0.045) were independent risk factors for poor survival. Perioperative blood transfusion is a strong predictor of poor survival after radical hepatectomy for HCCA. We suggest that circumvention of perioperative blood transfusion can play an important role in long-term survival for patients with HCCA.

  14. EVALUATION OF PERIODONTAL TISSUES CONDITION IN CHILDREN WITH BLOOD COAGULABILITY PATHOLOGY

    Directory of Open Access Journals (Sweden)

    M. A. Gavrilenko

    2013-12-01

    Full Text Available Background. Actuality of the problem is determined by the high prevalence of inflammatory diseases of periodontal tissues in children with blood pathology (100%. Primary prevention of dental caries and periodontal diseases has the exceptional importance in the dentist’s work with children who have blood coagulability disorders. Prevention of dental diseases of the oral cavity in this category of patients has a number of features because there is the risk of bleeding during both home oral hygiene and professional hygiene. Exogenous prevention (fluoride-containing gels, varnishes, solutions, sealants also has its own peculiarities in these children. On the other hand, the impossibility of preventive measures implementation is the significant factor in the pathogenesis of gingivitis and subsequently periodontitis in children with disorders of blood coagulability. Aim. To examine the status of oral hygiene in children with blood coagulability disorders. To examine the severity of inflammatory and destructive changes in the periodontal tissues in children with disorders of blood coagulability. To investigate timing and frequency of oral hygiene implementation in children with disorders of blood coagulability. To reveal the interrelations between the intensity, prevalence of periodontal tissues disorders in children with blood coagulability pathology and the periods of tooth development, taking into account the influence of risk factors and frequency of oral hygiene. Materials and methods. 120 children between 2 and 18 years old with blood coagulability disorders (hemophilia A, B, thrombocytopenia, thrombocytopathy were examined. Children were divided into following age groups: I – 2-5 years old (40 children, II – 6-10 years old (40 children, III – 11-18 years old (40 children, according to the periods of tooth development, with an equal number of children in groups according to diagnoses. Hygiene index value was determined according to

  15. Evaluation of periodontal tissues condition in children with blood coagulability pathology

    Directory of Open Access Journals (Sweden)

    M. A. Gavrilenko

    2013-12-01

    Full Text Available Background. Actuality of the problem is determined by the high prevalence of inflammatory diseases of periodontal tissues in children with blood pathology (100%. Primary prevention of dental caries and periodontal diseases has the exceptional importance in the dentist’s work with children who have blood coagulability disorders. Prevention of dental diseases of the oral cavity in this category of patients has a number of features because there is the risk of bleeding during both home oral hygiene and professional hygiene. Exogenous prevention (fluoride-containing gels, varnishes, solutions, sealants also has its own peculiarities in these children. On the other hand, the impossibility of preventive measures implementation is the significant factor in the pathogenesis of gingivitis and subsequently periodontitis in children with disorders of blood coagulability. Aim.To examine the status of oral hygiene in children with blood coagulability disorders.To examine the severity of inflammatory and destructive changes in the periodontal tissues in children with disorders of blood coagulability. To investigate timing and frequency of oral hygiene implementation in children with disorders of blood coagulability. To reveal the interrelations between the intensity, prevalence of periodontal tissues disorders in children with blood coagulability pathology and the periods of tooth development, taking into account the influence of risk factors and frequency of oral hygiene. Materials and methods. 120 children between 2 and 18 years old with blood coagulability disorders (hemophilia A, B, thrombocytopenia, thrombocytopathy were examined. Children were divided into following age groups: I – 2-5 years old (40 children, II – 6-10 years old (40 children, III – 11-18 years old (40 children, according to the periods of tooth development, with an equal number of children in groups according to diagnoses. Hygiene index value was determined according to Fedorov

  16. Influence of ionizing radiation and 12-crown-4 on coagulation system components of rat blood

    International Nuclear Information System (INIS)

    Kratenko, R.Yi.

    2006-01-01

    The influence of 12-crown-4 and ionizing radiation on some components of blood coagulation system: Ca 2+ contents and prostaglandin concentrations in the blood serum, and erythrocyte contents in the blood plasma are studied. The influence of 12-crown-4 and ionizing radiation increases the coagulational properties of erythrocytes. The synergism of ionizing irradiation and 12-crown-4 influence blood coagulation process points out at the occurrence of radiomimetic properties of the latter

  17. Rapid removal of fine particles from mine water using sequential processes of coagulation and flocculation.

    Science.gov (United States)

    Jang, Min; Lee, Hyun-Ju; Shim, Yonsik

    2010-04-01

    The processes of coagulation and flocculation using high molecular weight long-chain polymers were applied to treat mine water having fine flocs of which about 93% of the total mass was less than 3.02 microm, representing the size distribution of fine particles. Six different combinations of acryl-type anionic flocculants and polyamine-type cationic coagulants were selected to conduct kinetic tests on turbidity removal in mine water. Optimization studies on the types and concentrations of the coagulant and flocculant showed that the highest rate of turbidity removal was obtained with 10 mg L(-1) FL-2949 (coagulant) and 12 mg L(-1) A333E (flocculant), which was about 14.4 and 866.7 times higher than that obtained with A333E alone and that obtained through natural precipitation by gravity, respectively. With this optimized condition, the turbidity of mine water was reduced to 0 NTU within 20 min. Zeta potential measurements were conducted to elucidate the removal mechanism of the fine particles, and they revealed that there was a strong linear relationship between the removal rate of each pair of coagulant and flocculant application and the zeta potential differences that were obtained by subtracting the zeta potential of flocculant-treated mine water from the zeta potential of coagulant-treated mine water. Accordingly, through an optimization process, coagulation-flocculation by use of polymers could be advantageous to mine water treatment, because the process rapidly removes fine particles in mine water and only requires a small-scale plant for set-up purposes owing to the short retention time in the process.

  18. Variation in Medicare Expenditures for Treating Perioperative Complications: The Cost of Rescue.

    Science.gov (United States)

    Pradarelli, Jason C; Healy, Mark A; Osborne, Nicholas H; Ghaferi, Amir A; Dimick, Justin B; Nathan, Hari

    2016-12-21

    Treating surgical complications presents a major challenge for hospitals striving to deliver high-quality care while reducing costs. Costs associated with rescuing patients from perioperative complications are poorly characterized. To evaluate differences across hospitals in the costs of care for patients surviving perioperative complications after major inpatient surgery. Retrospective cohort study using claims data from the Medicare Provider Analysis and Review files. We compared payments for patients who died vs patients who survived after perioperative complications occurred. Hospitals were stratified using average payments for patients who survived following complications, and payment components were analyzed across hospitals. Administrative claims database of surgical patients was analyzed at hospitals treating Medicare patients nationwide. This study included Medicare patients aged 65 to 100 years who underwent abdominal aortic aneurysm repair (n = 69 207), colectomy for cancer (n = 107 647), pulmonary resection (n = 91 758), and total hip replacement (n = 307 399) between 2009 and 2012. Data analysis took place between November 2015 and March 2016. Clinical outcome of surgery (eg, no complication, complication and death, or complication and survival) and the individual hospital where a patient received an operation. Risk-adjusted, price-standardized Medicare payments for an episode of surgery. Risk-adjusted perioperative outcomes were also assessed. The mean age for Medicare beneficiaries in this study ranged from 74.1 years (pulmonary resection) to 78.2 years (colectomy). The proportion of male patients ranged from 37% (total hip replacement) to 77% (abdominal aortic aneurysm repair), and most patients were white. Among patients who experienced complications, those who were rescued had higher price-standardized Medicare payments than did those who died for all 4 operations. Assessing variation across hospitals, payments for patients

  19. Pretreatment of palm oil mill effluent (POME) using Moringa oleifera seeds as natural coagulant.

    Science.gov (United States)

    Bhatia, Subhash; Othman, Zalina; Ahmad, Abdul Latif

    2007-06-25

    Moringa oleifera seeds, an environmental friendly and natural coagulant are reported for the pretreatment of palm oil mill effluent (POME). In coagulation-flocculation process, the M. oleifera seeds after oil extraction (MOAE) are an effective coagulant with the removal of 95% suspended solids and 52.2% reduction in the chemical oxygen demand (COD). The combination of MOAE with flocculant (NALCO 7751), the suspended solids removal increased to 99.3% and COD reduction was 52.5%. The coagulation-flocculation process at the temperature of 30 degrees C resulted in better suspended solids removal and COD reduction compared to the temperature of 40, 55 and 70 degrees C. The MOAE combined with flocculant (NALCO 7751) reduced the sludge volume index (SVI) to 210mL/g with higher recovery of dry mass of sludge (87.25%) and water (50.3%).

  20. Robot-assisted partial nephrectomy for hilar tumors: perioperative outcomes.

    Science.gov (United States)

    Eyraud, Rémi; Long, Jean-Alexandre; Snow-Lisy, Devon; Autorino, Riccardo; Hillyer, Shahab; Klink, Joseph; Rizkala, Emad; Stein, Robert J; Kaouk, Jihad H; Haber, Georges-Pascal

    2013-06-01

    To compare perioperative outcomes of robot-assisted partial nephrectomy (RAPN) for hilar vs nonhilar tumors. The study retrospectively reviewed 364 patients with available computed tomography scans undergoing RAPN. Demographic data and perioperative outcomes results were compared between the hilar (group 1, n = 70) and nonhilar tumors (group 2, n = 294). Multivariate analysis was used to identify predictors of warm ischemia time (WIT), estimated blood loss (EBL), major perioperative complications, and postoperative renal function. There were no differences with respect to demographic variables. Hilar tumors had higher RENAL (radius, exophytic/endophytic properties of the tumor, nearness of tumor deepest portion to the collecting system or sinus, anterior/posterior descriptor and the location relative to polar lines) scores (P hilar tumors were associated with greater operative time (210 vs 180 minutes, P hilar vs nonhilar patients on postoperative day 3 (70.12 vs 74.71 mL/min/1.73 m(2), P = .31) or at last follow-up (72.62 vs 75.78 mL/min/1.73 m(2), P = .40), respectively. Multivariate analysis found hilar location was independently associated with increased WIT without significant changes in EBL, major complications, or postoperative renal function. RAPN represents a safe and effective procedure for hilar tumors. Hilar location for patients undergoing RAPN in a high-volume institution seems not be associated with an increased risk of transfusions, major complications, or decline of early postoperative renal function. Copyright © 2013 Elsevier Inc. All rights reserved.

  1. Perioperative Clinical Nurse Specialist Role Delineation: A Systematic Review

    National Research Council Canada - National Science Library

    Cole, Lisa M; Walker, Theodore J; Nader, Kelly C; Glover, Dennis E; Newkirk, Laura E

    2006-01-01

    A clearly defined role of the Perioperative Clinical Nurse Specialist (PONS) is not identified. The purpose of this study was to provide recommendations for a delineated role of the PONS that will provide role clarity and practice guidance...

  2. Blood coagulation and the risk of atherothrombosis: a complex relationship

    Directory of Open Access Journals (Sweden)

    van der Voort Danielle

    2004-12-01

    Full Text Available Abstract The principles of Virchov's triad appear to be operational in atherothrombosis or arterial thrombosis: local flow changes and particularly vacular wall damage are the main pathophysiological elements. Furthermore, alterations in arterial blood composition are also involved although the specific role and importance of blood coagulation is an ongoing matter of debate. In this review we provide support for the hypothesis that activated blood coagulation is an essential determinant of the risk of atherothrombotic complications. We distinguish two phases in atherosclerosis: In the first phase, atherosclerosis develops under influence of "classical" risk factors, i.e. both genetic and acquired forces. While fibrinogen/fibrin molecules participate in early plaque lesions, increased activity of systemic coagulation is of no major influence on the risk of arterial thrombosis, except in rare cases where a number of specific procoagulant forces collide. Despite the presence of tissue factor – factor VII complex it is unlikely that all fibrin in the atherosclerotic plaque is the direct result from local clotting activity. The dominant effect of coagulation in this phase is anticoagulant, i.e. thrombin enhances protein C activation through its binding to endothelial thrombomodulin. The second phase is characterized by advancing atherosclerosis, with greater impact of inflammation as indicated by an elevated level of plasma C-reactive protein, the result of increased production influenced by interleukin-6. Inflammation overwhelms protective anticoagulant forces, which in itself may have become less efficient due to down regulation of thrombomodulin and endothelial cell protein C receptor (EPCR expression. In this phase, the inflammatory drive leads to recurrent induction of tissue factor and assembly of catalytic complexes on aggregated cells and on microparticles, maintaining a certain level of thrombin production and fibrin formation. In advanced

  3. Does whole blood coagulation analysis reflect developmental haemostasis?

    DEFF Research Database (Denmark)

    Ravn, Hanne Berg; Andreasen, Jo Bønding; Hvas, Anne-Mette

    2017-01-01

    .05), but there was no sign of developmental changes in whole blood coagulation assessment when applying ROTEM, apart from clotting time in the EXTEM assay (P reach statistical significance. Citrate-anticoagulated blood showed...

  4. Emerging Risk Factors and Prevention of Perioperative Pulmonary Complications

    Directory of Open Access Journals (Sweden)

    Priyanka Bhateja

    2014-01-01

    Full Text Available Modern surgery is faced with the emergence of newer “risk factors” and the challenges associated with identifying and managing these risks in the perioperative period. Obstructive sleep apnea and obesity hypoventilation syndrome pose unique challenges in the perioperative setting. Recent studies have identified some of the specific risks arising from caring for such patients in the surgical setting. While all possible postoperative complications are not yet fully established or understood, the prevention and management of these complications pose even greater challenges. Pulmonary hypertension with its changing epidemiology and novel management strategies is another new disease for the surgeon and the anesthesiologist in the noncardiac surgical setting. Traditionally most such patients were not considered surgical candidates for any required elective surgery. Our review discusses these disease entities which are often undiagnosed before elective noncardiac surgery.

  5. Coagulation-Fenton coupled treatment for ecotoxicity reduction in highly polluted industrial wastewater.

    Science.gov (United States)

    Perdigón-Melón, J A; Carbajo, J B; Petre, A L; Rosal, R; García-Calvo, E

    2010-09-15

    A coupled coagulation-Fenton process was applied for the treatment of cosmetic industry effluents. In a first step, FeSO(4) was used as coagulant and the non-precipitated Fe(2+) remaining in dissolution was used as catalyst in the further Fenton process. In the coagulation process a huge decrease in total organic carbon (TOC) was achieved, but the high concentration of phenol derivatives was not diminished. The decrease in TOC in the coagulation step significantly reduces the amount of H(2)O(2) required in the Fenton process for phenol depletion. The coupled process, using a H(2)O(2) dose of only 2 g l(-1), reduced TOC and total phenol to values lower than 40 and 0.10 mg l(-1), respectively. The short reaction period (less than 15 min) in TOC and phenol degradation bodes well for improving treatment in a continuous regime. The combination of both processes significantly reduced the ecotoxicity of raw effluent and markedly increased its biodegradability, thus allowing easier treatment by the conventional biological units in conventional sewage treatment plants (STPs). Copyright 2010 Elsevier B.V. All rights reserved.

  6. Ultrasound imaging of Nd:YAG laser-induced tissue coagulation in porcine livers.

    Science.gov (United States)

    Ritzel, U; Wietzke-Braun, P; Brinck, U; Leonhardt, U; Ramadori, G

    2001-12-01

    Absorption of laser light energy induces denaturation of proteins and thermocoagulation of irradiated tissue. Recently, MRI-guided laser coagulation in combination with MR thermometry was reported as a treatment of liver tumours. In the present study ultrasonographic imaging was evaluated for its suitability in laser induced tissue thermocoagulation. Fresh porcine livers were used for ex vivo examinations. Placement of the laser catheter and tissue coagulation during laser light emission were online monitored by ultrasonography. Nd:YAG laser-induced tissue damage was evaluated by macroscopical and microscopical examinations of histological sections. During laser light emission a marked hyperdense signal enhancement was observed by ultrasonography which strongly correlated with the extent of macroscopic tissue damage. The size of laser-induced coagulation zone depended on both the power setting and total energy delivered. Carbonization of the tissue surrounding the laser tip is a limiting factor because of laser light absorption. However our data indicate that using appropriate laser energy and exposure time prevent carbonization although carbonization can not be visualized by ultrasonography. It is concluded from the present ex vivo studies that laser coagulation can be effectively performed under ultrasonographic guidance.

  7. Cutting and coagulation during intraoral soft tissue surgery using Er: YAG laser.

    Science.gov (United States)

    Onisor, I; Pecie, R; Chaskelis, I; Krejci, I

    2013-06-01

    To find the optimal techniques and parameters that enables Er:YAG laser to be used successfully for small intraoral soft tissue interventions, in respect to its cutting and coagulation abilities. In vitro pre-tests: 4 different Er:YAG laser units and one CO2 unit as the control were used for incision and coagulation on porcine lower jaws and optimal parameters were established for each type of intervention and each laser unit: energy, frequency, type, pulse duration and distance. 3 different types of intervention using Er:YAG units are presented: crown lengthening, gingivoplasty and maxillary labial frenectomy with parameters found in the in vitro pre-tests. The results showed a great decrease of the EMG activity of masseter and anterior temporalis muscles. Moreover, the height and width of the chewing cycles in the frontal plane increased after therapy. Er:YAG is able to provide good cutting and coagulation effects on soft tissues. Specific parameters have to be defined for each laser unit in order to obtain the desired effect. Reduced or absent water spray, defocused light beam, local anaesthesia and the most effective use of long pulses are methods to obtain optimal coagulation and bleeding control.

  8. Extraction of natural coagulant from peanut seeds for treatment of turbid water

    International Nuclear Information System (INIS)

    Birima, A H; Desa, M N M; Muda, Z C; Hammad, H A

    2013-01-01

    This study investigates the potential of peanut seeds as an environmental friendly and natural coagulant for the treatment of high turbid water. The peanut seeds have been used after oil extraction; and the active coagulation component was extracted by distilled water and salt solution of different salt concentrations. The salts used were NaCl, KNO 3 , KCl, NH 4 Cl and NaNO 3 . Synthetic water with 200 NTU turbidity was used. Peanut extracted with NaCl (PC-NaCl) could effectively remove 92% of the 200 NTU turbidity using only 20 mg/l, while peanut seeds extracted with distilled water (PC-DW) could remove only 31.5% of the same turbidity with the same dosage. The coagulant dosage did not affected by the concentration of the salt solution, however, residual turbidity decreased with increasing the concentration of the salt; and the relationship was found to be a second order polynomial curve with R 2 of 0.9312. The other salts tested were also found to be good solvents to extract the active coagulation component with no much difference from NaCl solution in terms of efficiency.

  9. Student nurses' experiences of preserved dignity in perioperative practice - Part I.

    Science.gov (United States)

    Blomberg, Ann-Catrin; Willassen, Elin; von Post, Iréne; Lindwall, Lillemor

    2015-09-01

    In recent years, operating theatre nurse students' education focussed on ethical value issues and how the patient's dignity is respected in the perioperative practice. Health professionals are frequently confronted with ethical issues that can impact on patient's care during surgery. The objective of this study was to present what operating theatre nurse students experienced and interpreted as preserved dignity in perioperative practice. The study has a descriptive design with a hermeneutic approach. Data were collected using Flanagan's critical incident technique. Operating theatre nurse students from Sweden and Norway participated and collected data in 2011, after education in ethics and dignity. Data consisting of 47 written stories and the text were analysed with hermeneutical text interpretation. The study was conducted accordance with the Declaration of Helsinki and approved by a local University Ethics Research Committee. The findings revealed that students experienced that operating theatre nurses perserved patient's dignity in perioperative practice by being present for each other and making themselves known to the patient. Operating theatre nurses caring for the patient by being compassionate and preserved the patient privacy. The new understanding that emerged was that the operating theatre nurse students understood that the operating theatre nurse wanted to care for the patient like a human being. In the discussion, we have illuminated how professional ethics may be threatened by more pragmatic and utilitarian arguments contained in regulations and transplant act. Preserved dignity is an ethical and caring act. Ethical questions and how to preserve dignity in perioperative practice should be discussed more both in educations of healthcare professionals and in clinical practice. © The Author(s) 2014.

  10. SYSTEM OF PRECISE DOSING OF COAGULANT IN THE PULVERIZING AERATOR POWERED BY WIND USING FUZZY LOGIC

    Directory of Open Access Journals (Sweden)

    Andrzej Osuch

    2017-06-01

    Full Text Available One of the methods used to support land restoration lakes is the method of pulverizing aeration. Use of aerators powered exclusively by wind improves the condition of reservoirs, while not compromising the environment. The pulverizing aeration process drive is windy on the water aeration zone near bottom, while removing harmful gases anaerobic metabolism. Aerators of this type due to the unique method of operation also enable dosing of inactivation coagulants with oxygenated water to the depths of the lake. Mileage coagulant dosing can be made dependent on the speed of the wind, which has an impact on the performance of his work, because with the increase of wind speed dispensing valve coagulants should be stronger open. One of the methods for assessing the state of lakes is to measure water transparency. The softer visibility, the most likely state of the water is better. Dosage of coagulant so you can make the transparency of the water. Similarly, with increasing transparency water dispensing valve should be more covered up. Control of the drain valve dispenser coagulant can be simultaneously dependent on two factors. The study was designed method of control drain valve dispenser coagulant using fuzzy inference.

  11. Studies on Removal of Dyes from wastewater using Electro-coagulation Process

    OpenAIRE

    N B. Patel; B D. Soni; J P. Ruparelia

    2000-01-01

    Electro-coagulation (EC) is one of the effective techniques to remove colour, COD and organic compounds from wastewater. In this paper electro coagulation technique has been used for the removal of colour and COD from dye solutions containing Direct Black 22 and Acid Red 97 using batch process. For batch the process effect of operational parameters such as current density, initial pH of the solution, time of electrolysis and electrode materials were studied to attempt max...

  12. Perioperative drug management. Reduction of potential drug-related problems in patients undergoing orthopaedic surgery by perioperative participation of a hospital pharmacist

    NARCIS (Netherlands)

    Duyvendak, M.; Bosman, J.; Klopotowska, J.; Kuiper-Herder, A.J.; Van Roon, E.N.; Brouwers, J.R.B.J.

    2007-01-01

    Objective: Drug management in the perioperative period is complex. Only little is known about the effects of clinical pharmaceutical care in this setting. The aim of this study was to determine the effect of a clinical pharmacy-based intervention on the number of potential drug-related problems in

  13. Particle counter as a tool to control pre-hydrolyzed coagulant dosing and rapid filtration efficiency in a conventional treatment system.

    Science.gov (United States)

    Gumińska, Jolanta; Kłos, Marcin

    2015-01-01

    Filtration efficiency in a conventional water treatment system was analyzed in the context of pre-hydrolyzed coagulant overdosing. Two commercial coagulants of different aluminum speciation were tested. A study was carried out at a water treatment plant supplied with raw water of variable quality. The lack of stability of water quality caused many problems with maintaining the optimal coagulant dose. The achieved results show that the type of coagulant had a very strong influence on the effectiveness of filtration resulting from the application of an improper coagulant dose. The overdosing of high basicity coagulant (PAC85) caused a significant increase of fine particles in the outflow from the sedimentation tanks, which could not be retained in the filter bed due to high surface charge and the small size of hydrolysis products. When using a coagulant of lower basicity (PAC70), it was much easier to control the dose of coagulant and to adjust it to the changing water quality.

  14. Investigation of isolation conditions and ion-exchange purification of protein coagulation components from common bean seed

    Directory of Open Access Journals (Sweden)

    Antov Mirjana G.

    2007-01-01

    Full Text Available Investigation of an extraction procedure of protein coagulants from common bean seed regarding concentration of NaCl and pH was performed. High values of protein concentration and coagulation activity in crude extract (9.19 g/l and 23.9%, respectively were obtained when the extraction was performed using 0.5 mol/l NaCl and water as solvent, which represents an advantage for economic and environmental reasons. Crude extract of common bean seed was purified by precipitation at two different percentages of (NH42SO4 saturation, followed by batch ion-exchange chromatography. The highest obtained coagulation activity, 45%, was determined in fraction that was eluated at 1.75 mol/l NaCl from resin loaded with proteins precipitated upon 80-100% (NH42SO4 saturation. High values of coagulation activity showed by some eluates suggest their application as natural coagulant for water purification. .

  15. Australian perioperative nurses' experiences of assisting in multi-organ procurement surgery: a grounded theory study.

    Science.gov (United States)

    Smith, Zaneta; Leslie, Gavin; Wynaden, Dianne

    2015-03-01

    Multi-organ procurement surgical procedures through the generosity of deceased organ donors, have made an enormous impact on extending the lives of recipients. There is a dearth of in-depth knowledge relating to the experiences of perioperative nurses working closely with organ donors undergoing multi-organ procurement surgical procedures. The aim of this study was to address this gap by describing the perioperative nurses experiences of participating in multi-organ procurement surgical procedures and interpreting these findings as a substantive theory. This qualitative study used grounded theory methodology to generate a substantive theory of the experiences of perioperative nurses participating in multi-organ procurement surgery. Recruitment of participants took place after the study was advertised via a professional newsletter and journal. The study was conducted with participants from metropolitan, rural and regional areas of two Australian states; New South Wales and Western Australia. Thirty five perioperative nurse participants with three to 39 years of professional nursing experience informed the study. Semi structured in-depth interviews were undertaken from July 2009 to April 2010 with a mean interview time of 60 min. Interview data was transcribed verbatim and analysed using the constant comparative method. The study results draw attention to the complexities that exist for perioperative nurses when participating in multi-organ procurement surgical procedures reporting a basic social psychological problem articulated as hiding behind a mask and how they resolved this problem by the basic social psychological process of finding meaning. This study provides a greater understanding of how these surgical procedures impact on perioperative nurses by providing a substantive theory of this experience. The findings have the potential to guide further research into this challenging area of nursing practice with implications for clinical initiatives, management

  16. Enzymatic lipid oxidation by eosinophils propagates coagulation, hemostasis, and thrombotic disease

    Science.gov (United States)

    Uderhardt, Stefan; Ackermann, Jochen A.; Fillep, Tobias; Hammond, Victoria J.; Willeit, Johann; Stark, Konstantin; Rossaint, Jan; Schubert, Irene; Mielenz, Dirk; Dietel, Barbara; Raaz-Schrauder, Dorette; Ay, Cihan; Thaler, Johannes; Heim, Christian; Collins, Peter W.; Schabbauer, Gernot; Mackman, Nigel; Voehringer, David; Nadler, Jerry L.; Lee, James J.; Massberg, Steffen; Rauh, Manfred; O’Donnell, Valerie B.

    2017-01-01

    Blood coagulation is essential for physiological hemostasis but simultaneously contributes to thrombotic disease. However, molecular and cellular events controlling initiation and propagation of coagulation are still incompletely understood. In this study, we demonstrate an unexpected role of eosinophils during plasmatic coagulation, hemostasis, and thrombosis. Using a large-scale epidemiological approach, we identified eosinophil cationic protein as an independent and predictive risk factor for thrombotic events in humans. Concurrent experiments showed that eosinophils contributed to intravascular thrombosis by exhibiting a strong endogenous thrombin-generation capacity that relied on the enzymatic generation and active provision of a procoagulant phospholipid surface enriched in 12/15-lipoxygenase–derived hydroxyeicosatetraenoic acid–phosphatidylethanolamines. Our findings reveal a previously unrecognized role of eosinophils and enzymatic lipid oxidation as regulatory elements that facilitate both hemostasis and thrombosis in response to vascular injury, thus identifying promising new targets for the treatment of thrombotic disease. PMID:28566277

  17. Effects of coagulating enzyme types (commercial calf rennet ...

    African Journals Online (AJOL)

    Aysegul

    2013-09-11

    clotting enzyme in traditional cheese-making world- wide (Fox, 1987 ... Following pre-brining, the cheeses were packaged in plastic cups (1 kg) containing ..... study the differential degradation of αs-casein by various coagulants.

  18. Impact of surgical case order on perioperative outcomes for robotic-assisted radical prostatectomy

    Directory of Open Access Journals (Sweden)

    Anil A Thomas

    2014-01-01

    Conclusions: Surgical case order may influence perioperative outcomes for RARP with decreased operative times and increased length of hospital stay associated with later cases. These findings indicate that select perioperative factors may improve with ascending case order as the surgical team "warms up" during the day. In addition, 3 rd round cases can increase hospital costs associated with increased lengths of hospital stay. Knowledge of these differences may assist in surgical planning to improve outcomes and limit costs.

  19. Coagulation system changes associated with susceptibility to infection in trauma patients.

    Science.gov (United States)

    Cole, Elaine; Davenport, Ross; De'Ath, Henry; De-Ath, Henry; Manson, Joanna; Brockamp, Thomas; Brohi, Karim

    2013-01-01

    Infection following trauma is associated with increased morbidity and mortality and is common following severe hemorrhage. There is a strong interaction between the coagulation and immunity. The objective of this study was to establish if there was an association between changes in coagulation status after hemorrhage and the subsequent incidence of infection. Prospective cohort study of adult injured patients presenting to a major trauma center during a 2-year period. Blood was drawn at 24 hours following admission and analyzed using functional thromboelastography testing and laboratory defined tests of coagulation and blood count. Patients were followed up for infectious episodes while in the hospital using Center for Disease Control definitions. A total of 158 patients were recruited; 71 (45%) developed infection and were older (44 years vs. 32 years, p = 0.01) and more severely injured (Injury Severity Score [ISS], 25 vs.10; p < 0.01). White blood cell counts at 24 hours were normal, and there was no difference between groups (both 9.6 × 10/(9)L). Protein C was lower in those with infection (70.2 IU/dL vs. 83.3 IU/dL, p = 0.02), with a dose-dependent increase in infection as levels of protein C decreased. Plasmin activation at 24 hours was also strongly associated with infection plasmin-antiplasmin (infection vs. no infection, 6,156 μg/L vs. 3,324 μg/L, p = 0.03). The infection cohort had overall 12% lower procoagulant levels (varied between factor VIII 6.4% and factor II 16.2%). There is a strong association between the status of the coagulation system after 24 hours and the development of infection following trauma. Improved early coagulation management may decrease infection rates in this patient group. Prognostic prospective study, level III.

  20. USE OF BETA-BLOCKERS IN THE PERIOPERATIVE PERIOD: HOW STRONG ARE THE EVIDENCES?

    Directory of Open Access Journals (Sweden)

    V. V. Samoylenko

    2015-09-01

    Full Text Available Optimization of the pharmacotherapy in preoperative period is the cornerstone of the concept of risk modification of cardiovascular complications in the perioperative period. Therefore, special attention has recently been focused on the use of beta-blockers in the postoperative period. Nowadays convincing evidence base for the use of this class of drugs in the perioperative period that was the basis for the development of clinical guidelines is accumulated. Moreover, results of large randomized trials of beta-blockers are controversial. This has resulted in significant differences in the classes of recommendations and levels of evidence.Analysis of the results of basic researches and the provisions of recommendations of the international and national professional medical societies on the use of beta-blockers in patients with cardiovascular disease to reduce the risk of cardiac complications in the perioperative period for planned extracardiac surgical procedures is presented.

  1. Competing role of catalysis-coagulation and catalysis-fragmentation in kinetic aggregation behaviours

    International Nuclear Information System (INIS)

    Li Xiao-Dong; Lin Zhen-Quan; Song Mei-Xia; Ke Jian-Hong

    2010-01-01

    We propose a kinetic aggregation model where species A aggregates evolve by the catalysis-coagulation and the catalysis-fragmentation, while the catalyst aggregates of the same species B or C perform self-coagulation processes. By means of the generalized Smoluchowski rate equation based on the mean-field assumption, we study the kinetic behaviours of the system with the catalysis-coagulation rate kernel K(i,j;l) ∝ l ν and the catalysis-fragmentation rate kernel F(i,j;l) ∝ l μ , where l is the size of the catalyst aggregate, and ν and μ are two parameters reflecting the dependence of the catalysis reaction on the size of the catalyst aggregate. The relation between the values of parameters ν and μ reflects the competing roles between the two catalysis processes in the kinetic evolution of species A. It is found that the competing roles of the catalysis-coagulation and catalysis-fragmentation in the kinetic aggregation behaviours are not determined simply by the relation between the two parameters ν and μ, but also depend on the values of these two parameters. When ν > μ and ν ≥ 0, the kinetic evolution of species A is dominated by the catalysis-coagulation and its aggregate size distribution a k (t) obeys the conventional or generalized scaling law; when ν k (t) approaches the scale-free form; and in other cases, a balance is established between the two competing processes at large times and a k (t) obeys a modified scaling law. (cross-disciplinary physics and related areas of science and technology)

  2. Treatment of Surface water in lebanon by using the coagulation-flocculation procedure

    International Nuclear Information System (INIS)

    SLIM, K.; Saad, Z.; Kazpard, V.; El Samarani, A.

    2005-01-01

    In the absence of application of environmental protection laws in Lebanon. Anthropic effluents are directly discharged in the course of rivers. More specially two coastal rivers (GHadir and Ibrahim)located near Beirut. Treatment of these surface waters is done by coagulation-flocculation process by using Al13 coagulant. The elimination of suspended matters in Ghadir and Ibrahim rivers is studied by simple jar test coupled to measurement of supernatant turbidity and sediment volume. Physical and chemical parameters of water before and after treatment are given by Atomic absorption and ion chromatography analysis. The optimal coagulation concentration of Al was defined relatively to lowest concentration of Aluminum needed for maximum turbidity removal in treated water. This study showed that hydrolysis of aluminum salts before adding to water is relevant to the use of similar quantities of Al for the coagulation-flocculation process that eliminates primarily suspended matter in river. Restabilisation is shown in all Jar tests of Ibrahim river, but not in Ghadir where buffering effect is elevated. Results also showed that waters with low turbidity request low concentration of aluminum for the destabilization process. For this, Ibrahim water treatment was found better than river Ghadir characterized by higher inputs of anthropogenic effluents in its course. In all cases, cationic exchanges with Al 1 3 polycations within the sediments caused the release of calcium and the elevation of its concentration in the supernatant. Sulfate concentration diminished continuously in supernatant after the addition of the optimal coagulation concentration of aluminum. (author)

  3. Weighted Flow Algorithms (WFA) for stochastic particle coagulation

    International Nuclear Information System (INIS)

    DeVille, R.E.L.; Riemer, N.; West, M.

    2011-01-01

    Stochastic particle-resolved methods are a useful way to compute the time evolution of the multi-dimensional size distribution of atmospheric aerosol particles. An effective approach to improve the efficiency of such models is the use of weighted computational particles. Here we introduce particle weighting functions that are power laws in particle size to the recently-developed particle-resolved model PartMC-MOSAIC and present the mathematical formalism of these Weighted Flow Algorithms (WFA) for particle coagulation and growth. We apply this to an urban plume scenario that simulates a particle population undergoing emission of different particle types, dilution, coagulation and aerosol chemistry along a Lagrangian trajectory. We quantify the performance of the Weighted Flow Algorithm for number and mass-based quantities of relevance for atmospheric sciences applications.

  4. Weighted Flow Algorithms (WFA) for stochastic particle coagulation

    Science.gov (United States)

    DeVille, R. E. L.; Riemer, N.; West, M.

    2011-09-01

    Stochastic particle-resolved methods are a useful way to compute the time evolution of the multi-dimensional size distribution of atmospheric aerosol particles. An effective approach to improve the efficiency of such models is the use of weighted computational particles. Here we introduce particle weighting functions that are power laws in particle size to the recently-developed particle-resolved model PartMC-MOSAIC and present the mathematical formalism of these Weighted Flow Algorithms (WFA) for particle coagulation and growth. We apply this to an urban plume scenario that simulates a particle population undergoing emission of different particle types, dilution, coagulation and aerosol chemistry along a Lagrangian trajectory. We quantify the performance of the Weighted Flow Algorithm for number and mass-based quantities of relevance for atmospheric sciences applications.

  5. Slaughterhouse wastewater treatment by combined chemical coagulation and electrocoagulation process.

    Science.gov (United States)

    Bazrafshan, Edris; Kord Mostafapour, Ferdos; Farzadkia, Mehdi; Ownagh, Kamal Aldin; Mahvi, Amir Hossein

    2012-01-01

    Slaughterhouse wastewater contains various and high amounts of organic matter (e.g., proteins, blood, fat and lard). In order to produce an effluent suitable for stream discharge, chemical coagulation and electrocoagulation techniques have been particularly explored at the laboratory pilot scale for organic compounds removal from slaughterhouse effluent. The purpose of this work was to investigate the feasibility of treating cattle-slaughterhouse wastewater by combined chemical coagulation and electrocoagulation process to achieve the required standards. The influence of the operating variables such as coagulant dose, electrical potential and reaction time on the removal efficiencies of major pollutants was determined. The rate of removal of pollutants linearly increased with increasing doses of PACl and applied voltage. COD and BOD(5) removal of more than 99% was obtained by adding 100 mg/L PACl and applied voltage 40 V. The experiments demonstrated the effectiveness of chemical and electrochemical techniques for the treatment of slaughterhouse wastewaters. Consequently, combined processes are inferred to be superior to electrocoagulation alone for the removal of both organic and inorganic compounds from cattle-slaughterhouse wastewater.

  6. Neuro-Coagulopathy: Blood Coagulation Factors in Central Nervous System Diseases.

    Science.gov (United States)

    De Luca, Ciro; Virtuoso, Assunta; Maggio, Nicola; Papa, Michele

    2017-10-12

    Blood coagulation factors and other proteins, with modulatory effects or modulated by the coagulation cascade have been reported to affect the pathophysiology of the central nervous system (CNS). The protease-activated receptors (PARs) pathway can be considered the central hub of this regulatory network, mainly through thrombin or activated protein C (aPC). These proteins, in fact, showed peculiar properties, being able to interfere with synaptic homeostasis other than coagulation itself. These specific functions modulate neuronal networks, acting both on resident (neurons, astrocytes, and microglia) as well as circulating immune system cells and the extracellular matrix. The pleiotropy of these effects is produced through different receptors, expressed in various cell types, in a dose- and time-dependent pattern. We reviewed how these pathways may be involved in neurodegenerative diseases (amyotrophic lateral sclerosis, Alzheimer's and Parkinson's diseases), multiple sclerosis, ischemic stroke and post-ischemic epilepsy, CNS cancer, addiction, and mental health. These data open up a new path for the potential therapeutic use of the agonist/antagonist of these proteins in the management of several central nervous system diseases.

  7. Slaughterhouse Wastewater Treatment by Combined Chemical Coagulation and Electrocoagulation Process

    Science.gov (United States)

    Bazrafshan, Edris; Kord Mostafapour, Ferdos; Farzadkia, Mehdi; Ownagh, Kamal Aldin; Mahvi, Amir Hossein

    2012-01-01

    Slaughterhouse wastewater contains various and high amounts of organic matter (e.g., proteins, blood, fat and lard). In order to produce an effluent suitable for stream discharge, chemical coagulation and electrocoagulation techniques have been particularly explored at the laboratory pilot scale for organic compounds removal from slaughterhouse effluent. The purpose of this work was to investigate the feasibility of treating cattle-slaughterhouse wastewater by combined chemical coagulation and electrocoagulation process to achieve the required standards. The influence of the operating variables such as coagulant dose, electrical potential and reaction time on the removal efficiencies of major pollutants was determined. The rate of removal of pollutants linearly increased with increasing doses of PACl and applied voltage. COD and BOD5 removal of more than 99% was obtained by adding 100 mg/L PACl and applied voltage 40 V. The experiments demonstrated the effectiveness of chemical and electrochemical techniques for the treatment of slaughterhouse wastewaters. Consequently, combined processes are inferred to be superior to electrocoagulation alone for the removal of both organic and inorganic compounds from cattle-slaughterhouse wastewater. PMID:22768233

  8. Current aspects of perioperative fluid handling in vascular surgery

    NARCIS (Netherlands)

    Jacob, Matthias; Chappell, Daniel; Hollmann, Markus W.

    2009-01-01

    Purpose of review Perioperative fluid management influences patient outcome. Vascular surgery unites various surgical procedures, mainly with a high impact on patients who often have relevant preexisting illnesses. There are only scarce data on this specialty, forcing the clinician to extrapolate

  9. Coagulation-agglomeration of fractal-like particles: structure and self-preserving size distribution.

    Science.gov (United States)

    Goudeli, Eirini; Eggersdorfer, Maximilian L; Pratsinis, Sotiris E

    2015-02-03

    Agglomeration occurs in environmental and industrial processes, especially at low temperatures where particle sintering or coalescence is rather slow. Here, the growth and structure of particles undergoing agglomeration (coagulation in the absence of coalescence, condensation, or surface growth) are investigated from the free molecular to the continuum regime by discrete element modeling (DEM). Particles coagulating in the free molecular regime follow ballistic trajectories described by an event-driven method, whereas in the near-continuum (gas-slip) and continuum regimes, Langevin dynamics describe their diffusive motion. Agglomerates containing about 10-30 primary particles, on the average, attain their asymptotic fractal dimension, D(f), of 1.91 or 1.78 by ballistic or diffusion-limited cluster-cluster agglomeration, corresponding to coagulation in the free molecular or continuum regimes, respectively. A correlation is proposed for the asymptotic evolution of agglomerate D(f) as a function of the average number of constituent primary particles, n̅(p). Agglomerates exhibit considerably broader self-preserving size distribution (SPSD) by coagulation than spherical particles: the number-based geometric standard deviations of the SPSD agglomerate radius of gyration in the free molecular and continuum regimes are 2.27 and 1.95, respectively, compared to ∼1.45 for spheres. In the transition regime, agglomerates exhibit a quasi-SPSD whose geometric standard deviation passes through a minimum at Knudsen number Kn ≈ 0.2. In contrast, the asymptotic D(f) shifts linearly from 1.91 in the free molecular regime to 1.78 in the continuum regime. Population balance models using the radius of gyration as collision radius underestimate (up to about 80%) the small tail of the SPSD and slightly overpredict the overall agglomerate coagulation rate, as they do not account for cluster interpenetration during coagulation. In the continuum regime, when a recently developed

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

    African Journals Online (AJOL)

    hope&shola

    2- concentrations for the treated water conforms to the Tanzanian Standards and WHO guidelines for drinking ... that S. incunum is promising as coagulant and disinfectant product for water purification. Key words: .... light greenish blue-grey.

  11. Effect of peri-operative chemotherapy on the quality of life of patients with early breast cancer

    NARCIS (Netherlands)

    Kiebert, G. M.; Hanneke, J.; de Haes, J. Hanneke C. J. M.; Kievit, J.; van de Velde, C. J.

    1990-01-01

    Since chemotherapy is assumed to have a negative impact on quality of life, the impact of peri-operative chemotherapy on physical, psychological and social well-being and on the activity level of patients with early stage breast cancer was investigated. 24 women received peri-operative chemotherapy

  12. TREATMENT OF LANDFILL LEACHATE BY COUPLING COAGULATION-FLOCCULATION OR OZONATION TO GRANULAR ACTIVATED CARBON ADSORPTION.

    Science.gov (United States)

    Oloibiri, Violet; Ufomba, Innocent; Chys, Michael; Audenaert, Wim; Demeestere, Kristof; Van Hulle, Stijn W H

    2015-01-01

    A major concern for landfilling facilities is the treatment of their leachate. To optimize organic matter removal from this leachate, the combination of two or more techniques is preferred in order to meet stringent effluent standards. In our study, coagulation-flocculation and ozonation are compared as pre- treatment steps for stabilized landfill leachate prior to granular activated carbon (GAC) adsorption. The efficiency of the pre treatment techniques is evaluated using COD and UVA254 measurements. For coagulation- flocculation, different chemicals are compared and optimal dosages are determined. After this, iron (III) chloride is selected for subsequent adsorption studies due to its high percentage of COD and UVA254 removal and good sludge settle-ability. Our finding show that ozonation as a single treatment is effective in reducing COD in landfill leachate by 66% compared to coagulation flocculation (33%). Meanwhile, coagulation performs better in UVA254 reduction than ozonation. Subsequent GAC adsorption of ozonated effluent, coagulated effluent and untreated leachate resulted in 77%, 53% and 8% total COD removal respectively (after 6 bed volumes). The effect of the pre-treatment techniques on GAC adsorption properties is evaluated experimentally and mathematically using Thomas and Yoon-Nelson models. Mathematical modelling of the experimental GAC adsorption data shows that ozonation increases the adsorption capacity and break through time with a factor of 2.5 compared to coagulation-flocculation.

  13. Temperature effects on flocculation, using different coagulants.

    Science.gov (United States)

    Fitzpatrick, C S B; Fradin, E; Gregory, J

    2004-01-01

    Temperature is known to affect flocculation and filter performance. Jar tests have been conducted in the laboratory, using a photometric dispersion analyser (PDA) to assess the effects of temperature on floc formation, breakage and reformation. Alum, ferric sulphate and three polyaluminium chloride (PACI) coagulants have been investigated for temperatures ranging between 6 and 29 degrees C for a suspension of kaolin clay in London tap water. Results confirm that floc formation is slower at lower temperatures for all coagulants. A commercial PACl product, PAX XL 19, produces the largest flocs for all temperatures; and alum the smallest. Increasing the shear rate results in floc breakage in all cases and the flocs never reform to their original size. This effect is most notable for temperatures around 15 degrees C. Breakage, in terms of floc size reduction, is greater for higher temperatures, suggesting a weaker floc. Recovery after increased shear is greater at lower temperatures implying that floc break-up is more reversible for lower temperatures.

  14. Comparative Evaluation of Aluminum Sulfate and Ferric Sulfate-Induced Coagulations as Pretreatment of Microfiltration for Treatment of Surface Water

    Directory of Open Access Journals (Sweden)

    Yali Song

    2015-06-01

    Full Text Available Two coagulants, aluminum sulfate and ferric chloride, were tested to reduce natural organic matter (NOM as a pretreatment prior to polyvinylidene fluoride (PVDF microfiltration (MF membranes for potable water treatment. The results showed that the two coagulants exhibited different treatment performance in NOM removal. Molecular weight (MW distributions of NOM in the tested surface raw water were concentrated at 3–5 kDa and approximately 0.2 kDa. Regardless of the coagulant species and dosages, the removal of 0.2 kDa NOM molecules was limited. In contrast, NOM at 3–5 kDa were readily removed with increasing coagulant dosages. In particular, aluminum sulfate favorably removed NOM near 5 kDa, whereas ferric chloride tended to reduce 3 kDa organic substances. Although aluminum sulfate and ferric chloride could improve the flux of the ensuing MF treatment, the optimal coagulant dosages to achieve effective pretreatment were different: 2–30 mg/L for aluminum sulfate and >15 mg/L for ferric chloride. The scanning electron microscope (SEM image of the membrane-filtered coagulated raw water showed that coagulation efficiency dramatically affected membrane flux and that good coagulation properties can reduce membrane fouling.

  15. Perioperative antibiotic usage by facial plastic surgeons: national survey results and comparison with evidence-based guidelines.

    Science.gov (United States)

    Grunebaum, Lisa Danielle; Reiter, David

    2006-01-01

    To determine current practice for use of perioperative antibiotics among facial plastic surgeons, to determine the extent of use of literature support for preferences of facial plastic surgeons, and to compare patterns of use with nationally supported evidence-based guidelines. A link to a Web site containing a questionnaire on perioperative antibiotic use was e-mailed to more than 1000 facial plastic surgeons in the United States. Responses were archived in a dedicated database and analyzed to determine patterns of use and methods of documenting that use. Current literature was used to develop evidence-based recommendations for perioperative antibiotic use, emphasizing current nationally supported guidelines. Preferences varied significantly for medication used, dosage and regimen, time of first dose relative to incision time, setting in which medication was administered, and procedures for which perioperative antibiotic was deemed necessary. Surgical site infection in facial plastic surgery can be reduced by better conformance to currently available evidence-based guidelines. We offer specific recommendations that are supported by the current literature.

  16. Anti-Coagulant and Anti-Thrombotic Properties of Blacklip Abalone (Haliotis rubra): In Vitro and Animal Studies.

    Science.gov (United States)

    Suleria, Hafiz Ansar Rasul; Masci, Paul P; Zhao, Kong-Nan; Addepalli, Rama; Chen, Wei; Osborne, Simone A; Gobe, Glenda C

    2017-08-04

    Sulphated polysaccharides with anti-thrombotic and anti-coagulant activities have been found in various marine biota. In this study, a previously characterised anti-thrombotic and anti-coagulant extract from blacklip abalone was fractionated by anion exchange chromatography (AEC), pooled (on a sulphated polysaccharide basis) and administered to Wistar rats via oral gavage (N = 8) for assessment as an oral therapeutic. To ensure that the preparation had anti-coagulant activity prior to oral administration, it was assessed in rat blood by thromboelastography (TEG) significantly increasing reaction (R) time (or time until clot formation). Following in vitro confirmation of anti-coagulant activity, 40 mg of the preparation was orally administered to rats with blood samples collected at 2, 4, and 6 h post-gavage. Assessment of all blood samples by TEG showed some prolongation of R time from 355 to 380 s after 4 h. Dosing of the post-gavage blood samples with the abalone preparation to confirm anti-thrombotic activity in vitro revealed residual anti-coagulant activity, further suggesting that oral administration did increase anti-coagulant potential in the collected blood but that bioavailability was low. Assessment of tissues and haematological parameters showed no obvious harmful effects of the abalone preparation in animals. In summary, even though oral administration of fractionated and pooled blacklip abalone extract to rats delayed clotting after 4 h, bioavailability of the preparation appeared to be low and may be more appropriate for intravenous administration as an anti-thrombotic or anti-coagulant therapeutic.

  17. EVALUATION OF FERRIC CHLORIDE AND ALUM EFFICIENCIES IN ENHANCED COAGULATION FOR TOC REMOVAL AND RELATED RESIDUAL METAL CONCENTRATIONS

    Directory of Open Access Journals (Sweden)

    A. Mesdaghinia, M. T. Rafiee, F. Vaezi and A. H. Mahvi

    2005-07-01

    Full Text Available Although the removal of colloidal particles continues to be an important reason for using coagulation, a newer objective, the removal of natural organic matter (NOM to reduce the formation of disinfection by-products (DBPs, is growing in importance. Enhanced coagulation is thus introduced to most water utilities treating surface water. Bench-scale experiments were conducted to compare the effectiveness of alum and ferric chloride in removing DBPs precursors from eight synthetic water samples, each representing a different element of the USEPA’s 3×3 enhanced coagulation matrix. The effect of enhanced coagulation on the residual metal (aluminum/iron concentration in the treated water was assessed as well. The removal of total organic carbon (TOC was dependent on the coagulant type and was enhanced with increasing coagulant dose, but the latter had no further considerable effect in case of increasing to high levels. For all the treated samples coagulation with ferric chloride proved to be more effective than alum at similar doses and the mean values of treatment efficiencies were 51% and 32% for ferric chloride and alum, respectively. Ferric chloride was therefore considered the better chemical for enhancing the coagulation process. Besides, due to less production of sludge by this coagulant, it would be predicted that treatment plants would be confronted to fewer problems with respect to final sludge disposal. Measurements of residual metal in treated water indicated that iron and aluminum concentrations had been increased as expected but the quality of water concerning the residual metal deteriorated much more in cases of under-dosing. Despite expecting high residual Al and Fe concentrations under enhanced coagulation, metal concentrations were frequently remained low and were not increased appreciably.

  18. Rapid removal of fine particles from mine water using sequential processes of coagulation and flocculation

    Energy Technology Data Exchange (ETDEWEB)

    Jang, M.; Lee, H.J.; Shim, Y. [Korean Mine Reclamation Corporation MIRECO, Seoul (Republic of Korea)

    2010-07-01

    The processes of coagulation and flocculation using high molecular weight long-chain polymers were applied to treat mine water having fine flocs of which about 93% of the total mass was less than 3.02 {mu} m, representing the size distribution of fine particles. Six different combinations of acryl-type anionic flocculants and polyamine-type cationic coagulants were selected to conduct kinetic tests on turbidity removal in mine water. Optimization studies on the types and concentrations of the coagulant and flocculant showed that the highest rate of turbidity removal was obtained with 10 mg L{sup -1} FL-2949 (coagulant) and 12 mg L{sup -1} A333E (flocculant), which was about 14.4 and 866.7 times higher than that obtained with A333E alone and that obtained through natural precipitation by gravity, respectively. With this optimized condition, the turbidity of mine water was reduced to 0 NTU within 20 min. Zeta potential measurements were conducted to elucidate the removal mechanism of the fine particles, and they revealed that there was a strong linear relationship between the removal rate of each pair of coagulant and flocculant application and the zeta potential differences that were obtained by subtracting the zeta potential of flocculant-treated mine water from the zeta potential of coagulant-treated mine water. Accordingly, through an optimization process, coagulation-flocculation by use of polymers could be advantageous to mine water treatment, because the process rapidly removes fine particles in mine water and only requires a small-scale plant for set-up purposes owing to the short retention time in the process.

  19. Infrared coagulation versus rubber band ligation in early stage hemorrhoids.

    Science.gov (United States)

    Gupta, P J

    2003-10-01

    The ideal therapy for early stages of hemorrhoids is always debated. Some are more effective but are more painful, others are less painful but their efficacy is also lower. Thus, comfort or efficacy is a major concern. In the present randomized study, a comparison is made between infrared coagulation and rubber band ligation in terms of effectiveness and discomfort. One hundred patients with second degree bleeding piles were randomized prospectively to either rubber band ligation (N = 54) or infrared coagulation (N = 46). Parameters measured included postoperative discomfort and pain, time to return to work, relief in incidence of bleeding, and recurrence rate. The mean age was 38 years (range 19-68 years). The mean duration of disease was 17.5 months (range 12 to 34 months). The number of male patients was double that of females. Postoperative pain during the first week was more intense in the band ligation group (2-5 vs 0-3 on a visual analogue scale). Post-defecation pain was more intense with band ligation and so was rectal tenesmus (P = 0.0059). The patients in the infrared coagulation group resumed their duties earlier (2 vs 4 days, P = 0.03), but also had a higher recurrence or failure rate (P = 0.03). Thus, we conclude that band ligation, although more effective in controlling symptoms and obliterating hemorrhoids, is associated with more pain and discomfort to the patient. As infrared coagulation can be conveniently repeated in case of recurrence, it could be considered to be a suitable alternative office procedure for the treatment of early stage hemorrhoids.

  20. Treatment of the oily produced water (OPW using coagulant mixtures

    Directory of Open Access Journals (Sweden)

    R. Hosny

    2016-09-01

    Full Text Available Treatment of the oily produced water (OPW before injection into oil reservoirs is necessary to reduce formation damage. This can be done using chemo-physical process to minimize the oil droplets in water. In this respect, this work aims to extract natural polymer (chitosan from shrimp shells and mix it with coagulants (chitosan/carboxy methyl cellulose and chitosan/aluminum sulfate to adsorb oil from OPW. Adsorption experiments were carried out in batch mode firstly to choose the best coagulants in water treatment, also to investigate the effects of pH on the adsorption uptake, adsorbent dosage, coagulant mixture doses and contact time. It was found that the oil removal by chitosan reached 96.35% and 59% at pH = 4 and pH = 9, respectively. The ability of chitosan to remove oil was increased after adding different coagulants CMC/or aluminum sulfate at average mixing time between 30 and 60 min. It was also found that the highest removal efficiency of chitosan/CMC is 99% at (90% chitosan: 10% CMC and chitosan/Al2(SO43 is 85% at (80% chitosan: 20% Al2(SO43. The SEM photographs of chitosan, chitosan/CMC and chitosan/Al2(SO43 mixture as oil removal showed that chitosan/Al2(SO43 lies between chitosan alone and chitosan/CMC mixture. Generally chitosan/CMC characterized significantly by its high ability to adsorb petroleum oil and suspended solids from OPW, additionally, reduces the economic cost of water treatment.

  1. Origin of serpin-mediated regulation of coagulation and blood pressure.

    Directory of Open Access Journals (Sweden)

    Yunjie Wang

    Full Text Available Vertebrates evolved an endothelium-lined hemostatic system and a pump-driven pressurized circulation with a finely-balanced coagulation cascade and elaborate blood pressure control over the past 500 million years. Genome analyses have identified principal components of the ancestral coagulation system, however, how this complex trait was originally regulated is largely unknown. Likewise, little is known about the roots of blood pressure control in vertebrates. Here we studied three members of the serpin superfamily that interfere with procoagulant activity and blood pressure of lampreys, a group of basal vertebrates. Angiotensinogen from these jawless fish was found to fulfill a dual role by operating as a highly selective thrombin inhibitor that is activated by heparin-related glycosaminoglycans, and concurrently by serving as source of effector peptides that activate type 1 angiotensin receptors. Lampreys, uniquely among vertebrates, thus use angiotensinogen for interference with both coagulation and osmo- and pressure regulation. Heparin cofactor II from lampreys, in contrast to its paralogue angiotensinogen, is preferentially activated by dermatan sulfate, suggesting that these two serpins affect different facets of thrombin's multiple roles. Lampreys also express a lineage-specific serpin with anti-factor Xa activity, which demonstrates that another important procoagulant enzyme is under inhibitory control. Comparative genomics suggests that orthologues of these three serpins were key components of the ancestral hemostatic system. It appears that, early in vertebrate evolution, coagulation and osmo- and pressure regulation crosstalked through antiproteolytically active angiotensinogen, a feature that was lost during vertebrate radiation, though in gnathostomes interplay between these traits is effective.

  2. Elimination of man-made radionuclides from natural waters by applying a standard coagulation-flocculation process

    International Nuclear Information System (INIS)

    Baeza, A.; Miro, C.; Salas, A.; Fernandez, M.; Herranz, M.; Legarda, F.

    2004-01-01

    Effectiveness of potable water treatment processes that consist of the stages of coagulation-flocculation-decantation, using iron-based coagulants, in eliminating gamma-emitting man-made radioisotopes of cesium, strontium, and americium from two natural waters with different degrees of mineralization was studied. The resulting decontamination was found to depend on the chemical behavior of each of the radionuclides considered, on the pH at which the process of coagulation is carried out, and on the concentration of the other stable cations present. (author)

  3. Perioperative lung protective ventilation in obese patients

    OpenAIRE

    Fernandez-Bustamante, Ana; Hashimoto, Soshi; Serpa Neto, Ary; Moine, Pierre; Vidal Melo, Marcos F; Repine, John E

    2015-01-01

    The perioperative use and relevance of protective ventilation in surgical patients is being increasingly recognized. Obesity poses particular challenges to adequate mechanical ventilation in addition to surgical constraints, primarily by restricted lung mechanics due to excessive adiposity, frequent respiratory comorbidities (i.e. sleep apnea, asthma), and concerns of postoperative respiratory depression and other pulmonary complications. The number of surgical patients with obesity is increa...

  4. Risk of disseminated intravascular coagulation in patients undergoing US-guided transperineal prostatic biopsy

    International Nuclear Information System (INIS)

    Stella, M.S.; Comparato, D.; Camici, M.; Evangelisti, L.; Gaudio, V.; De Negri, F.; Talarico, L.; Giusti, C.; Morelli, G.

    1991-01-01

    Disseminated intravascular coagulation (DIC) is a severe life-threatening acute bleeding disorder. Traumatized tissues, tumors, necrotic tissues, or bacterial endotoxines release similar material in the blood to the tissutal factors activating the coagulation cascade. This preliminary study was aimed at verifying the risk of DIV in patients undergoing US-guided transperineal prostatic biopsy with Chiba and Tru-Cut needles. To evaluate the activation degree of coagulation factors in the circulation, the authors measured the concentrations of urinary fibrin degradation products in 10 patients undergoing US-guided transperineal prostatic biopsy, both before and after biopsy, every second hour, for 24 hours. Every tube of urine sample contained soya bean trypsin inhibitor and bovine thrombin to prevent any further fibrin degradation during incubation period for the possible presence of blood in urine samples. The results showed that 7/10 patients had marked increase in urinary fibrin degradation product levels (up to 800 XXXX%), with a 3-phase trend: early peak after 2-6 hours, middle peak after 6-14 hours, and late peak after 18-24 hours, which proved the activation of the coagulation cascade

  5. Experimental investigation and modeling of dissolved organic carbon removal by coagulation from seawater.

    Science.gov (United States)

    Jeong, Sanghyun; Sathasivan, Arumugam; Kastl, George; Shim, Wang Geun; Vigneswaran, Saravanamuthu

    2014-01-01

    Coagulation removes colloidal matters and dissolved organic carbon (DOC) which can cause irreversible membrane fouling. However, how DOC is removed by coagulant is not well-known. Jar test was used to study the removal of hydrophobic and hydrophilic DOC fractions at various doses (0.5-8.0 mg-Fe(+3) L(-1)) of ferric chloride (FeCl3) and pH (5.0-9.0). Natural organic matter (NOM) in seawater and treated seawater were fractionated by liquid chromatography-organic carbon detector (LC-OCD). Compared to surface water, the removal of DOC in seawater by coagulation was remarkably different. Majority of DOC could be easily removed with very low coagulant dose (fraction (HB) was better removed at high pH while hydrophilic fraction (HF) was better removed at low pH. A modified model of Kastl et al. (2004) which assumed that the removal occurred by adsorption of un-dissociated compounds onto ferric hydroxide was formulated and successfully validated against the jar test data. Copyright © 2013 Elsevier Ltd. All rights reserved.

  6. Rheological behavior of raw natural rubber coagulated by microorganisms

    Directory of Open Access Journals (Sweden)

    Zhifen Wang

    2014-01-01

    Full Text Available Tests of the strain sweep, frequency sweep and stress relaxation for raw natural rubber coagulated by microorganisms (NR-m and raw natural rubber coagulated by acid (NR-a were carried out with the use of a rubber process analyzer (RPA. The results showed that the storage torque, complex viscosity of NR-m were higher than those of NR-a while the loss factor was lower. The effect of temperature on viscosity of raw NR was studied following the Arrhenious-Frenkel-Eyring model. The viscous flow behavior of NR-m was poorer than those of NR-a. Furthermore, stress relaxation measurements of raw NR showed a longer period of relaxation for NR-m.

  7. Engineering the substrate and inhibitor specificities of human coagulation Factor VIIa

    DEFF Research Database (Denmark)

    Larsen, Katrine S; Østergaard, Henrik; Bjelke, Jais R

    2007-01-01

    The remarkably high specificity of the coagulation proteases towards macromolecular substrates is provided by numerous interactions involving the catalytic groove and remote exosites. For FVIIa [activated FVII (Factor VII)], the principal initiator of coagulation via the extrinsic pathway, several...... for FVIIa by marked changes in primary substrate specificity and decreased rates of antithrombin III inhibition. Interestingly, these changes do not necessarily coincide with an altered ability to activate Factor X, demonstrating that inhibitor and macromolecular substrate selectivity may be engineered...

  8. Early activation of the coagulation system during lower body negative pressure

    DEFF Research Database (Denmark)

    Zaar, M; Johansson, P I; Nielsen, L B

    2009-01-01

    We considered that a moderate reduction of the central blood volume (CBV) may activate the coagulation system. Lower body negative pressure (LBNP) is a non-invasive means of reducing CBV and, thereby, simulates haemorrhage. We tested the hypothesis that coagulation markers would increase following...... moderate hypovolemia by exposing 10 healthy male volunteers to 10 min of 30 mmHg LBNP. Thoracic electrical impedance increased during LBNP (by 2.6 +/- 0.7 Omega, mean +/- SD; P pressure decreased (84 +/- 5 to 80...

  9. Chitosan as coagulant on cyanobacteria in lake restoration management may cause rapid cell lysis

    NARCIS (Netherlands)

    Mucci, Maira; Noyma, Natalia Pessoa; de Magalhaes, Leonardo; Miranda, Marcela; van Oosterhout, Frank; Guedes, Iame Alves; Huszar, Vera L. M.; Marinho, Marcelo Manzi; Lürling, Miquel

    2017-01-01

    Combining coagulant and ballast to remove cyanobacteria from the water column is a promising restoration technique to mitigate cyanobacterial nuisance in surface waters. The organic, biodegradable polymer chitosan has been promoted as a coagulant and is viewed as non-toxic. In this study, we show

  10. Coagulation Status in Hidradenitis Suppurativa

    DEFF Research Database (Denmark)

    Miller, Iben Marie; Johansen, Maria Egede; Mogensen, Ulla B

    2015-01-01

    BACKGROUND: Chronic inflammatory diseases other than hidradenitis suppurativa (HS) have been associated with prothrombotic/hypercoagulable status. OBJECTIVE: To investigate a possible association between the chronic inflammatory skin disease HS and prothrombotic/hypercoagulable state. METHODS: We.......3432). CONCLUSION: We did not find an association between HS and prothrombotic/hypercoagulable status. Thus, thrombocytes may not be activated in HS. Furthermore, INR may not be affected in HS, suggesting that intrinsic and vitamin K-dependent coagulation factors appear unaffected....

  11. Coagulation effectiveness of graphene oxide for the removal of turbidity from raw surface water.

    Science.gov (United States)

    Aboubaraka, Abdelmeguid E; Aboelfetoh, Eman F; Ebeid, El-Zeiny M

    2017-08-01

    This study presents the performance of graphene oxide (GO) as a coagulant in turbidity removal from naturally and artificially turbid raw surface water. GO is considered an excellent alternative to alum, the more common coagulant used in water treatment processes, to reduce the environmental release of aluminum. Effects of GO dosage, pH, and temperature on its coagulation ability were studied to determine the ideal turbidity removal conditions. The turbidity removal was ≥95% for all levels of turbid raw surface water (20, 100, and 200 NTU) at optimum conditions. The role of alkalinity in inducing turbidity removal by GO coagulation was much more pronounced upon using raw surface water samples compared with that using artificially turbid deionized water samples. Moreover, GO demonstrated high-performance removal of biological contaminants such as algae, heterotrophic bacteria, and fecal coliform bacteria by 99.0%, 98.8% and 96.0%, respectively, at a dosage of 40 mg/L. Concerning the possible environmental release of GO into the treated water following filtration process, there was no residual GO in a wide range of pH values. The outcomes of the study highlight the excellent coagulation performance of GO for the removal of turbidity and biological contaminants from raw surface water. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. Removal of arsenic and iron removal from drinking water using coagulation and biological treatment.

    Science.gov (United States)

    Pramanik, Biplob Kumar; Pramanik, Sagor Kumar; Suja, Fatihah

    2016-02-01

    Effects of biological activated carbon (BAC), biological aerated filter (BAF), alum coagulation and Moringa oleifera coagulation were investigated to remove iron and arsenic contaminants from drinking water. At an initial dose of 5 mg/L, the removal efficiency for arsenic and iron was 63% and 58% respectively using alum, and 47% and 41% respectively using Moringa oleifera. The removal of both contaminants increased with the increase in coagulant dose and decrease in pH. Biological processes were more effective in removing these contaminants than coagulation. Compared to BAF, BAC gave greater removal of both arsenic and iron, removing 85% and 74%, respectively. Longer contact time for both processes could reduce the greater concentration of arsenic and iron contaminants. The addition of coagulation (at 5 mg/L dosage) and a biological process (with 15 or 60 min contact time) could significantly increase removal efficiency, and the maximum removal was observed for the combination of alum and BAC treatment (60 min contact time), with 100% and 98.56% for arsenic and iron respectively. The reduction efficiency of arsenic and iron reduced with the increase in the concentration of dissolved organics in the feedwater due to the adsorption competition between organic molecules and heavy metals.

  13. Important issues for perioperative systemic antimicrobial prophylaxis in surgery

    NARCIS (Netherlands)

    Sinha, Bhanu; van Assen, Sander; Friedrich, Alexander W.

    PURPOSE OF REVIEW: Prevention of surgical site infections is a key issue to patient safety and the success of surgical interventions. Systemic antimicrobial prophylaxis is one important component of a perioperative infection prevention bundle. This review focuses on selected recent developments and

  14. Condutivity effect in electro-coagulation-flotation applied to physico-chemical wastewater treatment

    OpenAIRE

    Francisco Javier Cuba Terán; Mário Luiz Rodrigues Foco

    2007-01-01

    This study reports on the effect of conductivity on the simultaneous applicability of water electrolysis , chemical coagulation and flotation fundamentals in the treatment of wastewater with large amounts of suspended matter, characterizing electro-coagulation-flotation (ECF) . Results from experiments carried out in a pilot study implanted and operated in the Laboratory of Environment Control (LCA), at the State University of Campinas in Limeira are presented. ECF was developed in an electro...

  15. Chitosan as coagulant on cyanobacteria in lake restoration management may cause rapid cell lysis

    NARCIS (Netherlands)

    Nunes Teixeira Mucci, Maira; Noyma, Natalia Pessoa; Magalhães, de Leonardo; Miranda, Marcela; Oosterhout, van Frank; Guedes, Iamê Alves; Huszar, Vera L.M.; Marinho, Marcelo Manzi; Lürling, Miquel

    2017-01-01

    Combining coagulant and ballast to remove cyanobacteria from the water column is a promising restoration technique to mitigate cyanobacterial nuisance in surface waters. The organic, biodegradable polymer chitosan has been promoted as a coagulant and is viewed as non-toxic. In this study, we show

  16. Duty and dilemma: Perioperative nurses hiding an objection to participate in organ procurement surgery.

    Science.gov (United States)

    Smith, Zaneta

    2017-07-01

    Perioperative nurses assist in organ procurement surgery; however, there is a dearth of information of how they encounter making conscientious objection requests or refusals to participate in organ procurement surgery. Organ procurement surgical procedures can present to the operating room ad hoc and can catch a nurse who may not desire to participate by surprise with little opportunity to refuse as a result of staffing, skill mix or organizational work demands. This paper that stems from a larger doctoral research study exploring the experiences of perioperative nurses participating in multi-organ procurement surgery used a grounded theory method to develop a substantive theory of the nurses' experiences. This current paper aimed to highlight the experiences of perioperative nurses when confronted with expressing a conscientious objection towards their participation in these procedures. A number of organizational and cultural barriers within the healthcare organization were seen to hamper their ability in expressing a conscience-based refusal, which lead to their reluctant participation. Perioperative nurses must feel safe to express a conscientious objection towards these types of surgical procedures and feel supported in doing so by their respective hospital organizations and not be forced to participate unwillingly. © 2016 John Wiley & Sons Ltd.

  17. Treatment of Industrial Liquid Waste of Steel Plating by Coagulation-Flocculation Using Sodium Biphosphate

    International Nuclear Information System (INIS)

    Subiarto; Herlan Martono

    2007-01-01

    Research about treatment of industrial liquid waste of steel plating by coagulation-flocculation using sodium biphosphate have been conducted. The purpose of the treatment was the content reduction of Cr, Ni, and Cu in the liquid waste, so that produced effluent with Cr, Ni, and Cu content until they laid under mutual standard. The variables studied in this process were the solution pH, the coagulant/waste volume comparison, the speed of the fast stirring, and the time of the fast stirring. Optimum separation efficiency on coagulation-flocculation process of liquid waste of steel plating using sodium biphosphate at the condition of solution ph 9, coagulant/waste volume comparation 1.50, the speed of the fast stirring 400 rpm, and the time of fast stirring is 5 minute. Low stirring was conducted at 60 rpm for 60 minute. The yields of optimum separation efficiency in this condition were 99.48 % for Cr, 99.51 % for Ni, and 99.03 % for Cu. (author)

  18. Study of coagulant development and the characteristics for the treatment of tire remanufacturing wastewater

    Energy Technology Data Exchange (ETDEWEB)

    Yoo, E.S.; Yoon, I.M. [School of Natural Sciences, Honam Univ., Gwangju (Korea)

    2005-07-01

    This study was conducted to test the performance of various combinations of coagulants for effective wastewater treatment of the tire recycling industry. From the jar-test results, two kinds of coagulants, namely AlSi-1 and PASi-1, were found to be effective in decreasing BOD and COD{sub Cr} values from the polluted wastewater among various combinations of coagulants. In comparison to Al-based or Si-based singular salts, the Si-Al combined salts (PASi-1) exhibited a higher removal efficiency of 90% turbidity, 93% SS, 70 {proportional_to} 85% BOD{sub 5} and 85 {proportional_to} 91% COD{sub Cr} at 15 {+-} 2 C, pH7.5 {proportional_to} 9.5 and 2.0 mM of coagulant dosage. At 30 {+-} 2 C of tire recycling effluents, the combination effect was clearly shown in the removal of COD{sub Cr} over a wider range of pH. The reaction mechanisms of AlSi-1 and PASi-1 were also schematically studied. (orig.)

  19. Treatment of water turbidity and bacteria by using a coagulant extracted from Plantago ovata

    Directory of Open Access Journals (Sweden)

    Bahman Ramavandi

    2014-08-01

    Full Text Available A biocoagulant was successfully extracted from Plantago ovata by using an FeCl3-induced crude extract (FCE. The potential of FCE to act as a natural coagulant was tested for clarification using the turbid water of a river. Experimental tests were performed to evaluate the effects of turbidity concentration, coagulant quantity, water pH, and humic acid concentration on the coagulation of water turbidity by FCE. The maximum turbidity removal was occurred at water pH<8. At the optimum dosage of FCE, only 0.8 mg/L of dissolved organic carbon was released to the treated water. An increase in the humic acid led to the promotion of the water turbidity removal. Results demonstrated that the FCE removed more than 95.6% of all initial turbidity concentrations (50–300 NTU. High bacteriological quality was achieved in the treated water. FCE as an eco-friendly biocoagulant was revealed to be a very efficient coagulant for removing turbidity from waters.

  20. The Efficacy of Perioperative Antibiotic Therapy in Tonsillectomy Patients.

    Science.gov (United States)

    Orłowski, Krzysztof; Lisowska, Grażyna; Misiołek, Hanna; Paluch, Zbigniew; Misiołek, Maciej

    2016-01-01

    While the results of early research suggested that perioperative antibiotic prophylaxis in tonsillectomy patients is associated with many benefits, these data were not confirmed by further studies and meta-analyses. The aim of this study was to investigate the usefulness and efficacy of antibiotic monotherapy in the healing of surgical wounds of patients undergoing bilateral resection of the palatine tonsils, based on an analysis of selected objective and subjective characteristics of wound healing during the postoperative period. The study included 50 men and women who underwent routine resection of the palatine tonsils. The patients were randomized into two groups: Group I, undergoing tonsillectomy with cefuroxime prophylaxis (n = 25), and Group II, who were not given perioperative antibiotic therapy (n = 25). The severity of signs and complaints recorded on postoperative days 1-10 was scored on 3- and 10-item scales. The only significant intergroup differences pertained to problems with swallowing food and fluids on postoperative days 4-6, 8 and 9 (less prevalent in Group II), postoperative use of analgesics on postoperative day 9 (less frequent in Group II), the degree of mucosal swelling in the operated area on postoperative days 3 and 7 (less severe in Group II), and the amount of fibrin covering the tonsillar niches on the third postoperative day (significantly higher in Group I). The administration of antibiotics for prevention or control of infection should be preceded by a comprehensive analysis of the potential benefits and risks. Perioperative use of antibiotics is justified only in selected cases, i.e. in individuals with comorbidities.