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Sample records for phytotoxin undergoes photo-degradation

  1. Photo-degradation of imidazolium ionic liquids

    OpenAIRE

    Katoh, Ryuzi; Takahashi, Kenji

    2009-01-01

    Degradation of imidazolium ionic liquid, [bmim+][TFSA-] and iodide solution of [bmim+][TFSA-] by UV-laser irradiation has been studied through ground-state absorption and transient absorption spectroscopy. We found that excited state [bmim+]* undergoes degradation efficiently. © 2009 Elsevier Ltd. All rights reserved.

  2. Concentrated Light for Accelerated Photo Degradation of Polymer Materials

    DEFF Research Database (Denmark)

    Madsen, Morten Vesterager; Tromholt, Thomas; Norrman, Kion

    2013-01-01

    Concentrated light is used to perform photochemical degradation of polymer solar cell materials with acceleration factors up to 1200. At constant temperature the photon efficiency in regards to photo degradation is constant for 1–150 suns and oxygen diffusion rates are not a limiting factor. Acce...

  3. Phytotoxins: environmental micropollutants of concern?

    Science.gov (United States)

    Bucheli, Thomas D

    2014-11-18

    Natural toxins such as mycotoxins or phytotoxins (bioactive compounds from fungi and plants, respectively) have been widely studied in food and feed, where they are stated to out-compete synthetic chemicals in their overall human and animal toxicological risk. A similar perception and awareness is yet largely missing for environmental safety. This article attempts to raise concern in this regard, by providing (circumstantial) evidence that phytotoxins in particular can be emitted into the environment, where they may contribute to the complex mixture of organic micropollutants. Exposures can be orders-of-magnitude higher in anthropogenically managed/affected (agro-)ecosystems than in the pristine environment.

  4. Microbially produced phytotoxins and plant disease management ...

    African Journals Online (AJOL)

    Microbially produced phytotoxins and plant disease management. ... African Journal of Biotechnology ... Pathogenic fungi and bacteria often damage their host (plants) tissues by producing toxic metabolites, which induced various symptoms ...

  5. Selection of phytotoxin producing rhizobacteria

    Directory of Open Access Journals (Sweden)

    Daniel D.C. Carvalho

    2011-09-01

    Full Text Available In order to select phytotoxin producing rhizobacteria to control weed plants, twenty five bacterial strains previously isolated from the rhizospheres of various plants were grown in a liquid medium and, after cell removal by centrifugation, the liquid phases were freeze-dried and the products were extracted with ethyl acetate/methanol. The extracts were concentrated to dryness under vacuum and dissolved in water and sucrose solution to be submitted to in vitro assays of lettuce (Lactuca sativa L. seed germination and wheat (Triticum aestivum L. coleoptile growth. Although most samples affected coleoptile growth, only those from four strains reduced lettuce seed germination. Two strains of Bacillus cereus, one strain of B. pumilus and one of Stenotrophoonas altophilia were the most promising microorganisms for producing phytotoxin and, consequently, for the development of new weed control products.Com o objetivo de selecionar rizobactérias produtoras de fitotoxinas para uso no controle de plantas daninhas, vinte e cinco isolados bacterianos previamente obtidos das rizosferas de diferentes plantas foram cultivados em meio líquido e, após remoção das células por centrifugação, as fases líquidas foram liofilizadas e os resíduos obtidos foram submetidos à extração com acetato de etila/metanol. Os extratos foram concentrados sob vácuo até secura e dissolvidos em água e solução de sacarose para serem submetidos a testes in vitro de germinação de sementes de alface (Lactuca sativa L. e de crescimento de coleóptilos de trigo (Triticum aestivum L.. Embora a maior parte das amostras tenha desfavorecido o crescimento dos coleóptilos de trigo, somente as provenientes de quatro isolados reduziram a germinação das sementes de alface. Dois isolados de Bacillus cereus, um isolado de B. pumilus e um de Stenotrophomonas maltophilia foram os microrganismos mais promissores para a produção de fitotoxinas, com possibilidade de uso no

  6. Protective behaviour monitoring on wood photo-degradation by spectroscopic techniques coupled with chemometrics

    Science.gov (United States)

    Capobianco, Giuseppe; Calienno, Luca; Pelosi, Claudia; Scacchi, Martina; Bonifazi, Giuseppe; Agresti, Giorgia; Picchio, Rodolfo; Santamaria, Ulderico; Serranti, Silvia; Monaco, Angela Lo

    2017-02-01

    This paper reports the investigation on the effect of protective materials on poplar (Populus sp.) wood modifications as consequence of artificial photo-degradation in controlled environment. The novelty of this work is to try to understand what happens to wood surface under the protective layer. Shellac, beeswax and Linfoil® were tested to compare traditional and novel products generally used for wood. The samples, uncovered and covered by these protective layers, were artificially aged. Colour and chemical modifications due to ageing were investigated at different time intervals by reflectance spectrophotometry, Fourier transform infrared spectroscopy and hyperspectral imaging. The obtained data were elaborated by statistical and chemometric tools in order to verify their significance and to assess the relationship between groups of measurements. The results highlighted that shellac, beeswax and Linfoil® materials have a very low protective effect on wood photo-degradation for long times of exposure, by little reducing the changes of wood components.

  7. Sulfide as a soil phytotoxin - A review

    Directory of Open Access Journals (Sweden)

    Leon P M Lamers

    2013-07-01

    Full Text Available In wetland soils and underwater sediments of marine, brackish and freshwater systems, the strong phytotoxin sulfide may accumulate as a result of microbial reduction of sulfate during anaerobiosis, its level depending on prevailing edaphic conditions. In this review, we compare an extensive body of literature on phytotoxic effects of this reduced sulfur compound in different ecosystem types, and review the effects of sulfide at multiple ecosystem levels: the ecophysiological functioning of individual plants, plant-microbe associations, and community effects including competition and facilitation interactions. Recent publications on multi-species interactions in the rhizosphere show even more complex mechanisms explaining sulfide resistance. It is concluded that sulfide is a potent phytotoxin, profoundly affecting plant fitness and ecosystem functioning in the full range of wetland types including coastal systems, and at several levels. Traditional toxicity testing including hydroponic approaches generally neglect rhizospheric effects, which makes it difficult to extrapolate results to real ecosystem processes. To explain the differential effects of sulfide at the different organizational levels, profound knowledge about the biogeochemical, plant physiological and ecological rhizosphere processes is vital. This information is even more important, as anthropogenic inputs of sulfur into freshwater ecosystems and organic loads into freshwater and marine systems are still much higher than natural levels, and are steeply increasing in Asia. In addition, higher temperatures as a result of global climate change may lead to higher sulfide production rates in shallow waters.

  8. Semi-empirical study of ortho-cresol photo degradation in manganese-doped zinc oxide nanoparticles suspensions

    Directory of Open Access Journals (Sweden)

    Abdollahi Yadollah

    2012-08-01

    Full Text Available Abstract The optimization processes of photo degradation are complicated and expensive when it is performed with traditional methods such as one variable at a time. In this research, the condition of ortho-cresol (o-cresol photo degradation was optimized by using a semi empirical method. First of all, the experiments were designed with four effective factors including irradiation time, pH, photo catalyst’s amount, o-cresol concentration and photo degradation % as response by response surface methodology (RSM. The RSM used central composite design (CCD method consists of 30 runs to obtain the actual responses. The actual responses were fitted with the second order algebraic polynomial equation to select a model (suggested model. The suggested model was validated by a few numbers of excellent statistical evidences in analysis of variance (ANOVA. The used evidences include high F-value (143.12, very low P-value (2 = 0.99 and the adequate precision (47.067. To visualize the optimum, the validated model simulated the condition of variables and response (photo degradation % be using a few number of three dimensional plots (3D. To confirm the model, the optimums were performed in laboratory. The results of performed experiments were quite close to the predicted values. In conclusion, the study indicated that the model is successful to simulate the optimum condition of o-cresol photo degradation under visible-light irradiation by manganese doped ZnO nanoparticles.

  9. Photo-degradation of 2,4-dinitroanisole (DNAN): An emerging munitions compound.

    Science.gov (United States)

    Taylor, Susan; Walsh, Marianne E; Becher, Julie B; Ringelberg, David B; Mannes, Philip Z; Gribble, Gordon W

    2017-01-01

    The US military is developing insensitive munitions (IM) that are less sensitive to shock and high temperatures to minimize unintentional detonations. DNAN (2,4-dinitroanisole) is one of the main ingredients of these IM formulations. During live-fire training, chunks of IM formulations are scattered by partial detonations and, once on the soil, they weather and dissolve. DNAN changes color when exposed to sunlight suggesting that it photodegrades into other compounds. We investigated the photo-degradation of DNAN both as a pure solid and as part of solid IM formulations, IMX101, IMX104 and PAX21. The concentrations of degradation products found were small, <1%, relative to DNAN concentrations. We saw transient peaks in the chromatograms indicating intermediate, unstable products but we consistently found methoxy nitrophenols and methoxy nitroanilines. We also found one unknown in most of the samples and other unknowns less frequently.

  10. Two new zinniol-related phytotoxins from Alternaria solani.

    Science.gov (United States)

    Moreno-Escobar, Jorge; Puc-Carrillo, Alejandra; Cáceres-Farfán, Mirbella; Peña-Rodríguez, Luis M; Gamboa-Angulo, M Marcela

    2005-09-01

    Bioassay-guided purification of the organic crude extract of Alternaria solani resulted in the isolation of three metabolites responsible for causing necrosis on potato leaves. These phytotoxins were identified as 2-(2",3"-dimethyl-but-1-enyl)-zinniol (1), 8-zinniol methyl ether (2). and 8-zinniol methyl ether based on their spectroscopic data (IR, MS, 1H and 13CNMR). Metabolites 1 and 2 have been identified as new phytotoxins structurally related to zinniol (4). Additionally, 5-(3',3'-dimethylallyloxy)-7-methoxy-6-methyl-phthalide and 8-zinniol-2-(phenyl)-ethyl ether (3) were also isolated during the purification process.

  11. Automated characterization of varnishes photo-degradation using portable T-controlled Raman spectroscopy

    Science.gov (United States)

    Osticioli, I.; Ciofini, D.; Mencaglia, A. A.; Siano, S.

    2017-02-01

    In this work, a portable-Raman device (excitation wavelength 1064 nm) was employed for the first time for continuously monitoring the complex molecular dynamics of terpenoid resins (dammar, mastic, colophony, sandarac and shellac), which occur during their ageing under artificial light exposure. The instrumentation was equipped with a pyroelectric sensor allowing for temperature control of the sample's irradiated surface while the acquisition of spectra occurs by setting fixed maximum temperature and total radiant exposure. Resins were dropped into special pits over a dedicated rotating wheel moved by a USB motor. The rotation allowed samples sliding between the positions designated for the acquisition of the Raman spectra and that for artificial ageing. Samples were exposed to artificial light for 45-days and almost 400 spectra for each resin sample were collected. The exposure to artificial light led to significant changes allowing the characterization of the alteration process. The automated acquisition of a large number of spectra overtime during light-exposure has given the possibility to distinguish fast dynamics, mainly associated to solvent evaporation, from those slower due to resins photo-degradation processes.

  12. Kinetic studies of the photo-degradation of poly(arylene vinylenes)

    Energy Technology Data Exchange (ETDEWEB)

    O' Neill, Luke, E-mail: luke.oneill@dit.ie [Focas Institute, Dublin Institute of Technology, Camden Row., Dublin 8 (Ireland); Lynch, Patrick J. [School of Chemical and Pharmaceutical Sciences, Dublin Institute of Technology, Kevin St., Dublin 8 (Ireland); Focas Institute, Dublin Institute of Technology, Camden Row., Dublin 8 (Ireland); McGoldrick, Niamh [Department of Chemistry, Trinity College, Dublin 2 (Ireland); Byrne, Hugh J. [Focas Institute, Dublin Institute of Technology, Camden Row., Dublin 8 (Ireland); McNamara, Mary [School of Chemical and Pharmaceutical Sciences, Dublin Institute of Technology, Kevin St., Dublin 8 (Ireland)

    2012-09-15

    The kinetics of the degradation of a homologous series of poly(phenylene vinylenes) in which the phenylene units of the PPV structure are systematically substituted by naphthyl and anthyrl units is presented. Degradation is monitored according to the decay of the long wavelength absorption maximum upon illumination with UV radiation. Compared to toluene solution, the photo-degradation is seen to be accelerated in chloroform solution. All decays are fitted with first order kinetics. It is found that all substitutions improve the stability of the vinylene polymers against decay. In particular the highly electro-negative naphthyl group serves to drastically increase the stability due to electron depletion across the vinyl bond. The decay rate is shown to correlate well with the variation of the electronic properties of the backbone and with the reduction of vinylene bond strength as measured using Raman spectroscopy. - Highlights: Black-Right-Pointing-Pointer Novel polymer degradation investigation. Black-Right-Pointing-Pointer Systematic changing of polymer back-bone served to extend stability. Black-Right-Pointing-Pointer Raman spectroscopy shows vinyl bond weakening correlated with extended stability. Black-Right-Pointing-Pointer Degradation rate not solely dependent on electron changes on vinyl bond.

  13. The synthesis of hierarchical nanostructured MoS2/Graphene composites with enhanced visible-light photo-degradation property

    Science.gov (United States)

    Zhao, Yongjie; Zhang, Xiaowei; Wang, Chengzhi; Zhao, Yuzhen; Zhou, Heping; Li, Jingbo; Jin, HaiBo

    2017-08-01

    Novel two-dimensional materials with a layered structure are of special interest for a variety of promising applications. Herein, MoS2 and MoS2/Graphene nanocomposite with hierarchical nanostructure were successfully synthesized employing a one-step hydrothermal method. Photo-degradation of methylene blue (MB) and rhodamine (RHB) were adopted to assess the photo-degradation ability of the products. Comparing with bare MoS2, the hierarchical MoS2/Graphene nanocomposite achieved relatively higher degradation rate of 99% in 28 min for MB as well in 50 min for RHB. These results verified that this proposed hierarchical nanocomposite is a good photo-degradation semiconductor. The excellent performance was mainly ascribed to the synergistic effect of MoS2 and graphene layers. The MoS2 possessing a band gap of 1.9 eV would provide abundant electron-hole pairs. The graphene layers with excellent electro-conductivity could realize the quick transport of electrons via its extended π-conjugation structure, consequently benefiting the separation of photo-generated carriers. These findings indicate that the graphene layer is a promising candidate as a co-catalyst for MoS2 photo-catalyst, and also provide useful information for understanding the observed enhanced photocatalytic mechanism in experiments.

  14. Alternative natural dyes in water purification: Anthocyanin as TiO 2-sensitizer in methyl orange photo-degradation

    Science.gov (United States)

    Zyoud, Ahed; Zaatar, Nidal; Saadeddin, Iyad; Helal, Muath H.; Campet, Guy; Hakim, Moulki; Park, DaeHoon; Hilal, Hikmat S.

    2011-06-01

    Natural molecular dye, anthocyanin, is described here as safe sensitizer for TiO 2 particles in photo-degradation of organic contaminants in water. The dye is a promising replacement for the more costly and hazardous heavy metal based systems, such as CdS particles and Ru-compounds. TiO 2/anthocyanin effectively catalyzed the photo-degradation of methyl orange contaminant under solar simulator radiation. The new TiO 2/anthocyanin catalyst showed comparable efficiency to earlier systems, while avoiding their hazardous nature. When supported onto activated carbon (AC) particles, the resulting AC/TiO 2/anthocyanin system showed enhanced efficiency and ease of recovery from the catalytic reaction mixture. The natural dye molecules showed the tendency to degrade under photo-degradation conditions, just like earlier hazardous sensitizers. However, complete mineralization of anthocyanin occurred leaving no traces of organic species in solution. Sensitizer degradation caused deactivation of the supported catalyst on recovery. Such a shortcoming was overcome by re-treatment of the recovered catalysts with fresh dye. Effects of different reaction parameters on the catalyst efficiency were studied. A mechanism, similar to earlier CdS-sensitized catalyst systems, is proposed for the TiO 2/anthocyanin catalyst.

  15. Photo-degradation in air of the active layer components in a thiophene-quinoxaline copolymer:fullerene solar cell.

    Science.gov (United States)

    Hansson, Rickard; Lindqvist, Camilla; Ericsson, Leif K E; Opitz, Andreas; Wang, Ergang; Moons, Ellen

    2016-04-28

    We have studied the photo-degradation in air of a blend of [6,6]-phenyl-C61-butyric acid methyl ester (PCBM) and poly[2,3-bis-(3-octyloxyphenyl)quinoxaline-5,8-diyl-alt-thiophene-2,5-diyl] (TQ1), and how the photo-degradation affects the solar cell performance. Using near-edge X-ray absorption fine structure (NEXAFS) spectroscopy, changes to the electronic structure of TQ1 and PCBM caused by illumination in ambient air are investigated and compared between the pristine materials and the blend. The NEXAFS spectra show that the unoccupied molecular orbitals of TQ1 are not significantly changed by the exposure of pristine TQ1 to light in air, whereas those of PCBM are severely affected as a result of photo-induced degradation of PCBM. Furthermore, the photo-degradation of PCBM is accelerated by blending it with TQ1. While the NEXAFS spectrum of TQ1 remains unchanged upon illumination in air, its valence band spectrum shows that the occupied molecular orbitals are weakly affected. Yet, UV-Vis absorption spectra demonstrate photo-bleaching of TQ1, which is attenuated in the presence of PCBM in blend films. Illumination of the active layer of TQ1:PCBM solar cells prior to cathode deposition causes severe losses in electrical performance.

  16. Relationships between the stereochemistry and biological activity of fungal phytotoxins.

    Science.gov (United States)

    Evidente, Antonio; Andolfi, Anna; Cimmino, Alessio

    2011-10-01

    Toxins produced by phytopathogenic fungi assume great importance because of their involvement in several plant diseases. Although such pathogens are known to have seriously damaged crops, forest, and environmental resources, they represent a very important tool to develop new environmentally friendly herbicides and fungicides. This review deals with the relationships between the biological activity of some phytotoxins produced by pathogenic fungi for major forest plants and for damaging weeds and their stereochemistry. In particular, the methods used to determine their relative and/or absolute configuration will be illustrated. These include the application of Mosher's and Murata's methods, X-ray diffractometric analysis, circular dichroism, and the use of computational methods to determine the theoretical optical rotatory power as well as the CD spectrum. The importance of determining the absolute configuration to achieve the total synthesis of some phytotoxins, interesting for their potential practical application, is also discussed.

  17. Mercury Isotope Constraints on Depth of Methylation and Degree of Photo-Degradation of Methylmercury in the Central Pacific Ocean

    Science.gov (United States)

    Blum, J. D.; Popp, B. N.; Johnson, M. W.; Drazen, J. C.; Choy, C. A.

    2012-12-01

    with a 50% mixture of MMHg produced at depth with MMHg that was photo-degraded at the surface. This may explain, in part, the much lower total Hg concentration in near-surface fish feeding at the same trophic position as deeper feeding fish. The ratio of Δ199Hg to Δ201Hg in fish from this study is 1.20 (R2 = 0.998), which is identical to values for marine fish from the Gulf of Mexico and is similar to forage fish in the San Francisco Bay Estuary and the results of laboratory photochemical MMHg degradation experiments. Our results are consistent with deposition of Hg(II) from the atmosphere, methylation at depth in the marine water column (below the mixed layer in the oxygen minimum zone), and decreasing degrees of photodegradation of MMHg with depth in the water column.

  18. Molecular mechanisms of toxicity of important food-borne phytotoxins.

    Science.gov (United States)

    Rietjens, Ivonne M C M; Martena, Martijn J; Boersma, Marelle G; Spiegelenberg, Wim; Alink, Gerrit M

    2005-02-01

    At present, there is an increasing interest for plant ingredients and their use in drugs, for teas, or in food supplements. The present review describes the nature and mechanism of action of the phytochemicals presently receiving increased attention in the field of food toxicology. This relates to compounds including aristolochic acids, pyrrolizidine alkaloids, beta-carotene, coumarin, the alkenylbenzenes safrole, methyleugenol and estragole, ephedrine alkaloids and synephrine, kavalactones, anisatin, St. John's wort ingredients, cyanogenic glycosides, solanine and chaconine, thujone, and glycyrrhizinic acid. It can be concluded that several of these phytotoxins cause concern, because of their bioactivation to reactive alkylating intermediates that are able to react with cellular macromolecules causing cellular toxicity, and, upon their reaction with DNA, genotoxicity resulting in tumors. Another group of the phytotoxins presented is active without the requirement for bioactivation and, in most cases, these compounds appear to act as neurotoxins interacting with one of the neurotransmitter systems. Altogether, the examples presented illustrate that natural does not equal safe and that in modern society adverse health effects, upon either acute or chronic exposure to phytochemicals, can occur as a result of use of plant- or herb-based foods, teas, or other extracts.

  19. Study on the mechanism of photo-degradation of p-nitrophenol exposed to 254 nm UV light.

    Science.gov (United States)

    Zhao, Sufang; Ma, Hongjuan; Wang, Min; Cao, Changqing; Xiong, Jie; Xu, Yunshu; Yao, Side

    2010-08-15

    The degradation mechanism of p-nitrophenol (p-NP) exposed to 254 nm UV light was studied in the presence and the absence of oxygen respectively via both steady-state photolysis and time-resolved laser flash photolysis (LFP) experiments. It has been confirmed that p-NP can be photo-ionized to produce its radical cation (p-NP(+)) and hydrated electron (e(aq)(-)) with a quantum yield of 0.52. In neutral solution p-NP(+) will be quickly deprotonated to form its phenoxyl radical (p-NP) which will react with oxygen to promote the breakage of benzene ring of p-NP. The degradation efficiency of p-NP exposed to 254 nm UV is as low as commonly reported. However, oxygen could improve the photo-degradation efficiency, which is due to the reaction of oxygen with p-NP. The reaction between oxygen and p-NP has been experimentally confirmed both in LFP and in pulse radiolysis.

  20. The photochemistry of carbon nanotubes and its impact on the photo-degradation of dye pollutants in aqueous solutions.

    Science.gov (United States)

    Wu, Bingdang; Zhu, Dunxue; Zhang, Shujuan; Lin, Weizhen; Wu, Guozhong; Pan, Bingcai

    2015-02-01

    It is reported that carbon nanotubes (CNTs) could either generate reactive oxygen species (ROS) under light irradiation or serve as high-efficient scavenger for ROS. However, it is unclear which role predominates as CNTs enter into aquatic environment. To answer this question, a systematic study of the photochemistry of a pristine and a surface-functionalized CNTs in aqueous suspensions was investigated with both time-resolved and steady state analytical approaches. The transient absorption spectra demonstrate that CNTs could be photo-ionized and trap hydrated electrons upon high energy irradiation. In steady state UV irradiation, CNTs could promote the generation of ROS, such as (1)O2 and OH. However, in the presence of H2O2, the OH scavenging effect predominated in the aqueous suspensions of CNTs. The presence of CNTs suppressed the photo-degradation of dye pollutants, as an integrated result of inner filter effect, adsorption effect, and ROS generation and scavenging effect. The results provide useful information for the understanding of the environmental implications of CNTs. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. Effect of TiO2-Crystal Forms on the Photo-Degradation of EVA/PLA Blend Under Accelerated Weather Testing

    Science.gov (United States)

    Van Cong, Do; Trang, Nguyen Thi Thu; Giang, Nguyen Vu; Lam, Tran Dai; Hoang, Thai

    2016-05-01

    Photo-degradation of poly (ethylene-co-vinyl acetate) (EVA)/poly (lactic acid) (PLA) blend and EVA/PLA/TiO2 nanocomposites was carried out under accelerated weather testing conditions by alternating cycles of ultraviolet (UV) light and moisture at controlled and elevated temperatures. The characters, properties, and morphology of these materials before and after accelerated weather testing were determined by Fourier transform infrared spectroscopy, colour changes, viscosity, tensile test, thermogravimetric analysis, and field emission scanning electron microscopy. The increases in the content of oxygen-containing groups, colour changes; the decreases in viscosity, tensile properties, and thermal stability of these materials after accelerated weather testing are the evidence for the photo-degradation of the blend and nanocomposites. After accelerated weather testing, the appearance of many micro-holes and micro-pores on the surface of the collected samples was observed. The photo-degradation degree of the nanocomposites depended on the TiO2-crystal form. Rutile TiO2 do not enhance the degradation, but anatase and mixed crystals TiO2 nanoparticles promoted the degradation of the nanocomposites. Particularly, the mixed crystals TiO2 nanoparticles showed the highest photo-catalytic activity of the nanocomposites.

  2. Phytotoxin produced by Bipolaris euphorbiae in-vitro is effective against the weed Euphorbia heterophylla

    Directory of Open Access Journals (Sweden)

    Barbosa Aneli M.

    2002-01-01

    Full Text Available Four virulent strain isolates of the fungus, Bipolaris euphorbiae (previously identified as a Helminthosporium sp., isolated from host plants in four states within Brazil were screened for the production of phytotoxins that promoted wilting and defoliation of the Brazilian weed, Euphorbia heterophylla, commonly found growing among soyabean crops. Only one isolate, B. euphorbiae Strain I (EUPH petropar from Mato Grosso state, produced phytotoxin in-vitro when grown in stationary culture for 7 d at 28 ° C on minimum salts medium supplemented with 1.5 % glucose as the sole carbon source. Phytotoxin was also produced when the fungal strain was grown on fructose, galactose, mannose, xylose and sucrose. The addition of nitrogen source (yeast extract, peptone or malt extract to the culture medium did not influence phytotoxin production. The phytotoxin produced by Strain I was most active at pH 6.0, stable between pH 3-9, and was highly thermostable, remaining fully active when heated at 90 ° C for 1 h.

  3. The effect of stereochemistry on the biological activity of natural phytotoxins, fungicides, insecticides and herbicides.

    Science.gov (United States)

    Evidente, Antonio; Cimmino, Alessio; Andolfi, Anna

    2013-02-01

    Phytotoxins are secondary microbial metabolites that play an essential role in the development of disease symptoms induced by fungi on host plants. Although phytotoxins can cause extensive-and in some cases devastating-damage to agricultural crops, they can also represent an important tool to develop natural herbicides when produced by fungi and plants to inhibit the growth and spread of weeds. An alternative strategy to biologically control parasitic plants is based on the use of plant and fungal metabolites, which stimulate seed germination in the absence of the host plant. Nontoxigenic fungi also produce bioactive metabolites with potential fungicide and insecticide activity, and could be applied for crop protection. All these metabolites represent important tools to develop eco-friendly pesticides. This review deals with the relationships between the biological activity of some phytotoxins, seed germination stimulants, fungicides and insecticides, and their stereochemistry.

  4. The comparison of naturally weathered oil and artificially photo-degraded oil at the molecular level by a combination of SARA fractionation and FT-ICR MS

    Energy Technology Data Exchange (ETDEWEB)

    Islam, Ananna; Cho, Yunju [Kyungpook National University, Department of Chemistry, Daegu 702-701 (Korea, Republic of); Yim, Un Hyuk; Shim, Won Joon [Oil and POPs Research Group, Korea Institute of Ocean Science and Technology, Geoje 656-834 (Korea, Republic of); Kim, Young Hwan [Division of Mass Spectrometry Research and Center for Analytical Research in Disease Sciences, Korea Basic Science Institute, Ochang 863-883 (Korea, Republic of); Graduate School of Analytical Science and Technology, Chungnam National University, Daejeon 305-764 (Korea, Republic of); Kim, Sunghwan, E-mail: sunghwank@knu.ac.kr [Kyungpook National University, Department of Chemistry, Daegu 702-701 (Korea, Republic of); Division of Mass Spectrometry Research and Center for Analytical Research in Disease Sciences, Korea Basic Science Institute, Ochang 863-883 (Korea, Republic of)

    2013-12-15

    Highlights: • Weathered oils from the Hebei Spirit oil spill and photo degraded oils are compared. • We investigate changes of polar species at the molecular level by 15T FT-ICR MS. • Significant reduction of sulfur class compounds in saturates fraction is observed. • The relative abundance of protonated compounds (presumably basic nitrogen compounds) increase after degradation. • Changes of polar compounds occurred by natural and photo degradation are similar. -- Abstract: Two sets of oil samples, one obtained from different weathering stages of the M/V Hebei Spirit oil spill site and the other prepared by an in vitro photo-degradation experiment, were analyzed and compared at the molecular level by atmospheric pressure photo-ionization coupled with Fourier transform ion cyclotron resonance mass spectrometry (FT-ICR MS). For a more detailed comparison at the molecular level, the oil samples were separated into saturate, aromatic, resin, and asphaltene (SARA) fractions before MS analysis. Gravimetric analysis of the SARA fractions revealed a decreased weight percentage of the aromatic fraction and an increased resin fraction in both sets of samples. Molecular-level investigations of the SARA fractions showed a significant reduction in the S{sub 1} class in the saturate fraction and increase of S{sub 1}O{sub 1} class compounds with high DBE values in resin fraction. Levels of N{sub 1} and N{sub 1}O{sub 1} class compounds resulting in protonated ions (presumably basic nitrogen compounds) increased after degradation compared to compounds generating molecular ions (presumably non-basic nitrogen compounds). This study revealed changes occurring in heteroatom polar species of crude oils such as sulfur and nitrogen containing compounds that have not been easily detected with conventional GC based techniques.

  5. Regiospecific cytochrome P450-catalyzed nitration of L-tryptophan in thaxtomin phytotoxin biosynthesis

    Science.gov (United States)

    Thaxtomins, phytotoxins produced by plant pathogenic Streptomyces species, contain a rare nitro group that is essential for phytotoxicity. The N,N'-dimethyldiketopiperazine core of thaxtomins is assembled from L-phenylalanine and L-4-nitrotryptophan by a nonribosomal peptide synthetase. Nitric oxide...

  6. Soybean charcoal rot disease fungus Macrophomina phaseolina in Mississippi produces the phytotoxin (-)-botryodiplodin but no detectable phaseolinone.

    Science.gov (United States)

    Ramezani, Mohammad; Shier, W Thomas; Abbas, Hamed K; Tonos, Jennifer L; Baird, Richard E; Sciumbato, Gabriel L

    2007-01-01

    Research on charcoal rot disease in soybeans, and approximately 500 other plant diseases caused by the fungus Macrophomina phaseolina, has been severely hampered by unavailability of phaseolinone (1), an eremophilane sesquiterpenoid phytotoxin proposed to facilitate initial infection. Phytotoxin produced in cultures of disease-causing M. phaseolina isolated in Mississippi, and purified in a manner similar to that reported for 1, was shown to be (-)-botryodiplodin (2), a readily synthesized mycotoxin previously isolated from Botryodiplodia theobromae cultures. Phaseolinone was not detected, suggesting that 2 may be the phytotoxin that facilitates infection. The availability of 2 should facilitate studies on its role in plant disease.

  7. Photo-degradation of the antimicrobial ciprofloxacin at high pH: identification and biodegradability assessment of the primary by-products.

    Science.gov (United States)

    Vasconcelos, Tibiriçá G; Henriques, Danielle M; König, Armin; Martins, Ayrton F; Kümmerer, Klaus

    2009-07-01

    Photo-treatment for the removal of pharmaceuticals in effluents is a topic currently under discussion. In some countries effluents from hospitals are directly emitted into open ditches without any further treatment and with very little dilution. Under such circumstances photo-degradation in the environment can occur. However, photo-degradation does not necessarily end up with the complete mineralization of a chemical. Therefore, photo-product biodegradability and toxicity against environmental bacteria is of interest. Hospital effluents have often a pH around 9. Therefore, photo-oxidation (150W medium-pressure Hg-lamp, batch reactor) of ciprofloxacin (CIP) was studied at pH 9. The primary elimination of CIP was monitored and structures of photo-products were assessed by liquid chromatography ion trap mass spectrometry (LC-MS/MS). Five compounds were identified as probable products of photo-defluorination, -decarboxylation and loss of the piperazine moiety. These photo-products were not biodegradable in the Closed Bottle test - OECD 301D. They did not affect Vibrio fisheri in the applied concentrations.

  8. A novel visible light-driven Ag{sub 3}PO{sub 4}/SBA-15 nanocomposite: Preparation and application in the photo-degradation of pollutants

    Energy Technology Data Exchange (ETDEWEB)

    Chai, Yuanyuan; Wang, Li; Ren, Jia; Dai, Wei-Lin, E-mail: wldai@fudan.edu.cn

    2015-01-01

    Graphical abstract: - Highlights: • Highly efficient visible-light-driven Ag{sub 3}PO{sub 4}/SBA-15 nanocomposite. • Application in the photo-degradation of RhB. • Synthesis from a facile and simple colloidal method. • 20%-Ag{sub 3}PO{sub 4}/SBA-15 shows 8 times faster degradation rate than Ag{sub 3}PO{sub 4}. • Super stability and recycling ability. - Abstract: A novel visible light-driven environmental-benign Ag{sub 3}PO{sub 4}/SBA-15 nanocomposite photo-catalyst was synthesized for the photo-degradation of pollutants. The exploration on adsorption and photo-catalysis of dye or organic pollution for the nanocomposite was carried out. The adsorption capability for Ag{sub 3}PO{sub 4}/SBA-15 nanocomposite increases by 3 times compared with that of the Ag{sub 3}PO{sub 4} particles. The photo-catalytic activity of nanocomposite is higher than pristine Ag{sub 3}PO{sub 4} nanoparticle for the degradation of RhB or MO under visible light irradiation (λ > 420 nm). The effect of Ag{sub 3}PO{sub 4} loading on the catalytic performance was also studied. The results show that the optimum degradation is achieved over 20% Ag{sub 3}PO{sub 4}/SBA-15. Compared to pure Ag{sub 3}PO{sub 4} nanoparticle, the most efficient catalyst showed 8 times higher photo-catalytic activity for the degradation of RhB. The Ag{sub 3}PO{sub 4}/SBA-15 catalysts were systematically characterized by X-ray diffraction (XRD), transmission electron microscopy (TEM), X-ray photoelectron spectroscopy (XPS), UV–Vis diffuse reflectance spectroscopy (DRS), and N{sub 2}-adsorption–desorption isotherms (BET). A possible mechanism scheme regarding photo-degradation enhancement induced by dye enrichments has been proposed on the Ag{sub 3}PO{sub 4}/SBA-15 nanocomposite. Additionally, the SBA-15 support can enhance the efficiency of separation of catalyst from the reaction mixture, implying that the Ag{sub 3}PO{sub 4} loading on the SBA-15 catalyst will not result in the extra environment and health

  9. A novel visible light-driven Ag3PO4/SBA-15 nanocomposite: Preparation and application in the photo-degradation of pollutants

    Science.gov (United States)

    Chai, Yuanyuan; Wang, Li; Ren, Jia; Dai, Wei-Lin

    2015-01-01

    A novel visible light-driven environmental-benign Ag3PO4/SBA-15 nanocomposite photo-catalyst was synthesized for the photo-degradation of pollutants. The exploration on adsorption and photo-catalysis of dye or organic pollution for the nanocomposite was carried out. The adsorption capability for Ag3PO4/SBA-15 nanocomposite increases by 3 times compared with that of the Ag3PO4 particles. The photo-catalytic activity of nanocomposite is higher than pristine Ag3PO4 nanoparticle for the degradation of RhB or MO under visible light irradiation (λ > 420 nm). The effect of Ag3PO4 loading on the catalytic performance was also studied. The results show that the optimum degradation is achieved over 20% Ag3PO4/SBA-15. Compared to pure Ag3PO4 nanoparticle, the most efficient catalyst showed 8 times higher photo-catalytic activity for the degradation of RhB. The Ag3PO4/SBA-15 catalysts were systematically characterized by X-ray diffraction (XRD), transmission electron microscopy (TEM), X-ray photoelectron spectroscopy (XPS), UV-Vis diffuse reflectance spectroscopy (DRS), and N2-adsorption-desorption isotherms (BET). A possible mechanism scheme regarding photo-degradation enhancement induced by dye enrichments has been proposed on the Ag3PO4/SBA-15 nanocomposite. Additionally, the SBA-15 support can enhance the efficiency of separation of catalyst from the reaction mixture, implying that the Ag3PO4 loading on the SBA-15 catalyst will not result in the extra environment and health problems and reduce the cost of wastewater treatment.

  10. Seed-mediated synthesis and the photo-degradation activity of ZnO-graphene hybrids excluding the influence of dye adsorption

    Science.gov (United States)

    Fu, Dongying; Han, Gaoyi; Yang, Feifei; Zhang, Tianwen; Chang, Yunzhen; Liu, Feifei

    2013-10-01

    The nano-sized ZnO-graphene hybrid has been prepared through combining the facile sol-gel process and hydrothermal method by using Zn(NO3)2·6H2O and hexamethylenetetramine (HMT) as growing reactants in the presence of ZnO-graphene oxide (ZnO-GO) seeds. The obtained products have been characterized by X-ray diffraction, scanning electron microscopy, transmission electron microscopy, X-ray photoelectron spectroscopy, Raman spectroscopy and UV-vis absorption spectroscopy. The results show that the GO has been converted to reduced-graphene oxide during the hydrothermal process due to the released reductant from HMT. The photo-degradation of methylene blue in the presence of ZnO-graphene (excluding the influence of the dye adsorption on the catalyst) has also been investigated in detail. It is found that the preparation conditions have significant effects on photo-catalytic properties of the composites, and that ZnO-graphene prepared in the optimal conditions exhibits the optimum activity. This facile and low-cost method will make the composite a perfect candidate in applications of photo-catalysis and other areas.

  11. TiO2 coated CuO nanowire array: Ultrathin p-n heterojunction to modulate cationic/anionic dye photo-degradation in water

    Science.gov (United States)

    Scuderi, Viviana; Amiard, Guillaume; Sanz, Ruy; Boninelli, Simona; Impellizzeri, Giuliana; Privitera, Vittorio

    2017-09-01

    We report the photocatalytic efficiency of CuO nanowires covered with a thin TiO2 film, studied by dyes degradation in water. The CuO nanowires were synthesized on Cu foils by thermal oxidation. A subsequent TiO2 deposition (7, 15, 30, 50 nm thick) was performed by atomic layer deposition, developing an ultrathin p-n heterojunction. A structural characterization was obtained by X-ray diffraction analysis, scanning and transmission electron microscopies equipped with energy dispersive x-ray analysis. The photocatalytic activity of the investigated materials was tested by the degradation of a cationic (methylene blue) or anionic (methyl orange). The relevance of the reported results was discussed in relation with the effects of the ultrathin p-n TiO2/CuO heterojunction. The two semiconductors are in intimate connection increasing the exposed surface and only TiO2 is directly in contact with water. This allowed to study systematically the effect of the electric filed generated by the p-n junction on the interface TiO2/liquid and therefore to modulate cationic/anionic dyes photo-degradation in water.

  12. Seed-mediated synthesis and the photo-degradation activity of ZnO–graphene hybrids excluding the influence of dye adsorption

    Energy Technology Data Exchange (ETDEWEB)

    Fu, Dongying; Han, Gaoyi, E-mail: han_gaoyis@sxu.edu.cn; Yang, Feifei; Zhang, Tianwen; Chang, Yunzhen; Liu, Feifei

    2013-10-15

    The nano-sized ZnO–graphene hybrid has been prepared through combining the facile sol–gel process and hydrothermal method by using Zn(NO{sub 3}){sub 2}·6H{sub 2}O and hexamethylenetetramine (HMT) as growing reactants in the presence of ZnO–graphene oxide (ZnO–GO) seeds. The obtained products have been characterized by X-ray diffraction, scanning electron microscopy, transmission electron microscopy, X-ray photoelectron spectroscopy, Raman spectroscopy and UV–vis absorption spectroscopy. The results show that the GO has been converted to reduced-graphene oxide during the hydrothermal process due to the released reductant from HMT. The photo-degradation of methylene blue in the presence of ZnO–graphene (excluding the influence of the dye adsorption on the catalyst) has also been investigated in detail. It is found that the preparation conditions have significant effects on photo-catalytic properties of the composites, and that ZnO–graphene prepared in the optimal conditions exhibits the optimum activity. This facile and low-cost method will make the composite a perfect candidate in applications of photo-catalysis and other areas.

  13. Solanapyrones, Phytotoxins Produced by Alternaria solani: Biosynthesis and Isolation of Minor Components.

    Science.gov (United States)

    Oikawa, H; Yokota, T; Sakano, C; Suzuki, Y; Naya, A; Ichihara, A

    1998-01-01

    Two minor components of solanapyrones D and E, phytotoxins from Alternaria solani, were isolated. The absolute stereochemistry of D and the optical purity of solanapyrones A and D were determined by chemical transformation and measurement of the CD spectrum. In addition, complete signal assignment of the (1)H- and (13)C-NMR spectra of solanapyrones A and D, and their solution conformations were studied. Feeding experiments with various isotopically labeled acetates and methionine established the biosynthetic pathway of solanapyrones. The phytotoxicity of solanapyrones on lettuce seedlings is discussed.

  14. Mevalocidin: a novel, phloem mobile phytotoxin from Fusarium DA056446 and Rosellinia DA092917.

    Science.gov (United States)

    Gerwick, B Clifford; Brewster, William K; Deboer, Gerrit J; Fields, Steve C; Graupner, Paul R; Hahn, Donald R; Pearce, Cedric J; Schmitzer, Paul R; Webster, Jeffery D

    2013-02-01

    A multiyear effort to identify new natural products was built on a hypothesis that both phytotoxins from plant pathogens and antimicrobial compounds might demonstrate herbicidal activity. The discovery of one such compound, mevalocidin, is described in the current report. Mevalocidin was discovered from static cultures of two unrelated fungal isolates designated Rosellinia DA092917 and Fusarium DA056446. The chemical structure was confirmed by independent synthesis. Mevalocidin demonstrated broad spectrum post-emergence activity on grasses and broadleaves and produced a unique set of visual symptoms on treated plants suggesting a novel mode of action. Mevalocidin was rapidly absorbed in a representative grass and broadleaf plant. Translocation occurred from the treated leaf to other plant parts including roots confirming phloem as well as xylem mobility. By 24 hr after application, over 20 % had been redistributed through-out the plant. Mevalocidin is a unique phytotoxin based on its chemistry, with the uncommon attribute of demonstrating both xylem and phloem mobility in grass and broadleaf plants.

  15. Facile synthesis of aluminium doped zinc oxide-polyaniline hybrids for photoluminescence and enhanced visible-light assisted photo-degradation of organic contaminants

    Science.gov (United States)

    Mitra, Mousumi; Ghosh, Amrita; Mondal, Anup; Kargupta, Kajari; Ganguly, Saibal; Banerjee, Dipali

    2017-04-01

    The emergence of organic-inorganic photoactive materials has led to marked progress in the field of heterogeneous visible-light photocatalysis. Visible-light active aluminium doped zinc oxide-polyaniline (PAZ) hybrid was prepared employing in-situ oxidative polymerization of polyaniline (PANI) in the presence of aluminium doped zinc oxide (AlZnO) nanorods, synthesized via sol-gel route. The compositions, structural and optical properties of the synthesized hybrids were characterized. Among various samples, the 22 wt% aluminium doped zinc oxide-polyaniline (PAZ 3) hybrid show the best photocatalytic action for the degradation of methyl orange (MO) and rose bengal (RB) dyes under visible-light illumination, even after repeated use. The performance of the photocatalytic process was determined by the first order rate constant, 1.77 × 10-2 min-1 and 2.61 × 10-2 min-1 for MO and RB dyes, respectively. Scavenger test was used to determine the role of active species and accordingly a mechanism was proposed. Electrochemical impedance spectroscopy and linear scan voltammetry under dark and visible-light irradiation also established the visible-light activity of the PAZ hybrid due to decrease in the electron transfer resistance that resulted in an enhancement in photocurrent. The significant enhancement of photo degradation may be attributed to the efficiency of charge separation, induced by synergistic effect between an organic conductor PANI and an inorganic semiconductor AlZnO. Owing to its superior photo electrochemical performance and photocatalytic degradation, aluminium doped zinc oxide-polyaniline (PAZ) hybrid offers stable and efficient organic-inorganic hybrid hetero-structures in near future.

  16. Phytotoxin solanapyrone A produced by Ascochyta rabiei and Alternaria solani is nonessential for pathogenicity, but likely plays ecological roles

    Science.gov (United States)

    Ascochyta rabiei and Alternaria solani, causal agents of chickpea and potato blights respectively, produce the same phytotoxin solanapyrone A (SolA).The toxicity of SolA to plants has been documented, but its role in pathogenicity has not been investigated. In this study, we generated solanapyrone-d...

  17. Photo-degradation of basic green 1 and basic red 46 dyes in their binary solution by La2O3-Al2O3nanocomposite using first-order derivative spectra and experimental design methodology.

    Science.gov (United States)

    Fahimirad, Bahareh; Asghari, Alireza; Rajabi, Maryam

    2017-02-10

    In this work, the lanthanum oxide-aluminum oxide (La2O3-Al2O3) nanocomposite is introduced as an efficient photocatalyst for the photo-degradation of the dyes basic green 1 (BG1) and basic red 46 (BR46) in their binary aqueous solution under the UV light irradiation. The properties of this catalyst are determined by X-ray diffraction (XRD), scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDX), Brunauer-Emmett-Teller (BET), and UV-visible spectrophotometry. The first-order derivative spectra are used for the simultaneous analysis of the dyes in their binary solution. The screening investigations indicate that five parameters including the catalyst dosage, concentration of the dyes, irradiation time, and solution pH have significant effects on the photo-degradation of the dyes. The effects of these variables together with their interactions in the photo-degradation of the dyes are studied using the Box-Behnken design (BBD). Under the optimum experimental conditions, obtained via the desirability function, the photo-catalytic activities of La2O3-Al2O3 and pure Al2O3 are also investigated. The results obtained show an enhancement in the photo-catalytic activity when La2O3 nanoparticles are loaded on the surface of Al2O3 nanoparticles.

  18. Visible light photo catalytic inactivation of bacteria and photo degradation of methylene blue with Ag/TiO2 nanocomposite prepared by a novel method.

    Science.gov (United States)

    Tahir, Kamran; Ahmad, Aftab; Li, Baoshan; Nazir, Sadia; Khan, Arif Ullah; Nasir, Tabassum; Khan, Zia Ul Haq; Naz, Rubina; Raza, Muslim

    2016-09-01

    Water purification is one of the worldwide problem and most of the conventional methods are associated with a number of drawbacks. Therefore it is the need of the day to develop new methods and materials to overcome the problem of water purification. In this research work we present a simple and green approach to synthesize silver decorated titanium dioxide (Ag/TiO2) nanocomposite with an efficient photo catalytic activities. Phytochemicals of the Cestrum nocturnum leaf extract were used to synthesize silver nanoparticles (AgNPs), Titanium dioxide (TiO2) and Ag/TiO2 nanocomposite. To confirm the formation, crystal structure, particle size and shape of green synthesized nanoparticles and nanocomposite, they were characterized by UV-visible spectroscopy (UV-vis), X-ray diffraction spectroscopy (XRD), high resolution transmission electron microscopy (HRTEM), Scanning electron microscopy (SEM) and Fourier transform infrared spectroscopy (FT-IR). The AgNPs, TiO2 and Ag/TiO2 were evaluated for photo degradation of methylene blue (MB) and photo inhibition of Bacteria. The bio-synthesized Ag/TiO2 nanocomposite was observed to have strong catalytic activities for photo reduction of MB and photo inactivation of bacteria as compared to bare AgNPs and TiO2. In the presence of Ag/TiO2, 90% of MB was degraded only in 40min of irradiation. Alternatively the bare AgNPs and TiO2 degraded less than 30% and 80% respectively of MB even in more than 100min of irradiation. Similarly the Ag/TiO2 has very strong photo inhibition efficiency towards Escherichia coli and Pseudomonas aeruginosa. The zone of inhibition of irradiated Ag/TiO2 nanocomposites against E. coli and P. aeruginosa was 19mm and 17mm respectively which was two times higher than in dark. These promising photocatalytic activities of nanocomposite may be due to the highly decorated AgNPs over the surface of TiO2.

  19. Biotransformation of the streptomyces scabies phytotoxin thaxtomin A by the fungus aspergillus niger

    Energy Technology Data Exchange (ETDEWEB)

    Lazarovits, G.; Hill, J. [Agriculture and Agri-Food Canada, Southern Crop Protection and Food Research Centre, London, Ontario (Canada)]. E-mail: Lazarovitsg@agr.gc.ca; King, R. [Agriculture and Agri-Food Canada, Potato Research Centre, Fredericton, New Brunswick (Canada); Calhoun, L.A. [Univ. of New Brunswick, Dept. of Chemistry, Fredericton, New Brunswick (Canada)

    2004-07-01

    Of several hundred microorganisms randomly selected from the environment, only a fungal isolate identified as Aspergillus niger van Tiegham var. niger was found to transform the phytotoxin thaxtomin A to much less toxic metabolites. The rate and extent of transformation of thaxtomin A was tested under a variety of conditions, including different growth media, biomass concentrations, incubation periods, and shaker speeds. Under optimum conditions the fungus converted thaxtomin A into two major and five minor metabolites. The two major metabolites and three of the five minor metabolites were fully characterized by a combination of mass spectral and nuclear magnetic resonance techniques. When assayed on aseptically produced mini-tubers, the major metabolites proved to be much less phytotoxic than thaxtomin A. (author)

  20. The phytotoxin coronatine is a multifunctional component of the virulence armament of Pseudomonas syringae.

    Science.gov (United States)

    Geng, Xueqing; Jin, Lin; Shimada, Mikiko; Kim, Min Gab; Mackey, David

    2014-12-01

    Plant pathogens deploy an array of virulence factors to suppress host defense and promote pathogenicity. Numerous strains of Pseudomonas syringae produce the phytotoxin coronatine (COR). A major aspect of COR function is its ability to mimic a bioactive jasmonic acid (JA) conjugate and thus target the JA-receptor COR-insensitive 1 (COI1). Biological activities of COR include stimulation of JA-signaling and consequent suppression of SA-dependent defense through antagonistic crosstalk, antagonism of stomatal closure to allow bacterial entry into the interior of plant leaves, contribution to chlorotic symptoms in infected plants, and suppression of plant cell wall defense through perturbation of secondary metabolism. Here, we review the virulence function of COR, including updates on these established activities as well as more recent findings revealing COI1-independent activity of COR and shedding light on cooperative or redundant defense suppression between COR and type III effector proteins.

  1. Computational ECD spectrum simulation of the phytotoxin scytalone: importance of solvent effects on conformer populations.

    Science.gov (United States)

    Mazzeo, Giuseppe; Cimmino, Alessio; Andolfi, Anna; Evidente, Antonio; Superchi, Stefano

    2014-09-01

    A time-dependent Density Functional Theory (TDDFT) computational simulation of the electronic circular dichroism (ECD) spectrum of the phytotoxin scytalone (1), produced by different plant pathogenic fungi and involved in melanin production, was undertaken with the aim to establish a nonempirical correlation between the spectrum and the absolute configuration of this compound. In fact, very low optical rotation data of do not afford a reliable absolute configuration assignment while, on the contrary, the use of ECD can provide a useful tool for its stereochemical description. This structurally simple molecule displayed a considerable molecular flexibility, which made it mandatory to obtain an accurate conformers distribution to get a good reproduction of the experimental ECD spectrum. Only the application of an implicit integral equation formalism Polarizable Continuum Model (IEF-PCM) solvation model in the calculations allowed us to properly describe the conformer populations and finally obtain a more than satisfactory spectral simulation.

  2. Absolute configurations of phytotoxins seiricardine A and inuloxin A obtained by chiroptical studies.

    Science.gov (United States)

    Santoro, Ernesto; Mazzeo, Giuseppe; Petrovic, Ana G; Cimmino, Alessio; Koshoubu, Jun; Evidente, Antonio; Berova, Nina; Superchi, Stefano

    2015-08-01

    The absolute configuration (AC) of the plant phytotoxin inuloxin A, produced by Inula viscosa, and of the fungal phytotoxin seiricardine A, obtained from Seiridium fungi, pathogen for cypress, has been determined by experimental measurements and theoretical simulations of chiroptical properties of three related methods, namely, Optical Rotatory Dispersion (ORD), Electronic Circular Dichroism (ECD), and Vibrational Circular Dichroism (VCD). Computational prediction by Density Functional Theory (DFT) of VCD spectra and by Time-dependent DFT (TDDFT) of ORD and ECD spectra allowed to assign (7R,8R,10S) AC to naturally occurring (+)-inuloxin A. In the case of compound (-)-seiricardine A, which lacks useful for the analysis UV-Vis absorption, and thus provides a hardly detectable ECD spectrum and quite low ORD values, an introduction of a suitable chromophore by chemical derivatization was performed. The corresponding derivative, 2-O-p-bromobenzoate ester, gave rise to an intense ECD spectrum and higher ORD and VCD values. The comparison of computed spectra with the experimental ones allowed to assign (1S,2R,3aS,4S,5R,7aS) AC to (-)-2-O-p-bromobenzoate ester of seiricardine A and then to (-)-seiricardine A. This study further supports a recent trend of concerted application of more than a single chiroptical technique toward an unambiguous assignment of AC of flexible and complex natural products. Moreover, the use of chemical derivatization, with insertion of suitable chromophoric moieties has allowed to treat also UV-Vis transparent molecules by ECD and ORD spectroscopies.

  3. Effects of Eight Ions on Photo-Degradation of Cis-Cypermethrion in Water%卤素离子对顺式氯氰菊酯在水中光降解的影响

    Institute of Scientific and Technical Information of China (English)

    邹雅竹; 龚道新

    2016-01-01

    The effects of several anions(Na+、K+、SO42-、Cl-、Br-、I-) on the photo-degradation of α-cypermethrin in water were studied under high pressure mercury lamp (HPML). The results showed that the following anions: Na+, K+, SO42- almost had no effects on the photo-degradation of α-cypermethrin; the halogen anions - Cl-, Br-, I- all were quencher to α-cypermethrin and the effects were in positive correlation with its concentration; the effects of three halogen anions on α-cypermethrin were in order of I-> Br-> Cl-. It can be concluded: we could chose sodium salt or kalium salt for which had no effect on the photo-degradation, meanwhile, Cl-, Br-, I-had great effects on the photo-degradation of α-cypermethrin. Therefore, when assessing the environmental behavior and effect of α-cypermethrin, it is also vital to consider the influence of co-existing anions in water.%以高压汞灯为光源,研究了水体中存在的几种离子(Na+、K+、SO42-、Cl-、Br-、I-)对顺式氯氰菊酯光解的影响。实验结果表明Na+、K+、SO42原这3种离子对顺式氯氰菊酯几乎没有影响,在添加K2SO4和Na2SO4的情况下顺式氯氰菊酯的光解半衰期与在纯水中的半衰期的相比率分别为1.01及1.02;卤素离子Cl-、Br-、I-均对顺式氯氰菊酯有光猝灭作用,而且随着浓度的增大,猝灭作用增强;这3种卤素离子对顺式氯氰菊酯光猝灭作用的大小为I->Br->Cl-;这说明,在进行各种离子对顺式氯氰菊酯光解研究时,为避免综合因素影响可以选择钠盐或钾盐;另外Cl-、Br-、I-对顺式氯氰菊酯光解有着较大影响。

  4. The phytotoxin coronatine induces light-dependent reactive oxygen species in tomato seedlings.

    Science.gov (United States)

    Ishiga, Yasuhiro; Uppalapati, Srinivasa Rao; Ishiga, Takako; Elavarthi, Sathya; Martin, Bjorn; Bender, Carol L

    2009-01-01

    The phytotoxin coronatine (COR), which is produced by Pseudomonas syringae pv. tomato DC3000 (DC3000), has multiple roles in virulence that lead to chlorosis and a reduction in chlorophyll content. However, the physiological significance of COR-induced chlorosis in disease development is still largely unknown. Global expression analysis demonstrated that DC3000 and COR, but not the COR-defective mutant DB29, caused reduced expression of photosynthesis-related genes and result in a 1.5- to 2-fold reduction in maximum quantum efficiency of photosystem II (F(V)/F(M)). Tomato (Solanum lycopersicum) seedlings inoculated with DC3000 and incubated in a long daily photoperiod showed more necrosis than inoculated seedlings incubated in either dark or a short daily photoperiod. The accumulation of reactive oxygen species (ROS) was detected in cotyledons inoculated with either purified COR or DC3000 but not in tissues inoculated with DB29. Interestingly, COR-induced ROS accumulated only in light and was inhibited by 3-(3,4-dichlorophenyl)-1,1-dimethylurea and diphenylene iodonium, which function to inhibit electron transport from PSII. Furthermore, COR and DC3000 suppressed expression of the gene encoding the thylakoid Cu/Zn superoxide dismutase but not the cytosolic form of the same enzyme. In conclusion, these results demonstrate a role for COR-induced effects on photosynthetic machinery and ROS in modulating necrotic cell death during bacterial speck disease of tomato.

  5. 含氨甲酸铁络合物光敏剂的聚乙烯膜光降解性能的研究%Photo-degradable Property of Polyethylene Films with FeDRC Photosensitizers

    Institute of Scientific and Technical Information of China (English)

    廖明义; 杨玉涛

    2001-01-01

    A series of photosensitizers of ferrum complex withdialkyl-dithiocarbamic acid as ligand is synthesized,their infrared and ultraviolet spectra are tested.Based on artificial acceleration ultraviolet photo-degradation and natural exposure experiments,mechanical properties,viscometric average molecular weigh,infrared absorption and changes of carbonyl index of LDPE films with photosensitizers are measured.Results show that degradable effect of LDPE films with incorporation of 0.1 FEDIPC is better than that of those with other photosensitizers obviously.%合成了以二烷基二硫代氨基甲酸为配体的一系列铁络合物光敏剂,测试了光敏剂的红外和紫外光谱。通过人工加速紫外光降解试验和自然曝露试验,测定了含光敏剂的LDPE膜的力学性能、粘均相对分子质量、红外吸收及羰基指数的变化。结果表明:加入了0.1%二异丙基氨基甲酸铁(FeDIPC)的LDPE膜的光降解效果明显优于含其它光敏剂的LDPE膜。

  6. UHPLC-PDA-ESI-TOF/MS metabolic profiling and antioxidant capacity of arabica and robusta coffee silverskin: Antioxidants vs phytotoxins.

    Science.gov (United States)

    Panusa, Alessia; Petrucci, Rita; Lavecchia, Roberto; Zuorro, Antonio

    2017-09-01

    A deeper knowledge of the chemical composition of coffee silverskin (CS) is needed due to the growing interest in its use as a food additive or an ingredient of dietary supplements. Accordingly, the aim of this paper was to investigate the metabolic profile of aqueous extracts of two varieties of CS, Coffee arabica (CS-A), Coffee canephora var. robusta (CS-R) and of a blend of the two (CS-b) and to compare it to the profile of Coffee arabica green coffee (GC). Chlorogenic acids, caffeine, furokauranes, and atractyligenins, phytotoxins not previously detected in CS, were either identified or tentatively assigned. An unknown compound, presumably a carboxyatractyligenin glycoside was detected only in GC. Caffeine and chlorogenic acids were quantified while the content of furokauranes and atractyligens was estimated. GC and CS were also characterized in terms of total polyphenols and antioxidant capacity. Differences in the metabolites distribution, polyphenols and antioxidant capacity in GC and CS were detailed. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. The fungal phytotoxin alternariol 9-methyl ether and some of its synthetic analogues inhibit the photosynthetic electron transport chain.

    Science.gov (United States)

    Demuner, Antonio Jacinto; Barbosa, Luiz Cláudio Almeida; Miranda, Ana Cristina Mendes; Geraldo, Guilherme Carvalho; da Silva, Cleiton Moreira; Giberti, Samuele; Bertazzini, Michele; Forlani, Giuseppe

    2013-12-27

    Alternariol and monomethylalternariol are natural phytotoxins produced by some fungal strains, such as Nimbya and Alternaria. These substances confer virulence to phytopathogens, yet no information is available concerning their mode of action. Here we show that in the micromolar range alternariol 9-methyl ether is able to inhibit the electron transport chain (IC50 = 29.1 ± 6.5 μM) in isolated spinach chloroplasts. Since its effectiveness is limited by poor solubility in water, several alternariol analogues were synthesized using different aromatic aldehydes. The synthesized 6H-benzo[c]cromen-6-ones, 5H-chromene[4,3-b]pyridin-5-one, and 5H-chromene[4,3-c]pyridin-5-one also showed inhibitory properties, and three 6H-benzo[c]cromen-6-ones were more effective (IC50 = 12.8-22.8 μM) than the lead compound. Their addition to the culture medium of a cyanobacterial model strain was found to inhibit algal growth, with a relative effectiveness that was consistent with their activity in vitro. In contrast, the growth of a nonphotosynthetic plant cell culture was poorly affected. These compounds may represent a novel lead for the development of new active principles targeting photosynthesis.

  8. Regulation of coronafacoyl phytotoxin production by the PAS-LuxR family regulator CfaR in the common scab pathogen Streptomyces scabies.

    Directory of Open Access Journals (Sweden)

    Zhenlong Cheng

    Full Text Available Potato common scab is an economically important crop disease that is characterized by the formation of superficial, raised or pitted lesions on the potato tuber surface. The most widely distributed causative agent of the disease is Streptomyces scabies, which produces the phytotoxic secondary metabolite thaxtomin A that serves as a key virulence factor for the organism. Recently, it was demonstrated that S. scabies can also produce the phytotoxic secondary metabolite coronafacoyl-L-isoleucine (CFA-L-Ile as well as other related metabolites in minor amounts. The expression of the biosynthetic genes for CFA-L-Ile production is dependent on a PAS-LuxR family transcriptional regulator, CfaR, which is encoded within the phytotoxin biosynthetic gene cluster in S. scabies. In this study, we show that CfaR activates coronafacoyl phytotoxin production by binding to a single site located immediately upstream of the putative -35 hexanucleotide box within the promoter region for the biosynthetic genes. The binding activity of CfaR was shown to require both the LuxR and PAS domains, the latter of which is involved in protein homodimer formation. We also show that CFA-L-Ile production is greatly enhanced in S. scabies by overexpression of both cfaR and a downstream co-transcribed gene, orf1. Our results provide important insight into the regulation of coronafacoyl phytotoxin production, which is thought to contribute to the virulence phenotype of S. scabies. Furthermore, we provide evidence that CfaR is a novel member of the PAS-LuxR family of regulators, members of which are widely distributed among actinomycete bacteria.

  9. 紫外光和光氧化剂对水中氯仿及 三氯乙烯和四氯乙烯的光降解作用%Photo-Degradation of Chloroform, Trichloroethylene and Tetrachloroethylene in Water by UV and Photo-Oxidants

    Institute of Scientific and Technical Information of China (English)

    周细红; 曾清如

    2001-01-01

    为了探明紫外光和光氧化剂对卤烃光降解的影响,以H2O2和H2O2/草酸铁络合物为光氧化剂,研究了紫外光对氯仿、三氯乙烯和四氯乙烯的降解.结果表明,紫外光、紫外光/H2O2体系能有效地加速水溶液中三氯乙烯和四氯乙烯的光降解,但不能降解氯仿;而紫外光/ H2O2/草酸铁或紫外光/草酸铁络合物体系能有效地使水溶液中氯仿、三氯乙烯和四氯乙烯烃迅速光解脱氯;溶液pH值对卤烃光解有显著影响,pH值为2.5~3.5时光解速率最快.随着H2O2质量浓度的增加,卤烃光解速率提高,但H2O2增大到一定质量浓度时,其脱氯量反而降低.%The photo-degradation of chloroform, trichloroethylene and tetrachloroethylene by H2O2 and H2O2-ferrioxalate complexes as photo-oxidants under irradiation of UV was compared. The results show that the photodegradation of two kinds of chloroethylene in aqueous solution by UV, UV/ H2O2 is very effective;the photodegradation of chloroform by the photo-oxidants is not obvious;the photodegradation of three kinds of chloronated hydrocarbons by UV/ H2O2 /ferrioxalate or UV/ferrioxalate complexes is very significant. pH has significant effects on the photo-degradation of halogenated hydrocarbons and the highest rate of photo-degradation happens at pH 2.5~3.5. The rate of photo-degradation of halogenated hydrocarbons increases with the rice of H2O2 concentration, but the amount of dechloridation decreases when the concentration of H2O2 reaches a certain level.

  10. Cyclopaldic acid, seiridin, and sphaeropsidin A as fungal phytotoxins, and larvicidal and biting deterrents against Aedes aegypti (Diptera: Culicidae): structure-activity relationships.

    Science.gov (United States)

    Cimmino, Alessio; Andolfi, Anna; Avolio, Fabiana; Ali, Abbas; Tabanca, Nurhayat; Khan, Ikhlas A; Evidente, Antonio

    2013-07-01

    Aedes aegypti L. is the major vector of the arboviruses responsible for dengue fever, one of the most devastating human diseases. From a preliminary screening of fungal phytotoxins, cyclopaldic acid (1), seiridin (2), sphaeropsidin A (4), and papyracillic acid (5) were evaluated for their biting deterrent and larvicidal activities against Ae. aegypti L. Because compounds 1, 2, 4, and 5 exhibited mosquito biting deterrent activities and 1 and 4 demonstrated larvicidal activities, further structureactivity relationship studies were initiated on these toxins. In biting-deterrence bioassays, 1, 2, 4, and 5, 3,8-didansylhydrazone of cyclopaldic acid, 1F, 5-azidopentanoate of cyclopaldic acid A, 1G, the reduced derivative of cyclopaldic acid, 1 H, isoseiridin (3), 2'-O-acetylseiridin (2A), 2'-oxoseiridin (2C), 6-O-acetylsphaeropsidin A (4A), 8,14-methylensphaeropsidin A methyl ester (4B), and sphaeropsidin B (4C) showed activities higher than the solvent control. Sphaeropsidin B (4C) was the most active compound followed by 2A, while the other compounds were less active. Biting-deterrence activity of compound 4C was statistically similar to DEET. In the larvicidal screening bioassays, only compounds 1 and 4 demonstrated larvicidal activities. Based on LD50 values, compound 4 (LD50 36.8 ppm) was significantly more active than compound 1 (LD50 58.2 ppm). However, the activity of these compounds was significantly lower than permethrin.

  11. -coated nanostructures for dye photo-degradation in water

    Science.gov (United States)

    Scuderi, Viviana; Impellizzeri, Giuliana; Romano, Lucia; Scuderi, Mario; Nicotra, Giuseppe; Bergum, Kristin; Irrera, Alessia; Svensson, Bengt G.; Privitera, Vittorio

    2014-09-01

    The photocatalytic efficiency of a thin-film TiO2-coated nanostructured template is studied by dye degradation in water. The nanostructured template was synthesized by metal-assisted wet etching of Si and used as substrate for the deposition of a thin film of TiO2 (10 nm thick) by atomic layer deposition. A complete structural characterization was made by scanning and transmission electron microscopies. The significant photocatalytic performance was evaluated by the degradation of two dyes in water: methylene blue and methyl orange. The relevance of the reported results is discussed, opening the route toward the application of the synthesized nanostructured TiO2 for water purification.

  12. Soil microbial response to photo-degraded C60 fullerenes.

    Science.gov (United States)

    Berry, Timothy D; Clavijo, Andrea P; Zhao, Yingcan; Jafvert, Chad T; Turco, Ronald F; Filley, Timothy R

    2016-04-01

    Recent studies indicate that while unfunctionalized carbon nanomaterials (CNMs) exhibit very low decomposition rates in soils, even minor surface functionalization (e.g., as a result of photochemical weathering) may accelerate microbial decay. We present results from a C60 fullerene-soil incubation study designed to investigate the potential links between photochemical and microbial degradation of photo-irradiated C60. Irradiating aqueous (13)C-labeled C60 with solar-wavelength light resulted in a complex mixture of intermediate products with decreased aromaticity. Although addition of irradiated C60 to soil microcosms had little effect on net soil respiration, excess (13)C in the respired CO2 demonstrates that photo-irradiating C60 enhanced its degradation in soil, with ∼ 0.78% of 60 day photo-irradiated C60 mineralized. Community analysis by DGGE found that soil microbial community structure was altered and depended on the photo-treatment duration. These findings demonstrate how abiotic and biotic transformation processes can couple to influence degradation of CNMs in the natural environment.

  13. Preparing of TiO2 Nanofibers Using Electrospinning and Its Application to Photo-degradation of Organic Compound%静电纺丝法制备纳米二氧化钛纤维及其光降解有机物的性能研究

    Institute of Scientific and Technical Information of China (English)

    李美杰; 陆军建

    2015-01-01

    The titania precursor solution is prepared through sol-gel process, and the PVP/TiO2 composite nanofibers are prepared using electrospinning technique. The titanium dioxide precursor fibers are calcinated at 450 ° C for TiO2 nanofibers. Good-shaped, equal-sized TiO2 nanofibers of 300-500 nm can be generated when a voltage of 18 kv, a collecting distance of 20 cm, and a needle speed of 0. 002 mm/s is applied. Fluorescence spectrum analysis shows that TiO2 nanofibers have remarkable catalytic effect on the photo-degradation of the organic light yellow compound.%采用溶胶-凝胶法制备二氧化钛前驱体溶液,借助静电纺丝技术纺丝出PVP/TiO2前驱体复合纤维,将前驱体复合纤维在450 o C煅烧后得到TiO2纳米纤维。当纺丝电压为18 kv,接受距离为20 cm,注射器推进速度为0.002 mm/s时,所制备的TiO2纤维尺寸均一且表面形貌佳,纤维的尺寸在300-500 nm。借助荧光光谱分析法,初步证明了TiO2纳米纤维对有机染料耐晒黄的光降解具有显著的催化作用。

  14. Assignment of the absolute configuration of (+)-diplopyrone, the main phytotoxin produced by Diplodia mutila, the pathogen of the cork oak decline, by a nonempirical analysis of its chiroptical properties.

    Science.gov (United States)

    Giorgio, Egidio; Maddau, Lucia; Spanu, Emanuela; Evidente, Antonio; Rosini, Carlo

    2005-01-07

    The nonempirical assignment of the absolute configuration of (+)-diplopyrone, the main phytotoxin of Diplodia mutila, i.e., an endophytic fungus, widespread in Sardinian oak forests, and considered one of the main causes of cork oak decline, has been approached by two different methods: (a) the exciton analysis of the circular dichroism (CD) spectrum and (b) the ab initio calculation of the optical rotatory power. Both methods indicate that (+)-diplopyrone is 6-[(1S)-1-hydroxyethyl]-2,4a(S),6(R),8a(S)-tetrahydropyrano[3,2-b]pyran-2-one, so the stereostructure of this important biomolecule is safely determined for the first time. A comparison of advantages and limitations of the two methods of analysis is also presented.

  15. Metabonomic strategy for the investigation of the mode of action of the phytotoxin (5S,8R,13S,16R)-(-)-pyrenophorol using 1H nuclear magnetic resonance fingerprinting.

    Science.gov (United States)

    Aliferis, Konstantinos A; Chrysayi-Tokousbalides, Maria

    2006-03-08

    The biochemical mode of action of (5S,8R,13S,16R)-(-)-pyrenophorol isolated from a Drechslera avenae pathotype was investigated by using metabolic fingerprinting. (1)H NMR spectra of crude leaf extracts from untreated Avena sterilis seedlings and A. sterilis seedlings treated with pyrenophorol were compared with those obtained from treatments with the herbicides diuron, glyphosate, mesotrione, norflurazon, oxadiazon, and paraquat. Multivariate analysis was carried out to group treatments according to the mode of action of the phytotoxic substances applied. Analysis results revealed that none of the herbicide treatments fitted the pyrenophorol model and indicate that the effect of the phytotoxin on A. sterilis differs than those caused by glyphosate, mesotrione, norflurazon, oxadiazon, paraquat, and diuron, which inhibit 5-enolpyruvylshikimate-3-phosphate synthase, 4-hydroxyphenyl-pyruvate-dioxygenase, phytoene desaturase, protoporphyrinogen oxidase, photosystem I, and photosystem II, respectively. The method applied, combined with appropriate data preprocessing and analysis, was found to be rapid for the screening of phytotoxic substances for metabolic effects.

  16. AtNFXL1, an Arabidopsis homologue of the human transcription factor NF-X1, functions as a negative regulator of the trichothecene phytotoxin-induced defense response.

    Science.gov (United States)

    Asano, Tomoya; Masuda, Daisuke; Yasuda, Michiko; Nakashita, Hideo; Kudo, Toshiaki; Kimura, Makoto; Yamaguchi, Kazuo; Nishiuchi, Takumi

    2008-02-01

    Trichothecenes are a closely related family of phytotoxins that are produced by phytopathogenic fungi. In Arabidopsis, expression of AtNFXL1, a homologue of the putative human transcription repressor NF-X1, was significantly induced by application of type A trichothecenes, such as T-2 toxin. An atnfxl1 mutant growing on medium lacking trichothecenes showed no phenotype, whereas a hypersensitivity phenotype was observed in T-2 toxin-treated atnfxl1 mutant plants. Microarray analysis indicated that several defense-related genes (i.e. WRKYs, NBS-LRRs, EDS5, ICS1, etc.) were upregulated in T-2 toxin-treated atnfxl1 mutants compared with wild-type plants. In addition, enhanced salicylic acid (SA) accumulation was observed in T-2 toxin-treated atnfxl1 mutants, which suggests that AtNFXL1 functions as a negative regulator of these defense-related genes via an SA-dependent signaling pathway. We also found that expression of AtNFXL1 was induced by SA and flg22 treatment. Moreover, the atnfxl1 mutant was less susceptible to a compatible phytopathogen, Pseudomonas syringae pv. tomato strain DC3000 (Pst DC3000). Taken together, these results indicate that AtNFXL1 plays an important role in the trichothecene response, as well as the general defense response in Arabidopsis.

  17. Phytotoxins from the leaves of Ruta graveolens.

    Science.gov (United States)

    Hale, Amber L; Meepagala, Kumudini M; Oliva, Anna; Aliotta, Giovanni; Duke, Stephen O

    2004-06-01

    Bioassay-guided fractionation of the ethyl acetate extract of Ruta graveolens (common rue) leaves led to the isolation of the furanocoumarins 5-methoxypsoralen (5-MOP), 8-methoxypsoralen (8-MOP), and the quinolone alkaloid graveoline as phytotoxic constituents. Graveoline and 8-MOP substantially inhibited growth of Lactuca sativa (lettuce) seedlings and reduced chlorophyll content at 100 microM; this effect was not due to a direct effect on chlorophyll synthesis. Radical growth of L. sativa was inhibited by 10 microM 8-MOP. Graveoline inhibited growth of Lemna paucicostata (duckweed) at 100 microM. This is the first report of the phytotoxic activity of graveoline. Growth of Agrostis stolonifera (bentgrass) was inhibited by 5-MOP at 30 microM. All three compounds substantially reduced cell division in Allium cepa (onion) at or below 100 microM. None of the compounds caused significant cellular leakage of Cucumis sativus (cucumber) cotyledon disks at 100 microM. All three compounds inhibit plant growth, at least partially through inhibition of cell division.

  18. Hydrothermal synthesis spherical TiO2 and its photo-degradation property on salicylic acid

    Science.gov (United States)

    Guo, Wenlu; Liu, Xiaolin; Huo, Pengwei; Gao, Xun; Wu, Di; Lu, Ziyang; Yan, Yongsheng

    2012-07-01

    Anatase TiO2 spheres have been prepared using hydrothermal synthesis. The prepared spheres were characterized by X-ray diffraction (XRD), scanning electron microscope (SEM) and UV-vis diffuse reflectance spectra (UV-vis DRS). The TiO2 consisted of well-defined spheres with size of 3-5 μm. The photocatalytic activity of spherical TiO2 was determined by degradation of salicylic acid under visible light irradiation. It was revealed that the degradation rate of the spherical TiO2 which was processed at 150 °C for 48 h could reach 81.758%. And the kinetics of photocatalytic degradation obeyed first-order kinetic, which the rate constant value was 0.01716 S-1 of the salicylic acid onto TiO2 (temperature: 150, time: 48 h). The kinetics of adsorption followed the pseudo-second-order model and the rate constant was 1.2695 g mg-1 of the salicylic acid onto TiO2 (temperature: 150, time: 48 h).

  19. Biopolymer-based thermoplastic mixture for producing solid biodegradable shaped bodies and its photo degradation stability

    Science.gov (United States)

    Sulong, Nurulsaidatulsyida; Rus, Anika Zafiah M.

    2013-12-01

    In recent years, biopolymers with controllable lifetimes have become increasingly important for many applications in the areas of agriculture, biomedical implants and drug release, forestry, wild life conservation and waste management. Natural oils are considered to be the most important class of renewable sources. They can be obtained from naturally occurring plants, such as sunflower, cotton, linseed and palm oil. In Malaysia, palm oil is an inexpensive and commodity material. Biopolymer produced from palm oil (Bio-VOP) is a naturally occurring biodegradable polymer and readily available from agriculture. For packaging use however, Bio-VOP is not thermoplastic and its granular form is unsuitable for most uses in the plastics industry, mainly due to processing difficulties during extrusion or injection moulding. Thus, research workers have developed several methods to blend Bio-VOP appropriately for industrial uses. In particular, injections moulding processes, graft copolymerisation, and preparation of blends with thermoplastic polymers have been studied to produce solid biodegradable shaped bodies. HDPE was chosen as commercial thermoplastic materials and was added with 10% Bio-VOP for the preparation of solid biodegradable shaped bodies named as HD-VOP. The UV light exposure of HD-VOP at 12 minutes upon gives the highest strength of this material that is 17.6 MPa. The morphological structure of HD-VOP shows dwi structure surface fracture which is brittle and ductile properties.

  20. Surface Investigation of Photo-Degraded Wood by Colour Monitoring, Infrared Spectroscopy, and Hyperspectral Imaging

    OpenAIRE

    Giorgia Agresti; Giuseppe Bonifazi; Luca Calienno; Giuseppe Capobianco; Angela Lo Monaco; Claudia Pelosi; Rodolfo Picchio; Silvia Serranti

    2013-01-01

    The aim of this investigation is to study the changes occurring on the surface of poplar wood exposed to artificial irradiation in a Solar Box. Colour changes were monitored with a reflectance spectrophotometer. Surface chemical modifications were evaluated by measuring the infrared spectra. Hyperspectral imaging was also applied to study the surface wood changes in the visible-near infrared and the short wave infrared wavelength ranges. The data obtained from the different techniques were co...

  1. TiO2-coated nanostructures for dye photo-degradation in water.

    Science.gov (United States)

    Scuderi, Viviana; Impellizzeri, Giuliana; Romano, Lucia; Scuderi, Mario; Nicotra, Giuseppe; Bergum, Kristin; Irrera, Alessia; Svensson, Bengt G; Privitera, Vittorio

    2014-01-01

    The photocatalytic efficiency of a thin-film TiO2-coated nanostructured template is studied by dye degradation in water. The nanostructured template was synthesized by metal-assisted wet etching of Si and used as substrate for the deposition of a thin film of TiO2 (10 nm thick) by atomic layer deposition. A complete structural characterization was made by scanning and transmission electron microscopies. The significant photocatalytic performance was evaluated by the degradation of two dyes in water: methylene blue and methyl orange. The relevance of the reported results is discussed, opening the route toward the application of the synthesized nanostructured TiO2 for water purification.

  2. An Effective Novel ReactionSystem For The Photo-Degradation of Aqueous Organic Pollutants

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    A novel reaction system consisted of a supported TiO2 film electrode, a Ru-Ti oxide film electrode and air (oxygen) electrode is reported. The air (oxygen) electrode can provide H2O2 continuously for homogeneous photochemical oxidation reaction on the spot. In this reactor, degradation reaction of aniline occur from interface of TiO2 film to ail solution which is irradiated by ultraviolet ray. The degradation rate of aniline was characterized by measuring the change of chemical oxygen demand (COD) in solution under different conditions. It was found that the degradation rate of aniline in the novel system increased apparently as compared with single heterogeneous photocatalysis and homogeneous photochemistry system. It can be explained in terms of combining acts of heterogeneous photocatalysis and homogeneous photochemistry.

  3. Concurrent dyes adsorption and photo-degradation on fly ash based substrates

    Energy Technology Data Exchange (ETDEWEB)

    M. Visa; L. Andronic; D. Lucaci; A. Duta [Transylvania University of Brasov, Brasov (Romania)

    2011-02-15

    Most of the dyes are organic compounds, with different degree of polarization and different groups with various steric effects, making their complete biodegradation slow or even impossible. Adsorption on fly ash and fly ash based substrates represents a possible alternative for simultaneous removal of dyes and heavy metals form wastewaters resulted in the textile industry. Adsorption (under visible light) and adsorption and photodegradation (under UV irradiation) studies were done on Methylene blue solutions and on their mixtures with heavy metals (copper and cadmium), in systems using fly ash as single substrate, or mixed with a wide band gap semiconductor (TiO{sub 2}). The titanium oxides and hematite content in fly ash proved to be responsible for photodegradation processes even in the absence of the TiO{sub 2} powder, confirming that modified fly ash is a viable candidate in developing up scalable processes for advanced wastewater treatment. The kinetic and thermodynamic studies allow to calculate the parameters and to describe the complex mechanisms, involving competitive adsorption.

  4. Surface Investigation of Photo-Degraded Wood by Colour Monitoring, Infrared Spectroscopy, and Hyperspectral Imaging

    Directory of Open Access Journals (Sweden)

    Giorgia Agresti

    2013-01-01

    Full Text Available The aim of this investigation is to study the changes occurring on the surface of poplar wood exposed to artificial irradiation in a Solar Box. Colour changes were monitored with a reflectance spectrophotometer. Surface chemical modifications were evaluated by measuring the infrared spectra. Hyperspectral imaging was also applied to study the surface wood changes in the visible-near infrared and the short wave infrared wavelength ranges. The data obtained from the different techniques were compared to find the possible correlations in order to evaluate the applicability of the Hyperspectral imaging to investigate wood modifications in a non-invasive modality. The study of colour changes showed an important variation due to photo-irradiation which is the greatest change occurring within the first 24 hours. Infrared spectroscopy revealed that lignin degrades mainly in the first 48 hours. Concerning Hyperspectral imaging, the spectral features in the visible-near infrared range are mainly linked to the spectral shape, whereas in the short wave infrared cellulose and lignin affect shape and reflectance levels. The proposed approach showed that a correlation can be established between colour variation and wood degradation in the visible-near infrared range; furthermore in the short wave infrared region surface chemical changes can be assessed.

  5. Solar photo-degradation of a pharmaceutical wastewater effluent in a semi-industrial autonomous plant.

    Science.gov (United States)

    Expósito, Antonio J; Durán, Antonio; Monteagudo, José M; Acevedo, Alba

    2016-05-01

    An industrial wastewater effluent coming from a pharmaceutical laboratory has been treated in a semi-industrial autonomous solar compound parabolic collector (CPC) plant. A photo-Fenton process assisted with ferrioxalate has been used. Up to 79% of TOC can be removed in 2 h depending on initial conditions when treating an aqueous effluent containing up to 400 ppm of initial organic carbon concentration (TOC). An initial ratio of Fe(II)/TOC higher than 0.5 guarantees a high removal. It can be seen that most of TOC removal occurs early in the first hour of reaction. After this time, mineralization was very slow, although H2O2 was still present in solution. Indeed it decomposed to form oxygen in inefficient reactions. It is clear that remaining TOC was mainly due to the presence of acetates which are difficult to degrade.

  6. Design inspections for systems undergoing design modifications

    Energy Technology Data Exchange (ETDEWEB)

    Grimes, B.K.; Norkin, D.P.

    1987-01-01

    The US Nuclear Regulatory Commission's (NRC's) Office of Inspection and Enforcement (IE) has conducted direct inspections (integrated design inspections) of the technical aspects of the nuclear plant design process for several plants under construction. It has also evaluated independent design verification programs and engineering assurance programs at a number of other plants under construction. Many of the lessons learned from these construction phase efforts are directly applicable to operating plants undergoing major modifications. This has been confirmed by IE direct inspections of the design aspects of safety systems outage modifications, which have identified significant potential safety-related deficiencies. The paper discusses methodology for design inspections; failure to maintain up-to-date design basis documentation; and lessons learned common to plants under construction and undergoing major modifications.

  7. Aspirin in patients undergoing noncardiac surgery

    DEFF Research Database (Denmark)

    Devereaux, P J; Mrkobrada, Marko; Sessler, Daniel I

    2014-01-01

    BACKGROUND: There is substantial variability in the perioperative administration of aspirin in patients undergoing noncardiac surgery, both among patients who are already on an aspirin regimen and among those who are not. METHODS: Using a 2-by-2 factorial trial design, we randomly assigned 10......,010 patients who were preparing to undergo noncardiac surgery and were at risk for vascular complications to receive aspirin or placebo and clonidine or placebo. The results of the aspirin trial are reported here. The patients were stratified according to whether they had not been taking aspirin before...... the study (initiation stratum, with 5628 patients) or they were already on an aspirin regimen (continuation stratum, with 4382 patients). Patients started taking aspirin (at a dose of 200 mg) or placebo just before surgery and continued it daily (at a dose of 100 mg) for 30 days in the initiation stratum...

  8. Sleep Disorders in ESRD Patients Undergoing Hemodialysis

    OpenAIRE

    Mohammad Reza Abassi; Amin Safavi; Masoumeh Haghverdi; Babak Saedi

    2016-01-01

    Kidney failure affects different aspects of normal life. Among different manifestations, sleep problem can be considered as a common complaint of ESRD (End Stage Renal Disease) patients. In this study, we aimed to investigate the interrelationship between sleep disorders in ESRD patients and their characteristics. Through a cross-sectional study (2010-2011), 88 ESRD patients undergoing maintenance hemodialysis thrice weekly were recruited to enter the study. We used a self-administered questi...

  9. 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.

  10. Dermatillomania: In patient undergoing orthodontic treatment

    Directory of Open Access Journals (Sweden)

    Adit

    2014-01-01

    Full Text Available Dermatillomania is a disorder in which a person habitually picks their skin, and this is a form of self-injury. It can involve any part of the body, but usually involves the face, neck, arms and shoulders. Symptoms often follow an event that has caused severe emotional distress. A dermatillomania or compulsive skin picking episode may be a conscious response to anxiety or depression but is frequently done as an unconscious habit. In this case report, a patient undergoing orthodontic treatment was found to be suffering from dermatillomania and was treated using psychological counseling.

  11. Thromboprophylaxis for women undergoing caesarean section.

    LENUS (Irish Health Repository)

    Kennedy, C

    2012-02-01

    Thromboprophylaxis for women undergoing caesarean section (CS) was introduced in the hospital in 1995. This study audited the use of tinzaparin prophylaxis in a nested cohort of women who screened negative for diabetes mellitus at 28 weeks gestation. All the women had their weight measured and BMI calculated at the first antenatal visit. Of the 284 women, 68 (24%) had a CS and all received tinzaparin. Of the 68, however, 94% received a dose lower than recommended. Compliance with prophylaxis was complete but compliance with the recommended dosage was suboptimal, which may result in venous thromboembolism after CS despite thromboprophylaxis.

  12. Oral surgery in patients undergoing chemoradiation therapy.

    Science.gov (United States)

    Demian, Nagi M; Shum, Jonathan W; Kessel, Ivan L; Eid, Ahmed

    2014-05-01

    Oral health care in patients undergoing chemotherapy and/or radiation therapy can be complex. Care delivered by a multidisciplinary approach is timely and streamlines the allocation of resources to provide prompt care and to attain favorable outcomes. A hospital dentist, oral and maxillofacial surgeon, and a maxillofacial prosthodontist must be involved early to prevent avoidable oral complications. Prevention and thorough preparation are vital before the start of chemotherapy and radiation therapy. Oral complications must be addressed immediately and, even with the best management, can cause delays and interruption in treatment, with serious consequences for the outcome and prognosis. Copyright © 2014 Elsevier Inc. All rights reserved.

  13. Avaliação da capacidade de produzir fitotoxinas in vitro por parte de fungos com propriedades antagônicas a nematóides In vitro evaluation of the phytotoxin production ability by fungi with antagonic properties to nematodes

    Directory of Open Access Journals (Sweden)

    Daniel Diego Costa Carvalho

    2006-12-01

    Full Text Available Em trabalho preliminar foram obtidos 24 isolados fúngicos com propriedades antagônicas a nematóides parasitas de plantas segundo experimentos realizados em laboratório. Para dar continuidade a tal trabalho, tornou-se desejável dispor de metodologia simples e de baixo custo para selecionar aqueles sem capacidade de produção de substâncias fitotóxicas, para serem empregados em experimentos em casa-de-vegetação com fitonematóides. Conseqüentemente, cultivaram-se os fungos em meio líquido e, após filtração, as fases líquidas foram liofilizadas e extraídas com acetato de etila/metanol. Os extratos foram concentrados sob vácuo e dissolvidos em água e solução de sacarose para serem submetidos a testes in vitro com sementes de alface (Lactuca sativa L. e com coleóptilos de trigo (Triticum aestivum L., respectivamente. Vinte e três isolados pertencentes aos gêneros Arthrobotrys, Aspergillus, Coniothyrium, Cunninghamella, Cylindrocarpon, Fusarium, Monacrosporium, Mortierella, Paecilomyces, Penicillium, Sclerotinia, Trichoderma e Verticillium, apresentaram atividade tóxica contra os coleóptilos de trigo. Apenas os isolados de Cylindrocarpon magnusianum (Sacc. Wollenw., Fusarium moniliforme Shelden, Mortierella sp., Paecilomyces lilacinus (Thom. Samson e Penicillium sp. apresentaram atividade fitotóxica no teste com sementes de alface. Somente um isolado de F. moniliforme se mostrou inativo em ambos os testes, o que sugere que não seja produtor de fitotoxinas.In a previous work 24 fungi cultures were selected due to their antagonic properties to phytonematodes in laboratory experiments. To proceed to further studies, it became desirable to use a simple and inexpensive methodology to identify those fungi able to produce phytotoxic substances, so that only the non phytotoxin producers could be used in green-house experiments with plant parasite nematodes. Thus, fungi were grown in liquid medium and the resulting mixtures were

  14. Clinical effect of Fuzheng quyu therapy in patients undergoing ...

    African Journals Online (AJOL)

    undergoing radiotherapy after cervical carcinoma surgery ... level blood coagulation, and also improves quality of life (QoL) in patients undergoing radiotherapy after cervical ... require high postoperative QoL and hope to ... clinical symptoms.

  15. Extra-1 acupressure for children undergoing anesthesia.

    Science.gov (United States)

    Wang, Shu-Ming; Escalera, Sandra; Lin, Eric C; Maranets, Inna; Kain, Zeev N

    2008-09-01

    Acupuncture and related techniques have been used as adjuncts for perioperative anesthesia management. We examined whether acupressure in the Extra-1 (Yin-Tang) point would result in decreased preprocedural anxiety and reduced intraprocedural propofol requirements in a group of children undergoing endoscopic procedures. Fifty-two children were randomized to receive acupressure bead intervention either at the Extra-1 acupuncture point or at a sham point. A Bispectral Index (BIS) monitor was applied to all children before the onset of the intervention. Anxiety was assessed at baseline and before entrance to the operating room. Anesthetic techniques were standardized and maintained with IV propofol infusion titrated to keep BIS values of 40-60. We found that after the intervention, children in the Extra-1 group experienced reduced anxiety whereas children in the sham group experienced increased anxiety (-9% [-3 to -15] vs 2% [-6 to 7.4], P = 0.012). In contrast, no significant changes in BIS values were observed in the preprocedural waiting period between groups (P = ns). We also found that total intraprocedural propofol requirements did not differ between the two study groups (214 +/- 76 microg x kg(-1) x min(-1) vs 229 +/- 95 microg x kg(-1) x min(-1), P = 0.52). We conclude that acupressure bead intervention at Extra-1 acupoint reduces preprocedural anxiety in children undergoing endoscopic procedures. This intervention, however, has no impact on BIS values or intraprocedural propofol requirements.

  16. Spatial learning in men undergoing alcohol detoxification.

    Science.gov (United States)

    Ceccanti, Mauro; Hamilton, Derek; Coriale, Giovanna; Carito, Valentina; Aloe, Luigi; Chaldakov, George; Romeo, Marina; Ceccanti, Marco; Iannitelli, Angela; Fiore, Marco

    2015-10-01

    Alcohol dependence is a major public health problem worldwide. Brain and behavioral disruptions including changes in cognitive abilities are common features of alcohol addiction. Thus, the present study was aimed to investigate spatial learning and memory in 29 alcoholic men undergoing alcohol detoxification by using a virtual Morris maze task. As age-matched controls we recruited 29 men among occasional drinkers without history of alcohol dependence and/or alcohol related diseases and with a negative blood alcohol level at the time of testing. We found that the responses to the virtual Morris maze are impaired in men undergoing alcohol detoxification. Notably they showed increased latencies in the first movement during the trials, increased latencies in retrieving the hidden platform and increased latencies in reaching the visible platform. These findings were associated with reduced swimming time in the target quadrant of the pool where the platform had been during the 4 hidden platform trials of the learning phase compared to controls. Such increasing latency responses may suggest motor control, attentional and motivational deficits due to alcohol detoxification.

  17. Bubble dynamics in perfused tissue undergoing decompression.

    Science.gov (United States)

    Meisel, S; Nir, A; Kerem, D

    1981-02-01

    A mathematical model describing bubble dynamics in a perfused tissue undergoing decompression is presented, taking into account physical expansion and inward diffusion from surrounding supersaturated tissue as growth promoting factors and tissue gas elimination by perfusion, tissue elasticity, surface tension and inherent unsaturation as resolving driving forces. The expected behavior after a step reduction of pressure of a bubble initially existing in the tissue, displaying both growth and resolution has been demonstrated. A strong perfusion-dependence of bubble resolution time at low perfusion rates is apparent. The model can account for various exposure pressures and saturation fractions of any inert gas-tissue combination for which a set of physical and physiological parameters is available.

  18. Thermodynamics of a qubit undergoing dephasing

    Science.gov (United States)

    Marcantoni, S.

    2017-05-01

    The thermodynamics of a qubit undergoing dephasing due to the coupling with the external environment is discussed. First of all, we assume the dynamics of the system to be described by a master equation in Lindblad form. In this framework, we review a standard formulation of the first and second law of thermodynamics that has been known in literature for a long time. After that, we explicitly model the environment with a set of quantum harmonic oscillators choosing the interaction such that the global dynamics of system and bath is analytically solvable and the Lindblad master equation is recovered in the weak-coupling limit. In this generalized setting, we can show that the correlations between system and bath play a fundamental role in the heat exchange. Moreover, the internal entropy production of the qubit is proven to be positive for arbitrary coupling strength.

  19. Reducing psychological distress in patients undergoing chemotherapy.

    Science.gov (United States)

    Milanti, Ariesta; Metsälä, Eija; Hannula, Leena

    Psychological distress is a common problem among patients with cancer, yet it mostly goes unreported and untreated. This study examined the association of a psycho-educational intervention with the psychological distress levels of breast cancer and cervical cancer patients undergoing chemotherapy. The design of the study was quasi-experimental, pretest-posttest design with a comparison group. One hundred patients at a cancer hospital in Jakarta, Indonesia, completed Distress Thermometer screening before and after chemotherapy. Fifty patients in the intervention group were given a psycho-educational video with positive reappraisal, education and relaxation contents, while receiving chemotherapy. Patients who received the psycho-educational intervention had significantly lower distress levels compared with those in the control group. Routine distress screening, followed by distress management and outcome assessment, is needed to improve the wellbeing of cancer patients.

  20. Inflammatory response in patients undergoing uterine artery embolization as compared to patients undergoing conventional hysterectomy

    DEFF Research Database (Denmark)

    Brøchner, A C; Mygil, B; Elle, B;

    2009-01-01

    : To investigate whether uterine artery embolization generates a reduced inflammatory response as compared with conventional hysterectomy. MATERIAL AND METHODS: 40 women, 20 in each group, entered this prospective, non-randomized study. The two groups were comparable concerning age, comorbidity, and body......-mass index (BMI). RESULTS: We found a significant difference between the inflammatory responses in women undergoing embolization compared with the inflammatory response in women having an abdominal hysterectomy. Women undergoing embolization were subjected to a much smaller inflammatory burden, their total...... morphine consumption was lower, and their return to work was faster than women subjected to conventional hysterectomy. CONCLUSION: Uterine artery embolization generates a reduced inflammatory response compared with conventional hysterectomy....

  1. Inducing Tropical Cyclones to Undergo Brownian Motion

    Science.gov (United States)

    Hodyss, D.; McLay, J.; Moskaitis, J.; Serra, E.

    2014-12-01

    Stochastic parameterization has become commonplace in numerical weather prediction (NWP) models used for probabilistic prediction. Here, a specific stochastic parameterization will be related to the theory of stochastic differential equations and shown to be affected strongly by the choice of stochastic calculus. From an NWP perspective our focus will be on ameliorating a common trait of the ensemble distributions of tropical cyclone (TC) tracks (or position), namely that they generally contain a bias and an underestimate of the variance. With this trait in mind we present a stochastic track variance inflation parameterization. This parameterization makes use of a properly constructed stochastic advection term that follows a TC and induces its position to undergo Brownian motion. A central characteristic of Brownian motion is that its variance increases with time, which allows for an effective inflation of an ensemble's TC track variance. Using this stochastic parameterization we present a comparison of the behavior of TCs from the perspective of the stochastic calculi of Itô and Stratonovich within an operational NWP model. The central difference between these two perspectives as pertains to TCs is shown to be properly predicted by the stochastic calculus and the Itô correction. In the cases presented here these differences will manifest as overly intense TCs, which, depending on the strength of the forcing, could lead to problems with numerical stability and physical realism.

  2. Preoperative information needs of children undergoing tonsillectomy.

    LENUS (Irish Health Repository)

    Buckley, Aoife

    2012-02-01

    AIMS AND OBJECTIVES: To identify the information needs of children undergoing tonsillectomy with reference to content of information, method of delivery, information providers and timing of information provision. BACKGROUND: Tonsillectomy can be anxiety provoking for children and preoperative preparation programmes are long recognised to reduce anxiety. However, few have been designed from the perspectives of children and to date little is known about how best to prepare children in terms of what to tell them, how to convey information to them, who can best provide information and what is the best timing for information provision. DESIGN: A qualitative descriptive study. METHOD: Data were collected from nine children (aged 6-9) using interviews supported by a write and draw technique. Data were coded and categorised into themes reflecting content, method, providers and timing of information. RESULTS: Children openly communicated their information needs especially on what to tell them to expect when facing a tonsillectomy. Their principal concerns were about operation procedures, experiencing \\'soreness\\' and discomfort postoperatively and parental presence. Mothers were viewed as best situated to provide them with information. Children were uncertain about what method of information and timing would be most helpful to them. CONCLUSION: Preoperative educational interventions need to take account of children\\'s information needs so that they are prepared for surgery in ways that are meaningful and relevant to them. Future research is needed in this area. RELEVANCE TO CLINICAL PRACTICE: Practical steps towards informing children about having a tonsillectomy include asking them what they need to know and addressing their queries accordingly. Child-centred information leaflets using a question and answer format could also be helpful to children.

  3. [Adapting immunisation schedules for children undergoing chemotherapy].

    Science.gov (United States)

    Fernández-Prada, María; Rodríguez-Martínez, María; García-García, Rebeca; García-Corte, María Dolores; Martínez-Ortega, Carmen

    2016-10-20

    Children undergoing chemotherapy for cancer have special vaccination needs after completion of the treatment. The aim of this study was to evaluate the adaptation of post-chemotherapy vaccination schedules. An observational study was performed on a retrospective cohort that included all children aged from 0 to 14 years, who completed chemotherapy in a tertiary hospital between 2009 and 2015. Inclusion and exclusion criteria were applied. Immunisation was administered in accordance with the guidelines of the Vaccine Advisory Committee of the Spanish Association of Paediatrics. Primary Care immunisation and clinical records of the Preventive Medicine and Public Health Department were reviewed. Of the 99 children who had received chemotherapy, 51 (70.6% males) were included in the study. As regards the type of tumour, 54.9% had a solid organ tumour, and 45.1% had a haematological tumour. Post-chemotherapy immunisation was administered to 70.6%. The most common vaccines received were: diphtheria-tetanus-pertussis or diphtheria-tetanus (54.9%), meningococcus C (41.2%), and seasonal influenza (39.2%). The rate of adaptation of the immunisation schedule after chemotherapy was 9.8%. The pneumococcal conjugate vaccine against 7v or 13v was administered to 21.6% of study subjects. However, only 17.6% received polysaccharide 23v. None received vaccination against hepatitis A. No statistically significant differences were observed between adherence to immunisation schedules and type of tumour (P=.066), gender (P=.304), or age (P=.342). Post-chemotherapy immunisation of children with cancer is poor. The participation of health professionals in training programs and referral of paediatric cancer patients to Vaccine Units could improve the rate of schedule adaptation and proper immunisation of this population. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  4. Sleep Disorders in ESRD Patients Undergoing Hemodialysis

    Directory of Open Access Journals (Sweden)

    Mohammad Reza Abassi

    2016-04-01

    Full Text Available Kidney failure affects different aspects of normal life. Among different manifestations, sleep problem can be considered as a common complaint of ESRD (End Stage Renal Disease patients. In this study, we aimed to investigate the interrelationship between sleep disorders in ESRD patients and their characteristics. Through a cross-sectional study (2010-2011, 88 ESRD patients undergoing maintenance hemodialysis thrice weekly were recruited to enter the study. We used a self-administered questionnaire into which the data were reflected. The patients selected their specific sleep disorders using a nine-item scale while the Epworth Sleepiness Scale (ESS determined both the presence and severity of sleep disorders. The data was finally analyzed with their baseline characteristics, dialysis characteristics, medication/stimulants use, and clinical and biochemical parameters. Over 95% of the patients had, at least, one specific sleep disorder while the ESS revealed 36.36% of patients as normal, 59.09% as having mild sleep disorders, and 4.54% as having moderate to severe sleep disorders. Sleep disorders were significantly correlated with older ages (P=0.035, dialysis dose (P=0.001, blood creatinine levels (P=0.037, upper airways obstruction (P=0.035, hepatomegaly (P=0.006, hepatic failure (P=0.001, higher blood TSH levels (P=0.039, history of hypothyroidism (P=0.005, and the use of levodopa (P=0.004, anti-hypertensive medications (P=0.006, benzodiazepines (P=0.006, Eprex (Erythropoietin (P=0.001, Venofer (Iron Sucrose Injection (P=0.013, and phosphate-binders agents (P=0.018. Sleep disorders are common findings among ESRD patients and seem to be a more complicated issue than a simple accumulation of the wastes products in the body. Whatever the causes of sleep disorders are, disorder-specific treatments should be considered.

  5. Should patients undergoing a bronchoscopy be sedated?

    Science.gov (United States)

    Gonzalez, R; De-La-Rosa-Ramirez, I; Maldonado-Hernandez, A; Dominguez-Cherit, G

    2003-04-01

    The techniques, drugs and depth of sedation for flexible fiberoptic bronchoscopy is controversial, and several reports consider that the routine use of sedation is not a prerequisite. We evaluate whether the addition of sedation with propofol improves patient tolerance, compared to local anesthesic of the airway only. Eighteen patients with pneumonia undergoing flexible fiberoptic bronchoscopy were included in a randomized, single blind, prospective controlled study. The non-sedation group received airway topical anesthesia, whereas the sedation group received topical anesthesia and intravenous sedation with propofol. The degree of pain, cough, sensation of asphyxiation, degree of amnesia, global tolerance and acceptance of another bronchoscopy in the future were noted. Changes in blood pressure, heart rate and saturation of oxygen by pulse oximetry were also evaluated. The patients in sedation group had less cough (P < 0.05), pain (P < 0.01) and sensation of asphyxiation (P < 0.001). Global tolerance to the procedure was significantly better in the group under sedation (P < 0.01). These patients had total amnesia to the procedure (P < 0.0001), thus is more probable that will accept another bronchoscopy in the future (P < 0.01). There was a significant rise in heart rate and blood pressure in the patients without sedation. There were no differences in oxygen saturation (P = 0.75). Our results show that if we administer propofol for sedation, in addition to local anesthesia of the airway, the tolerance to the procedure is much better. Also it appears that sedation with propofol is safe if we carefully select and monitor the patient.

  6. Perioperative Education of Patient Undergoing Cardiac Surgery

    Directory of Open Access Journals (Sweden)

    Alexandros Zacharis

    2011-04-01

    Full Text Available In recent years, the number of patients undergoing cardiac surgeries is steadily increasing. In Greece, approximately 10,500 patients per year are admitted to some kind of cardiac operation. Constant evolution of heart surgery techniques calls for adaptation of the perioperative nursing care given. Patient education, as an important part of the perioperative care, is directly related to the reduction of postoperative complications and stress management, thus promoting the patient's overall postoperative well-being. Aim: The aim of this review was to present the most important aspects of the patient's perioperative education and the role that the nurse has to play in it. Methods: Data from selected articles were extracted from Pubmed, Chinahl and Cohrane, as well as from non-electronically published scientific studies ranging from 1998-2010 and 2003-2008 respectively. Results: According to the literature, perioperative patient education can be implemented in various ways, such as through verbal updates, the use of audiovisual means and the provision of informative leaflets. The teaching topics can be divided into those of the preoperative and postoperative phase. Stress management prepares the patients psychologically and also enhances the therapeutic nurse-patient relationship. The teaching of breathing techniques and isometric exercises of the lower limbs, the cessation of smoking, the diet to be followed, as well as the management of medication, aim in the patients' physical preparation, in order to optimize their postoperative course. Conclusion: Perioperative patient education, regardless of how it is implemented, constitutes both an integral part of the nursing care and an independent nursing intervention per se, which strengthens the nurses' autonomy and improves the patient's postoperative course.

  7. Hydrothermal synthesis spherical TiO{sub 2} and its photo-degradation property on salicylic acid

    Energy Technology Data Exchange (ETDEWEB)

    Guo Wenlu, E-mail: liu287856624@163.com [School of Biology and Chemical Engineering, Jiangsu University of Science and Technology, Mengxi Road 2, Zhenjiang 212003 (China); Liu Xiaolin [School of Biology and Chemical Engineering, Jiangsu University of Science and Technology, Mengxi Road 2, Zhenjiang 212003 (China); Huo Pengwei; Gao Xun; Wu Di; Lu Ziyang; Yan Yongsheng [School of Chemistry and Chemical Engineering, Jiangsu University, Zhenjiang 212013 (China)

    2012-07-01

    Anatase TiO{sub 2} spheres have been prepared using hydrothermal synthesis. The prepared spheres were characterized by X-ray diffraction (XRD), scanning electron microscope (SEM) and UV-vis diffuse reflectance spectra (UV-vis DRS). The TiO{sub 2} consisted of well-defined spheres with size of 3-5 {mu}m. The photocatalytic activity of spherical TiO{sub 2} was determined by degradation of salicylic acid under visible light irradiation. It was revealed that the degradation rate of the spherical TiO{sub 2} which was processed at 150 Degree-Sign C for 48 h could reach 81.758%. And the kinetics of photocatalytic degradation obeyed first-order kinetic, which the rate constant value was 0.01716 S{sup -1} of the salicylic acid onto TiO{sub 2} (temperature: 150, time: 48 h). The kinetics of adsorption followed the pseudo-second-order model and the rate constant was 1.2695 g mg{sup -1} of the salicylic acid onto TiO{sub 2} (temperature: 150, time: 48 h).

  8. Morphology induced photo-degradation study of low temperature, chemically derived ZnO/SnO2 heterostructure

    Science.gov (United States)

    Pal, Shreyasi; Maiti, Soumen; Chattopadhyay, Kalyan Kumar

    2016-05-01

    Rational construction of heterostructure is a key pathway to pursue highly active photocatalysts that also offers prospects to explore the relationship between structural aspect and photocatalytic efficiency. Here, we adopted a two-step wet chemical protocol for decoration of ZnO nanowires with SnO2 nanoclusters. ZnO nanowires were prepared by one pot ambient conditioned synthesis from commercial zinc powder. In sequence, synthesized ZnO nanowires were engineered with varying quantity SnO2 nanoclusters via low temperature hydrothermal method. Environmental remediation through catalytic activity of the samples was inspected taking two dyes having different ionic character (Methyl Orange and Rhodamine B) under UV irradiation where the optimized hybrid displayed better performance than mono component oxides. Enhancement in catalytic performance could be enlightened by the heterostructure formation at the ZnO/SnO2 interface which in turns prolonged photogenerated carrier separation and extend the photo response range. Furthermore, the photocatalysis performance by heterostructure could be recycled for several times without noticeable decrease in their catalytic activity.

  9. Evaluation of fungal- and photo-degradation as potential treatments for the removal of sunscreens BP3 and BP1

    Energy Technology Data Exchange (ETDEWEB)

    Gago-Ferrero, Pablo, E-mail: pablo.gago@idaea.csic.es [Departament de Quimica Ambiental, IDAEA-CSIC, C/ Jordi Girona 18-26, 08034 Barcelona (Spain); Badia-Fabregat, Marina, E-mail: marina.badia@uab.cat [Departament d' Enginyeria Quimica, Escola d' Enginyeria, Universitat Autonoma de Barcelona, 08193 Bellaterra, Barcelona (Spain); Olivares, Alba, E-mail: esalba.olivares@idaea.csic.es [Departament de Quimica Ambiental, IDAEA-CSIC, C/ Jordi Girona 18-26, 08034 Barcelona (Spain); Pina, Benjamin, E-mail: benjami.pina@idaea.csic.es [Departament de Quimica Ambiental, IDAEA-CSIC, C/ Jordi Girona 18-26, 08034 Barcelona (Spain); Blanquez, Paqui, E-mail: paqui.blanquez@uab.cat [Departament d' Enginyeria Quimica, Escola d' Enginyeria, Universitat Autonoma de Barcelona, 08193 Bellaterra, Barcelona (Spain); Vicent, Teresa, E-mail: teresa.vicent@uab.cat [Departament d' Enginyeria Quimica, Escola d' Enginyeria, Universitat Autonoma de Barcelona, 08193 Bellaterra, Barcelona (Spain); Caminal, Gloria, E-mail: gloria.caminal@uab.cat [Unitat de Biocatalisi Aplicada associada al IQAC (CSIC-UAB). Escola d' Enginyeria, Universitat Autonoma de Barcelona, 08193 Bellaterra, Barcelona (Spain); Diaz-Cruz, M. Silvia, E-mail: silvia.diaz@idaea.csic.es [Departament de Quimica Ambiental, IDAEA-CSIC, C/ Jordi Girona 18-26, 08034 Barcelona (Spain); and others

    2012-06-15

    Photodecomposition might be regarded as one of the most important abiotic factors affecting the fate of UV absorbing compounds in the environment and photocatalysis has been suggested as an effective method to degrade organic pollutants. However, UV filters transformation appears to be a complex process, barely addressed to date. The white rot fungus Trametes versicolor is considered as a promising alternative to conventional aerobic bacterial degradation, as it is able to metabolise a wide range of xenobiotics. This study focused on both degradation processes of two widely used UV filters, benzophenone-3 (BP3) and benzophenone-1 (BP1). Fungal treatment resulted in the degradation of more than 99% for both sunscreens in less than 24 h, whereas photodegradation was very inefficient, especially for BP3, which remained unaltered upon 24 h of simulated sunlight irradiation. Analysis of metabolic compounds generated showed BP1 as a minor by-product of BP3 degradation by T. versicolor while the main intermediate metabolites were glycoconjugate derivatives. BP1 and BP3 showed a weak, but significant estrogenic activity (EC50 values of 0.058 mg/L and 12.5 mg/L, respectively) when tested by recombinant yeast assay (RYA), being BP1 200-folds more estrogenic than BP3. Estrogenic activity was eliminated during T. versicolor degradation of both compounds, showing that none of the resulting metabolites possessed significant estrogenic activity at the concentrations produced. These results demonstrate the suitability of this method to degrade both sunscreen agents and to eliminate estrogenic activity. - Highlights: Black-Right-Pointing-Pointer Fungus T. versicolor is able to degrade totally BP3 and BP1 in few hours in a fluidised bed bioreactor. Black-Right-Pointing-Pointer BP3 is not degraded under simulated sunlight. Black-Right-Pointing-Pointer Glycoconjugates have been identified as the main intermediate metabolites. Black-Right-Pointing-Pointer Decrease in endocrine activity was found in both photodegradation and biodegradation.

  10. Visible light photo-degradation of methylene blue over Fe or Cu promoted ZnO nanoparticles.

    Science.gov (United States)

    Mardani, Hamid Reza; Forouzani, Mehdi; Ziari, Mitra; Biparva, Pourya

    2015-04-15

    CuxZn(1-x)O, FexZn(1-x)O (x=0.01) and ZnO nanoparticles were and were characterized by X-ray diffraction, ultraviolet and visible spectroscopy, FTIR spectroscopy and SEM. The photodegradation of an aqueous solution of methylene blue (as an organic pollutant) by nanoparticles with H2O2 (30%) under visible light and the progress of the reaction were monitored by UV-Vis spectroscopy absorption. The photocatalytic oxidation efficiency of all nanoparticles was 100% at the appropriate time. The degradation time was 90 min for FeZnO, 120 min for CuZnO and 210 min for ZnO. This indicates that the photocatalytic activity of the doped nanoparticles was better than that of ZnO alone. ZnO doped with a small amount of Fe or Cu decreased the size of the nanoparticles and the band gap and increased photocatalytic efficiency.

  11. Photo-degradation and stabilization effects in operating organic photovoltaic devices by joint photo-current and morphological monitoring

    Energy Technology Data Exchange (ETDEWEB)

    Paci, B.; Generosi, A.; Rossi Albertini, V.; Perfetti, P. [ISM-C.N.R., Area di Ricerca di Tor Vergata, Via del Fosso del Cavaliere 100, 00133 Roma (Italy); de Bettignies, R. [Laboratoire Composants Solaires, CEA INES-RDI, Savoie Technolac, BP 332, 50 avenue du lac Leman, 73377 Le Bourget du Lac (France); Sentein, C. [CEA Saclay, DRT-LITEN-DSEN-GENEC-L2C, F91191 Gif-sur-Yvette (France)

    2008-07-15

    We report on a joint morphological/photoelectrical study of polymer-based photovoltaic (PV) cells in working conditions. The bulk heterojunction devices investigated are based on an active layer of poly(3-hexyl thiophene) blended with methano-fullerene, combining good PV performances with promising stability. The set-up adopted allowed the electrical properties of the device to be directly correlated to the modification of the electrode morphological parameters (thickness and roughness), which were obtained by in situ energy dispersive X-ray reflectometry (EDXR). The results of this joint time-dependent characterization demonstrated how the observed photo-induced oxidation process, limited to the buried electrode interface, is responsible for a fast decrease in the photo-current. The time-resolved measurements allowed to rule out the dynamics of the morphological changes and showed that the interface morphology may be stabilized by annealing treatments, with a significant improvement of the cell efficiency. (author)

  12. Photo-degradation of Acid-red 3B dye catalyzed by TiO2 nanotubes

    Institute of Scientific and Technical Information of China (English)

    JIANG Fang; ZHENG Shou-rong; ZHENG Zheng; XU Zhao-yi; WANG Yan-jin

    2006-01-01

    TiO2 nanotube precursor was synthesized by the hydrothermal reaction of TiO2 powders with NaOH solution and the properties of the nanotube materials were tuned using different post-treatments. Transmission electron microscopic (TEM) observation revealed that the nanotube could be obtained by either a direct rinse with acid solution or rinse with distilled water followed by acid solution. The results of X-ray diffraction (XRD) and inductively coupled plasma (ICP) analysis indicated that the nanotube material on the post-treatment. The results of the photocatalytic reaction showed that the degradation of Acid-red 3B dye fitted pseudo-zero-order kinetics and TiO2 nanotube prepared under direct rinse with acid solution exhibited a higher catalytic efficiency compared to other catalysts.

  13. An instant photo-excited electrons relaxation on the photo-degradation properties of TiO2-x films

    CSIR Research Space (South Africa)

    Nkosi, SS

    2014-11-01

    Full Text Available %. The prepared films were characterized by XRD, SEM and AFM.A connection between the photocatalytic degradation performance and photo-excited electron recovery/relaxation was observed. It was found that longer photo-excited electron recovery/relaxation leads...

  14. Evaluation of fungal- and photo-degradation as potential treatments for the removal of sunscreens BP3 and BP1.

    Science.gov (United States)

    Gago-Ferrero, Pablo; Badia-Fabregat, Marina; Olivares, Alba; Piña, Benjamin; Blánquez, Paqui; Vicent, Teresa; Caminal, Gloria; Díaz-Cruz, M Silvia; Barceló, Damià

    2012-06-15

    Photodecomposition might be regarded as one of the most important abiotic factors affecting the fate of UV absorbing compounds in the environment and photocatalysis has been suggested as an effective method to degrade organic pollutants. However, UV filters transformation appears to be a complex process, barely addressed to date. The white rot fungus Trametes versicolor is considered as a promising alternative to conventional aerobic bacterial degradation, as it is able to metabolise a wide range of xenobiotics. This study focused on both degradation processes of two widely used UV filters, benzophenone-3 (BP3) and benzophenone-1 (BP1). Fungal treatment resulted in the degradation of more than 99% for both sunscreens in less than 24 h, whereas photodegradation was very inefficient, especially for BP3, which remained unaltered upon 24 h of simulated sunlight irradiation. Analysis of metabolic compounds generated showed BP1 as a minor by-product of BP3 degradation by T. versicolor while the main intermediate metabolites were glycoconjugate derivatives. BP1 and BP3 showed a weak, but significant estrogenic activity (EC50 values of 0.058 mg/L and 12.5 mg/L, respectively) when tested by recombinant yeast assay (RYA), being BP1 200-folds more estrogenic than BP3. Estrogenic activity was eliminated during T. versicolor degradation of both compounds, showing that none of the resulting metabolites possessed significant estrogenic activity at the concentrations produced. These results demonstrate the suitability of this method to degrade both sunscreen agents and to eliminate estrogenic activity.

  15. [Synthesis, characterization and photo degradation application for dye-rhodamine B of nano-iron oxide/bentonite].

    Science.gov (United States)

    Liu, Ying; Li, Yi-min; Wen, Li-hua; Hou, Ke-yong; Li, Hai-yang

    2006-10-01

    The iron oxide/bentonite was prepared through a reaction of a solution of OH-Fe salt with bentonite clay dispersion. BET, XRD an d HRTEM were used t o study i ts surface area, microstructure, and average particle size. The iron oxide/bentonite nano composite was developed as the heterogeneous catalyst for successful discoloration and mineralization of dye rhodamine B And the effects of solution pH, H2O2 molar concentration, catalyst loading and initial rhodamine B concentration were studied in detail by photometric method. The process of degradation was traced by UV-Visible spectrum. Besides, the comparison between the heterogeneous photo-Fenton process and homogeneous photo-Fenton process was performed. The result shows that, it has large surface area and mainly consists of high catalytic activity alpha-Fe2O3. The discoloration ratio is up to 97% and the COD(Cr), removal ratio is 71% after 4 h in the presence of pH 3.0, 2.5 x 10(-5) mol x L(-1) rhodamine B 100 mL, 0.3 g x L(-1) catalyst, 10 mmol x L(-1) H2O2 and UV. The rhodamine B degradating speed of heterogeneous photo-Fenton process is much faster than that of homogeneous photo-Fenton process. The catalyst can be reused after being treated.

  16. INTESTINAL MALROTATION IN PATIENTS UNDERGOING BARIATRIC SURGERY.

    Science.gov (United States)

    Vidal, Eduardo Arevalo; Rendon, Francisco Abarca; Zambrano, Trino Andrade; García, Yudoco Andrade; Viteri, Mario Ferrin; Campos, Josemberg Marins; Ramos, Manoela Galvão; Ramos, Almino Cardoso

    Intestinal malrotation is a rare congenital anomaly. In adults is very difficult to recognize due to the lack of symptoms. Diagnosis is usually incidental during surgical procedures or at autopsy. To review the occurrence and recognition of uneventful intestinal malrotation discovered during regular cases of bariatric surgeries. Were retrospectively reviewed the medical registry of 20,000 cases undergoing bariatric surgery, from January 2002 to January 2016, looking for the occurrence of intestinal malrotation and consequences in the intraoperative technique and immediate evolution of the patients. Five cases (0,025%) of intestinal malrotation were found. All of them were males, aging 45, 49, 37,52 and 39 years; BMI 35, 42, 49, 47 and 52 kg/m2, all of them with a past medical history of morbid obesity. The patient with BMI 35 kg/m2 suffered from type 2 diabetes also. All procedures were completed by laparoscopic approach, with no conversions. In one patient was not possible to move the jejunum to the upper abdomen in order to establish the gastrojejunostomy and a sleeve gastrectomy was performed. In another patient was not possible to fully recognize the anatomy due to bowel adhesions and a single anastomosis gastric bypass was preferred. No leaks or bleeding were identified. There were no perioperative complications. All patients were discharged 72 h after the procedure and no immediate 30-day complications were reported. Patients with malrotation can successfully undergo laparoscopic bariatric surgery. May be necessary changes in the surgical original strategy regarding the malrotation. Surgeons must check full abdominal anatomical condition prior to start the division of the stomach. Má-rotação intestinal é rara anomalia congênita em adultos de difícil reconhecimento devido à falta de sintomas. O diagnóstico é feito geralmente incidentalmente durante procedimentos cirúrgicos ou durante autópsia. Verificar a ocorrência e reconhecimento não eventual

  17. 75 FR 9902 - Agency Forms Undergoing Paperwork Reduction Act Review

    Science.gov (United States)

    2010-03-04

    ... reports include: Creutzfeldt-Jakob Disease (CJD), Cyclospora, Dengue, Hantavirus, Kawasaki Syndrome... HUMAN SERVICES Centers for Disease Control and Prevention Agency Forms Undergoing Paperwork Reduction Act Review The Centers for Disease Control and Prevention (CDC) publishes a list of...

  18. 78 FR 15368 - Agency Forms Undergoing Paperwork Reduction Act Review

    Science.gov (United States)

    2013-03-11

    ... (CJD), Cyclosporiasis, Dengue, Hantavirus, Kawasaki Syndrome, Legionellosis, Lyme disease, Malaria... HUMAN SERVICES Centers for Disease Control and Prevention Agency Forms Undergoing Paperwork Reduction Act Review The Centers for Disease Control and Prevention (CDC) publishes a list of...

  19. 76 FR 40915 - Agency Forms Undergoing Paperwork Reduction Act Review

    Science.gov (United States)

    2011-07-12

    ... and Zoonotic Infectious Diseases (NCEZID), Centers for Disease Control and Prevention (CDC... HUMAN SERVICES Centers for Disease Control and Prevention Agency Forms Undergoing Paperwork Reduction Act Review The Centers for Disease Control and Prevention (CDC) publishes a list of...

  20. Experiense with remineraling means in patients undergoing orthodontic treatment

    Directory of Open Access Journals (Sweden)

    Stepanova Ye.A.

    2011-03-01

    Full Text Available In patients undergoing orthodontic treatment using bracket-technology a high risk of caries development. The algorithm of preventive interventions for the prevention of hair demineralization of enamel of the teeth

  1. 75 FR 63485 - Agency Forms Undergoing Paperwork Reduction Act Review

    Science.gov (United States)

    2010-10-15

    ... the National Electronic Telecommunications System for Surveillance (NETSS) to reflect its national... HUMAN SERVICES Centers for Disease Control and Prevention Agency Forms Undergoing Paperwork Reduction Act Review The Centers for Disease Control and Prevention (CDC) publishes a list of information...

  2. 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...

  3. 78 FR 25741 - Agency Forms Undergoing Paperwork Reduction Act Review

    Science.gov (United States)

    2013-05-02

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Agency Forms Undergoing Paperwork Reduction...): National Surveys of Assistance Dog Providers and Veterans, National Institute for Occupational Safety...

  4. Phytotoxins Produced by Fungi Associated with Grapevine Trunk Diseases

    Directory of Open Access Journals (Sweden)

    Antonio Evidente

    2011-12-01

    Full Text Available Up to 60 species of fungi in the Botryosphaeriaceae family, genera Cadophora, Cryptovalsa, Cylindrocarpon, Diatrype, Diatrypella, Eutypa, Eutypella, Fomitiporella, Fomitiporia, Inocutis, Phaeoacremonium and Phaeomoniella have been isolated from decline-affected grapevines all around the World. The main grapevine trunk diseases of mature vines are Eutypa dieback, the esca complex and cankers caused by the Botryospheriaceae, while in young vines the main diseases are Petri and black foot diseases. To understand the mechanism of these decline-associated diseases and the symptoms associated with them, the toxins produced by the pathogens involved in these diseases were isolated and characterised chemically and biologically. So far the toxins of only a small number of these decline fungi have been studied. This paper presents an overview of the toxins produced by the most serious of these vine wood pathogens: Eutypa lata, Phaeomoniella chlamydospora, Phaeoacremonium aleophilum and some taxa in the Botryosphaeriaceae family, and examines how these toxins produce decline symptoms. The chemical structure of these metabolites and in some cases their vivotoxin nature are also discussed.

  5. Phytotoxins produced by fungi associated with grapevine trunk diseases.

    Science.gov (United States)

    Andolfi, Anna; Mugnai, Laura; Luque, Jordi; Surico, Giuseppe; Cimmino, Alessio; Evidente, Antonio

    2011-12-01

    Up to 60 species of fungi in the Botryosphaeriaceae family, genera Cadophora, Cryptovalsa, Cylindrocarpon, Diatrype, Diatrypella, Eutypa, Eutypella, Fomitiporella, Fomitiporia, Inocutis, Phaeoacremonium and Phaeomoniella have been isolated from decline-affected grapevines all around the World. The main grapevine trunk diseases of mature vines are Eutypa dieback, the esca complex and cankers caused by the Botryospheriaceae, while in young vines the main diseases are Petri and black foot diseases. To understand the mechanism of these decline-associated diseases and the symptoms associated with them, the toxins produced by the pathogens involved in these diseases were isolated and characterised chemically and biologically. So far the toxins of only a small number of these decline fungi have been studied. This paper presents an overview of the toxins produced by the most serious of these vine wood pathogens: Eutypa lata, Phaeomoniella chlamydospora, Phaeoacremonium aleophilum and some taxa in the Botryosphaeriaceae family, and examines how these toxins produce decline symptoms. The chemical structure of these metabolites and in some cases their vivotoxin nature are also discussed.

  6. Molecular mechanisms of toxicity of important food-borne phytotoxins

    NARCIS (Netherlands)

    Rietjens, I.M.C.M.; Martena, M.J.; Boersma, M.G.; Spiegelenberg, W.; Alink, G.M.

    2005-01-01

    At present, there is an increasing interest for plant ingredients and their use in drugs, for teas, or in food supplements. The present review describes the nature and mechanism of action of the phytochemicals presently receiving increased attention in the field of food toxicology. This relates to c

  7. Predictors of willingness to undergo elective musculoskeletal surgery

    Directory of Open Access Journals (Sweden)

    Gandhi R

    2013-03-01

    Full Text Available Rajiv Gandhi,1,2 Anthony V Perruccio,1,3 Y Raja Rampersaud1,21Division of Orthopaedic Surgery, Toronto Western Hospital, University Health Network, 2Department of Surgery, Faculty of Medicine, University of Toronto, 3Institute of Health Policy, Management and Evaluation, University of Toronto, Ontario, CanadaPurpose: Knowledge of what influences patients’ willingness to undergo elective orthopedic surgery is vital to the patient shared decision-making process. We sought to document the prevalence and identify the predictors of unwillingness to undergo surgery among a cohort of hip/knee, foot/ankle, neck/back, and hip/knee patients.Patients and methods: Patient demographics and information on patient health status, perceptions of risk and success of surgery, and willingness to undergo surgery were collected. Sequential logistic regression models were used to investigate the influence of the captured variables on willingness to undergo surgery.Results: Overall, 392 (20% of 1946 participants reported being unwilling to undergo or unsure about undergoing (“unwilling/unsure” surgery if it was offered to them. From adjusted analyses, low income and non-White ethnicity were associated with a greater likelihood of being unwilling/unsure. Compared with hip/knee patients, neck/back patients were more likely to report being unwilling/unsure (odds ratio: 1.90 [95% confidence interval: 1.36, 265]; no differences were found between the remaining anatomical groups. However, when perceptions of risk and success were additionally considered, the influence for the neck/back cohort was significantly attenuated. Foot/ankle and elbow/shoulder patients were found to be significantly less likely to report unwillingness when perceptions were considered.Conclusion: In addition to demographic/economic influences, perceptions of surgical risk and success play a critical role in patients’ willingness to undergo surgery.Keywords: risk perception, orthopedic surgery

  8. Assessing Cardiovascular Health Using Life′s Simple 7 in a Chinese Population Undergoing Stroke Prevention

    Directory of Open Access Journals (Sweden)

    Qiong Yang

    2015-01-01

    Conclusions: Few Chinese patients undergoing stroke prevention had optimal CVH (determined using LS7. Additionally, fewer patients undergoing secondary prevention had optimal CVH than those undergoing primary prevention. In particular, physical activity and diet status in this population require improvement.

  9. Factors that motivate people to undergo cosmetic surgery.

    Science.gov (United States)

    Furnham, Adrian; Levitas, James

    2012-01-01

    A sample of 204 British participants completed a questionnaire that assessed their attitude toward cosmetic surgery as well as measures of self-esteem, life satisfaction, self-rated physical attractiveness, religiosity and media consumption. Two factors emerged from a factor analysis of their attitudes toward surgery: likelihood to undergo, and benefits of undergoing, cosmetic surgery. Females with low self-esteem, low life satisfaction, low self-rated attractiveness and little religious beliefs who were heavy television watchers reported a greater likelihood of undergoing cosmetic surgery. Stepwise regression analysis with the two attitude factors as criterion variables showed two major predictors for likelihood: religiousness and low self-esteem, and four major predictors for benefit: religousness, media consumption, life satisfaction and sex. The role of religion is considered in this context.

  10. The effect of malnutrition on patients undergoing elective joint arthroplasty.

    Science.gov (United States)

    Huang, Ronald; Greenky, Max; Kerr, Glenn J; Austin, Matthew S; Parvizi, Javad

    2013-09-01

    Malnutrition has been linked to serious complications in patients undergoing elective total joint arthroplasty (TJA). This study prospectively evaluated 2,161 patients undergoing elective TJA for malnutrition as defined by either an abnormal serum albumin or transferrin. The overall incidence of malnutrition was 8.5% (184 of 2,161) and the rate of overall complications in the malnourished group was 12% as compared to 2.9% in patients with normal parameters (PMalnutrition predicted serious complications involving hematoma formation, infection, renal and cardiac complications. Obesity, defined by a body mass index (BMI) of 30kg/m(2) was present in 42.9% of malnourished patients with a significantly higher complication rate in this cohort. Malnutrition remains prevalent in patients >55years-old undergoing TJA and is associated with a significant increase in post-operative complications.

  11. Prevention of Orthopaedic Implant Infection in Patients Undergoing Dental Procedures.

    Science.gov (United States)

    Watters, William; Rethman, Michael P; Hanson, Nicholas Buck; Abt, Elliot; Anderson, Paul A; Carroll, Karen C; Futrell, Harry C; Garvin, Kevin; Glenn, Stephen O; Hellstein, John; Hewlett, Angela; Kolessar, David; Moucha, Calin; O'Donnell, Richard J; O'Toole, John E; Osmon, Douglas R; Evans, Richard Parker; Rinella, Anthony; Steinberg, Mark J; Goldberg, Michael; Ristic, Helen; Boyer, Kevin; Sluka, Patrick; Martin, William Robert; Cummins, Deborah S; Song, Sharon; Woznica, Anne; Gross, Leeaht

    2013-03-01

    The Prevention of Orthopaedic Implant Infection in Patients Undergoing Dental Procedures evidence-based clinical practice guideline was codeveloped by the American Academy of Orthopaedic Surgeons (AAOS) and the American Dental Association. This guideline replaces the previous AAOS Information Statement, "Antibiotic Prophylaxis in Bacteremia in Patients With Joint Replacement," published in 2009. Based on the best current evidence and a systematic review of published studies, three recommendations have been created to guide clinical practice in the prevention of orthopaedic implant infections in patients undergoing dental procedures. The first recommendation is graded as Limited; this recommendation proposes that the practitioner consider changing the long-standing practice of routinely prescribing prophylactic antibiotic for patients with orthopaedic implants who undergo dental procedures. The second, graded as Inconclusive, addresses the use of oral topical antimicrobials in the prevention of periprosthetic joint infections. The third recommendation, a Consensus statement, addresses the maintenance of good oral hygiene.

  12. Rosuvastatin and cardiovascular events in patients undergoing hemodialysis

    DEFF Research Database (Denmark)

    Fellström, Bengt C; Jardine, Alan G; Schmieder, Roland E;

    2009-01-01

    BACKGROUND: Statins reduce the incidence of cardiovascular events in patients at high cardiovascular risk. However, a benefit of statins in such patients who are undergoing hemodialysis has not been proved. METHODS: We conducted an international, multicenter, randomized, double-blind, prospective...... trial involving 2776 patients, 50 to 80 years of age, who were undergoing maintenance hemodialysis. We randomly assigned patients to receive rosuvastatin, 10 mg daily, or placebo. The combined primary end point was death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke......: In patients undergoing hemodialysis, the initiation of treatment with rosuvastatin lowered the LDL cholesterol level but had no significant effect on the composite primary end point of death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke. (ClinicalTrials.gov number, NCT00240331.)...

  13. 76 FR 34705 - Agency Forms Undergoing Paperwork Reduction Act Review

    Science.gov (United States)

    2011-06-14

    ... or foot injury; having a family member who has had a DVT; taking birth control pills; or getting... HUMAN SERVICES Centers for Disease Control and Prevention Agency Forms Undergoing Paperwork Reduction Act Review The Centers for Disease Control and Prevention (CDC) publishes a list of information...

  14. 75 FR 65488 - Agency Forms Undergoing Paperwork Reduction Act Review

    Science.gov (United States)

    2010-10-25

    ... diseases, cholera and other vibrio illnesses, Listeria, babesiosis, brucellosis, Harmful Algal Bloom... Human Rabies Patient Info 50 1 15/60 Waterborne Diseases Outbreak Form 57 1 20/60 Cholera and other... HUMAN SERVICES Centers for Disease Control and Prevention Agency Forms Undergoing Paperwork...

  15. 75 FR 26256 - Agency Forms Undergoing Paperwork Reduction Act Review

    Science.gov (United States)

    2010-05-11

    ... diseases, cholera and other vibrio illnesses, Listeria, Calcinet, Harmful Algal Bloom-related Infectious... Waterborne Diseases Outbreak Form 57 1 20/60 Cholera and other Vibrio illnesses 450 1 20/60 Outbreak Report... HUMAN SERVICES Centers for Disease Control and Prevention Agency Forms Undergoing Paperwork...

  16. 78 FR 17406 - Agency Forms Undergoing Paperwork Reduction Act Review

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    2013-03-21

    ..., by conducting a training program for State and local vital statistics staff to assist in developing... a high degree of uniformity and quality in the data provided by the States. This training program is... HUMAN SERVICES Centers for Disease Control and Prevention Agency Forms Undergoing Paperwork Reduction...

  17. 77 FR 61410 - Agency Forms Undergoing Paperwork Reduction Act Review

    Science.gov (United States)

    2012-10-09

    ... HUMAN SERVICES Centers for Disease Control and Prevention Agency Forms Undergoing Paperwork Reduction... questions about the usefulness of resources posted on the YSI Web site and satisfaction with the site. No..., CDC's evaluation contractor will use information obtained through Google Analytics to assess...

  18. 77 FR 61406 - Agency Forms Undergoing Paperwork Reduction Act Review

    Science.gov (United States)

    2012-10-09

    ...-- National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Centers for Disease Control and... HUMAN SERVICES Centers for Disease Control and Prevention Agency Forms Undergoing Paperwork Reduction Act Review The Centers for Disease Control and Prevention (CDC) publishes a list of...

  19. 75 FR 154 - Agency Forms Undergoing Paperwork Reduction Act Review

    Science.gov (United States)

    2010-01-04

    ... for Zoonotic, Vector-Borne, and Enteric Diseases (NCZVED), Centers for Disease Control and Prevention... HUMAN SERVICES Centers for Disease Control and Prevention Agency Forms Undergoing Paperwork Reduction Act Review The Centers for Disease Control and Prevention (CDC) publishes a list of...

  20. 78 FR 59700 - Agency Forms Undergoing Paperwork Reduction Act Review

    Science.gov (United States)

    2013-09-27

    ... Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention (CDC). Background and... HUMAN SERVICES Centers for Disease Control and Prevention Agency Forms Undergoing Paperwork Reduction Act Review The Centers for Disease Control and Prevention (CDC) publishes a list of...

  1. 78 FR 13345 - Agency Forms Undergoing Paperwork Reduction Act Review

    Science.gov (United States)

    2013-02-27

    ...)--Revision--National Center Emerging and Zoonotic Infectious Diseases (NCEZID), Centers for Disease Control... HUMAN SERVICES Centers for Disease Control and Prevention Agency Forms Undergoing Paperwork Reduction Act Review The Centers for Disease Control and Prevention (CDC) publishes a list of...

  2. 76 FR 29243 - Agency Forms Undergoing Paperwork Reduction Act Review

    Science.gov (United States)

    2011-05-20

    ... Reporting Forms--New--National Center for Emerging, Zoonotic and Infectious Diseases (NCEZID), Centers for... HUMAN SERVICES Centers for Disease Control and Prevention Agency Forms Undergoing Paperwork Reduction Act Review The Centers for Disease Control and Prevention (CDC) publishes a list of...

  3. 78 FR 13344 - Agency Forms Undergoing Paperwork Reduction Act Review

    Science.gov (United States)

    2013-02-27

    ... Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention (CDC). Background and... HUMAN SERVICES Centers for Disease Control and Prevention Agency Forms Undergoing Paperwork Reduction Act Review The Centers for Disease Control and Prevention (CDC) publishes a list of...

  4. Reported analgesic administration to rabbits undergoing experimental surgical procedures.

    Science.gov (United States)

    Coulter, Claire A; Flecknell, Paul A; Leach, Matthew C; Richardson, Claire A

    2011-02-21

    It has become widely accepted that whenever animals are used in scientific procedures, the 3Rs principle of replacement, reduction and refinement described by William Russell and Rex Burch should be adhered to. Animals should be replaced with non-sentient alternatives if possible, the number of animals used should be reduced and experimental procedures should be refined to minimise pain, suffering and distress. Administration of analgesic agents to animals undergoing surgical procedures is a refinement used to alleviate pain. In this study, a structured literature review was carried out to examine current trends in analgesic administration to rabbits undergoing experimental surgical procedures. 128 papers from 51 peer-reviewed journals were selected for inclusion in this review. Reporting administration of systemic analgesia to rabbits in peer-reviewed scientific papers increased significantly from 16% to 50% between 1995-1997 and 2005-2007 (P rabbits undergoing surgical procedures is increasing, rabbits do not always receive analgesia when they undergo experimental surgery. Other practices in rabbit perioperative care that could be improved, highlighted by this survey include: 1) changing the timing of analgesic administration by giving systemic analgesics pre- or perioperatively rather than only postoperatively, 2) using multimodal analgesia when pain is likely to be moderate to severe and 3) increasing the use of non-steroidal anti-inflammatory drugs and use of other techniques such as epidural analgesia particularly for orthopaedic procedures.

  5. Reported analgesic administration to rabbits undergoing experimental surgical procedures

    Directory of Open Access Journals (Sweden)

    Leach Matthew C

    2011-02-01

    Full Text Available Abstract Background It has become widely accepted that whenever animals are used in scientific procedures, the 3Rs principle of replacement, reduction and refinement described by William Russell and Rex Burch should be adhered to. Animals should be replaced with non-sentient alternatives if possible, the number of animals used should be reduced and experimental procedures should be refined to minimise pain, suffering and distress. Administration of analgesic agents to animals undergoing surgical procedures is a refinement used to alleviate pain. In this study, a structured literature review was carried out to examine current trends in analgesic administration to rabbits undergoing experimental surgical procedures. Results 128 papers from 51 peer-reviewed journals were selected for inclusion in this review. Reporting administration of systemic analgesia to rabbits in peer-reviewed scientific papers increased significantly from 16% to 50% between 1995-1997 and 2005-2007 (P P Conclusions Although this review provides evidence that systemic analgesic administration to rabbits undergoing surgical procedures is increasing, rabbits do not always receive analgesia when they undergo experimental surgery. Other practices in rabbit perioperative care that could be improved, highlighted by this survey include: 1 changing the timing of analgesic administration by giving systemic analgesics pre- or perioperatively rather than only postoperatively, 2 using multimodal analgesia when pain is likely to be moderate to severe and 3 increasing the use of non-steroidal anti-inflammatory drugs and use of other techniques such as epidural analgesia particularly for orthopaedic procedures.

  6. Anesthesia and postoperative delirium in older adults undergoing hip surgery

    NARCIS (Netherlands)

    Slor, C.J.; de Jonghe, J.F.M.; Vreeswijk, R.; Groot, E.; Ploeg, T.V.D.; van Gool, W.A.; Eikelenboom, P.; Snoeck, M.; Schmand, B.; Kalisvaart, K.J.

    2011-01-01

    OBJECTIVES: To examine the effects of general anesthesia on the risk of incident postoperative delirium in older adults undergoing hip surgery. DESIGN: Secondary analysis of haloperidol prophylaxis for delirium clinical trial data. Predefined risk factors for delirium were assessed prior to surgery.

  7. Screening for chromosomal abnormalities in 2650 infertile couples undergoing ICSI.

    Science.gov (United States)

    Kayed, Hesham F; Mansour, Ragaa T; Aboulghar, Mohamed A; Serour, Gamal I; Amer, Alaa E; Abdrazik, Ashraf

    2006-03-01

    Chromosomal abnormalities are the major contributor to the genetic risks of infertility treatment associated with intracytoplasmic sperm injection (ICSI). The study objective was to assess prospectively the frequency of chromosomal aberrations in couples undergoing ICSI. A total of 2650 infertile couples (5300 patients) underwent chromosome analysis before undergoing ICSI in the Egyptian IVF-ET Centre. Heparinized blood samples were cultured, harvested and banded according to standard methods. Overall, 96.94% of the patients studied (5138/5300) had a normal karyotype, while the remaining 162 patients (3.06%) had an abnormal karyotype. Male patients constituted the majority of abnormalities; 138 males (85.19%) and 24 females (14.81%). These chromosomal aberrations included 117 cases (2.2%) of sex chromosome abnormalities; 113 males and four females. Forty-five patients (0.85%) had autosomal aberrations; 25 of them were males and 20 were females. The current data show that chromosomal abnormalities affect 3.06% of infertile patients, and occur in both sexes, but more predominantly in males undergoing ICSI for male factor infertility. It is recommended that chromosomal analysis be performed before undergoing ICSI, to identify patients who can be offered preimplantation genetic diagnosis.

  8. 76 FR 29245 - Agency Forms Undergoing Paperwork Reduction Act Review

    Science.gov (United States)

    2011-05-20

    ...--New--Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health... Diabetes is one of the most common chronic diseases among children in the United States. When diabetes... HUMAN SERVICES Centers for Disease Control and Prevention Agency Forms Undergoing Paperwork...

  9. Anesthesia and postoperative delirium in older adults undergoing hip surgery

    NARCIS (Netherlands)

    Slor, C.J.; de Jonghe, J.F.M.; Vreeswijk, R.; Groot, E.; Ploeg, T.V.D.; van Gool, W.A.; Eikelenboom, P.; Snoeck, M.; Schmand, B.; Kalisvaart, K.J.

    2011-01-01

    OBJECTIVES: To examine the effects of general anesthesia on the risk of incident postoperative delirium in older adults undergoing hip surgery. DESIGN: Secondary analysis of haloperidol prophylaxis for delirium clinical trial data. Predefined risk factors for delirium were assessed prior to surgery.

  10. Clinical benefit of steroid use in patients undergoing cardiopulmonary bypass

    DEFF Research Database (Denmark)

    Whitlock, Richard P; Chan, Simon; Devereaux, P J;

    2008-01-01

    We sought to establish the efficacy and safety of prophylactic steroids in adult patients undergoing cardiopulmonary bypass (CPB). We performed a meta-analysis of randomized trials reporting the effects of prophylactic steroids on clinical outcomes after CPB. Outcomes examined were mortality...

  11. A Model Project on Joint Custody for Families Undergoing Divorce.

    Science.gov (United States)

    Zemmelman, Steven E.; And Others

    1987-01-01

    A model of service for parents undergoing divorce and considering joint custody of their children is described. The model integrates several intervention strategies, including mediation, group treatment, divorce counseling, and child guidance. The applicability of the model to a range of problems related to divorce and child custody is…

  12. [Pharmacokinetics of defibrotide in uremic patients undergoing hemodialysis].

    Science.gov (United States)

    Rossi, R; Farma, A; Maggi, G C; Marelli, A

    1991-12-01

    Defibrotide pharmacokinetics were studied in 6 voluntary healthy subjects and in 10 uremic patients undergoing dialysis during which (instead of heparin) defibrotide was administered to prevent fibrino-formation in the circuit. Blood concentrations of the drug were assessed (expressed with reference to the residual glycidic deoxyribose) during a standard dialysis using defibrotide, 3.5, 15, 30, 45, 60 and 90 minutes after the defibrotide bolus (200 mg) had been injected into the arterial channel. The half-lives of the alpha and beta plasmatic phases were found to be equal at 3.79 and 41.4 min in dialysed subjects and at 1.13 and 16.54 in healthy volunteers. These results indicate that in uremic patients undergoing dialysis at intervals using defibrotide, a longer time is required to eliminate the drug from the circulation. This variation does not however appear to be significant in terms of the therapeutic use of the drug during dialysis.

  13. Sedation versus general anaesthesia in paediatric patients undergoing chest CT

    Energy Technology Data Exchange (ETDEWEB)

    Lam, W.W.M.; So, N.M.C.; Metreweli, C. [Chinese Univ. of Hong Kong, Dept. of Diagnostic Radiology and Organ Imaging (China); Chen, P.P. [Chinese Univ. of Hong Kong, Anaesthesiology and Intensive Care (China)

    1998-05-01

    Objective: CT of the chest in paediatric patients often requires sedation or general anaesthesia to minimize motion artefacts. Both sedation and general anaesthesia are associated with atelectasis which obscures the underlying pulmonary pathology. We conducted a prospective study to compare these two methods with respect to degree of motion artefacts and extent of atelectasis. Material and Methods: Nineteen patients undergoing 22 chest CT examinations were randomly selected for either sedation or general anaesthesia. The total area of atelectasis and the degree of motion artefacts were measured. Results: The mean percentage of atelectasis was 6.67% for general anaesthesia and 0.01% for sedation (p=0.01). There was no significant difference in the quality of the images between the sedation patients and the general anaesthesia patients. Conclusion: Whenever the clinical condition permits it, sedation rather than general anaesthesia should be given to paediatric patients undergoing chest CT. (orig.).

  14. Postural balance in Alzheimer's disease patients undergoing sensory pitfalls

    Directory of Open Access Journals (Sweden)

    Brunna Berton

    Full Text Available Abstract Despite consensus regarding the interference of cognitive processes on the human balance, the impact that different sensory stimuli have on the stabilometric measures remains unclear. Here, we investigated changes in the postural balance of individuals with Alzheimer's disease (AD and in healthy controls undergoing different proprioceptive and somesthetic pitfalls. We included 17 subjects submitted to eight sensorimotor dynamics with differences in the support bases, contact surfaces, and visual clues. The measurements used to assess participants balance were as follows: position of the body in space, range of instability, area of the support base, and velocity of postural control. From a total of 56 cross-sectional analyses, 21.42% pointed out differences between groups. Longitudinal analyses showed that tasks with proprioceptive and somesthetic pitfalls similarly impact imbalance in both groups. The current results suggest that AD subjects and healthy controls had different patterns submitted to balance, but suffered similar interference when undergoing proprioceptive and somesthetic challenges.

  15. Benthic processes in fresh water fluffy sediments undergoing resuspension

    OpenAIRE

    Daniele Longhi; Marco Bartoli; Daniele Nizzoli; Pierluigi Viaroli

    2013-01-01

    In the Po river plain relict freshwater wetlands are characterised by a low free water to emergent macrophyte surface ratio, rapid infilling and fluffy sediments, undergoing frequent resuspension. Particle mixing should alter the steep gradients of dissolved gas, nutrient and organic matter quality that generally characterise sediments, with implications for benthic processes. Sediment features and solute fluxes were studied from December 2003 to February 2005 within the Busatello swamp compl...

  16. Nursing Care of Patients Undergoing Chemotherapy Desensitization: Part II.

    Science.gov (United States)

    Jakel, Patricia; Carsten, Cynthia; Carino, Arvie; Braskett, Melinda

    2016-04-01

    Chemotherapy desensitization protocols are safe, but labor-intensive, processes that allow patients with cancer to receive medications even if they initially experienced severe hypersensitivity reactions. Part I of this column discussed the pathophysiology of hypersensitivity reactions and described the development of desensitization protocols in oncology settings. Part II incorporates the experiences of an academic medical center and provides a practical guide for the nursing care of patients undergoing chemotherapy desensitization.
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  17. [The diet of the elderly person undergoing dialysis].

    Science.gov (United States)

    Gourc, Christophe; Ramade, Nathalie

    2016-01-01

    The elderly patient undergoing dialysis is often at risk of undernutrition. The condition may already be present at the pre-dialysis stage and can worsen once dialysis starts. Aside from the impact on the patient's quality of life and general health status, undernutrition exposes them to serious risk of complications and can be life-threatening. It is therefore essential that it is diagnosed early. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  18. General Anaesthesia Protocols for Patients Undergoing Electroconvulsive Therapy

    Science.gov (United States)

    Narayanan, Aravind; Lal, Chandar; Al-Sinawi, Hamed

    2017-01-01

    Objectives This study aimed to review general anaesthesia protocols for patients undergoing electroconvulsive therapy (ECT) at a tertiary care hospital in Oman, particularly with regards to clinical profile, potential drug interactions and patient outcomes. Methods This retrospective study took place at the Sultan Qaboos University Hospital (SQUH), Muscat, Oman. The electronic medical records of patients undergoing ECT at SQUH between January 2010 and December 2014 were reviewed for demographic characteristics and therapy details. Results A total of 504 modified ECT sessions were performed on 57 patients during the study period. All of the patients underwent a uniform general anaesthetic regimen consisting of propofol and succinylcholine; however, they received different doses between sessions, as determined by the treating anaesthesiologist. Variations in drug doses between sessions in the same patient could not be attributed to any particular factor. Self-limiting tachycardia and hypertension were periprocedural complications noted among all patients. One patient developed aspiration pneumonitis (1.8%). Conclusion All patients undergoing ECT received a general anaesthetic regimen including propofol and succinylcholine. However, the interplay of anaesthetic drugs with ECT efficacy could not be established due to a lack of comprehensive data, particularly with respect to seizure duration. In addition, the impact of concurrent antipsychotic therapy on anaesthetic dose and subsequent complications could not be determined. PMID:28417028

  19. Educational Needs of Patients Undergoing Total Joint Arthroplasty

    Science.gov (United States)

    MacKay, Crystal; Saryeddine, Tina; Davis, Aileen M.; Flannery, John F.; Jaglal, Susan B.; Levy, Charissa; Mahomed, Nizar

    2010-01-01

    ABSTRACT Purpose: To identify the educational needs of adults who undergo total hip and total knee replacement surgery. Methods: A qualitative research design using a semi-standardized interviewing method was employed. A purposive sampling technique was used to recruit participants, who were eligible if they were scheduled to undergo total hip or total knee replacement or had undergone total hip or total knee replacement in the previous 3 to 6 months. A comparative contrast method of analysis was used. Results: Of 22 potential participants who were approached, 15 participated. Five were booked for upcoming total hip or total knee replacement and 10 had undergone at least one total hip or total knee replacement in the previous 3 to 6 months. Several themes related to specific educational needs and factors affecting educational needs, including access, preoperative phase, surgery and medical recovery, rehabilitation process and functional recovery, fears, and expectations counterbalanced with responsibility, emerged from the interviews. Conclusions: Educational needs of adults who undergo total hip and knee replacement surgery encompass a broad range of topics, confirming the importance of offering an all-inclusive information package regarding total hip and total knee replacement. PMID:21629598

  20. Sinusitis in patients undergoing allogeneic bone marrow transplantation - a review.

    Science.gov (United States)

    Drozd-Sokolowska, Joanna Ewa; Sokolowski, Jacek; Wiktor-Jedrzejczak, Wieslaw; Niemczyk, Kazimierz

    Sinusitis is a common morbidity in general population, however little is known about its occurrence in severely immunocompromised patients undergoing allogeneic hematopoietic stem cell transplantation. The aim of the study was to analyze the literature concerning sinusitis in patients undergoing allogeneic bone marrow transplantation. An electronic database search was performed with the objective of identifying all original trials examining sinusitis in allogeneic hematopoietic stem cell transplant recipients. The search was limited to English-language publications. Twenty five studies, published between 1985 and 2015 were identified, none of them being a randomized clinical trial. They reported on 31-955 patients, discussing different issues i.e. value of pretransplant sinonasal evaluation and its impact on post-transplant morbidity and mortality, treatment, risk factors analysis. Results from analyzed studies yielded inconsistent results. Nevertheless, some recommendations for good practice could be made. First, it seems advisable to screen all patients undergoing allogeneic hematopoietic stem cell transplantation with Computed Tomography (CT) prior to procedure. Second, patients with symptoms of sinusitis should be treated before hematopoietic stem cell transplantation (HSCT), preferably with conservative medical approach. Third, patients who have undergone hematopoietic stem cell transplantation should be monitored closely for sinusitis, especially in the early period after transplantation. Copyright © 2016 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  1. [Heart rate recovery after exercise in subjects undergoing cardiologic rehabilitation].

    Science.gov (United States)

    Mejer, Anna; Urzedowicz, Beata; Rembek-Wieliczko, Magdalena; Koziróg, Marzena; Ciećwierz, Julita; Kowalski, Jan

    2012-12-01

    Research indicates that slow heart rate recovery 1-2 minutes after exercise is a predictor of cardiovascular mortality, sudden mortality as well. It is hardly related to myocardial ischemia; most of all, it is related to impaired activities of the parasympathetic system. The purpose of this study was to assess HRR in subjects after a surgical treatment (percutaneous coronary intervention - PCI) of acute coronary syndromes (ACS), undergoing cardiologic rehabilitation. The study comprised 58 subjects, 42 men and 16 women aged 49-68 (56.8 +/- 7.6) after ACS treated with PCI undergoing cardiologic rehabilitation (stage 2)--group I. The comparative group comprised 34 subjects, 25 men and 9 women aged 46-61 (55.5 +/- 8.9 lat) who were clinically healthy and who underwent a single sub-maximal exercise test--group II. In subjects undergoing rehabilitation, an exercise test was performed twice --before and after stage 2 of rehabilitation. HRR was defined as a difference between the peak heart rate and those after the 1st (HRR1) and 2nd (HRR) minute of recovery. After stationary rehabilitation as a part of stage 2 of cardiologic rehabilitation, HRR2 was 26.3 +/- 10.6/min and was 40.8/min +/- 13.8/min; both these values were not significantly different from values observed in healthy subjects (p > 0.05). Significant increase in HRR1 and HRR2 was observed after the completion of stage 2 of cardiologic rehabilitation in ill subjects (p < 0.05) as compared to initial values. In subjects after ACS treated with PCI, it is observed that HRR changes back to normal values observed in healthy subjects as a result of underwent cardiologic rehabilitation. HRR should become an important factor in assessing effectiveness of conducted cardiologic rehabilitation.

  2. [The health of adults undergoing an eviction process].

    Science.gov (United States)

    Bolívar Muñoz, Julia; Bernal Solano, Mariola; Mateo Rodríguez, Inmaculada; Daponte Codina, Antonio; Escudero Espinosa, Cecilia; Sánchez Cantalejo, Carmen; González Usera, Isis; Robles Ortega, Humbelina; Mata Martín, José Luis; Fernández Santaella, M Carmen; Vila Castellar, Jaime

    2016-01-01

    To analyze perceived health status and other health-related indicators in the adult population in Granada (Spain) undergoing an eviction process from their homes, whether rented or owned, in comparison with health indicators in the general adult population in Andalusia. A cross-sectional survey was administered by trained staff. The survey included instruments from the Andalusian Health Survey 2011 for measuring variables related to physical and mental health, as well as health-related habits. We compared the results with those obtained from the Andalusian general population through the Andalusian Health Survey. A bivariate analysis using the χ2 test and a multivariate logistic regression analysis were conducted. We obtained a total sample of 205 people in the process of eviction. A total of 59.5% (n=122) were women, and 40.5% (n=83) were men. Participants were more likely to have poor health (odds ratio [OR]: 12.63, 95% confidence interval [95%CI]: 8.74-18.27), have cardiovascular diseases (OR: 3.08; 95%CI: 1.54- 6.16), or to smoke (OR: 1.68; 95% CI: 1.21-2.33) compared with the Andalusian general population. Most of the health indicators analyzed showed a worse outcome for women undergoing an eviction process. Our results suggest that, in the current context of economic crisis, people undergoing a process of eviction in Granada and its metropolitan area show poorer health than the Andalusian general population. Further research is needed on health and evictions from different methodological approaches, for a better understanding of the topic. Copyright © 2015 SESPAS. Published by Elsevier Espana. All rights reserved.

  3. Laparoscopy decreases complications for obese patients undergoing elective rectal surgery.

    Science.gov (United States)

    Vargas, Gabriela M; Sieloff, Eric P; Parmar, Abhishek D; Tamirisa, Nina P; Mehta, Hemalkumar B; Riall, Taylor S

    2016-05-01

    While there are many reported advantages to laparoscopic surgery compared to open surgery, the impact of a laparoscopic approach on postoperative morbidity in obese patients undergoing rectal surgery has not been studied. Our goal was to determine whether obese patients undergoing laparoscopic rectal surgery experienced the same benefits as non-obese patients. We identified patients undergoing rectal resections using the National Surgical Quality Improvement Project Participant Use Data File. We performed multivariable analyses to determine the independent association between laparoscopy and postoperative complications. A total of 26,437 patients underwent rectal resection. The mean age was 58.5 years, 32.6 % were obese, and 47.2 % had cancer. Laparoscopic procedures were slightly less common in obese patients compared to non-obese patients (36.0 vs. 38.2 %, p = 0.0006). In unadjusted analyses, complications were lower with the laparoscopic approach in both obese (18.9 vs. 32.4 %, p obese (15.6 vs. 25.3 %, p obesity worsened. The likelihood of experiencing a postoperative complication increased by 25, 45, and 75 % for obese class I, obese class II, and obese class III patients, respectively. A laparoscopic approach was associated with a 40 % decreased odds of a postoperative complication for all patients (OR 0.60, 95 % CI 0.56-0.64). Laparoscopic rectal surgery is associated with fewer complications when compared to open rectal surgery in both obese and non-obese patients. Obesity was an independent risk factor for postoperative complications. In appropriately selected patients, rectal surgery outcomes may be improved with a minimally invasive approach.

  4. Estimating glomerular filtration rate preoperatively for patients undergoing hepatectomy

    Institute of Scientific and Technical Information of China (English)

    Yoshimi Iwasaki; Tokihiko Sawada; Shozo Mori; Yukihiro Iso; Masato Katoh; Kyu Rokkaku; Junji Kita; Mitsugi Shimoda; Keiichi Kubota

    2009-01-01

    AIM: To compare creatinine clearance (Ccr) with estimated glomerular filtration rate (eGFR) in preoperative renal function tests in patients undergoing hepatectomy. METHODS: The records of 197 patients undergoing hepatectomy between August 2006 and August 2008 were studied, and preoperative Ccr, a three-variable equation for eGFR (eGFR3) and a five-variable equation for eGFR (eGFR5) were calculated. Abnormal values were defined as Ccr < 50 mL/min, eGFR3 and eGFR5 < 60 mL/min per 1.73 m2. The maximum increases in the postoperative serum creatinine (post Cr) level and postoperative rate of increase in the serum Cr level (post Cr rate) were compared. RESULTS: There were 37 patients (18.8%) withabnormal Ccr, 31 (15.7%) with abnormal eGFR3, and 40 (20.3%) with abnormal eGFR5. Although there were no significant differences in the post Cr rate between patients with normal and abnormal Ccr, eGFR3 and eGFR5 values, the post Cr level was significantly higher in patients with eGFR3 and eGFR5 abnormality than in normal patients ( P < 0.0001). Post Cr level tended to be higher in patients with Ccr abnormality ( P = 0.0936 and P = 0.0875, respectively). CONCLUSION: eGFR5 and the simpler eGFR3, rather than Ccr, are recommended as a preoperative renal function test in patients undergoing hepatectomy.

  5. The impact of patients controlled analgesia undergoing orthopedic surgery

    Directory of Open Access Journals (Sweden)

    Aluane Silva Dias

    2016-06-01

    Full Text Available ABSTRACT INTRODUCTION: The currently common musculoskeletal disorders have been increasingly treated surgically, and the pain can be a limiting factor in postoperative rehabilitation. RATIONALE: Patient controlled analgesia (PCA controls pain, but its adverse effects can interfere with rehabilitation and in the patient discharge process. This study becomes important, since there are few studies evaluating this correlation. OBJECTIVES: To compare the outcomes of patients who used and did not use patient controlled analgesia in postoperative orthopedic surgery with respect to pain, unscheduled need for O2 (oxygen, and time of immobility and in-hospital length of stay. METHODS: This is an observational, prospective study conducted at Hospital Abreu Sodré from May to August 2012. The data was daily obtained through assessments and interviews of patients undergoing total hip arthroplasty (THA and total knee arthroplasty (TKA, thoracolumbar spine arthrodesis (long PVA, cervical spine arthrodesis (cervical AVA and lumbar spine arthrodesis (lumbar PVA. RESULTS: The study showed some differences between groups, namely: the painful level was higher in the group undergoing lumbar PVA without PCA compared with the group with PCA (p = 0.03 and in the group of long PVA without PCA in the early postoperative period. This latter group used O2 for a longer time (p = 0.09. CONCLUSION: In this study, PCA was useful for analgesia in patients undergoing lumbar PVA and probably would have influenced the usage time of O2 in the group of long PVA in face of a larger sample. The use of PCA did not influence the time of leaving the bed and the in-hospital length of stay for the patients studied.

  6. Venous thromboembolism in 13 Indonesian patients undergoing major orthopedic surgery

    Directory of Open Access Journals (Sweden)

    Karmel L. Tambunan

    2009-12-01

    Full Text Available Aim: To estimate the incidence of VTE in Indonesian patients undergoing major orthopedic surgery and not receiving thromboprophylaxis.Methods: This was an open clinical study of consecutive Indonesian patients undergoing major orthopedic surgery, conducted in 3 centers in Jakarta. Bilateral venography was performed between days 5 and 8 after surgery to detect the asymptomatic and to confi rm the symptomatic VTE. These patients were followed up to one month after surgery.Results: A total of 17 eligible patients were studied, which a median age of 69 years and 76.5% were females. Sixteen out of the 17 patients (94.1% underwent hip fracture surgery (HFS. The median time from injury to surgery was 23 days (range 2 to 197 days, the median duration of surgery was 90 minutes (range 60 to 255 minutes, and the median duration of immobilization was 3 days (range 1 to 44 days. Thirteen out of the 17 patients were willing to undergo contrast venography. A symptomatic VTE was found in 9 patients (69.2% at hospital discharge. Symptomatic VTE was found in 3 patients (23.1%, all corresponding to clinical signs of DVT and none with clinical sign of PE. These patients were treated initially with a low molecular weight heparin, followed by warfarin. Sudden death did not occur up to hospital discharge. From hospital discharge until 1-month follow-up, there were no additional cases of symptomatic VTE. No sudden death, bleeding complication, nor re-hospitalization was found in the present study.Conclusion: The incidence of asymptomatic (69.2% and symptomatic (23.1% VTE after major orthopedic surgery without thromboprophylaxis in Indonesian patients (SMART and AIDA, and still higher than the results of the Western studies. A larger study is required to establish the true incidence, and more importantly, that the use of thromboprophylaxis in these patients is warranted. (Med J Indones 2009; 18: 249-56Keywords: venous thromboembolism (VTE, orthopedic surgery, Indonesia

  7. Cerebroprotective effect of piracetam in patients undergoing open heart surgery.

    Science.gov (United States)

    Holinski, Sebastian; Claus, Benjamin; Alaaraj, Nour; Dohmen, Pascal Maria; Neumann, Konrad; Uebelhack, Ralf; Konertz, Wolfgang

    2011-01-01

    Reduction of cognitive function is a possible side effect after the use of cardiopulmonary bypass (CPB) during cardiac surgery. Since it has been proven that piracetam is cerebroprotective in patients undergoing coronary bypass surgery, we investigated the effects of piracetam on the cognitive performance of patients undergoing open heart surgery. Patients scheduled for elective open heart surgery were randomized to the piracetam or placebo group in a double-blind study. Patients received 12 g of piracetam or placebo at the beginning of the operation. Six neuropsychological subtests from the Syndrom Kurz Test and the Alzheimer's Disease Assessment Scale were performed preoperatively and on day 3, postoperatively. To assess the overall cognitive function and the degree of cognitive decline across all tests after the surgery, we combined the six test-scores by principal component analysis. A total of 88 patients with a mean age of 67 years were enrolled into the study. The mean duration of CPB was 110 minutes. Preoperative clinical parameters and overall cognitive functions were not significantly different between the groups. The postoperative combined score of the neuropsychological tests showed deterioration of cognitive function in both groups (piracetam: preoperative 0.19 ± 0.97 vs. postoperative -0.97 ± 1.38, p piracetam did not perform better than those taking placebo, and both groups had the same decline of overall cognitive function (p = 0.955). Piracetam had no cerebroprotective effect in patients undergoing open heart surgery. Unlike the patients who underwent coronary surgery, piracetam did not reduce the early postoperative decline of neuropsychological abilities in heart valve patients.

  8. Unexplained hemolysis in patients undergoing ECMO: beware of hypertriglyceridemia.

    Science.gov (United States)

    Venado, A; Wille, K; Belott, S C; Diaz-Guzman, E

    2015-09-01

    Hemolysis is a common complication of extracorporeal membrane oxygenation (ECMO) support and is associated with increased mortality. Frequent monitoring of markers of hemolysis is performed at ECMO centers. We report two cases of spurious hemolysis caused by hypertriglyceridemia in patients undergoing ECMO support. Critically ill patients, including those receiving ECMO, may be at risk of developing medication-induced hypertriglyceridemia. The interference of lipids with the measurement of plasma free hemoglobin, a marker of hemolysis, should be recognized. Our cases highlight the importance of investigating hypertriglyceridemia as part of the assessment of unexplained hemolysis in patients supported with ECMO. © The Author(s) 2014.

  9. Anesthetists approach in a neonate with nesidioblastoma undergoing pancreatectomy

    Directory of Open Access Journals (Sweden)

    Kiran Patel

    2013-01-01

    Full Text Available Persistent hyperinsulinemic hypoglycemia of infancy (PHHI is rare, but an important cause of hypoglycemia in infants, associated with a number of structural abnormalities of the endocrine pancreas is collectively termed as "Islet cell dysmaturation syndrome." We present the anesthetic management in a clinically diagnosed case of PHHI in a 22 days old full term child, undergoing Subtotal Pancreatectomy. We have discussed the challenges faced in the intra-operative period in managing this neonate for pancreatic resection surgery with focus on intra-operative management of blood glucose levels.

  10. Nursing care for patients undergoing transoral robotic surgery.

    Science.gov (United States)

    Murray, Shannon

    2009-01-01

    Otorhinolaryngologists began developing new operative techniques to minimize open surgical resections of the head and neck. While striving to reduce the morbidity and mortality associated with head and neck surgery and decrease the many psychosocial issues facing these patients, a new procedure defined as Transoral Robotic Surgery (TORS) was developed. With the development of new surgical techniques, nursing care must also change to meet the needs of the patient. As the TORS procedure becomes fully defined, so is nursing's role in the care of the patient. This paper aims to define TORS and discuss the nursing care of the patient undergoing this new surgical procedure.

  11. Modeling Study of Planar Flexible Manipulator Undergoing Large Deformation

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    The planar flexible manipulator undergoing large deformation is investigated by using finite element method (FEM). Three kinds of reference frames are employed to describe the deformation of arbitrary point in the flexible manipulator, which are global frame, body-fixed frame and co-rotational frame. The rigid-flexible coupling dynamic equation of the planar flexible manipulator is derived using the Hamilton's principle. Numerical simulations are carried out in the end of this paper to demonstrate the effectiveness of the proposed model. The simulation results indicate that the proposed model is efficient not only for small deformation but also for large deformation.

  12. Fospropofol disodium injection for the sedation of patients undergoing colonoscopy.

    Science.gov (United States)

    Levitzky, Benjamin E; Vargo, John J

    2008-08-01

    Sedation plays a central role in making colonoscopy tolerable for patients and feasible for the endoscopist to perform. The array of agents used for endoscopic sedation continues to evolve. Fospropofol (FP), a prodrug of propofol with a slower pharmacokinetic profile, is currently under evaluation for use during endoscopic procedures. Preliminary data suggests that FP dosed at 6.5 mg/kg is well tolerated by most patients with perineal paresthesias being the most commonly experienced adverse effect. This article will examine the current literature on the use of FP for the sedation of patients undergoing colonoscopy, highlighting the pharmacokinetics, pharmacodynamics, risks, and common adverse events associated with the novel sedative/hypnotic.

  13. Immediate hemodynamic response to furosemide in patients undergoing chronic hemodialysis.

    Science.gov (United States)

    Schmieder, R E; Messerli, F H; deCarvalho, J G; Husserl, F E

    1987-01-01

    To evaluate the effect of furosemide on cardiovascular hemodynamics in patients with end-stage renal failure, we studied ten patients undergoing hemodialysis three times a week. Arterial pressure, heart rate, and cardiac output (indocyanine green dye) were measured in triplicate; total peripheral resistance and central blood volume were calculated by standard formulas. Hemodynamics were determined at baseline and 5, 10, 15, and 30 minutes after intravenous (IV) bolus injection of furosemide 60 mg. Furosemide produced a decrease in central blood volume of -13% +/- 2.2% from pretreatment values (P less than .01) that was most pronounced five minutes after injection, together with a fall in cardiac output (from 6.76 +/- 0.59 to 6.17 +/- 0.52 L/min, P less than .10). Stroke volume decreased with a maximum fall occurring after 15 minutes (from 84 +/- 7 to 79 +/- 7 mL/min, P less than .05), and total peripheral resistance increased (from 15.8 +/- 2.1 to 17.8 +/- 2.3 units, P less than .05) after furosemide. Arterial pressure and heart rate did not change. The decrease in central blood volume reflects a shift of the total blood volume from the cardiopulmonary circulation to the periphery, suggesting dilation of the peripheral venous bed. Thus, even in patients undergoing hemodialysis, furosemide acutely decreases left ventricular preload by venous dilation and should therefore prove to be beneficial in acute volume overload.

  14. [Has ketamine preemptive analgesic effect in patients undergoing abdominal hysterectomy?].

    Science.gov (United States)

    Karaman, Semra; Kocabaş, Seden; Zincircioğlu, Ciler; Firat, Vicdan

    2006-07-01

    The aim of this study was to determine if preemptive use of the NMDA receptor antogonist ketamine decreases postoperative pain in patients undergoing abdominal hystrectomy. A total of 60 patients admitted for total abdominal hysterectomy were included in this study after the approval of the ethic committee, and the patients were randomly classified into three groups. After standart general anaesthesia, before or after incision patients received bolus saline or ketamine. Group S received only saline while Group Kpre received ketamine 0.4 mg/kg before incision and saline after incision, and Group Kpost received saline before incision and 0.4 mg/kg ketamine after incision. Postoperatif analgesia was maintained with i.v. PCA morphine. Pain scores were assessed with Vizüal Analog Scale (VAS), Verbal Rating Scale (VRS) at 1., 2, 3., 4., 8., 12. ve 24. hours postoperatively. First analgesic requirement time, morphine consumption and side effects were recorded. There were no significant differences between groups with respect to VAS / VRS scores, the time for first analgesic dose, and morphine consumption ( p>0.05). Patients in Group S had significantly lower sedation scores than either of the ketamine treated groups ( pketamin had no preemptive analgesic effect in patients undergoing abdominal hysterectomy, but further investigation is needed for different operation types and dose regimens.

  15. Hemoglobin optimization and transfusion strategies in patients undergoing cardiac surgery

    Institute of Scientific and Technical Information of China (English)

    Mahdi; Najafi; David; Faraoni

    2015-01-01

    Although red blood cells(RBCs) transfusion is sometimes associated with adverse reactions,anemia could also lead to increased morbidity and mortality in highrisk patients. For these reasons,the definition of perioperative strategies that aims to detect and treat preoperative anemia,prevent excessive blood loss,and define "optimal" transfusion algorithms is crucial. Although the treatment with preoperative iron and erythropoietin has been recommended in some specific conditions,several controversies exist regarding the benefit-to-risk balance associated with these treatments. Further studies are needed to better define the indications,dosage,and route of administration for preoperative iron with or without erythropoietin supplementation. Although restrictive transfusion strategies in patients undergoing cardiac surgery have been shown to effectively reduce the incidence and the amount of RBCs transfusion without increase in side effects,some high-risk patients(e.g.,symptomatic acute coronary syndrome) could benefit from higher hemoglobin concentrations. Despite all efforts made last decade,a significant amount of work remains to be done to improve hemoglobin optimization and transfusion strategies in patients undergoing cardiac surgery.

  16. Maintaining periodontal health in patients undergoing orthodontic treatment

    Directory of Open Access Journals (Sweden)

    Shobhana Misra

    2012-01-01

    Full Text Available Presence of fixed orthodontic appliances in the mouth leads to accumulation of food debris and an elevation in the amount of plaque. It also hinders plaque removal by tooth brushing alone. Chemical agents may be used during the active phase of orthodontic treatment to reduce the bacterial plaque accumulation and decrease the occurrence of periodontal disease in these patients. The present study was therefore done to compare the efficacy of chemical plaque control by chlorhexidiene in patients undergoing orthodontic treatment. Forty five subjects for this double blind study were assigned randomly into three groups of 15 each. Gingival inflammation, plaque accumulation, and bleeding on probing, were recorded at baseline (10 days after prophylaxis, and at the end of one month in all the three groups. The data obtained was subjected to stastical analysis. Anova test showed significant difference among all the three groups for bleeding index, modified gingival index and plaque index. Paired t test showed significant differences in bleeding index for pre and post treatment recordings for chlorhexidine group. Modified gingival index showed significant difference in the chlorhexidine group. For plaque index significant difference was found for chlorhexidine, and control groups. Chlorhexidine mouthrinse 0.12% was found to be the most effective in reducing the bleeding scores, modified gingival index scores and the plaque index scores. It can therefore be said that chlorhexidine mouthrinse 0.12% provides greater benefits to the patients undergoing fixed orthodontic treatment.

  17. Children Undergoing Radiotherapy: Swedish Parents' Experiences and Suggestions for Improvement.

    Science.gov (United States)

    Ångström-Brännström, Charlotte; Engvall, Gunn; Mullaney, Tara; Nilsson, Kristina; Wickart-Johansson, Gun; Svärd, Anna-Maja; Nyholm, Tufve; Lindh, Jack; Lindh, Viveca

    2015-01-01

    Approximately 300 children, from 0 to 18 years old, are diagnosed with cancer in Sweden every year. Of these children, 80-90 of them undergo radiotherapy treatment for their cancer. Although radiotherapy is an encounter with advanced technology, few studies have investigated the child's and the parent's view of the procedure. As part of an ongoing multicenter study aimed to improve patient preparation and the care environment in pediatric radiotherapy, this article reports the findings from interviews with parents at baseline. The aim of the present study was twofold: to describe parents' experience when their child undergoes radiotherapy treatment, and to report parents' suggestions for improvements during radiotherapy for their children. Sixteen mothers and sixteen fathers of children between 2-16 years old with various cancer diagnoses were interviewed. Data were analyzed using content analysis. The findings showed that cancer and treatment turns people's lives upside down, affecting the entire family. Further, the parents experience the child's suffering and must cope with intense feelings. Radiotherapy treatment includes preparation by skilled and empathetic staff. The parents gradually find that they can deal with the process; and lastly, parents have suggestions for improvements during the radiotherapy treatment. An overarching theme emerged: that despair gradually turns to a sense of security, with a sustained focus on and close interaction with the child. In conclusion, an extreme burden was experienced around the start of radiotherapy, though parents gradually coped with the process.

  18. Knowledge of electromyography (EMG) in patients undergoing EMG examinations.

    Science.gov (United States)

    Mondelli, Mauro; Aretini, Alessandro; Greco, Giuseppe

    2014-01-01

    The aim of this study was to evaluate knowledge of electromyography (EMG) in patients undergoing the procedure. In one year, 1,586 consecutive patients (mean age 56 years; 58.8% women) were admitted to two EMG labs to undergo EMG for the first time. The patients found to be "informed" about the how an EMG examination is performed and about the purpose of EMG numbered 448 (28.2%), while those found to be "informed" only about the manner of its execution or only about its purpose numbered 161 (10.2%) and 151 (9.5%), respectively. The remaining 826 (52.1%) patients had either no information, or the information they had was very poor or incorrect (this was particularly true if they had been consulting websites). Being "informed" was associated with level of education (high), type of referring physician (specialist) and with an appropriate referral diagnosis specified in the EMG request. The quality of patient information on EMG was found to be very poor and could be improved. Physicians referring patients for EMG examinations, especially general practitioners, should assume primary responsibility for patient education and counseling in this field.

  19. Cerebroprotective effect of piracetam in patients undergoing coronary bypass burgery.

    Science.gov (United States)

    Holinski, Sebastian; Claus, Benjamin; Alaaraj, Nour; Dohmen, Pascal Maria; Kirilova, Kremena; Neumann, Konrad; Uebelhack, Ralf; Konertz, Wolfgang

    2008-11-01

    Reduction of cognitive function is a possible side effect after cardiac surgery using cardiopulmonary bypass. We investigated the cerebroprotective effect of piracetam on cognitive performance in patients undergoing coronary artery bypass surgery under cardiopulmonary bypass. Patients scheduled for elective, primary and isolated coronary bypass surgery were randomised either to piracetam or placebo group. The study was performed in a double blind fashion. Patients received either 12 g piracetam or placebo at the beginning of the operation. Six neuropsychological subtests from the Syndrom Kurz Test and the Alzheimer's Disease Assessment Scale were performed preoperatively and on the third postoperative day. To assess the overall cognitive function and the degree of cognitive decline across all tests after surgery we combined the six test-scores by principal component analysis. A total number of 120 patients were enrolled into the study. Preoperative overall cognitive function were not significantly different between the groups. The postoperative combined score of the neuropsychological tests showed a deterioration of cognitive function in both groups (placebo-pre: -0.06+/-0.99 vs placebo-post: -1.38+/-1.11; ppiracetam-pre: 0.06+/-1.02 vs piracetam-post: -0.65+/-0.93; ppiracetam patients performed significantly better compared to the placebo patients after the operation and had a less decline of overall cognitive function (pPiracetam has a cerebroprotective effect in patients undergoing coronary artery bypass surgery with the use of cardiopulmonary bypass. It reduces an early postoperative substantial decline of neuropsychological abilities.

  20. Prevalence of renal artery stenosis in patients undergoing cardiac catheterization.

    Science.gov (United States)

    Marcantoni, Carmelita; Carmelita, Marcantoni; Rastelli, Stefania; Stefania, Rastelli; Zanoli, Luca; Luca, Zanoli; Tripepi, Giovanni; Giovanni, Tripepi; Di Salvo, Marilena; Marilena, Di Salvo; Monaco, Sergio; Sergio, Monaco; Sgroi, Carmelo; Carmelo, Sgroi; Capodanno, Davide; Davide, Capodanno; Tamburino, Corrado; Corrado, Tamburino; Castellino, Pietro; Pietro, Castellino

    2013-08-01

    To investigate the prevalence of significant renal artery stenosis (RAS ≥50%), and to identify clinical predictors for significant RAS in patients with an elevated cardiovascular risk, such as those affected by ischemic heart disease. In patients with an elevated cardio-vascular risk, both atherosclerotic renovascular disease and coronary artery disease (CAD) are likely to occur. Prospectively from April 2007 to March 2008, all consecutive patients with ischemic heart disease undergoing non-emergent cardiac catheterization were also evaluated for atherosclerotic RAS by renal arteriography. A RAS ≥50% was considered as significant. A total of 1,298 patients underwent cardiac and renal angiography. Significant RAS was found in 70 out of 1,298 patients (5.4%). The presence of peripheral vascular disease, eGFR 66 years, dyslipidemia, CAD severity and pulse pressure >52 mmHg were independent clinical predictors of significant RAS, and jointly produced a ROC AUC of 0.79 (95% CI 0.73-0.85, P < 0.001). Based on these data, a prediction rule for significant RAS was developed, and it showed an adequate predictive performance with 64% sensitivity and 82% specificity. In a large cohort of patients undergoing coronary angiography, significant RAS is a relatively rare comorbidity (5.4%). A model based on simple clinical variables may be useful for the clinical identification of high CV risk patients who may be suitable for renal arteriography at the time of cardiac catheterization.

  1. Nasogastric intubation causes gastroesophageal reflux in patients undergoing elective laparotomy.

    LENUS (Irish Health Repository)

    Manning, B J

    2012-02-03

    BACKGROUND: The routine use of nasogastric tubes in patients undergoing elective abdominal operation is associated with an increased incidence of postoperative fever, atelectasis, and pneumonia. Previous studies have shown that nasogastric tubes have no significant effect on the incidence of gastroesophageal reflux or on lower esophageal sphincter pressure in healthy volunteers. We hypothesized that nasogastric intubation in patients undergoing laparotomy reduces lower esophageal sphincter pressure and promotes gastroesophageal reflux in the perioperative period. METHODS: A prospective randomized case-control study was undertaken in which 15 consenting patients, admitted electively for bowel surgery, were randomized into 2 groups. Group 1 underwent nasogastric intubation after induction of anesthesia, and Group 2 did not. All patients had manometry and pH probes placed with the aid of endoscopic vision at the lower esophageal sphincter and distal esophagus, respectively. Nasogastric tubes, where present, were left on free drainage, and sphincter pressures and pH were recorded continuously during a 24-hour period. Data were analyzed with 1-way analysis of variance. RESULTS: The mean number of reflux episodes (defined as pH < 4) in the nasogastric tube group was 137 compared with a median of 8 episodes in the group managed without nasogastric tubes (P =.006). The median duration of the longest episode of reflux was 132 minutes in Group 1 and 1 minute in Group 2 (P =.001). A mean of 13.3 episodes of reflux lasted longer than 5 minutes in Group 1, with pH less than 4 for 37.4% of the 24 hours. This was in contrast to Group 2 where a mean of 0.13 episodes lasted longer than 5 minutes (P =.001) and pH less than 4 for 0.2% of total time (P =.001). The mean lower esophageal sphincter pressures were lower in Group 1. CONCLUSIONS. These findings demonstrate that patients undergoing elective laparotomy with routine nasogastric tube placement have significant gastroesophageal

  2. Quality of life of women undergoing treatment for cervical cancer

    Directory of Open Access Journals (Sweden)

    Francieli Ana Dallabrida

    2014-04-01

    Full Text Available This study aimed to evaluate the quality of life of women with cervical cancer. This is a cross-sectional, descriptive study developed with 43 women undergoing oncological treatment assisted at an Oncology High Complexity Center, in the Southern region of Brazil. The instrument used was the European Organization for Research and Treatment of Cancer – Quality of Life Questionnaire Core-30, and the data were analyzed through descriptive statistics. The average age was 54.6 years old. Married women prevailed (53.4%, with incomplete elementary education (72.1% and income from one to two minimum wages (62.8%. Quality of Life was considered very satisfactory. According to the development scales and emotional functioning, the result was from regular to satisfactory. The most frequent symptoms were fatigue, lack of appetite and pain. There is a need of structure of public health policies, for preventing cervical cancer in the most vulnerable population.

  3. Care of the patient undergoing robotic-assisted laparoscopic pyeloplasty.

    Science.gov (United States)

    Francis, Paula; Winfield, Howard N

    2006-04-01

    Laparoscopic pyeloplasty as a treatment for ureteropelvic junction obstruction has shown comparable success rates with open pyeloplasty techniques. The use of robotic technology to assist during laparoscopic pyeloplasty procedures has been encouraged by the steep learning curve for laparoscopic surgical skills, and the complexity of laparoscopic suturing. Robotic technology provides the surgeon with the ability to filter out any physiologic hand tremor, more degrees of freedom of movement than traditional laparoscopic instruments, the ability to scale movement to provide better control for microsurgery, better ergonomics during surgery, and three-dimensional vision. Details of the procedure and specific nursing care of the patient undergoing robotic-assisted laparoscopic pyeloplasty at the University of Iowa Hospital and Clinics are described.

  4. Adiabatic shear bands localization in materials undergoing deformations

    Science.gov (United States)

    Ryabov, P. N.; Kudryashov, N. A.; Muratov, R. V.

    2017-01-01

    We consider the adiabatic shear banding phenomenon in composite materials undergoing the high speed shear deformations. The mathematical model of adiabatic shear banding in thermo-visco-plastic material is given. New two step numerical algorithm which is based on the Courant-Isaacson-Rees scheme that allows one to simulate fully localized plastic flow from initial stage of localization is proposed. To test this numerical algorithm we use three benchmark problems. The testing results show the accuracy and efficiency of proposed algorithm. The features of adiabatic shear bands formation in composites are studied. The existence of characteristic depth of localization in composites is shown. Influence of initial temperature distribution on the processes of adiabatic shear bands formation in composites is considered.

  5. Liquid discharges from patients undergoing {sup 131}I treatments

    Energy Technology Data Exchange (ETDEWEB)

    Barquero, R. [Servicio de Radiofisica y Proteccion Radiologica, Hospital Universitario Rio Hortega, E-47010 Valladolid (Spain)], E-mail: rbarquero@hurh.sacyl.es; Basurto, F. [Departamento de Fisica Teorica, Atomica y Optica, Universidad de Valladolid, E-47010 Valladolid (Spain); Nunez, C. [Servicio de Radiofisica y Proteccion Radiologica, Fundacion Jimenez Diaz, FJD, E-82001 Madrid (Spain); Esteban, R. [Servicio de Radiologia, Hospital Clinico Universitario, E-47005 Valladolid (Spain)

    2008-10-15

    This work discusses the production and management of liquid radioactive wastes as excretas from patients undergoing therapy procedures with {sup 131}I radiopharmaceuticals in Spain. The activity in the sewage has been estimated with and without waste radioactive decay tanks. Two common therapy procedures have been considered, the thyroid cancer (4.14 GBq administered per treatment), and the hyperthyroidism (414 MBq administered per treatment). The calculations were based on measurements of external exposure around the 244 hyperthyroidism patients and 23 thyroid cancer patients. The estimated direct activity discharged to the sewage for two thyroid carcinomas and three hyperthyroidisms was 14.57 GBq and 1.27 GBq, respectively, per week; the annual doses received by the most exposed individual (sewage worker) were 164 {mu}Sv and 13 {mu}Sv, respectively. General equations to calculate the activity as a function of the number of patient treated each week were also obtained.

  6. Opportunistic microorganisms in patients undergoing antibiotic therapy for pulmonary tuberculosis

    Directory of Open Access Journals (Sweden)

    Silvia Maria Rodrigues Querido

    2011-12-01

    Full Text Available Antimicrobial therapy may cause changes in the resident oral microbiota, with the increase of opportunistic pathogens. The aim of this study was to compare the prevalence of Candida, Staphylococcus, Pseudomonas and Enterobacteriaceae in the oral cavity of fifty patients undergoing antibiotic therapy for pulmonary tuberculosis and systemically healthy controls. Oral rinsing and subgingival samples were obtained, plated in Sabouraud dextrose agar with chloramphenicol, mannitol agar and MacConkey agar, and incubated for 48 h at 37ºC. Candida spp. and coagulase-positive staphylococci were identified by phenotypic tests, C. dubliniensis, by multiplex PCR, and coagulase-negative staphylococci, Enterobacteriaceae and Pseudomonas spp., by the API systems. The number of Candida spp. was significantly higher in tuberculosis patients, and C. albicans was the most prevalent specie. No significant differences in the prevalence of other microorganisms were observed. In conclusion, the antimicrobial therapy for pulmonary tuberculosis induced significant increase only in the amounts of Candida spp.

  7. [Evaluation of quality of life in elders undergoing hemodialysis].

    Science.gov (United States)

    Takemoto, Angélica Yukari; Okubo, Patrícia; Bedendo, João; Carreira, Lígia

    2011-06-01

    Hemodialysis affects not only physical but psychological and social aspects, with repercussions on personal and family life. Considering the increase in the elderly population in Brazil, this study aims to evaluate the quality of life of elderly patients with chronic renal failure undergoing hemodialysis. This is a quantitative, descriptive exploratory study with elderly patients held in a facility specializing in hemodialysis in Guarapuava, Paraná, Brazil. The data were collected between May and June 2010, through a structured instrument and were submitted to the statistical software Statistica 7.1. Analyzing the domains of the questionnaire the highest score refers to the social domain (70.42) and the lowest, to the physical domain (49.37). Thus, the quality of life of these elderly had to be low, with variations according to the analyzed field. Researches aimed at assessing quality of life are relevant and instrumentalize the daily practice of care.

  8. Active vibration control of structures undergoing bending vibrations

    Science.gov (United States)

    Pla, Frederic G. (Inventor); Rajiyah, Harindra (Inventor)

    1995-01-01

    An active vibration control subassembly for a structure (such as a jet engine duct or a washing machine panel) undergoing bending vibrations caused by a source (such as the clothes agitator of the washing machine) independent of the subassembly. A piezoceramic actuator plate is vibratable by an applied electric AC signal. The plate is connected to the structure such that vibrations in the plate induced by the AC signal cause canceling bending vibrations in the structure and such that the plate is compressively pre-stressed along the structure when the structure is free of any bending vibrations. The compressive prestressing increases the amplitude of the canceling bending vibrations before the critical tensile stress level of the plate is reached. Preferably, a positive electric DC bias is also applied to the plate in its poling direction.

  9. [Mucositis in head and neck cancer patients undergoing radiochemotherapy].

    Science.gov (United States)

    Santos, Renata Cristina Schmidt; Dias, Rodrigo Souza; Giordani, Adelmo José; Segreto, Roberto Araújo; Segreto, Helena Regina Comodo

    2011-12-01

    The objective of present study was to classify oral mucositis according to the Common Toxicity Criterion (CTC) international parameters in head and neck tumor patients simultaneously treated with radio and chemotherapy, and characterize a patient profile in our area, observing the individuals' habits, tumor characteristics, treatment protocol and acute reaction intensity. Fifty patients undergoing simultaneous 66 to 70 Gy megavoltage radiotherapy and cisplatin/carboplatin chemotherapy were evaluated in this study. Weekly evaluations of the degree of mucositis were perfoemed according to CTC, a four-degree ordinal scale; 36% of all patients and 100% of those with diabetes discontinued treatment due to mucositis, showing that this pathology contributes to the severity of mucositis.

  10. Fospropofol disodium injection for the sedation of patients undergoing colonoscopy

    Directory of Open Access Journals (Sweden)

    Benjamin E Levitzky

    2008-09-01

    Full Text Available Benjamin E Levitzky1, John J Vargo21Department of Gastroenterology and Hepatology, 2Section of Therapeutic and Hepatobiliary Endoscopy, Department of Gastroenterology and Hepatology, Cleveland Clinic Foundation, Cleveland, Ohio, USAAbstract: Sedation plays a central role in making colonoscopy tolerable for patients and feasible for the endoscopist to perform. The array of agents used for endoscopic sedation continues to evolve. Fospropofol (FP, a prodrug of propofol with a slower pharmacokinetic profi le, is currently under evaluation for use during endoscopic procedures. Preliminary data suggests that FP dosed at 6.5 mg/kg is well tolerated by most patients with perineal paresthesias being the most commonly experienced adverse effect. This article will examine the current literature on the use of FP for the sedation of patients undergoing colonoscopy, highlighting the pharmacokinetics, pharmacodynamics, risks, and common adverse events associated with the novel sedative/hypnotic.Keywords: fospropofol, Aquavan, propofol, sedation, colonoscopy

  11. Medanta insulin protocols in patients undergoing cardiac surgery

    Directory of Open Access Journals (Sweden)

    Beena Bansal

    2014-01-01

    Full Text Available Hyperglycemia is common in patients undergoing cardiac surgery and is associated with poor outcomes. This is a review of the perioperative insulin protocol being used at Medanta, the Medicity, which has a large volume cardiac surgery setup. Preoperatively, patients are usually continued on their preoperative outpatient medications. Intravenous insulin infusion is intiated postoperatively and titrated using a column method with a choice of 7 scales. Insulin dose is calculated as a factor of blood glucose and patient′s estimated insulin sensitivity. A comparison of this protocol is presented with other commonly used protocols. Since arterial blood gas analysis is done every 4 hours for first two days after cardiac surgery, automatic data collection from blood gas analyzer to a central database enables collection of glucose data and generating glucometrics. Data auditing has helped in improving performance through protocol modification.

  12. Should violent offenders be forced to undergo neurotechnological treatment?

    DEFF Research Database (Denmark)

    Petersen, Thomas Søbirk; Kragh, Kristian

    2017-01-01

    ’s right to freedom of thought. We argue that this objection can be challenged. First, we present some specifications of what a right to freedom of thought might mean. We focus on the recently published views of Jared Craig, and Jan Cristopher Bublitz and Reinhard Merkel. Secondly, we argue that forcing...... violent offenders to undergo certain kinds of NT may not violate the offender’s right to freedom of thought as that right is specified by Craig, and Bublitz and Merkel. Thirdly, even if non-consensual NT is used in a way that does violate freedom of thought, such use can be difficult to abandon without...... inconsistency. For if one is not an abolitionist, and therefore accepts traditional state punishments for violent offenders like imprisonment – which, the evidence shows, often violate the offender’s right to freedom of thought – then, it is argued, one will have reason to accept that violent offenders can...

  13. Anesthetic management in an appendix tumor patient undergoing hyperthermic chemotherapy

    Directory of Open Access Journals (Sweden)

    Yonca Yanlı

    2013-06-01

    Full Text Available Cytoreductive surgery combined with hyperthermic intraperitonealchemotherapy (HIPEC is a complex and multidisciplinerprocedure that is being used increasingly forperitoneal and appendix malignency. First of all the macroscopictumor tissues are extracted after that peritonealperfusion is started with giving heated 42°C chemotherapeuticsolution via abdominal drains. It is important tomaintain normovolemia, to regulate coagulation and renalparameters during perioperative period, to compansatehypothermia during cytoreductive surgery and hyperthermiaduring HIPEC and to regulate hemodynamic changesdue to increased abdominal pressure during HIPEC.In this case report, we aimed to share anaesthetic experienceand to evaluate anaesthetic problems in 45 yearsold ASA I patient undergoing cytoreductive surgery andhypertermic intraperitoneal chemotherapy in which newlyestablished in our hospital for appendix tumor. J Clin ExpInvest 2013; 4 (2: 234-237Key words: Anaesthesia, general, hyperthermic intraperitonealchemotherapy, cytoreductive surgery.

  14. Dexamethasone and risk of bleeding in children undergoing tonsillectomy.

    Science.gov (United States)

    Mahant, Sanjay; Keren, Ron; Localio, Russell; Luan, Xianqun; Song, Lihai; Shah, Samir S; Tieder, Joel S; Wilson, Karen M; Elden, Lisa; Srivastava, Rajendu

    2014-05-01

    To determine whether dexamethasone use in children undergoing tonsillectomy is associated with increased risk of postoperative bleeding. Retrospective cohort study using a multihospital administrative database. Thirty-six US children's hospitals. Children undergoing same-day tonsillectomy between the years 2004 and 2010. We used discrete time failure models to estimate the daily hazards of revisits for bleeding (emergency department or hospital admission) up to 30 days after surgery as a function of dexamethasone use. Revisits were standardized for patient characteristics, antibiotic use, year of surgery, and hospital. Of 139,715 children who underwent same-day tonsillectomy, 97,242 (69.6%) received dexamethasone and 4182 (3.0%) had a 30-day revisit for bleeding. The 30-day cumulative standardized risk of revisits for bleeding was greater with dexamethasone use (3.11% vs 2.71%; standardized difference 0.40% [95% confidence interval, 0.13%-0.67%]; P = .003), and the increased risk was observed across all age strata. Dexamethasone use was associated with a higher standardized rate of revisits for bleeding in the postdischarge time periods of days 1 through 5 but not during the peak period for secondary bleeding, days 6 and 7. In a real-world practice setting, dexamethasone use was associated with a small absolute increased risk of revisits for bleeding. However, the upper bound of this risk increase does not cross published thresholds for a minimal clinically important difference. Given the benefits of dexamethasone in reducing postoperative nausea and vomiting and the larger body of evidence from trials, these results support guideline recommendations for the routine use of dexamethasone.

  15. Postpolypectomy bleeding in patients undergoing colonoscopy on uninterrupted clopidogrel therapy.

    Science.gov (United States)

    Singh, Mandeep; Mehta, Nilesh; Murthy, Uma K; Kaul, Vivek; Arif, Asma; Newman, Nancy

    2010-05-01

    The risk of postpolypectomy bleeding (PPB) in patients undergoing colonoscopy on uninterrupted clopidogrel therapy has not been established. To assess the PPB rate and outcome and identify risk factors associated with PPB in patients taking clopidogrel. Single-center, retrospective study. Demographics, clinical parameters, polyp characteristics, polypectomy techniques, and postpolypectomy events in the groups were compared by univariate analysis. Stepwise logistic regression analyses identified independent risk factors associated with PPB. Veterans Affairs Medical Center. A total of 142 patients (375 polypectomies) taking clopidogrel (cases) and 1243 patients (3226 polypectomies) not taking clopidogrel (controls). None. Postpolypectomy bleeding, hospitalization, and mortality. The immediate (intraprocedural) bleeding rate was similar in the 2 groups (2.1% vs 2.1%). Delayed (postprocedural) PPB rate was higher in the group taking clopidogrel (3.5% vs 1.0%, P = .02). Delayed bleeding of significance requiring hospitalization and transfusion/intervention was also higher in patients taking clopidogrel (2.1% vs 0.4%, P = .04). The length of hospital stay and interventions for PPB were comparable between the 2 groups. There was no mortality. Concomitant use of clopidogrel and aspirin/other nonsteroidal anti-inflammatory drugs (odds ratio 3.7; 95% CI, 1.6-8.5) and the number of polyps removed (OR 1.3; 95% CI, 1.2-1.4) were the only significant risk factors associated with PPB. Clopidogrel alone was not an independent risk factor for PPB. Retrospective study and small number of patients with PPB. The PPB rate is significantly higher in patients undergoing polypectomy while taking clopidogrel and concomitant aspirin/nonsteroidal anti-inflammatory drugs; however, the risk is small and the outcome is favorable. Routine cessation of clopidogrel in patients before colonoscopy/polypectomy is not necessary. 2010 American Society for Gastrointestinal Endoscopy. Published by Mosby

  16. Telecommunication system for children undergoing stem cell transplantation.

    Science.gov (United States)

    Higuchi, Kazumi; Nakazawa, Yozo; Sakata, Nobuhiro; Takizawa, Masaomi; Ohso, Keiko; Tanaka, Miyuki; Yanagisawa, Ryu; Koike, Kenichi

    2011-12-01

    Isolation in a germ-free unit is a stressful experience for pediatric patients undergoing hematopoietic stem cell transplantation (HSCT). To reduce the psychological distress of such children, a Web-based telecommunications system was developed. The authors developed a telecommunication system that linked a laminar air flow (LAF) room that had a high efficiency particulate air filter with the hospital school/patients' homes via the Internet. Fifteen children isolated in the LAF room for allogeneic HSCT were enrolled in this study. The present study evaluated whether the system was feasible for the patients during the acute phase of HSCT. In 10 patients, the proportion of days when they telecommunicated with teachers and/or other patients in the hospital school was 64.6 ± 32.3%. The telecommunication with the hospital school facilitated the continuation of school study under teachers' guidance, reducing the problem of lost schooling. In 13 patients, the proportion of days when they telecommunicated with their homes was 68.0 ± 34.8%. Ten of them frequently telecommunicated with their family members (especially siblings), and three patients called out to their pets at home. The incidence of telecommunication on the days when the patients had HSCT-related symptoms including vomiting did not differ from that of telecommunication on the days when no symptoms were evident. A telecommunication system linked to a hospital school and/or the patients' homes is feasible for children undergoing HSCT, and may improve their health-related quality of life. A larger, prospective study is required to evaluate whether the telecommunication system can reduce HSCT-associated psychological and psychiatric symptoms. © 2011 The Authors. Pediatrics International © 2011 Japan Pediatric Society.

  17. Performance of PROMIS for Healthy Patients Undergoing Meniscal Surgery.

    Science.gov (United States)

    Hancock, Kyle J; Glass, Natalie; Anthony, Chris A; Hettrich, Carolyn M; Albright, John; Amendola, Annunziato; Wolf, Brian R; Bollier, Matthew

    2017-06-07

    The Patient-Reported Outcomes Measurement Information System (PROMIS) was developed as an extensive question bank with multiple health domains that could be utilized for computerized adaptive testing (CAT). In the present study, we investigated the use of the PROMIS Physical Function CAT (PROMIS PF CAT) in an otherwise healthy population scheduled to undergo surgery for meniscal injury with the hypotheses that (1) the PROMIS PF CAT would correlate strongly with patient-reported outcome instruments that measure physical function and would not correlate strongly with those that measure other health domains, (2) there would be no ceiling effects, and (3) the test burden would be significantly less than that of the traditional measures. Patients scheduled to undergo meniscal surgery completed the PROMIS PF CAT, Knee injury and Osteoarthritis Outcome Score (KOOS), Marx Knee Activity Rating Scale, Short Form-36 (SF-36), and EuroQol-5 Dimension (EQ-5D) questionnaires. Correlations were defined as high (≥0.7), high-moderate (0.61 to 0.69), moderate (0.4 to 0.6), moderate-weak (0.31 to 0.39), or weak (≤0.3). If ≥15% respondents to a patient-reported outcome measure obtained the highest or lowest possible score, the instrument was determined to have a significant ceiling or floor effect. A total of 107 participants were analyzed. The PROMIS PF CAT had a high correlation with the SF-36 Physical Functioning (PF) (r = 0.82, p ceiling effects, with 0% of the participants achieving the lowest and highest score, respectively. The PROMIS PF CAT correlates strongly with currently used patient-reported outcome measures of physical function and demonstrates no ceiling effects for patients with meniscal injury requiring surgery. It may be a reasonable alternative to more burdensome patient-reported outcome measures.

  18. Cilostazol may prevent cardioembolic stroke in patients undergoing antiplatelet therapy.

    Science.gov (United States)

    Horie, Nobutaka; Kaminogo, Makio; Izumo, Tsuyoshi; Hayashi, Kentaro; Tsujino, Akira; Nagata, Izumi

    2015-07-01

    Randomised trials have shown the efficacy of antiplatelet therapy with cilostazol to prevent secondary ischaemic stroke. Recently, cilostazol has been reported to prevent the development and/or recurrence of atrial fibrillation (AF), which can potentially prevent cardioembolic stroke in patients undergoing antiplatelet therapy. Herein, we examined the impact of prior antiplatelet therapy with cilostazol on the incidence of cardioembolic stroke, which had not been fully investigated. Using the multicenter retrospective study of stroke risk in antithrombotic therapy (RESTATE) database, we analysed consecutive patients with primary or secondary stroke under single antiplatelet therapy. We evaluated the characteristics of ischaemic stroke based on the type of antiplatelet agent used: aspirin, ticlopidine/clopidogrel or cilostazol. Of 1069 consecutive patients with primary or secondary stroke during antithrombotic therapy from January to December 2012, 615 patients received single antiplatelet therapy (293 and 322 cases of primary and secondary strokes, respectively). Interestingly, the percentage of cardioembolic infarction was significantly lower in patients taking cilostazol compared with other agents. Multivariate regression analysis found that age (OR: 1.03, 95% CI: 1.01-1.06, P = 0.0029), serum creatinine (OR: 1.17, 95% CI: 1.03-1.34, P = 0.0198), aspirin (OR: 1.75, 95% CI: 1.00-3.22, P = 0.0486), cilostazol (OR: 0.19, 95% CI: 0.03-0.73, P = 0.0125), and smoking (OR: 1.86, 95% CI: 1.16-2.94, P = 0.0102) were independently associated with cardioembolic stroke. Cilostazol may prevent cardioembolic stroke in patients undergoing antiplatelet therapy. This could be a novel strategy for cardioembolic stroke prevention potentially by affecting cardiac remodelling, in contrast to secondary anticoagulant therapy.

  19. Psychological determinants of life satisfaction in women undergoing infertility treatment

    Directory of Open Access Journals (Sweden)

    Aleksandra Anna Dembińska

    2016-01-01

    Full Text Available Background Infertility treatment is a long-term process, spread out over months, or even years, and carries no guarantee of success. It generates an incessant state of uncertainty which becomes a chronic state of psychological discomfort. Each stage of treatment may become a source of more trouble. Women deciding to undergo infertility treatment are exposed to many negative feelings concerning different aspects of their life. Participants and procedure The present study was an attempt to understand psychological determinants of life satisfaction in women undergoing infertility treatment. The study group included 470 women treated for infertility. Results Patients perceiving more social support in general, as well as more of the support types used in the study, i.e. emotional, instrumental, informational and institutional support, and support from family and friends, have better self-esteem, higher acceptance of their infertility, higher satisfaction with life, higher hope as an emotional state, and lower levels of anxiety and depression. Three negative emotional states, i.e. anxiety, depression and irritation, are predictors influencing (lowering life satisfaction of women struggling with infertility. The strongest of these predictors is depression, which is also a factor lowering the acceptance of one’s own infertility. The conducted analyses revealed that predictors influencing the life satisfaction of patients treated for infertility are self-esteem and acceptance of one’s own infertility (apart from the aforementioned emotional state – anxiety, depression, irritation. It was found that the higher the self-esteem and acceptance of one’s own infertility, the higher was the satisfaction with life. Conclusions Knowledge of these determinants is extremely valuable for medical personnel conducting treatments, because, according to many studies, the psychological state of women suffering from procreation problems is connected not only with

  20. The use of ovarian cancer cells from patients undergoing surgery to generate primary cultures capable of undergoing functional analysis.

    Science.gov (United States)

    O Donnell, Rachel L; McCormick, Aiste; Mukhopadhyay, Asima; Woodhouse, Laura C; Moat, Madeleine; Grundy, Anna; Dixon, Michelle; Kaufman, Angelika; Soohoo, San; Elattar, Ahmed; Curtin, Nicola J; Edmondson, Richard J

    2014-01-01

    The use of cell lines or animal models has significant disadvantages when dealing with a set of heterogeneous diseases such as epithelial ovarian cancer. This has clinical relevance in that biomarkers developed using cell line or animal models are often not transferable to the clinical setting. In this study, we describe the development of a robust protocol for developing primary cultures of ovarian cancer which will overcome some of these difficulties. Women undergoing surgery for ovarian cancer were recruited and samples of ascites and solid tumour deposits were used to develop primary cultures. Cells were characterised using a panel of immunofluorescent antibodies prior to use in a variety of assays including functional assessment of DNA repair pathways. During the four year study period, viable cultures, confirmed to be epithelial in origin were generated from 156 of 172 (91%) cases recruited. Characterisation was carried out using a panel of antibodies including pancytokeratin, CA125, EpCAM, MOC-31, D2-40 and vimentin. Senescence occurred between the 2nd and 8th passages in all cultures except one in which spontaneous immortalization occurred. Cells could be successfully cultured even after a period of storage at 4°C and cultured cells were capable of being used for a variety of applications including functional assays. Upon functional assessment there was minimal intra-tumour heterogeneity. It is therefore possible to derive viable ovarian cancer cell cultures in the majority of patients undergoing surgery. Cells cultured directly from patient cancers provide an accurate and highly diverse model.

  1. The use of ovarian cancer cells from patients undergoing surgery to generate primary cultures capable of undergoing functional analysis.

    Directory of Open Access Journals (Sweden)

    Rachel L O Donnell

    Full Text Available The use of cell lines or animal models has significant disadvantages when dealing with a set of heterogeneous diseases such as epithelial ovarian cancer. This has clinical relevance in that biomarkers developed using cell line or animal models are often not transferable to the clinical setting. In this study, we describe the development of a robust protocol for developing primary cultures of ovarian cancer which will overcome some of these difficulties. Women undergoing surgery for ovarian cancer were recruited and samples of ascites and solid tumour deposits were used to develop primary cultures. Cells were characterised using a panel of immunofluorescent antibodies prior to use in a variety of assays including functional assessment of DNA repair pathways. During the four year study period, viable cultures, confirmed to be epithelial in origin were generated from 156 of 172 (91% cases recruited. Characterisation was carried out using a panel of antibodies including pancytokeratin, CA125, EpCAM, MOC-31, D2-40 and vimentin. Senescence occurred between the 2nd and 8th passages in all cultures except one in which spontaneous immortalization occurred. Cells could be successfully cultured even after a period of storage at 4°C and cultured cells were capable of being used for a variety of applications including functional assays. Upon functional assessment there was minimal intra-tumour heterogeneity. It is therefore possible to derive viable ovarian cancer cell cultures in the majority of patients undergoing surgery. Cells cultured directly from patient cancers provide an accurate and highly diverse model.

  2. Preoperative autologous plateletpheresis in patients undergoing open heart surgery.

    Directory of Open Access Journals (Sweden)

    Tomar Akhlesh

    2003-01-01

    Full Text Available Blood conservation is an important aspect of care provided to the patients undergoing cardiac operations with cardiopulmonary bypass (CPB. It is even more important in patients with anticipated prolonged CPB, redo cardiac surgery, patients having negative blood group and in patients undergoing emergency cardiac surgery. In prolonged CPB the blood is subjected to more destruction of important coagulation factors, in redo surgery the separation of adhesions leads to increased bleeding and difficulty in achieving the haemostasis and in patients with negative blood group and emergency operations, the availability of sufficient blood can be a problem. Harvesting the autologous platelet rich plasma (PRP can be a useful method of blood conservation in these patients. The above four categories of patients were prospectively studied, using either autologous whole blood donation or autologous platelet rich plasma (PRP harvest in the immediate pre-bypass period. Forty two patients were included in the study and randomly divided into two equal groups of 21 each, control group (Group I in which one unit of whole blood was withdrawn, and PRP group (Group II where autologous plateletpheresis was utilised. After reversal of heparin, autologous whole blood was transfused in the control group and autologous PRP was transfused in the PRP group. The chest tube drainage and the requirement of homologous blood and blood products were recorded. Average PRP harvest was 643.33 +/- 133.51 mL in PRP group and the mean whole blood donation was 333.75 +/- 79.58 mL in the control group. Demographic, preoperative and intra operative data showed no statistically significant differences between the two groups. The PRP group patients drained 26.44% less (p<0.001 and required 38.5% less homologous blood and blood products (p<0.05, in the postoperative period. Haemoglobin levels on day zero (day of operation and day three were statistically not different between the two groups. We

  3. Nitric oxide synthetase and Helicobacter pylori in patients undergoing appendicectomy.

    LENUS (Irish Health Repository)

    Kell, M R

    2012-02-03

    BACKGROUND: This study was designed to determine whether Helicobacter pylori forms part of the normal microenvironment of the appendix, whether it plays a role in the pathogenesis of acute appendicitis, and whether it is associated with increased expression of inducible nitric oxide synthetase (iNOS) in appendicular macrophages. METHODS: Serology for H. pylori was performed on 51 consecutive patients undergoing emergency appendicectomy. Appendix samples were tested for urease activity, cultured and stained for H. pylori, graded according to the degree of inflammatory infiltrate, and probed immunohistochemically for iNOS expression. RESULTS: The mean age of the patients was 21 (range 7-51) years. Seventeen patients (33 per cent) were seropositive for H. pylori but no evidence of H. pylori was found in any appendix specimen. However, an enhanced inflammatory cell infiltration was observed in seropositive patients (P < 0.04) and the expression of macrophage iNOS in the mucosa of normal and inflamed appendix specimens was increased (P < 0.01). CONCLUSION: H. pylori does not colonize the appendix and is unlikely to be a pathogenic stimulus for appendicitis. Priming effects on mucosal immunology downstream from the foregut may occur after infection with H. pylori.

  4. Postoperative Adiponectin Levels in Pediatric Patients Undergoing Open Heart Surgery

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    A. Thaler

    2013-01-01

    Full Text Available Background. Adipose tissue is an important endocrine organ that secretes cytokines, including adiponectin, levels of which are negatively correlated with the severity of the inflammatory process. Aim. To assess the time course of adiponectin levels following open heart surgery with cardiopulmonary bypass and its correlation with early postoperative outcomes. Materials and Methods. Blood samples were obtained from 24 children undergoing cardiac surgery and analyzed for adiponectin, C-reactive protein, and other inflammatory markers. Results. Baseline adiponectin levels were negatively correlated with patients’ preoperative weight and age. Postoperative adiponectin levels decreased compared to baseline ( and correlated negatively with duration of cardiopulmonary bypass (, , length of stay in the pediatric intensive care unit (, , and the inotropic score (, . Adiponectin levels were positively correlated with sVCAM 1 levels; however, there was no correlation between adiponectin levels and sP selectin, tPA, MCP1, and sCD40. Conclusions. The inflammatory response after open heart surgery with cardiopulmonary bypass is associated with a reduction in adiponectin levels. Prolonged or more complicated surgery induced a more substantial inflammatory process characterized by a significant reduction in adiponectin levels over time and a delayed return to baseline levels.

  5. Pain Measurement through Temperature Changes in Children Undergoing Dental Extractions

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    Eleazar S. Kolosovas-Machuca

    2016-01-01

    Full Text Available Background and Objective. Pain evaluation in children can be a difficult task, since it possesses sensory and affective components that are often hard to discriminate. Infrared thermography has previously been used as a diagnostic tool for pain detection in animals; therefore, the aim of this study was to assess the presence of temperature changes during dental extractions and to evaluate its correlation with heart rate changes as markers of pain and discomfort. Methods. Thermographic changes in the lacrimal caruncle and heart rate measurements were recorded in healthy children scheduled for dental extraction before and during the procedure and compared. Afterwards, correlation between temperature and heart rate was assessed. Results. We found significant differences in temperature and heart rate before the procedure and during the dental extraction (mean difference 4.07°C, p<0.001, and 18.11 beats per minute, p<0.001 and no evidence of correlation between both measurements. Conclusion. Thermographic changes in the lacrimal caruncle can be detected in patients who undergo dental extractions. These changes appear to be stable throughout time and to possess very little intersubject variation, thus making them a candidate for a surrogate marker of pain and discomfort. Future studies should be performed to confirm this claim.

  6. Large pericardial effusion as a complication in adults undergoing SCT.

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    Norkin, M; Ratanatharathorn, V; Ayash, L; Abidi, M H; Al-Kadhimi, Z; Lum, L G; Uberti, J P

    2011-10-01

    Large pericardial effusion (LPE) leading to cardiac tamponade is a rare complication described in patients undergoing SCT. This complication is considered to be a manifestation of chronic GVHD; however its pathophysiology is poorly understood. Currently, there are no published data systematically describing the incidence, clinical characteristics and outcomes of LPEs in adult stem cell transplant recipients. We retrospectively evaluated 858 adult patients (512 autologous, 148 related and 198 unrelated donor) who underwent hematopoietic stem cell and BM transplants at our institution from 2005 to 2008 for the development of post transplant LPE. Seven patients (0.8%) were found to have LPEs and all these patients had undergone unrelated allografts. The median day of diagnosis post transplant was 229 (range 42-525). None of these patients had active manifestations of GVHD other than serositis at the time of LPE detection. Pericardial window (PW) was successfully placed in all patients who developed cardiac tamponade and most patients with LPE were effectively treated by increasing immunosuppression. We conclude that LPE is a rare late complication after allogeneic transplant in adults and in our study developed only after unrelated transplant. PW can be safely performed in these patients and LPEs can be successfully treated with intensification of systemic immunosupression.

  7. Antioxidative effects of propofol vs. ketamin in individuals undergoing surgery.

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    Khoshraftar, Ebrahim; Ranjbar, Akram; Kharkhane, Behroz; Tavakol Heidary, Shayesteh; Gharebaghi, Zohre; Zadkhosh, Nahid

    2014-07-01

    Propofol (2, 6-diisopropylphenol) is a widely used intravenous sedative-hypnotic agent for both induction/maintenance of anesthesia and sedation of critically ill patients. The present study aimed to evaluate oxidative stress biomarkers in individuals undergoing surgery with propofol and ketamine at doses used to induce anesthesia. The plasma oxidative stress biomarkers such as total antioxidant capacity (TAC), lipid peroxidation (LPO), total thiol molecules (TTM) and antioxidant enzymes activity such as glutathione peroxidase (GPx), superoxidedismutase (SOD) and catalase (CAT) were studied in blood samples obtained from 40 patients with propofol, and compared to samples from 40 patients with ketamine aged 11 - 50 years. The results showed that the ketamine group had significantly higher blood LPO level, GPx and SOD activity while having lower blood TAC and TTM concentrations in comparison to the propofol group. In conclusion, our findings showed that propofol has antioxidant effects in human. Further studies need to be conducted to demonstrate the exact mechanism of oxidative stress caused by anesthesia in surgery patients.

  8. Pectoral stretching program for women undergoing radiotherapy for breast cancer.

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    Lee, T S; Kilbreath, S L; Refshauge, K M; Pendlebury, S C; Beith, J M; Lee, M J

    2007-05-01

    Surgery and radiotherapy commonly cause adverse musculoskeletal problems, particularly loss of strength and range of motion, in the upper quadrant of breast cancer patients. Few well-designed studies have investigated whether these impairments can be prevented. Stretching is an effective technique for increasing range of motion, hence the aim of this study was to investigate whether a stretching program reduced acute musculoskeletal impairments in patients undergoing radiotherapy for breast cancer. Sixty-four women were recruited prior to commencement of radiotherapy following breast cancer surgery. Participants were randomised to either a control or stretch group. Participants in both groups were reviewed by the physical therapist on a weekly basis for approximately 6 weeks, and were given general information about skin care and lymphedema. The control group received no advice about exercise. The stretch group received instruction on low-load, prolonged pectoral stretches, which were to be performed daily and were checked at weekly visits. Shoulder range of motion, strength, arm circumference, and quality of life measurements were taken prior to, and at completion of radiotherapy, and at 7 months after radiotherapy. There was no difference in any outcome between groups. Breast symptoms increased for both groups during radiotherapy, without loss of strength or range of movement. The incidence of lymphedema during the study was low for both groups and did not differ between groups. The pectoral stretching program did not influence the outcomes measured because the symptoms reported by patients were not a consequence of contracture.

  9. Dysphagia outcomes in patients with brain tumors undergoing inpatient rehabilitation.

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    Wesling, Michele; Brady, Susan; Jensen, Mary; Nickell, Melissa; Statkus, Donna; Escobar, Nelson

    2003-01-01

    The purpose of this retrospective study was to compare functional dysphagia outcomes following inpatient rehabilitation for patients with brain tumors with that of patients following a stroke. Group 1 (n = 24) consisted of consecutive admissions to the brain injury program with the diagnosis of brain tumor and dysphagia. Group 2 (n = 24) consisted of matched, consecutive admissions, with the diagnosis of acute stroke and dysphagia. Group 2 was matched for age, site of lesion, and initial composite cognitive FIM score. The main outcome measures for this study included the American Speech-Language-Hearing Association (ASHA) National Outcome Measurement System (NOMS) swallowing scale, length of stay, hospital charges, and medical complications. Results showed that swallowing gains made by both groups as evaluated by the admission and discharge ASHA NOMS levels were considered to be statistically significant. The differences for length of stay, total hospital charges, and speech charges between the two groups were not considered to be statistically significant. Three patients in the brain tumor group (12.5%) demonstrated dysphagia complications of either dehydration or pneumonia during their treatment course as compared to 0% in the stroke group. This study confirms that functional dysphagia gains can be achieved for patients with brain tumors undergoing inpatient rehabilitation and that they should be afforded the same type and intensity of rehabilitation for their swallowing that is provided to patients following a stroke.

  10. Oral changes in individuals undergoing hematopoietic stem cell transplantation

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    Regina Haddad Barrach

    2015-04-01

    Full Text Available INTRODUCTION: Patients undergoing hematopoietic stem cell transplantation receive high doses of chemotherapy and radiotherapy, which cause severe immunosuppression.OBJECTIVE: To report an oral disease management protocol before and after hematopoietic stem cell transplantation.METHODS: A prospective study was carried out with 65 patients aged > 18 years, with hematological diseases, who were allocated into two groups: A (allogeneic transplant, 34 patients; B (autologous transplant, 31 patients. A total of three dental status assessments were performed: in the pre-transplantation period (moment 1, one week after stem cell infusion (moment 2, and 100 days after transplantation (moment 3. In each moment, oral changes were assigned scores and classified as mild, moderate, and severe risks.RESULTS: The most frequent pathological conditions were gingivitis, pericoronitis in the third molar region, and ulcers at the third moment assessments. However, at moments 2 and 3, the most common disease was mucositis associated with toxicity from the drugs used in the immunosuppression.CONCLUSION: Mucositis accounted for the increased score and potential risk of clinical complications. Gingivitis, ulcers, and pericoronitis were other changes identified as potential risk factors for clinical complications.

  11. Analysis of corneal esthesia in patients undergoing photorefractive keratectomy

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    Elmar Torres Neto

    2015-12-01

    Full Text Available ABSTRACT Purpose: To quantitatively analyze corneal esthesia in patients undergoing photorefractive keratectomy (PRK surgery. Methods: Forty-five patients selected for PRK in one eye underwent corneal esthesia using a Cochet-Bonnet esthesiometer preoperatively and 30 and 90 days postoperatively. Patients with a refractive diopter error of 4 or greater received intraoperative 0.02% mitomycin C for 20 s. Results: Twenty-four (53.3% of the 45 eyes received intraoperative 0.02% mitomycin. Decreased sensitivity was observed on postoperative day 30. By postoperative day 90, corneal esthesia had normalized but remained 14.9% lower than preoperative levels. In the mitomycin group, no recovery of corneal esthesia to normal sensitivity levels was observed. The mean esthesiometer level was 39.2 mm on postoperative day 90 (P<0.001. Conclusions: The results of the present study demonstrate recovery of corneal esthesia to normal levels at 90 days postoperatively in patients who did not receive mitomycin C. In patients administered mitomycin C, a 23.59% reduction in the corneal touch threshold was observed compared with preoperative levels indicating a failure of recovery to normal levels.

  12. Blood Transfusion Strategies in Patients Undergoing Extracorporeal Membrane Oxygenation

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    Hyoung Soo Kim

    2017-02-01

    Full Text Available Extracorporeal membrane oxygenation (ECMO is frequently associated with bleeding and coagulopathy complications, which may lead to the need for transfusion of multiple blood products. However, blood transfusions are known to increase morbidity and mortality, as well as hospital cost, in critically ill patients. In current practice, patients on ECMO receive a transfusion, on average, of 1-5 packed red blood cells (RBCs/day, with platelet transfusion accounting for the largest portion of transfusion volume. Generally, adult patients require more transfusions than neonates or children, and patients receiving venovenous ECMO for respiratory failure tend to need smaller transfusion volumes compared to those receiving venoarterial ECMO for cardiac failure. Observation studies have reported that a higher transfusion volume was associated with increased mortality. To date, the evidence for transfusion in patients undergoing ECMO is limited; most knowledge on transfusion strategies was extrapolated from studies in critically ill patients. However, current data support a restrictive blood transfusion strategy for ECMO patients, and a low transfusion trigger seems to be safe and reasonable.

  13. Radiation dose estimation of patients undergoing lumbar spine radiography

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    Prince Kwabena Gyekye

    2013-01-01

    Full Text Available Radiation dose to organs of 100 adult patients undergoing lumbar spine (LS radiography at a University Hospital have been assessed. Free in air kerma measurement using an ionization chamber was used for the patient dosimetry. Organ and effective dose to the patients were estimated using PCXMC (version 1.5 software. The organs that recorded significant dose due to LS radiography were lungs, stomach, liver, adrenals, kidney, pancreas, spleen, galbladder, and the heart. It was observed that the stomach recorded the highest dose (48.2 ± 1.2 μGy for LS anteroposterior (AP. The spleen also recorded the highest dose (41.2 ± 0.5 μGy for LS lateral (LAT. The mean entrance surface air kerma (ESAK of LS LAT (122.2 μGy was approximately twice that of LS AP (76.3 μGy, but the effective dose for both examinations were approximately the same (LS LAT = 8.6 μSv and LS AP = 10.4 μSv. The overall stochastic health effect of radiation to patients due to LS radiography in the University Hospital is independent of the projection of the examination (AP or LAT.

  14. Is Antibiotic Prophylaxis Necessary in Patients Undergoing Ureterolithotripsy?

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    Ali Pasha Meysamie

    2011-08-01

    Full Text Available Transurethral Ureterolithotripsy (TUL is a frequently used procedure in urology departments. Many urologists perform TUL without antibiotic prophylaxis; however the use of chemoprophylaxis before TUL remains a controversial issue in urology. Thisstudy was carried out to assess the safety of omitting antibiotic prophylaxis prior to TUL. In a prospective randomized clinical trial from January 2005 to December 2007, 114 patients with ureteral stones were enrolled; Fifty seven had preoperative antibiotic prophylaxis administered before TUL and fifty seven patients underwent TUL without antibiotic prophylaxis. The rate of postoperative infectious complications (fever, positive blood culture, significant bactriuria, the length of hospital stay and overall stone free rate were compared between the two groups. There was no statistically significant difference between two groups in the operation time, length of hospital stay, postoperative bacteriuria, positive urine culture, postoperative fever and overall success rate of TUL. It appears that the incidence of infectious complications does not increase in patients undergoing TUL without antibiotic prophylaxis if they have negative pre-operative urine culture and antiseptic technique have been performed thorough the procedure.

  15. Anxiety in Children Undergoing VCUG: Sedation or No Sedation?

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    David W. Herd

    2008-01-01

    Full Text Available Background. Voiding cystourethrograms are distressing for children and parents. Nonpharmacological methods reduce distress. Pharmacological interventions for VCUG focus on sedation as well as analgesia, anxiolysis, and amnesia. Sedation has cost, time, and safety issues. Which agents and route should we use? Are we sure that sedation does not influence the ability to diagnose vesicoureteric reflux? Methods. Literature search of Medline, EMBASE, and the Cochrane Database. Review of comparative studies found. Results. Seven comparative studies including two randomised controlled trials were reviewed. Midazolam given orally (0.5-0.6 mg/kg or intranasally (0.2 mg/kg is effective with no apparent effect on voiding dynamics. Insufficient evidence to recommend other sedating agents was found. Deeper sedating agents may interfere with voiding dynamics. Conclusion. Midazolam reduces the VCUG distress, causes amnesia, and does not appear to interfere with voiding dynamics. Midazolam combined with simple analgesia is an effective method to reduce distress to children undergoing VCUG.

  16. Transient heterogeneity in an aquifer undergoing bioremediation of hydrocarbons.

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    Schillig, P C; Devlin, J F; Roberts, J A; Tsoflias, G P; McGlashan, M A

    2011-01-01

    Localized, transient heterogeneity was studied in a sand aquifer undergoing benzene, toluene, ethylbenzene, and xylene bioremediation using a novel array of multilevel, in situ point velocity probes (PVPs). The experiment was conducted within a sheet-pile alleyway to maintain a constant average flow direction through time. The PVPs measured changes in groundwater velocity direction and magnitude at the centimeter scale, making them ideal to monitor small-scale changes in hydraulic conductivity (K). Velocities were shown to vary nonuniformly by up to a factor of 3 when a source of oxygen was established down-gradient of the petroleum spill. In spite of these local variations, the average groundwater velocity within the 7 m × 20 m sheet-piled test area only varied within ± 25%. The nonuniform nature of the velocity variations across the gate indicated that the changes were not due solely to seasonal hydraulic gradient fluctuations. At the conclusion of the experiment, microbial biomass levels in the aquifer sediments was approximately 1 order of magnitude higher in the oxygen-amended portion of the aquifer than at the edge of the plume or in locations up-gradient of the source. These data suggest that the transient velocities resulted, at least in part, from enhanced biological activity that caused transient heterogeneities in the porous medium.

  17. Selected indices of peritoneal fibrosis in patients undergoing peritoneal dialysis

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    Józef Penar

    2009-04-01

    Full Text Available Peritoneal dialysis is an alternative to hemodialysis in the treatment of patients with end-stage renal disease. Long-term use of peritoneal dialysis is limited by progressive alterations in the peritoneal membrane. The pathological changes in the peritoneum are due to the exposure to traditional nonphysiological peritoneal dialysis fluids that have low pH, high glucose and glucose degradation product content, and high molarity. Repeated episodes of bacterial peritonitis are another cause of peritoneal membrane damage. The characteristic features of peritoneal alterations include peritoneal fibrosis and morphologic changes in the peritoneal microvasculature with the accumulation of extracellular matrix in the submesothelial area and loss of mesothelial cells. These changes in the peritoneal membrane cause ultrafiltration failure and loss of dialysis efficacy. The pathogenesis of the peritoneal membrane damage is very complicated and understanding the processes involved in these alterations will be crucial in improving treatment with peritoneal dialysis. Some points of view on fibrosis of peritoneal membrane in patients undergoing peritoneal dialysis are presented here.

  18. Heart rhythm complexity impairment in patients undergoing peritoneal dialysis

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    Lin, Yen-Hung; Lin, Chen; Ho, Yi-Heng; Wu, Vin-Cent; Lo, Men-Tzung; Hung, Kuan-Yu; Liu, Li-Yu Daisy; Lin, Lian-Yu; Huang, Jenq-Wen; Peng, Chung-Kang

    2016-06-01

    Cardiovascular disease is one of the leading causes of death in patients with advanced renal disease. The objective of this study was to investigate impairments in heart rhythm complexity in patients with end-stage renal disease. We prospectively analyzed 65 patients undergoing peritoneal dialysis (PD) without prior cardiovascular disease and 72 individuals with normal renal function as the control group. Heart rhythm analysis including complexity analysis by including detrended fractal analysis (DFA) and multiscale entropy (MSE) were performed. In linear analysis, the PD patients had a significantly lower standard deviation of normal RR intervals (SDRR) and percentage of absolute differences in normal RR intervals greater than 20 ms (pNN20). Of the nonlinear analysis indicators, scale 5, area under the MSE curve for scale 1 to 5 (area 1-5) and 6 to 20 (area 6-20) were significantly lower than those in the control group. In DFA anaylsis, both DFA α1 and DFA α2 were comparable in both groups. In receiver operating characteristic curve analysis, scale 5 had the greatest discriminatory power for two groups. In both net reclassification improvement model and integrated discrimination improvement models, MSE parameters significantly improved the discriminatory power of SDRR, pNN20, and pNN50. In conclusion, PD patients had worse cardiac complexity parameters. MSE parameters are useful to discriminate PD patients from patients with normal renal function.

  19. Preoperative expectations and values of patients undergoing Mohs micrographic surgery.

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    Chuang, Gary S; Leach, Brian C; Wheless, Lee; Lang, Pearon G; Cook, Joel

    2011-03-01

    Dermatologists have championed Mohs micrographic surgery (MMS) for its unsurpassed treatment success for skin cancers, safety profile, cost-effectiveness, and tissue-sparing quality. It is unclear whether patients undergoing MMS also value these characteristics. To evaluate patients' preoperative expectations of MMS and identify the factors that may influence such expectations The study prospectively recruited participants who were newly diagnosed with skin cancer and referred for MMS. A questionnaire listing the characteristics of MMS was given to the participants asking them to score the importance of each characteristic on a 10-point scale. The participants were also asked to provide information regarding their gender, age, subjective health status, education level, family annual income, and their referral source On average, participants placed the highest value, in descending order, on a treatment that yielded the highest cure rate, reconstruction initiation only after complete tumor removal, and the surgeon being a skin cancer specialist. Overall, participants placed high values on characteristics of MMS that dermatologists have long esteemed. Our data corroborate that MMS is a valuable procedure that meets the expectations not just of physicians, but also of patients. The authors have indicated no significant interest with commercial supporters. © 2011 by the American Society for Dermatologic Surgery, Inc.

  20. Epidemiological evaluation of hepatic trauma victims undergoing surgery

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    Mitre Kalil

    2016-02-01

    Full Text Available Objective : to evaluate the epidemiological variables and diagnostic and therapeutic modalities related to hepatic trauma patients undergoing laparotomy in a public referral hospital in the metropolitan region of Vitória-ES. Methods : we conducted a retrospective study, reviewing charts of trauma patients with liver injuries, whether isolated or in association with other organs, who underwent exploratory laparotomy, from January 2011 to December 2013. Results : We studied 392 patients, 107 of these with liver injury. The male: female ratio was 6.6 : 1 and the mean age was 30.12 years. Penetrating liver trauma occurred in 78.5% of patients, mostly with firearms. Associated injuries occurred in 86% of cases and intra-abdominal injuries were more common in penetrating trauma (p <0.01. The most commonly used operative technique was hepatorrhaphy and damage control surgery was applied in 6.5% of patients. The average amounts of blood products used were 6.07 units of packed red blood cells and 3.01 units of fresh frozen plasma. The incidence of postoperative complications was 29.9%, the most frequent being infectious, including pneumonia, peritonitis and intra-abdominal abscess. The survival rate of patients suffering from blunt trauma was 60%, and penetrating trauma, 87.5% (p <0.05. Conclusion : despite technological advances in diagnosis and treatment, mortality rates in liver trauma remain high, especially in patients suffering from blunt trauma in relation to penetrating one.

  1. Heart-Kidney Biomarkers in Patients Undergoing Cardiac Stress Testing

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    Mikko Haapio

    2011-01-01

    Full Text Available We examined association of inducible myocardial perfusion defects with cardiorenal biomarkers, and of diminished left ventricular ejection fraction (LVEF with kidney injury marker plasma neutrophil gelatinase-associated lipocalin (NGAL. Patients undergoing nuclear myocardial perfusion stress imaging were divided into 2 groups. Biomarkers were analyzed pre- and poststress testing. Compared to the patients in the low ischemia group (n=16, the patients in the high ischemia group (n=18 demonstrated a significantly greater rise in cardiac biomarkers plasma BNP, NT-proBNP and cTnI. Subjects were also categorized based on pre- or poststress test detectable plasma NGAL. With stress, the group with no detectable NGAL had a segmental defect score 4.2 compared to 8.2 (P=.06 in the detectable NGAL group, and 0.9 vs. 3.8 (P=.03 at rest. BNP rose with stress to a greater degree in patients with detectable NGAL (10.2 vs. 3.5 pg/mL, P=.03. LVEF at rest and with stress was significantly lower in the detectable NGAL group; 55.8 versus 65.0 (P=.03 and 55.1 vs. 63.8 (P=.04, respectively. Myocardial perfusion defects associate with biomarkers of cardiac stress, and detectable plasma NGAL with significantly lower LVEF, suggesting a specific heart-kidney link.

  2. Uhlmann Connection in Fermionic Systems Undergoing Phase Transitions

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    Mera, Bruno; Vlachou, Chrysoula; Paunković, Nikola; Vieira, Vítor R.

    2017-07-01

    We study the behavior of the Uhlmann connection in systems of fermions undergoing phase transitions. In particular, we analyze some of the paradigmatic cases of topological insulators and superconductors in one dimension, as well as the BCS theory of superconductivity in three dimensions. We show that the Uhlmann connection signals phase transitions in which the eigenbasis of the state of the system changes. Moreover, using the established fidelity approach and the study of the edge states, we show the absence of thermally driven phase transitions in the case of topological insulators and superconductors. We clarify what is the relevant parameter space associated with the Uhlmann connection so that it signals the existence of order in mixed states. In addition, the study of Majorana modes at finite temperature opens the possibility of applications in realistic stable quantum memories. Finally, the analysis of the different behavior of the BCS model and the Kitaev chain, with respect to the Uhlmann connection, suggested that in realistic scenarios the gap of topological superconductors could also, generically, be temperature dependent.

  3. Can patients with schizophrenia undergo renal transplantation with success?

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    Saoussen Bouhlel

    2014-01-01

    Full Text Available We report a case of a 41-year-old man suffering from paranoid schizophrenia. The patient has been consulting in our psychiatric hospital since he was 29 years old. Eight years later, he developed kidney failure and required peritoneal dialysis. After more than two years, the nephrology team indicated a renal transplantation and his brother suggested giving his kidney. There were no obstacles for transplantation in the immune and histological compatibilities; the psychiatric staff decided to check the patient′s compliance with medication. The patient was compliant to all his medications and to the salt-free diet after the transplant operation. Few weeks later, he developed steroid-induced diabetes. Through the last two years, he had psychotic exacerbations with major anxiety and fear of losing the transplant. These relapses were managed by increasing doses of antipsychotics without need for hospitalization. At the present time, three years after transplantation, the nephrologists are decreasing the immunosuppressive agents and the steroids. The renal function is optimum and the diabetes is stabilized. This case exemplifies the potential for schizophrenic patients to undergo renal transplantation and to comply with follow-up medical care through a close cooperation between the patient′s family, the psychiatric staff and the nephrology team.

  4. Surgical site infection in women undergoing surgery for gynecologic cancer.

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    Mahdi, Haider; Gojayev, Anar; Buechel, Megan; Knight, Jason; SanMarco, Janice; Lockhart, David; Michener, Chad; Moslemi-Kebria, Mehdi

    2014-05-01

    The objectives of this study were to describe the rate and predictors of surgical site infection (SSI) after gynecologic cancer surgery and identify any association between SSI and postoperative outcome. Patients with endometrial, cervical, or ovarian cancers from 2005 to 2011 were identified from the American College of Surgeons National Surgical Quality Improvement Program. The extent of surgical intervention was categorized into modified surgical complexity scoring (MSCS) system. Univariate and multivariate logistic regression analyses were used. Odds ratios were adjusted for patient demographics, comorbidities, preoperative laboratory values, and operative factors. Of 6854 patients, 369 (5.4%) were diagnosed with SSI. Surgical site infection after laparotomy was 3.5 times higher compared with minimally invasive surgery (7% vs 2%; P Surgical site infection was associated with longer mean hospital stay and higher rate of reoperation, sepsis, and wound dehiscence. Surgical site infection was not associated with increased risk of acute renal failure or 30-day mortality. These findings were consistent in subset of patients with deep or organ space SSI. Seven percent of patients undergoing laparotomy for gynecologic malignancy developed SSI. Surgical site infection is associated with longer hospital stay and more than 5-fold increased risk of reoperation. In this study, we identified several risk factors for developing SSI among gynecologic cancer patients. These findings may contribute toward identification of patients at risk for SSI and the development of strategies to reduce SSI rate and potentially reduce the cost of care in gynecologic cancer surgery.

  5. Myoinositol Improves Embryo Development in PCOS Patients Undergoing ICSI

    Science.gov (United States)

    2016-01-01

    The aim of this study was to investigate the activity of myoinositol, in a court of 217 PCOS women undergoing intracytoplasmic sperm injection (ICSI), on pregnancy rate, embryo development, estradiol, and progesterone concentration in blood serum, superoxide dismutase (SOD), and catalase (CAT) in follicular fluid. Concerning the court of patient, 112 (groups I and II) out of 217 were PCOS women, whereas group III consisted of healthy subjects (not PCOS). Group I patients were treated with 400 μg of folic acid per day for 3 months before ICSI, whereas group II patients received 4000 mg of myoinositol and 400 μg of folic acid per day for 3 months before ICSI. Group II revealed a shorter embryo/blastocyst development period between microinjection and 5-cell stage compared to group I. The difference in SOD concentration between groups I and II and between groups II and III was statistically significant. In group II, 34.62% of pregnancies were obtained, whereas in group I this number reached 20% (NS). Myoinositol increased embryo development dynamics and accelerated blastocyst stage reaching time; however, no effect was shown on clinical pregnancy. Furthermore, it restored SOD concentration, lowered in PCOS women, but did not exert any effect on CAT concentration. PMID:27777587

  6. Psychologists in preoperative programmes for children undergoing surgery.

    Science.gov (United States)

    Cuzzocrea, Francesca; Costa, Sebastiano; Gugliandolo, Maria Cristina; Larcan, Rosalba

    2016-06-01

    This study aimed to verify whether psychologists and game activities could reduce preoperative anxiety and promote compliance in paediatric patients. More specifically, we sought to evaluate whether it would be better to propose contextualized games or just distracting activities. A total of 104 children undergoing surgery were assigned to the following 4 conditions of treatment: (1) contextual games and psychological accompaniment, (2) only contextual games, (3) distracting activities, and (4) only psychological accompaniment. Observed children's anxiety was assessed using modified Yale Preoperative Anxiety Scale and compliant behaviours with modified form of Induction Compliance Checklist. Children in the first condition (complete intervention - contextual games and psychological accompaniment) were less anxious and more cooperative in the preoperative period and during the induction of anaesthesia than in the other three conditions. In particular, contextual activities (second condition) were found to be more efficient than psychological accompaniment (fourth condition), whereas the worst condition was proposing only distracting activities (third condition). In order to help young hospitalized patients in paediatric surgery structures, it is necessary to propose games that can prepare them for what will happen as well as the support of a psychologist.

  7. Obesity Increases Operative Time in Children Undergoing Laparoscopic Cholecystectomy.

    Science.gov (United States)

    Pandian, T K; Ubl, Daniel S; Habermann, Elizabeth B; Moir, Christopher R; Ishitani, Michael B

    2017-03-01

    Few studies have assessed the impact of obesity on laparoscopic cholecystectomy (LC) in pediatric patients. Children who underwent LC were identified from the 2012 to 2013 American College of Surgeons' National Surgical Quality Improvement Program Pediatrics data. Patient characteristics, operative details, and outcomes were compared. Multivariable logistic regression was utilized to identify predictors of increased operative time (OT) and duration of anesthesia (DOAn). In total, 1757 patients were identified. Due to low rates of obesity in children obese). Among obese children, 80.6% were girls. A higher proportion of obese patients had diabetes (3.0% versus 1.0%, P obesity was an independent predictor of OT >90 (odds ratio [OR] 2.02; 95% confidence interval [95% CI] 1.55-2.63), and DOAn >140 minutes (OR 1.86; 95% CI 1.42-2.43). Obesity is an independent risk factor for increased OT in children undergoing LC. Pediatric surgeons and anesthesiologists should be prepared for the technical and physiological challenges that obesity may pose in this patient population.

  8. Music increases satisfaction in elderly outpatients undergoing cataract surgery.

    Science.gov (United States)

    Cruise, C J; Chung, F; Yogendran, S; Little, D

    1997-01-01

    Music has long been known to reduce anxiety, minimize the need for sedatives, and make patients feel more at ease. The purpose of the study was to evaluate the effect of music in elderly outpatients undergoing elective cataract surgery with retrobulbar block and monitored anaesthetic care using fentanyl or alfentanil and midazolam. One hundred and twenty one patients were prospectively and randomly assigned to hear: relaxing suggestions, white noise, operating room noise or relaxing music via audio-cassette headphones. Vital signs were documented before and after retrobulbar block and every 15 min thereafter. Anxiety was assessed using the State-Trait Anxiety Inventory (STAI) before and after surgery. Visual analogue scales (VAS) were used to assess anxiety and patient satisfaction postoperatively with a standardized questionnaire. Between group comparisons were made using Chi-Square, or ANOVA, where appropriate. There were no differences between groups in STAI or anxiety VAS scores at any time. Differences were noted in systolic blood pressure, but not in other vital signs. Patients' ratings of the whole operative experience, satisfaction with the tape played, general level of relaxation and preference for the chosen tape for subsequent surgery were different (music > relaxing suggestions > white noise and OR noise, P music, rather than relaxing suggestions or white noise or OR noise. The type of auditory stimuli to which the patients were exposed did not influence the level of anxiety.

  9. [Anesthetic consideration in patients undergoing catheter ablation for atrial fibrillation].

    Science.gov (United States)

    Oda, Toshiyuki; Takahama, Yutaka

    2012-11-01

    This chapter describes anesthetic consideration in patients undergoing catheter ablation for atrial fibrillation (AF) based on electrophysiologic or pharmacological aspects. In the 2011 guidelines of the Japanese Circulation Society for non-pharmacotherapy of cardiac arrhythmias, catheter ablation is recommended as Class I therapeutic modality for the patients with drug-refractory paroxysmal AF. Catheter ablation of AF is an invasive and long-lasting procedure necessitating sedation during treatment. However, in the most of the patients, sedation or anesthesia is possibly performed by cardiologists using propofol, midazolam or dexmedetomidine. Deep sedation accompanies a high risk of ventilatory or circulatory derangement. Furthermore, life-threatening complications, such as cerebral infarction or cardiac tamponade, can occur during ablation. Patients with AF are increasing in number as a trend in the aging society, resulting in an increase in catheter ablation in high risk patients. To accomplish safe anesthetic management of the patients for catheter ablations, anesthesiologists are required to have fundamental knowledge and skill in the performance of the catheter ablation.

  10. Measuring radiation dose to patients undergoing fluoroscopically-guided interventions

    Science.gov (United States)

    Lubis, L. E.; Badawy, M. K.

    2016-03-01

    The increasing prevalence and complexity of fluoroscopically guided interventions (FGI) raises concern regarding radiation dose to patients subjected to the procedure. Despite current evidence showing the risk to patients from the deterministic effects of radiation (e.g. skin burns), radiation induced injuries remain commonplace. This review aims to increase the awareness surrounding radiation dose measurement for patients undergoing FGI. A review of the literature was conducted alongside previous researches from the authors’ department. Studies pertaining to patient dose measurement, its formalism along with current advances and present challenges were reviewed. Current patient monitoring techniques (using available radiation dosimeters), as well as the inadequacy of accepting displayed dose as patient radiation dose is discussed. Furthermore, advances in real-time patient radiation dose estimation during FGI are considered. Patient dosimetry in FGI, particularly in real time, remains an ongoing challenge. The increasing occurrence and sophistication of these procedures calls for further advances in the field of patient radiation dose monitoring. Improved measuring techniques will aid clinicians in better predicting and managing radiation induced injury following FGI, thus improving patient care.

  11. Effect of music on patients undergoing outpatient colonoscopy

    Institute of Scientific and Technical Information of China (English)

    Matthew L Bechtold; Rodney A Perez; Srinivas R Puli; John B Marshall

    2006-01-01

    AIM: To evaluate the effect of relaxing music during colonoscopy under low-dose conscious sedation, on patient satisfaction, scope insertion time and procedure duration, medication doses, and the perceived adequacy of sedation and scope insertion difficulty on the part of the endoscopist.SETHODS: One hundred and sixty-seven consecutive adult outpatients presenting for routine colonoscopy under low-dose conscious sedation were randomized to undergo their procedures either with music played during the procedure or no music played.RESULTS: There were no statistical differences between the two groups in terms of meperidine dose, midazolam dose, time to reach the cecum, total procedure time,endoscopist assessment of scope insertion difficulty,endoscopist assessment of adequacy of sedation, or the pain experience of the patients during their procedure.The music group did report significantly better overall procedure satisfaction as compared to the non music group on two of our three different scales.CONCLUSION: While music does not result in shortened procedure times, lower doses of sedative medications or perceived patient pain, the patients who have music playing during their procedures report modestly greater satisfaction with their procedures.

  12. Ultrafast transient absorption spectrum of the room temperature Ionic liquid 1-hexyl-3-methylimidazolium bromide: Confounding effects of photo-degradation

    Science.gov (United States)

    Musat, Raluca M.; Crowell, Robert A.; Polyanskiy, Dmitriy E.; Thomas, Marie F.; Wishart, James F.; Katsumura, Yosuke; Takahashi, Kenji

    2015-12-01

    The photochemistry of the charge transfer (CT) band of the room temperature ionic liquid (RTIL) 1-hexyl-3-methylimidazolium bromide (HMIm+/Br-) is investigated using near-IR to vis ultrafast transient absorption (TA) and steady-state UV absorption spectroscopies. Continuous irradiation of the CT band at 266 nm results in the formation of photo-products that absorb strongly at 266 nm. It is shown that these photo-products, which are apparently very stable, adversely affect ultrafast TA measurements. Elimination of these effects reveals at least two transient species that exist within the TA detection window of 100 fs to 3 ns and 500-1250 nm. One of the components is a short-lived (mechanism.

  13. Photo degradation of methyl orange an azo dye by advanced Fenton process using zero valent metallic iron: influence of various reaction parameters and its degradation mechanism.

    Science.gov (United States)

    Gomathi Devi, L; Girish Kumar, S; Mohan Reddy, K; Munikrishnappa, C

    2009-05-30

    Advanced Fenton process (AFP) using zero valent metallic iron (ZVMI) is studied as a potential technique to degrade the azo dye in the aqueous medium. The influence of various reaction parameters like effect of iron dosage, concentration of H(2)O(2)/ammonium per sulfate (APS), initial dye concentration, effect of pH and the influence of radical scavenger are studied and optimum conditions are reported. The degradation rate decreased at higher iron dosages and also at higher oxidant concentrations due to the surface precipitation which deactivates the iron surface. The rate constant for the processes Fe(0)/UV and Fe(0)/APS/UV is twice compared to their respective Fe(0)/dark and Fe(0)/APS/dark processes. The rate constant for Fe(0)/H(2)O(2)/UV process is four times higher than Fe(0)/H(2)O(2)/dark process. The increase in the efficiency of Fe(0)/UV process is attributed to the cleavage of stable iron complexes which produces Fe(2+) ions that participates in cyclic Fenton mechanism for the generation of hydroxyl radicals. The increase in the efficiency of Fe(0)/APS/UV or H(2)O(2) compared to dark process is due to continuous generation of hydroxyl radicals and also due to the frequent photo reduction of Fe(3+) ions to Fe(2+) ions. Though H(2)O(2) is a better oxidant than APS in all respects, but it is more susceptible to deactivation by hydroxyl radical scavengers. The decrease in the rate constant in the presence of hydroxyl radical scavenger is more for H(2)O(2) than APS. Iron powder retains its recycling efficiency better in the presence of H(2)O(2) than APS. The decrease in the degradation rate in the presence of APS as an oxidant is due to the fact that generation of free radicals on iron surface is slower compared to H(2)O(2). Also, the excess acidity provided by APS retards the degradation rate as excess H(+) ions acts as hydroxyl radical scavenger. The degradation of Methyl Orange (MO) using Fe(0) is an acid driven process shows higher efficiency at pH 3. The efficiency of various processes for the de colorization of MO dye is of the following order: Fe(0)/H(2)O(2)/UV>Fe(0)/H(2)O(2)/dark>Fe(0)/APS/UV>Fe(0)/UV>Fe(0)/APS/dark>H(2)O(2)/UV approximately Fe(0)/dark>APS/UV. Dye resisted to degradation in the presence of oxidizing agent in dark. The degradation process was followed by UV-vis and GC-MS spectroscopic techniques. Based on the intermediates obtained probable degradation mechanism has been proposed. The result suggests that complete degradation of the dye was achieved in the presence of oxidizing agent when the system was amended with iron powder under UV light illumination. The concentration of Fe(2+) ions leached at the end of the optimized degradation experiment is found to be 2.78 x 10(-3)M. With optimization, the degradation using Fe(0) can be effective way to treat azo dyes in aqueous solution.

  14. Effect of low-molecular-weight organic acids on photo-degradation of phenanthrene catalyzed by Fe(III)-smectite under visible light.

    Science.gov (United States)

    Jia, Hanzhong; Chen, Hongxia; Nulaji, Gulimire; Li, Xiyou; Wang, Chuanyi

    2015-11-01

    The photolysis of polycyclic aromatic hydrocarbons (PAHs) is potentially an important process for its transformation and fate on contaminated soil surfaces. In this study, phenanthrene is employed as a model to explore PAH photodegradation with the assistance of Fe(III)-smectite under visible-light while focusing on roles played by five low-molecular-weight organic acids (LMWOAs), i.e., malic acid, oxalic acid, citric acid, ethylenediaminetetraacetic acid (EDTA), and nitrilotriacetic acid. Our results show that oxalic acid is most effective in promoting the photodegradation of phenanthrene, while only a slight increase in the rate of phenanthrene photodegradation is observed in the presence of malic acid. Electron paramagnetic resonance experiments confirm the formation of CO2(-) radicals in the presence of malic and oxalic acid, which provides strong evidence for generating OH and subsequent photoreaction pathways. The presence of EDTA or nitrilotriacetic acid significantly inhibits both Fe(II) formation and phenanthrene photodegradation because these organic anions tend to chelate with Fe(III), leading to decreases in the electron-accepting potential of Fe(III)-smectite and a weakened interaction between phenanthrene and Fe(III)-smectite. These observations provide valuable insights into the transformation and fate of PAHs in the natural soil environment and demonstrate the potential for using some LMWOAs as additives for the remediation of contaminated soil.

  15. ZnSe-WO3 nano-hetero-assembly stacked on Gum ghatti for photo-degradative removal of Bisphenol A: Symbiose of adsorption and photocatalysis.

    Science.gov (United States)

    Kumar, Amit; Naushad, Mu; Rana, Anamika; Inamuddin; Preeti; Sharma, Gaurav; Ghfar, Ayman A; Stadler, Florian J; Khan, Mohammad R

    2017-11-01

    In this research work we report Gum-ghatti supported ZnSe-WO3 nano-hetero-assembly for solar powered degradation of endocrine disruptor Bisphenol S (BPA). The photocatalyst was characterized by Scanning electron microscopy (SEM), High resolution transmission electron microscopy (HRTEM), Small area electron diffraction (SAED), X-Ray diffraction (XRD), Fourier transform infra red spectroscopy (FTIR), Photoluminescence (PL), Energy dispersive X-ray (EDX), UV-vis spectrophotometry and Brauner Emmet Teller surface area analyzer (BET). We achieve a Z-scheme photocatalyst (ZnSe-WO3) with a higher charge flow and visible absorption. Gum ghatti acts as a superadsorbent and a sink for charge carriers. The removal of BPA has been studied under three experimental protocols where 99.5% removal was achieved by symbiose of photocatalysis-adsorption-ozonation in just 45min hetero-assembly has a high surface area, stability and reduced carrier recombination. The results have been analyzed by scavenger effect, mass spectrometry, kinetics and total organic carbon (TOC) analysis. 49.4% of TOC was removed and COD was reduced to 16.7% after 2h in symbiotic condition. From the band edges and scavenger effect it was inferred that superoxide radical anions are major attacking species. The work paves way for designing of novel photocatalysts with increasing biogenic quotient and higher efficiency. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Session 6: Photo-degradation of phenol in aqueous phase using glass micro-rods containing transparent TiO{sub 2} films

    Energy Technology Data Exchange (ETDEWEB)

    Medina-Valtierra, J. [Departamento de Ingenieria Quimica y Bioquimica, Tecnologico de Aguascalientes, Aguascalientes (Mexico); Moctezuma, E. [Escuela de Ciencias Quiicas, UASLP, S.L.P (Mexico); Los Reyes, J.A. de [Area de Ingenieria Quimica, UAM-Iztapalapa, D.F. (Mexico)

    2004-07-01

    In this work, a transparent TiO{sub 2} film was prepared on fiberglass by a sol-gel method in order to generate a novel catalytic material. Moreover, the ease of preparing micro-rods from fiberglass containing TiO{sub 2} film will be described. The main goal of this study is to develop a procedure for the efficient degradation of phenol by a simple photo-catalytic process with no additional separation steps of the catalyst. (authors)

  17. Photo-degradation of Methyl Orange by Polysaccharides/LaFe0.8Cu0.2O3 Composite Films

    Directory of Open Access Journals (Sweden)

    Aojie Deng

    2014-03-01

    Full Text Available The objective of this work was to prepare a series of composite films (polysaccharides with LaFe0.8Cu0.2O3 for the degradation of methyl orange under ultraviolet irradiation. LaFe0.8Cu0.2O3 was prepared by a sol-gel method, and the composite films were obtained by cross-linking reactions between polysaccharides (xylan and chitosan and LaFe0.8Cu0.2O3. Physical and chemical properties of the composite films were investigated by XRD, FTIR, SEM, and BET. Moreover, the influence of the weight ratio of polysaccharide to LaFe0.8Cu0.2O3 on the methyl orange degradation reaction was also studied. Results showed that 67% of the degradation efficiency was achieved within 480 min using chitosan/LaFe0.8Cu0.2O3 (2:1 as photocatalysts, while 58% was for xylan/LaFe0.8Cu0.2O3 (1:1. The difference was due to the variety in the structure of chitosan and xylan.

  18. 纳米ZnO/PS薄膜的制备及光降解性能%Preparation and photo degradation of nano-ZnO/polystyrene composite film

    Institute of Scientific and Technical Information of China (English)

    傅敏; 冉德超; 汤敏; 郝丽萌; 皮俊敏

    2013-01-01

    利用纳米ZnO与聚苯乙烯(PS)高速共混法制备了一种在紫外光下具有自降解性能的复合薄膜.分析表明,经过KH570处理的纳米ZnO与PS通过化学键的方式桥联在一起.TG分析表明,复合薄膜的耐热性较PS有所提高;SEM图像显示0.5 wt% ZnO在PS薄膜表面分布均匀,经过UV照射后薄膜表面出现光腐蚀现象.复合薄膜紫外光自降解实验表明:0.5 wt% ZnO/PS薄膜在15W的紫外灯照射下,15d的自降解率为3.715%.%Composite film which has self-degradation performance under UV light was prepared by blending nano-ZnO and polystyrene at high speed in this study. Analysis indicates that after adding the coupling agent KH57O, nano-ZnO and PS were linked together through chemical bonding. The TG spectra showed that ZnO/PS composite film has higher heat resistant than pure PS. Also, SEM images indicated that 0. 5 wt% nano-ZnO were evenly distributed in the PS membrane, however, light corrosion appeared on the membrane surface after UV irradiation. The UV irradiation experiments showed that for a 0. 5 wt% ZnO/PS composite film, after 15 days at a UV irradiation power of 15 W, the degradation rate reached 3. 715% .

  19. The influence of different coordination environments on one-dimensional Cu(ii) coordination polymers for the photo-degradation of organic dyes.

    Science.gov (United States)

    Hussain, Navid; Bhardwaj, Vimal K

    2016-05-04

    Three new Cu(ii) coordination polymers, namely, {[Cu3(L(1))(NO3)2(DMF)(H2O)]·3(DMF)}n (), [Cu3(L(1))(Cl)2(DMF)2]n () and [Cu3(L(2))(NO3)4(H2O)4]n (), were synthesized from pyridine-2,6-dicarbohydrazide based imine linked tritopic ligands. All the complexes were characterized using elemental analysis, IR, UV-vis spectroscopy and ESI-MS. The solid state structures of complexes were determined using single crystal X-ray crystallography. The complexes contain trinuclear copper units connected through different anions that lead to the formation of one dimensional (ID) chain structures. Depending upon the anion of the copper salt and donor atoms of the ligands used in complexation, a small variation in the structures was observed. In complex , the trinuclear copper units are connected by phenoxo-bridging (μ2-O(-)) along with one coordinated water molecule, whereas complex is connected through chloride bridging (μ2-Cl) and complex is connected through nitrate ions (μ-[O-N-O]) along with four water molecules. Photo-catalytic activities of the synthesized complexes () were investigated. All the complexes were found to be photo-catalytically active; however, the distinct coordination environment of the metal ions (i.e. difference in the coordinated water molecules and donor sites of ligands) played a significant role in the catalytic activities. Therefore, this study presents comparative photo-catalytic studies of different coordination environments of metal ions in one-dimensional Cu(ii) coordination polymers. The results provide a potential pathway for the rational design of more efficient photo-catalysts.

  20. Profile of newborns undergoing early stimulation in a neonatal intensive care unit

    National Research Council Canada - National Science Library

    Karla Camila Lima de Souza; Nataly Gurgel Campos; Francisco Fleury Uchoa Santos Júnior

    2014-01-01

    Objective: To describe the profile of newborns undergoing early stimulation in a neonatal intensive care unit, characterizing the study population according to their neonatal variables and risk factors...

  1. Kinetics of plasma membrane and mitochondrial alterations in cells undergoing apoptosis

    National Research Council Canada - National Science Library

    Lizard, G; Fournel, S; Genestier, L; Dhedin, N; Chaput, C; Flacher, M; Mutin, M; Panaye, G; Revillard, J P

    1995-01-01

    ... of the nucleus, whereas integrity of the plasma membrane and organelles is preserved. Conversely cells undergoing necrosis display an early desintegration of cytoplasmic membrane and swelling of mitochondria...

  2. Radiation Dose Estimation for Pediatric Patients Undergoing Cardiac Catheterization

    Science.gov (United States)

    Wang, Chu

    Patients undergoing cardiac catheterization are potentially at risk of radiation-induced health effects from the interventional fluoroscopic X-ray imaging used throughout the clinical procedure. The amount of radiation exposure is highly dependent on the complexity of the procedure and the level of optimization in imaging parameters applied by the clinician. For cardiac catheterization, patient radiation dosimetry, for key organs as well as whole-body effective, is challenging due to the lack of fixed imaging protocols, unlike other common X-ray based imaging modalities. Pediatric patients are at a greater risk compared to adults due to their greater cellular radio-sensitivities as well as longer remaining life-expectancy following the radiation exposure. In terms of radiation dosimetry, they are often more challenging due to greater variation in body size, which often triggers a wider range of imaging parameters in modern imaging systems with automatic dose rate modulation. The overall objective of this dissertation was to develop a comprehensive method of radiation dose estimation for pediatric patients undergoing cardiac catheterization. In this dissertation, the research is divided into two main parts: the Physics Component and the Clinical Component. A proof-of-principle study focused on two patient age groups (Newborn and Five-year-old), one popular biplane imaging system, and the clinical practice of two pediatric cardiologists at one large academic medical center. The Physics Component includes experiments relevant to the physical measurement of patient organ dose using high-sensitivity MOSFET dosimeters placed in anthropomorphic pediatric phantoms. First, the three-dimensional angular dependence of MOSFET detectors in scatter medium under fluoroscopic irradiation was characterized. A custom-made spherical scatter phantom was used to measure response variations in three-dimensional angular orientations. The results were to be used as angular dependence

  3. Pharmacokinetics of bupivacaine after intraperitoneal administration to cats undergoing ovariohysterectomy.

    Science.gov (United States)

    Benito, Javier; Monteiro, Beatriz P; Beaudry, Francis; Lavoie, Anne-Marie; Lascelles, B Duncan X; Steagall, Paulo V

    2016-06-01

    OBJECTIVE To evaluate pharmacokinetics of bupivacaine after IP administration to cats undergoing ovariohysterectomy. ANIMALS 8 healthy cats. PROCEDURES Anesthesia was induced with propofol and maintained with isoflurane. Buprenorphine (0.02 mg/kg, IV) and meloxicam (0.2 mg/kg, SC) were administered. A 20-gauge catheter was inserted into a jugular vein for blood sample collection. A ventral midline incision was made, and a solution of 0.5% bupivacaine (2 mg/kg) diluted with an equal volume of saline (0.9% NaCl) solution (final concentration, 0.25% bupivacaine) was injected into the peritoneal space over the right and left ovarian pedicles and caudal aspect of the uterus before ovariohysterectomy. Cats were monitored for signs of bupivacaine toxicosis. Venous blood samples (2 mL) were collected before (time 0) and 2, 5, 10, 15, 20, 30, 60, 120, and 240 minutes after bupivacaine administration. Plasma bupivacaine concentrations were determined with a liquid chromatography-tandem mass spectrometry method. Pharmacokinetic parameters were determined by data plotting followed by analysis with a noncompartmental model. RESULTS No signs of bupivacaine toxicosis were observed. Maximum bupivacaine plasma concentration was 1,030 ± 497.5 ng/mL at a mean ± SD value of 30 ± 24 minutes after administration. Mean elimination half-life was 4.79 ± 2.7 hours. Mean clearance indexed by bioavailability and volume of distribution indexed by bioavailability were 0.35 ± 0.18 L•h/kg and 2.10 ± 0.84 L/kg, respectively. CONCLUSIONS AND CLINICAL RELEVANCE Intraperitoneal administration of bupivacaine resulted in concentrations that did not cause observable toxicosis. Studies to investigate analgesic effects for this technique in cats are warranted.

  4. Disaccharidase activity in children undergoing esophagogastroduodenoscopy: A systematic review

    Institute of Scientific and Technical Information of China (English)

    Taylor Daileda; Peter Baek; Morgan E Sutter; Kalpesh Thakkar

    2016-01-01

    AIM:To investigate the utility of intestinal disaccharide analysis during esophagogastroduodenoscopy(EGD)in children,we performed a systematic review of studies examining disaccharide activity.METHODS:All full-length articles published in English during 1966-2014 were included if:(1)participants had small intestinal biopsy evaluation of disaccharide activity;(2)levels of lactase,sucrase,maltase or palatinase were reported;and(3)age of participants was under 18 years.RESULTS:Thirty articles examining 34753 disaccharide assays fulfilled the specific search,inclusion,and exclusion criteria.All of the studies were observational in design and 57%(17)were prospective.Sixteen studies were conducted in the United States and 9European studies were identified.The biggest study enrolled about 30,314 procedures and 13 studies investigated fewer than 50 procedures.Eleven studies examined Caucasian subjects,3 studies examined Asian subjects,and 6 examined African subjects.Only one Hispanic subject was included.In studies reporting disaccharide deficiency,the overall proportion of lactase deficiency was 39.2%,sucrase deficiency was9.0%,maltase deficiency was 12.6%and palatinase deficiency was 9.1%.The prevalence of duodenal inflammatory changes ranged from 6%to 24%for nonspecific histological lesions(e.g.,duodenitis).Sixteen studies examined the association of histologic findings with disaccharide activities,and 12 studies reported an inverse association between degree of histologic inflammation and disaccharide levels.CONCLUSION:We reviewed 30 studies including34753 biopsy specimens with disaccharide analysis from children undergoing EGD.Our findings advocate a large study is to further illuminate the importance of EGDwith disaccharide analysis in children.

  5. Postoperative sepsis prediction in patients undergoing major cancer surgery.

    Science.gov (United States)

    Sood, Akshay; Abdollah, Firas; Sammon, Jesse D; Arora, Nivedita; Weeks, Matthew; Peabody, James O; Menon, Mani; Trinh, Quoc-Dien

    2017-03-01

    Cancer patients are at increased risk for postoperative sepsis. However, studies addressing the issue are lacking. We sought to identify preoperative and intraoperative predictors of 30-d sepsis after major cancer surgery (MCS) and derive a postoperative sepsis risk stratification tool. Patients undergoing one of nine MCSs (gastrointestinal, urological, gynecologic, or pulmonary) were identified within the American College of Surgeons National Surgical Quality Improvement Program (2005-2011, n = 69,169). Multivariable adjusted analyses (MVA) were performed to identify the predictors of postoperative sepsis. A composite sepsis risk score (CSRS) was constructed using the regression coefficients of predictors significant on MVA. The score was stratified into low, intermediate, and high risk, and its predictive accuracy for sepsis, septic shock, and mortality was assessed using the area under the curve analysis. Overall, 4.3% (n = 2954) of patients developed postoperative sepsis. In MVA, Black race (odds ratio [OR] = 1.30, P = 0.002), preoperative hematocrit 3 (P sepsis. CSRS demonstrated favorable accuracy in predicting postoperative sepsis, septic shock, and mortality (area under the curve 0.72, 0.75, and 0.74, respectively). Furthermore, CSRS risk stratification demonstrated high concordance with sepsis rates, 1.3% in low-risk patients versus 9.7% in high-risk patients. Similarly, 30-d mortality rate varied from 0.5% to 5.5% (10-fold difference) in low-risk patients versus high-risk patients. Our study identifies the major risk factors for 30-d sepsis after MCS. These risk factors have been converted into a simple, accurate bedside sepsis risk score. This tool might facilitate improved patient-physician interaction regarding the risk of postoperative sepsis and septic shock. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Incidence of bacteremia in cirrhotic patients undergoing upper endoscopic ultrasonography.

    Science.gov (United States)

    Fernández-Esparrach, Gloria; Sendino, Oriol; Araujo, Isis; Pellisé, Maria; Almela, Manel; González-Suárez, Begoña; López-Cerón, María; Córdova, Henry; Sanabria, Erwin; Uchima, Hugo; Llach, Josep; Ginès, Àngels

    2014-01-01

    The incidence of bacteremia after endoscopic ultrasonography (EUS) or EUS-guided fine-needle aspiration (EUS-FNA) is between 0% and 4%, but there are no data on this topic in cirrhotic patients. To prospectively assess the incidence of bacteremia in cirrhotic patients undergoing EUS and EUS-FNA. We enrolled 41 cirrhotic patients. Of these, 16 (39%) also underwent EUS-FNA. Blood cultures were obtained before and at 5 and 30 min after the procedure. When EUS-FNA was used, an extra blood culture was obtained after the conclusion of radial EUS and before the introduction of the sectorial echoendoscope. All patients were clinically followed up for 7 days for signs of infection. Blood cultures were positive in 16 patients. In 10 patients, blood cultures grew coagulase-negative Staphylococcus, Corynebacterium species, Propionibacterium species or Acinetobacterium Lwoffii, which were considered contaminants (contamination rate 9.8%, 95% CI: 5.7-16%). The remaining 6 patients had true positive blood cultures and were considered to have had true bacteremia (15%, 95% CI: 4-26%). Blood cultures were positive after diagnostic EUS in five patients but were positive after EUS-FNA in only one patient. Thus, the frequency of bacteremia after EUS and EUS-FNA was 12% and 6%, respectively (95% CI: 2-22% and 0.2-30%, respectively). Only one of the patients who developed bacteremia after EUS had a self-limiting fever with no other signs of infection. Asymptomatic Gram-positive bacteremia developed in cirrhotic patients after EUS and EUS-FNA at a rate higher than in non-cirrhotic patients. However, this finding was not associated with any clinically significant infections. Copyright © 2013 Elsevier España, S.L. and AEEH y AEG. All rights reserved.

  7. Benthic processes in fresh water fluffy sediments undergoing resuspension

    Directory of Open Access Journals (Sweden)

    Daniele Longhi

    2013-02-01

    Full Text Available In the Po river plain relict freshwater wetlands are characterised by a low free water to emergent macrophyte surface ratio, rapid infilling and fluffy sediments, undergoing frequent resuspension. Particle mixing should alter the steep gradients of dissolved gas, nutrient and organic matter quality that generally characterise sediments, with implications for benthic processes. Sediment features and solute fluxes were studied from December 2003 to February 2005 within the Busatello swamp complex (Northern Italy by means of a combination of core incubation, porewater extraction and microprofiling. At the study site, along a 10 cm vertical profile, sediment organic matter content (32.5%, porosity (0.94 and density (1.02 g cm–3 were nearly constant. Oxygen demand measured by dark core incubation (12.7-56.9 mmol m–2 d–1 was strongly correlated with water temperature. Rates agreed reasonably well with diffusive oxygen fluxes calculated from microprofiles while ammonium and phosphorus regeneration rates predicted from porewater gradients (-309.3-43.4 and -0.1-0.7 μmol m–2 d–1, respectively were significantly lower than rates measured via core incubations (-129.8-5420.5 and -120.4-35.4 μmol m–2 d–1, respectively. This is a probable consequence of insufficient vertical resolution of nutrient profiles and lack of steady state conditions. A sediment resuspension experiment, carried out under controlled laboratory conditions, indicated large instantaneous oxygen and nitrate consumption, a transient increase of denitrification rates and the rapid release of ammonium and soluble reactive phosphorus. In unconsolidated sediments, resuspension and mixing of sediment particles are key processes regulating mineralisation rates and benthic-pelagic coupling.

  8. Anesthesia for patients undergoing transsternal thymectomy for juvenile myasthenia gravis

    Directory of Open Access Journals (Sweden)

    Lianne Stephenson

    2011-01-01

    Full Text Available Background: Juvenile myasthenia gravis (JMG is the rare form of myasthenia gravis presenting in childhood and adolescence. When medical management fails, thymectomy is offered for these patients. Complete resection of the thymus is best achieved through transsternal thymectomy. Anesthetic management of patients with JMG is challenging, particularly in regards to the goals of postoperative pain control, respiratory function, and extubation. Methods: We retrospectively reviewed the medical records of 13 patients, ranging in age from 6 to 22 years, who underwent transsternal thymectomy for JMG. Information on patient demographics, characteristics of their disease and treatment, anesthetic management, and postoperative course were collected. Results: All patients had undergone multiple treatment modalities and presented for surgery because of inadequate symptom control with medical management. As expected for a pediatric population, anesthesia induction was age dependent. 40% of the patients underwent an inhalation induction and 60% underwent an intravenous induction. Anesthesia was maintained with a low-dose inhalation agent in all patients, supplemented in 84% of patients with a remifentanil infusion, and in 69% of patients with an epidural infusion. Muscle relaxants were avoided in all patients. With this regimen, 92% of patients could be extubated successfully in the operating room. Conclusion: We found that avoidance of muscle relaxants and use of remifentanil with a low-dose hypnotic agent provided a stable intraoperative course, facilitated rapid emergence, and allowed early extubation in patients with JMG undergoing transsternal thymectomy. Epidural analgesia reduced the need for intra- and postoperative intravenous opioids and did not have an adverse effect on respiratory strength.

  9. Dizziness and Falls in Obese Inpatients Undergoing Metabolic Rehabilitation

    Science.gov (United States)

    Corna, Stefano; Aspesi, Valentina; Cau, Nicola; Scarpina, Federica; Gattini Valdés, Natalia; Brugliera, Luigia; Cimolin, Veronica

    2017-01-01

    Aim The relationship between dizziness and falls in the obese population is a relatively unexplored issue. The aims of the present study were to define the 1-year prevalence of dizziness in an obese inpatient population undergoing metabolic rehabilitation and to investigate possible correlations with fall events. Materials and Methods We recruited 329 obese subjects: 203 female (BMI 43,74 kg/m2 ± 0.5 SE; age 17–83 years, 58.33 ± 0.9 SE) and 126 male (BMI 44,27kg/m2 ± 0.7 DE age 27–79 years, 58.84 ± 1 SE). To assess dizziness we used the validated Italian version (38) of the Dizziness Handicap Inventory (DHI). Results Out of the experimental sample, 100 subjects did not complain of dizziness and felt confident about their balance control, while 69.6% reported some degree of dizziness. Their mean DHI score was 22.3, which corresponds to mild dizziness. Twenty-one percent reported more severe dizziness (DHI score > 40). The majority of our sample reported minor dizziness and its perception appears to be independent from BMI: DHI scores were consistent across classes of obesity. Discussion The rate of dizziness and falls (30.1%) in an this obese population was higher than that previously reported in a general matched population. However, obese subjects, in our sample, seem to underestimate their risk of fall and DHI score does not appear a reliable predictor of falls. Since complications associated with falls in obese persons generally require longer treatments than in lean individuals, our findings should be taken into account in order to identify other predictors, including cognitive and perceptual, of risk of fall and to implement fall prevention programs. PMID:28076370

  10. Does obesity prolong anesthesia in children undergoing common ENT surgery?

    Science.gov (United States)

    Lee, Jennifer J; Sun, Lena S; Gu, Brian; Kim, Minjae; Wang, Shuang; Han, Sena

    2014-10-01

    To report the epidemiology of obesity in a pediatric surgical population and determine whether obesity is a risk factor for longer anesthesia duration. Childhood obesity is a significant public health problem in the United States. Epidemiologic studies on pediatric surgical populations have been limited to states with very high prevalence of adult obesity (Michigan, Texas). Data from other states and more recent data since 2006 are unavailable. We examined anesthesia records for surgical patients age 2-18 years at Columbia University Medical Center from January 2009 to December 2010. Patients undergoing bariatric surgery or those with records missing preoperative height or weight data were excluded. Body mass index (BMI) was calculated as weight (kg)/height (m(2) ). BMI ≥95th percentile according to national growth charts were considered obese. We reviewed 9522 patients of which 1639 were obese (17.2%). The sex-age category interaction on obesity was not significant using logistic regression (P = 0.11). Among surgical groups, the otolaryngology (ENT) cohort had the highest obesity rate (21.7%, 360/1656). Obese children who had tonsillectomy, adenoidectomy, or both did not have a prolonged anesthetic (P = 0.33) or surgical duration (P = 0.61) compared with nonobese children, adjusting for surgeon, season, surgical procedure code, and ASA status. Children presenting for surgery, particularly the ENT cohort, have a high prevalence of obesity. Obese and nonobese children who had tonsillectomy, adenoidectomy, or both had comparable durations of anesthesia. Therefore, obesity did not lead to longer anesthetic duration. © 2014 John Wiley & Sons Ltd.

  11. Insulin pump therapy in patients with diabetes undergoing surgery.

    Science.gov (United States)

    Nassar, Adrienne A; Boyle, Mary E; Seifert, Karen M; Beer, Karen A; Apsey, Heidi A; Schlinkert, Richard T; Stearns, Joshua D; Cook, Curtiss B

    2012-01-01

    To assess perioperative management of patients with diabetes mellitus who were being treated with insulin pump therapy. We reviewed records for documentation of insulin pump status and glucose monitoring during preoperative, intraoperative, and postanesthesia care unit (PACU) phases of surgery. Thirty-five patients (21 men) with insulin pumps underwent surgical procedures between January 1, 2006, and December 31, 2010. Mean age was 56 years, mean diabetes duration was 31 years, and mean duration of insulin pump therapy was 7 years. All patients were white, and 29 had type 1 diabetes mellitus. Of the 50 surgical procedures performed during the study period, 16 were orthopedic, 9 were general surgical, 7 were urologic, and 7 were kidney transplant operations; the remaining 11 procedures were in other surgical specialties. The mean (± standard deviation) time in the preoperative area was 118 ± 75 minutes, mean intraoperative time was 177 ± 102 minutes, and mean PACU time was 170 ± 78 minutes. Of the 50 procedures, status of pump use was documented in 32 cases in the preoperative area, 14 cases intraoperatively, and 30 cases in the PACU. Glucose values were recorded in 47 cases preoperatively, 30 cases intraoperatively, and 48 cases in the PACU. Results showed inconsistent documentation of pump use and glucose monitoring throughout the perioperative period, even for patients with prolonged anesthesia and recovery times. It was often unclear whether the pump was in place and operational during the intraoperative period. Guidelines should be developed for management of insulin pump-treated patients who are to undergo surgery.

  12. [Evaluation of nurse workload in patients undergoing therapeutic hypothermia].

    Science.gov (United States)

    Argibay-Lago, Ana; Fernández-Rodríguez, Diego; Ferrer-Sala, Nuria; Prieto-Robles, Cristina; Hernanz-del Río, Alexandre; Castro-Rebollo, Pedro

    2014-01-01

    Therapeutic hypothermia (TH) is recommended to minimize neurological damage in patients surviving sudden cardiac arrest (SCA). There is scarcity of data evaluating the nursing workload in these patients. The objective of the study is to assess the workload of nurses whilst treating patients undergoing TH after SCA. A 43-month prospective-retrospective comparative cohort study was designed. Patients admitted to intensive care unit, for recovered SCA and persistent coma, were included. A comparison was made using the baseline characteristics, medical management, in-hospital mortality, and nursing workload during the first 96hours using the Therapeutic Intervention Scoring System-28 (TISS-28); Nursing Activities Score (NAS); and Nine Equivalents of Nursing Manpower Use Score (NEMS) scales among patients who received TH and those who did not. A total 46 patients were included: 26 in the TH group and 20 in the Non-TH group. Regarding baseline characteristics and management, the TH group presented higher prevalence of smoking habit (69 vs. 25%, p=0.012), out-of-hospital SCA (96 vs. 55%, p<0.001), and the performance of coronary angiography (96 vs. 65%, p=0.014) compared with the non-TH group. No differences were observed in the nursing workload, assessed by TISS 28, NAS or NEMS scales, or in-hospital mortality. In this study performance of TH in SCA survivors is not associated with an increase in nursing workload. The installation of a TH program does not require the use of more nursing resources in terms of workload. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  13. Incidental adenocarcinoma in patients undergoing surgery for stricturing Crohn's disease

    Science.gov (United States)

    Kristo, Ivan; Riss, Stefan; Argeny, Stanislaus; Maschke, Svenja; Chitsabesan, Praminthra; Stift, Anton

    2017-01-01

    AIM To evaluate frequency and clinical course of incidental adenocarcinoma in patients with stricturing Crohn's disease (CD). METHODS In this study, consecutive patients, who were operated on for stricturing CD between 1997-2012, were included at an academic tertiary referral center. Demographic data and clinical course were obtained by an institutional database and individual chart review. Besides baseline characteristics, intraoperative findings and CD related history were also recorded. Colorectal cancer was classified and staged according to the Union for International Cancer Control (UICC). RESULTS During the study period 484 patients underwent resections due to stricturing CD. Incidental adenocarcinoma was histologically confirmed in 6 (1.2%) patients (4 males, 2 females). Patients diagnosed with colorectal cancer had a median age of 43 (27-66) years and a median history of CD of 16 (7-36) years. Malignant lesions were found in the rectum (n = 4, 66.7%), descending colon (n = 1, 16.7%) and ileocolon (n = 1, 16.7%). According to the UICC classification two patients were stages as I (33.3%), whereas the other patients were classified as stage IIA (16.7%), stage IIIB (16.7%), stage IIIC (16.7%) and stage IV (16.7%), respectively. After a median follow-up of 2 (0.03-8) years only 1 patient is still alive. CONCLUSION The frequency of incidental colorectal cancer in patients, who undergo surgery for stenotic CD, is low but associated with poor prognosis. However, surgeons need to be aware about the possibility of malignancy in stricturing CD, especially if localized in the rectum. PMID:28210083

  14. Fecal corticoid monitoring in whooping cranes (Grus americana) undergoing reintroduction

    Science.gov (United States)

    Hartup, Barry K.; Olsen, Glenn H.; Czekala, Nancy M.

    2005-01-01

    We used radioimmunoassay to determine fecal corticoid concentrations and assess potential stress in 10 endangered whooping cranes (Grus americana) undergoing reintroduction to the wild. Fecal samples were collected shortly after hatching at a captive facility in Maryland, during field training in Wisconsin, and throughout a human-led migration to Florida. After a 14-day decline following hatching, fecal corticoid concentrations stabilized at baseline levels for the duration of the captive period, despite exposure to potentially stressful stimuli. Shipment of the cranes to the field training site was correlated with an eight- to 34-fold increase in fecal corticoid concentrations, which returned to baseline levels within 1 week. Increases were positively correlated with age but not body weight at the time of shipping. Fecal corticoid concentrations during the training period increased slightly and exhibited greater variation than levels observed at the captive facility, but were well within expected norms based on previous studies. Fecal corticoid concentrations increased twofold following premigration physical examinations and placement of radiotransmitters, and persisted for up to 4 days before they returned to baseline levels. Though fecal corticoid concentrations and variation during the migration period were similar to training levels, there was an overall decline in fecal corticoid concentrations during the artificial migration. Acute stressors, such as capture, restraint, and severe storms, were associated with stress responses by the cranes that varied in accordance with lasting physical or psychological stimuli. The overall reintroduction process of costume-rearing, ultralight aircraft habituation, training, and artificial migration was not associated with elevations in fecal corticoid concentrations suggestive of chronic stress.

  15. Acute kidney injury in patients undergoing cardiac surgery.

    Science.gov (United States)

    Coppolino, Giuseppe; Presta, Piera; Saturno, Laura; Fuiano, Giorgio

    2013-01-01

    The incidence of postoperative acute kidney injury (AKI) in patients undergoing cardiac surgery ranges from 7.7% to 28.1% in different studies, probably in relation to the criteria adopted to define AKI. AKI markedly increases mortality risk. However, despite the development of less invasive techniques, cardiac surgery remains the first option in many conditions such as severe coronary artery disease, valve diseases and complex interventions. The risk of postsurgery AKI can be reduced by adopting less invasive approaches, such as off-pump coronary artery bypass grafting or transcatheter aortic valve implantation, but these options cannot be employed in all cases. Thus, since traditional cardiac surgery remains the only option in many cases, it is important to adopt strategies helping the clinician to prevent AKI or diagnose it early. Old age, preprocedural chronic kidney disease, obesity, some comorbidities, wide pulse pressure and some pharmacological regimens represent risk factors for postsurgery AKI and mortality. Important intraoperative factor are use and duration of cardiopulmonary bypass. Postoperative efforts should be aimed toward maximizing cardiac output, avoiding drugs vasoconstricting the renal artery, providing adequate crystalloid infusion and alkalinizing urine. Fluid management should not be based on the measurements for cardiac filling pressures, which are mostly unreliable in these patients. Novel biomarkers such as cystatin C, kidney injury molecule-1 and human neutrophil gelatinase-associated lipocalin have been found to change earlier than creatinine, particularly when measured in combination, so their use in clinical practice can facilitate early diagnosis and treatment of AKI. The occurrence of oliguria despite adequate cardiovascular therapy can be managed with furosemide, possibly using continuous infusion, or renal replacement therapy.

  16. Understanding women's hesitancy to undergo less frequent cervical cancer screening.

    Science.gov (United States)

    Gerend, Mary A; Shepherd, Melissa A; Kaltz, Emily A; Davis, Whitney J; Shepherd, Janet E

    2017-02-01

    Inappropriate cervical cancer screening (e.g., screening too often) can result in unnecessary medical procedures, treatment, and psychological distress. To balance the benefits and harms, cervical cancer screening guidelines were recently modified in favor of less frequent screening (i.e., every 3 to 5 years). This study investigated women's acceptance of less frequent cervical cancer screening and their primary concerns about extending the screening interval beyond one year. A national sample of 376 U.S. women ages 21-65 completed an online survey in 2014. Predictors of willingness to get a Pap test every 3 to 5 years were identified using logistic regression. We also examined perceived consequences of less frequent screening. Over two thirds were willing to undergo less frequent screening if it was recommended by their healthcare provider. Nevertheless, nearly 20% expressed discomfort with less frequent screening and 45% were either in opposition or unsure whether they would be comfortable replacing Pap testing with primary HPV testing. Women whose most recent Pap test was (vs. was not) within the past year and women who ever (vs. never) had an abnormal Pap test were less willing to extend the screening interval. Additionally, women who typically saw an obstetrician/gynecologist or nurse practitioner for their Pap test (vs. a family physician) were less accepting of the guidelines. Hesitancy about the longer screening interval appears to stem from concern about developing cancer between screenings. Findings contribute to the growing body of research on cancer overscreening and may inform interventions for improving adherence to cancer screening guidelines.

  17. Pulmonary physiotherapy effect on patients undergoing open cardiac surgery

    Directory of Open Access Journals (Sweden)

    Seyed Kazem Shakuri

    2014-09-01

    Full Text Available Backgrounds and Objectives — Respiratory complications after open heart surgeries are common problems which can lead to death if not properly managed. The aim of this study was to evaluate the role of pulmonary rehabilitation before and after surgery for reducing the risk of pulmonary complications after surgery also correlations of the six-minute walk test and respiratory following open heart surgery. Material and Methods — In a randomized clinical trial, 60 patients undergoing heart surgery were divided into two groups randomly (groups A and B. In group A it was performed physiotherapy before and after chest physiotherapy surgery, but on patients in group B were done only chest physiotherapy after surgery. Effects of preoperative pulmonary rehabilitation were compared between two groups, using spirometry and six-minute walk test. Results — Thirty nine of males (65% and 21 females (35% with a mean age of 8.10±9.56 was been analyzed. The mean difference in predicted forced vital capacity (CI95%: 1.3 to 8.7 and predicted peak flow indices (CI95%: 1.9 to 9.4 of spirometery indicator was significant, also evaluation of six-minute walk test showed, mean difference in walking distant (CI95%: 8.8 to 21.0 and mean oxyhemoglobin saturation (CI95%: 0.59 to 1.67 in group A was more than group B. Inverse correlation of heart rate with forced vital capacity showed that patients with more restriction had more heart rate during the walking test. Conclusion — Pulmonary rehabilitation program before surgery is recommended to reduce complications of heart surgery. Further evaluations are necessary in relation to the sensitivity and specificity of six-minute walk test parameters alone in the evaluation of respiratory performance.

  18. Pulsed photothermal depth profiling of tattoos undergoing laser removal treatment

    Science.gov (United States)

    Milanic, Matija; Majaron, Boris

    2012-02-01

    Pulsed photothermal radiometry (PPTR) allows noninvasive determination of temperature depth profiles induced by pulsed laser irradiation of strongly scattering biological tissues and organs, including human skin. In present study, we evaluate the potential of this technique for investigational characterization and possibly quantitative evaluation of laser tattoo removal. The study involved 5 healthy volunteers (3 males, 2 females), age 20-30 years, undergoing tattoo removal treatment using a Q-switched Nd:YAG laser. There were four measurement and treatment sessions in total, separated by 2-3 months. Prior to each treatment, PPTR measurements were performed on several tattoo sites and one nearby healthy site in each patient, using a 5 ms Nd:YAG laser at low radiant exposure values and a dedicated radiometric setup. The laser-induced temperature profiles were then reconstructed by applying a custom numerical code. In addition, each tatoo site was documented with a digital camera and measured with a custom colorimetric system (in tristimulus color space), providing an objective evaluation of the therapeutic efficacy to be correlated with our PPTR results. The results show that the laser-induced temperature profile in untreated tattoos is invariably located at a subsurface depth of 300 μm. In tattoo sites that responded well to laser therapy, a significant drop of the temperature peak was observed in the profiles obtained from PPTR record. In several sites that appeared less responsive, as evidenced by colorimetric data, a progressive shift of the temperature profile deeper into the dermis was observed over the course of consecutive laser treatments, indicating that the laser tattoo removal was efficient.

  19. Paravertebral block versus thoracic epidural for patients undergoing thoracotomy.

    Science.gov (United States)

    Yeung, Joyce H Y; Gates, Simon; Naidu, Babu V; Wilson, Matthew J A; Gao Smith, Fang

    2016-02-21

    Operations on structures in the chest (usually the lungs) involve cutting between the ribs (thoracotomy). Severe post-thoracotomy pain can result from pleural (lung lining) and muscular damage, costovertebral joint (ribcage) disruption and intercostal nerve (nerves that run along the ribs) damage during surgery. Poor pain relief after surgery can impede recovery and increase the risks of developing complications such as lung collapse, chest infections and blood clots due to ineffective breathing and clearing of secretions. Effective management of acute pain following thoracotomy may prevent these complications and reduce the likelihood of developing chronic pain. A multi-modal approach to analgesia is widely employed by thoracic anaesthetists using a combination of regional anaesthetic blockade and systemic analgesia, with both non-opioid and opioid medications and local anaesthesia blockade.There is some evidence that blocking the nerves as they emerge from the spinal column (paravertebral block, PVB) may be associated with a lower risk of major complications in thoracic surgery but the majority of thoracic anaesthetists still prefer to use a thoracic epidural blockade (TEB) as analgesia for their patients undergoing thoracotomy. In order to bring about a change in practice, anaesthetists need a review that evaluates the risk of all major complications associated with thoracic epidural and paravertebral block in thoracotomy. To compare the two regional techniques of TEB and PVB in adults undergoing elective thoracotomy with respect to:1. analgesic efficacy;2. the incidence of major complications (including mortality);3. the incidence of minor complications;4. length of hospital stay;5. cost effectiveness. We searched for studies in the Cochrane Central Register of Controlled Trials (CENTRAL 2013, Issue 9); MEDLINE via Ovid (1966 to 16 October 2013); EMBASE via Ovid (1980 to 16 October 2013); CINAHL via EBSCO host (1982 to 16 October 2013); and reference lists of

  20. Enhanced Recovery After Surgery Program in Patients Undergoing Pancreaticoduodenectomy

    Science.gov (United States)

    Xiong, Junjie; Szatmary, Peter; Huang, Wei; de la Iglesia-Garcia, Daniel; Nunes, Quentin M.; Xia, Qing; Hu, Weiming; Sutton, Robert; Liu, Xubao; Raraty, Michael G.

    2016-01-01

    -regression analysis. Our study suggested that ERAS was as safe as CPC and improved recovery of patients undergoing PD, thus reducing in-hospital costs. General adoption of ERAS protocols during PD should be recommended. PMID:27149448

  1. Micronutrient deficiency in obese subjects undergoing low calorie diet

    Directory of Open Access Journals (Sweden)

    Damms-Machado Antje

    2012-06-01

    Full Text Available Abstract Background The prevalence of micronutrient deficiencies is higher in obese individuals compared to normal-weight people, probably because of inadequate eating habits but also due to increased demands among overweight persons, which are underestimated by dietary reference intakes (DRI intended for the general population. We therefore evaluated the dietary micronutrient intake in obese individuals compared to a reference population and DRI recommendations. Furthermore, we determined the micronutrient status in obese subjects undergoing a standardized DRI-covering low-calorie formula diet to analyze if the DRI meet the micronutrient requirements of obese individuals. Methods In 104 subjects baseline micronutrient intake was determined by dietary record collection. A randomly assigned subgroup of subjects (n = 32 underwent a standardized DRI-covering low-calorie formula diet over a period of three months. Pre- and post-interventional intracellular micronutrient status in buccal mucosa cells (BMC was analyzed, as well as additional micronutrient serum concentrations in 14 of the subjects. Results Prior to dietetic intervention, nutrition was calorie-rich and micronutrient-poor. Baseline deficiencies in serum concentrations were observed for 25-hydroxyvitamin-D, vitamin C, selenium, iron, as well as ß-carotene, vitamin C, and lycopene in BMC. After a three-month period of formula diet even more subjects had reduced micronutrient levels of vitamin C (serum, BMC, zinc, and lycopene. There was a significant negative correlation between lipophilic serum vitamin concentrations and body fat, as well as between iron and C-reactive protein. Conclusions The present pilot study shows that micronutrient deficiency occurring in obese individuals is not corrected by protein-rich formula diet containing vitamins and minerals according to DRI. In contrast, micronutrient levels remain low or become even lower, which might be explained by insufficient

  2. Effects of Glutamine Supplementation on Patients Undergoing Abdominal Surgery

    Institute of Scientific and Technical Information of China (English)

    Yue-ping Fan; Jian-chun Yu; Wei-ming Kang; Qun Zhang

    2009-01-01

    Objective To evaluate the effects of supplementation of glutamine (GLN) on maintaining glutathione (GSH) level, immune system function, liver function, and clinical outcome of patients receiving abdominal operation. Methods Forty patients undergoing elective abdominal surgical treatment were randomly divided into 2 groups: study group (n = 20) and control group (n = 20). All patients received total parenteral nutrition (TPN) for up to 7 days during perioperative period. The study group received TPN supplemented with GLN dipeptide while the control group received TPN without GLN dipeptide. Patients in both groups received equivalent nitrogen and caloric intake. Blood sample was taken on preoperative day, and the 1st, 3rd, 6th postoperative day to measure GSH level, immune indexes, and liver function indexes. Results The decrease of GSH level in plasma and red blood cell (RBC) in study group was less than that in control group during postoperative period. Ratio of GSH/glutathione disulfide (GSSG) in plasma in study group was higher than that in control group on the 3rd postoperative day (52.53 ± 11.46 vs. 31.43 ± 7.27, P = 0.001). Albumin level in study group was higher than that in control group on the 3rd postoperative day (37.7 ± 3.8 g/L vs. 33.8 ± 4.2 g/L, P = 0.02). There was no significant difference in the levels of immunoglobin (IgG, IgM, IgA) or T lymphocyte subgroup (CD4, CD8, CD4/CD8) in both groups during postoperative period. There was one case with infectious complication in control group, while none in study group. A trend of shortened hospital stay was observed in study group compared with control group (22.3 ± 2.1 d vs. 24.9 ± 1.7 d, P = 0.32). Conclusions Supplementation of GLN-enriched TPN has beneficial effects on maintaining GSH levels in plasma and RBC, sustaining GSH/GSSG ratio and albumin level, and keeping antioxidant abilities during postoperative period in patients with abdominal operation, with the trends of decreasing incidence of

  3. Protection effects of Sigmart for no-reflow or myocardial reperfusion injury after undergoing PCI surgery

    Institute of Scientific and Technical Information of China (English)

    Xiao-Peng Wu; Xuan-Qi Wang; Lei-Sen Han; Chong-Zhen Wang; Yin-Juan Mao; Wei-Jie Li

    2015-01-01

    Objective:To study the protection effects of Sigmart for lack of reflow or myocardial myocardial reperfusion injury after undergoing PCI surgery.Methods: A total of 150 patients undergoing PCI surgery were selected and divided into control group and observation group with 75 cases in each group. After undergoing the surgery, both groups were given low molecular heparin 4 100 IU for 3 d, 100 mg + aspirin + atorvastatin 20 mg + clopidogrel 75 mg. 5 mL of blood specimen were collected for detection of troponin I (TnI), myocardial enzyme spectrum (CK, CK-MB) level to evaluate myocardial myocardial reperfusion injury after undergoing PCI surgery. Also electrocardiogram (ECG) were detected. Six months after the surgery, effects of Sigmart for lack of reflow or myocardial myocardial reperfusion injury after undergoing PCI surgery were evaluated.Results: 1, 6, 12, 24 h after the surgery, TnI, Mb, CK-Mb levels of were significant different from those before undergoing the surgery, and these levels of the observation group were significant higher than that of the control group. ST segment elevation at 2, 12, and 24 h after undergoing the surgery were significant obvious than that of the control group. According to the follow up, incidence of comprehensive end point event was significant higher than that of the control group. SAQ and SF-36 scores of the two groups were significant different. Conclusion: Sigmart shows good protection effects for lack of reflow or myocardial myocardial reperfusion injury after undergoing PCI surgery.

  4. The transversus abdominis plane block provides effective postoperative analgesia in patients undergoing total abdominal hysterectomy.

    LENUS (Irish Health Repository)

    Carney, John

    2008-12-01

    Patients undergoing total abdominal hysterectomy suffer significant postoperative pain. The transversus abdominis plane (TAP) block is a recently described approach to providing analgesia to the anterior abdominal wall. We evaluated the analgesic efficacy of the TAP block in patients undergoing total abdominal hysterectomy via a transverse lower abdominal wall incision, in a randomized, controlled, double-blind clinical trial.

  5. Pain relief for women undergoing oocyte retrieval for assisted reproduction.

    Science.gov (United States)

    Kwan, Irene; Bhattacharya, Siladitya; Knox, Fiona; McNeil, Alex

    2013-01-31

    Various methods of conscious sedation and analgesia have been used for pain relief during oocyte recovery in in vitro fertilisation (IVF) and intra-cytoplasmic sperm injection (ICSI) procedures. The choice of agent has also been influenced by the quality of sedation and analgesia as well as by concerns about possible detrimental effects on reproductive outcomes. To assess the effectiveness and safety of different methods of conscious sedation and analgesia on pain relief and pregnancy outcomes in women undergoing transvaginal oocyte retrieval. We searched the Menstrual Disorders and Subfertility Group Specialised Register, Cochrane Central Register of Controlled Trials (CENTRAL) on The Cochrane Library, MEDLINE, EMBASE, PsycINFO, CINAHL (from their inception to present); the National Research Register and Current Controlled Trials. We searched reference lists of included studies for relevant studies and contacted authors for information on unpublished and ongoing trials. There was no language restriction. The search was updated in July 2012. Only randomised controlled trials comparing different methods of conscious sedation and analgesia for pain relief during oocyte recovery were included. Quality assessment and data extraction were performed independently by two review authors. Interventions were classified and analysed under broad categories or strategies of sedation and pain relief to compare different methods and administrative protocols of conscious sedation and analgesia. Outcomes were extracted and the data were pooled when appropriate. With this update, nine new studies were identified resulting in a total of 21 trials including 2974 women undergoing oocyte retrieval. These trials compared five different categories of conscious sedation and analgesia: 1) conscious sedation and analgesia versus placebo; 2) conscious sedation and analgesia versus other active interventions such as general and acupuncture anaesthesia; 3) conscious sedation and analgesia plus

  6. Use of ketofol to control emergence agitation in children undergoing adenotonsillectomy

    Directory of Open Access Journals (Sweden)

    Sherry N. Rizk

    2014-01-01

    Conclusion: Ketofol provides a promising new option for controlling emergence agitation with adequate postoperative sedative and analgesic effect, good recovery criteria and hemodynamic stability compared to propofol and control groups in children undergoing adenoidectomy or adenotonsillectomy.

  7. Topical versus caudal ketamine/bupivacaine combination for postoperative analgesia in children undergoing inguinal herniotomy

    Directory of Open Access Journals (Sweden)

    Hala Saad Abdel-Ghaffar

    2017-01-01

    Conclusion: Wound instillation of bupivacaine/ketamine is a simple, noninvasive, and effective technique that could be a safe alternative to CK for postoperative analgesia in children undergoing inguinal hernia repair.

  8. Can shared care deliver better outcomes for patients undergoing total hip replacement?

    NARCIS (Netherlands)

    Rosendal, H.; Beekum, W.T. van; Nijhof, P.; Witte, L.P. de; Schrijvers, A.J.P.

    2000-01-01

    Objectives: To assess whether shared care for patients undergoing total hip replacement delivers better outcomes compared to care as usual. Design: Prospective, observational cohort study. Setting: Two regions in the Netherlands where different organisational health care models have been

  9. Associations between dietary patterns and semen quality in men undergoing IVF/ICSI treatment

    NARCIS (Netherlands)

    Vujkovic, M.; Vries, de J.H.M.; Dohle, G.R.; Bonsel, G.J.; Lindemans, J.; Macklon, N.S.; Spek, van der P.J.; Steegers, E.A.P.; Steegers-Theunissen, R.P.M.

    2009-01-01

    BACKGROUND: This study investigates whether dietary patterns, substantiated by biomarkers, are associated with semen quality. METHODS: In 161 men of subfertile couples undergoing in vitro fertilization treatment in a tertiary referral clinic in Rotterdam, the Netherlands, we assessed nutrient intake

  10. Evaluation of pulmonary function in renal transplant recipients and chronic renal failure patients undergoing maintenance hemodialysis

    Directory of Open Access Journals (Sweden)

    Mohamed E. Abdalla

    2013-01-01

    Conclusion: There is impairment of lung function in patients with CRF undergoing hemodialysis. The main changes are small airway obstruction, reduction in carbon monoxide transfer and diminished 6MWT that were not completely improved in the kidney transplant patients.

  11. Associations between dietary patterns and semen quality in men undergoing IVF/ICSI treatment

    NARCIS (Netherlands)

    Vujkovic, M.; Vries, de J.H.M.; Dohle, G.R.; Bonsel, G.J.; Lindemans, J.; Macklon, N.S.; Spek, van der P.J.; Steegers, E.A.P.; Steegers-Theunissen, R.P.M.

    2009-01-01

    BACKGROUND: This study investigates whether dietary patterns, substantiated by biomarkers, are associated with semen quality. METHODS: In 161 men of subfertile couples undergoing in vitro fertilization treatment in a tertiary referral clinic in Rotterdam, the Netherlands, we assessed nutrient

  12. Associations between dietary patterns and semen quality in men undergoing IVF/ICSI treatment

    NARCIS (Netherlands)

    Vujkovic, M.; de Vries, J. H.; Dohle, G. R.; Bonsel, G. J.; Lindemans, J.; Macklon, N. S.; van der Spek, P. J.; Steegers, E. A. P.; Steegers-Theunissen, R. P. M.

    This study investigates whether dietary patterns, substantiated by biomarkers, are associated with semen quality. In 161 men of subfertile couples undergoing in vitro fertilization treatment in a tertiary referral clinic in Rotterdam, the Netherlands, we assessed nutrient intakes and performed

  13. Comparison of Intravenous Paracetamol and Tramadol in Children Undergoing Major Abdominal Surgery

    Directory of Open Access Journals (Sweden)

    Aysu Aydogan

    2015-06-01

    Conclusion: It was concluded that, intravenous paracetamol was provided effective analgesia but it was not superior to intravenous tramadol in children undergoing major abdominal surgery. [Cukurova Med J 2015; 40(2.000: 275-281

  14. Impact of Intraoperative Events on Cerebral Tissue Oximetry in Patients Undergoing Cardiopulmonary Bypass

    NARCIS (Netherlands)

    Severdija, E.E.; Vranken, N.P.; Teerenstra, S.; Ganushchak, Y.M.; Weerwind, P.W.

    2015-01-01

    Previous studies showed that decreased cerebral saturation during cardiac surgery is related to adverse postoperative outcome. Therefore, we investigated the influence of intraoperative events on cerebral tissue saturation in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). A t

  15. Relationship Between Reverse Remodeling and Cardiopulmonary Exercise Capacity in Heart Failure Patients Undergoing Cardiac Resynchronization Therapy

    NARCIS (Netherlands)

    Mastenbroek, Mirjam H; van t Sant, Jetske; Versteeg, Henneke; Cramer, MJ; Doevendans, Pieter A; Pedersen, Susanne S; Meine, Mathias

    BACKGROUND: Studies on the relationship between left ventricular reverse remodeling and cardiopulmonary exercise capacity in heart failure patients undergoing cardiac resynchronization therapy (CRT) are scarce and inconclusive. METHODS AND RESULTS: Eighty-four patients with a 1st-time

  16. Relationship between reverse remodeling and cardiopulmonary exercise capacity in heart failure patients undergoing cardiac resynchronization therapy

    NARCIS (Netherlands)

    Mastenbroek, M.H.; Sant, Jetske Van't; Versteeg, H.; Cramer, Maarten J; Doevendans, Pieter A; Pedersen, Susanne S; Meine, Mathias

    2016-01-01

    BACKGROUND: Studies on the relationship between left ventricular reverse remodeling and cardiopulmonary exercise capacity in heart failure patients undergoing cardiac resynchronization therapy (CRT) are scarce and inconclusive. METHODS AND RESULTS: Eighty-four patients with a 1st-time

  17. The association between radiographic severity and pre-operative function in patients undergoing primary knee replacement for osteoarthritis

    DEFF Research Database (Denmark)

    Dowsey, Michelle M; Dieppe, Paul; Lohmander, Stefan

    2012-01-01

    To determine the association between radiographic osteoarthritis (OA) and pre-operative function in patients undergoing primary knee replacement.......To determine the association between radiographic osteoarthritis (OA) and pre-operative function in patients undergoing primary knee replacement....

  18. Anesthetic recovery and hemodynamic effects of continuous thiopental infusion versus halothane for maintenance anesthesia in patients undergoing ocular surgery

    NARCIS (Netherlands)

    Shoroghi, Mehrdad; Farahbakhsh, Farshid; Sheikhvatan, Mehrdad; Sheikhfathollahi, Mahmood; Abbasi, Ali; Talebi, Azam

    2011-01-01

    Purpose: To investigate anesthesia recovery and hemodynamic status in patients under thiopental infusion or halothane maintenance anesthesia undergoing ocular surgery. Methods: Fifty-nine voluntary patients undergoing ocular surgery in Farabi hospital were allocated to one of two maintenance anesthe

  19. Mycoplasma in urine and blood following catheterisation of patients undergoing vascular surgery

    DEFF Research Database (Denmark)

    Levi, N; Eiberg, J; Skov Jensen, J;

    1997-01-01

    The purpose of this investigation was to determine if mycoplasmas enter the bloodstream after urinary tract catheterisation in patients undergoing vascular surgery in order to evaluate the efficiency of the routine prophylactic antibiotic treatment.......The purpose of this investigation was to determine if mycoplasmas enter the bloodstream after urinary tract catheterisation in patients undergoing vascular surgery in order to evaluate the efficiency of the routine prophylactic antibiotic treatment....

  20. Population pharmacokinetics of daptomycin in adult patients undergoing continuous renal replacement therapy

    OpenAIRE

    Xu, Xiaoying; Khadzhynov, Dmytro; Peters, Harm; Chaves, Ricardo L.; Hamed, Kamal; Levi, Micha; Corti, Natascia

    2016-01-01

    Aim The objective of this population pharmacokinetic (PK) analysis was to provide guidance for the dosing interval of daptomycin in patients undergoing continuous renal replacement therapy (CRRT). Methods A previously published population PK model for daptomycin was updated with data from patients undergoing continuous veno?venous haemodialysis (CVVHD; n?=?9) and continuous veno?venous haemodiafiltration (CVVHDF; n?=?8). Model?based simulations were performed to compare the 24?h AUC, C max an...

  1. Safety and feasibility of a combined exercise intervention for inoperable lung cancer patients undergoing chemotherapy

    DEFF Research Database (Denmark)

    Quist, Morten; Rørth, Mikael; Langer, Seppo

    2012-01-01

    To investigate the safety and feasibility of a six-week supervised structured exercise and relaxation training programme on estimated peak oxygen consumption, muscle strength and health related quality of life (HRHRQOL) in patients with inoperable lung cancer, undergoing chemotherapy.......To investigate the safety and feasibility of a six-week supervised structured exercise and relaxation training programme on estimated peak oxygen consumption, muscle strength and health related quality of life (HRHRQOL) in patients with inoperable lung cancer, undergoing chemotherapy....

  2. Spectra of fiber Bragg grating and long period fiber grating undergoing linear and quadratic strain

    Institute of Scientific and Technical Information of China (English)

    YUAN Yin-quan; LIANG Lei; ZHANG Dong-eheng

    2009-01-01

    The effects of linear and quadratic strain on the reflective spectrum of FBG and the transmission spectrum of LPFG have been numerically investigated based on the coupled -mode equations. The results show that for the FBG or LPFG undergo-ing only linear strain, the reflection or transmission spectrum is symmetrical about its central wavelength, the dependence relationships of the central wavelength shift, full-width-at-half-maximum, peak intensity upon the strain gradient have been obtained.

  3. Hypovitaminosis D in patients undergoing kidney transplant: the importance of sunlight exposure.

    Science.gov (United States)

    Vilarta, Cristiane F; Unger, Marianna D; Dos Reis, Luciene M; Dominguez, Wagner V; David-Neto, Elias; Moysés, Rosa M; Titan, Silvia; Custodio, Melani R; Hernandez, Mariel J; Jorgetti, Vanda

    2017-07-01

    Recent studies have shown a high prevalence of hypovitaminosis D, defined as a serum 25-hydroxyvitamin D level less than 30 ng/ml, in both healthy populations and patients with chronic kidney disease. Patients undergoing kidney transplant are at an increased risk of skin cancer and are advised to avoid sunlight exposure. Therefore, these patients might share two major risk factors for hypovitaminosis D: chronic kidney disease and low sunlight exposure. This paper describes the prevalence and clinical characteristics of hypovitaminosis D among patients undergoing kidney transplant. We evaluated 25-hydroxyvitamin D serum levels in a representative sample of patients undergoing kidney transplant. We sought to determine the prevalence of hypovitaminosis D, compare these patients with a control group, and identify factors associated with hypovitaminosis D (e.g., sunlight exposure and dietary habits). Hypovitaminosis D was found in 79% of patients undergoing kidney transplant, and the major associated factor was low sunlight exposure. These patients had higher creatinine and intact parathyroid hormone serum levels, with 25-hydroxyvitamin D being inversely correlated with intact parathyroid hormone serum levels. Compared with the control group, patients undergoing kidney transplant presented a higher prevalence of 25-hydroxyvitamin D deficiency and lower serum calcium, phosphate and albumin but higher creatinine and intact parathyroid hormone levels. Our results confirmed the high prevalence of hypovitaminosis D in patients undergoing kidney transplant. Therapeutic strategies such as moderate sunlight exposure and vitamin D supplementation should be seriously considered for this population.

  4. Anti-ENA antibody profile in hepatitis C patients undergoing hemodialysis.

    Science.gov (United States)

    Batchoun, Raymond G; Al-Najdawi, Malek A; Al-Taamary, Sameh

    2011-07-01

    Infection with hepatitis C virus (HCV) is increasing all over the world, especially among hemodialysis patients. HCV is one of the major autoantibody inducing viruses, where anti-nuclear antibodies (ANA), anti-smooth muscle antibodies (ASMA), anti-liver kidney microsome antibodies (LKM-1), and rheumatoid factor (RF) have been related to HCV. Few studies have investigated the presence of anti-extractable nuclear antigens (ENA) antibodies in chronic liver diseases, especially in chronic hepatitis C cases, but none investigated its immunostimulation role in hemodialysis units. The aim of the study was to assess the prevalence of HCV among chronic kidney disease- Stage 5 (CKD5) patients undergoing hemodialysis and the prevalence of ENA antibodies among them. Sera of 134 patients with chronic kidney disease undergoing hemodialysis, were screened for HCV antibodies and ENA antibodies profile, using ELISA and Immunoblot technique. 41 HCV-positive blood bank donors were used as controls. Sixty-four (47.7%) of 134 patients undergoing hemodialysis were infected with HCV. Thirty-three (51.6%) of 64 patients with HCV infection undergoing hemodialysis had anti-ENA antibodies: 9 (27.3%) showed anti-SSA antibodies and 22 (66.7%) had anti-SSB antibodies. The prevalence of anti-ENA antibodies was significantly higher in the patients with HCV infection, undergoing hemodialysis, compared with both control groups (hepatitis C-positive blood bank donors and hepatitis C-negative patients undergoing hemodialysis). Seventeen of 33 HCV antibodies-positive males undergoing hemodialysis had anti-ENA antibodies, compared with 16 of 31 females, indicating no sex related difference. This study emphasizes the high prevalence of HCV infection in our hemodialysis patients, comparable to that of other Middle Eastern countries, but higher than Western ones. A strong association was observed between anti-HCV positivity and hemodialysis duration, as well as anti-ENA antibody profile. However, these

  5. Outcomes are Worse in US Patients Undergoing Surgery on Weekends Compared With Weekdays.

    Science.gov (United States)

    Glance, Laurent G; Osler, Turner; Li, Yue; Lustik, Stewart J; Eaton, Michael P; Dutton, Richard P; Dick, Andrew W

    2016-06-01

    Increasing surgical access to previously underserved populations in the United States may require a major expansion of the use of operating rooms on weekends to take advantage of unused capacity. Although the so-called weekend effect for surgery has been described in other countries, it is unknown whether US patients undergoing moderate-to-high risk surgery on weekends are more likely to experience worse outcomes than patients undergoing surgery on weekdays. The aim of this study was to determine whether patients undergoing surgery on weekends are more likely to die or experience a major complication compared with patients undergoing surgery on a weekday. Using all-payer data, we conducted a retrospective cohort study of 305,853 patients undergoing isolated coronary artery bypass graft surgery, colorectal surgery, open repair of abdominal aortic aneurysm, endovascular repair of abdominal aortic aneurysm, and lower extremity revascularization. We compared in-hospital mortality and major complications for weekday versus weekend surgery using multivariable logistic regression analysis. After controlling for patient risk and surgery type, weekend elective surgery [adjusted odds ratio (AOR)=3.18; 95% confidence interval (CI), 2.26-4.49; Psurgery (AOR=2.11; 95% CI, 1.68-2.66; Psurgery. Weekend elective (AOR=1.58; 95% CI, 1.29-1.93; Psurgery (AOR=1.61; 95% CI, 1.42-1.82; Psurgery. Patients undergoing nonemergent major cardiac and noncardiac surgery on the weekends have a clinically significantly increased risk of death and major complications compared with patients undergoing surgery on weekdays. These findings should prompt decision makers to seek to better understand factors, such physician and nurse staffing, which may contribute to the weekend effect.

  6. Influence of Continuous Nursing on the Psychological State and Coping Style of Patients Undergoing Pacemaker Implantation

    Directory of Open Access Journals (Sweden)

    Xin LIU

    2015-10-01

    Full Text Available Background: Patients undergoing pacemaker implantation often experience anxiety and fear. As such, studies have focused on the mechanisms that relieve the negative emotions caused by the intervention. Continuous nursing is a safe and effective nursing mode. In this study, continuous nursing intervention was provided for elderly patients undergo-ing pacemaker implantation and an empirical investigation was performed to determine the effects of their negative emotion and disease-coping ability.Methods: Overall, 114 (68 males and 46 females elderly patients who were undergoing pacemaker implantation from Harbin City (China, were enrolled in the study. The patients were divided into two groups, namely, the control group and the intervention group, based on different nursing methods. Routine nursing was applied to the control group; continuous nursing support was provided for the intervention group from January 2014 to January 2015. The nursing results of the two groups were compared. These results were also evaluated using self-rating depression scale, self-rating anxiety scale, and trait coping style questionnaire.Result: The effects of depression and anxiety intervention were significant in the intervention group (P<0.05. Com-pared with the control group, the intervention group did not significantly differ. The coping style of the intervention group elicited significant effects. Compared with the control group, the intervention group was significantly different (P < 0.05.Conclusion: Continuous nursing can relieve the negative emotion and improve the negative coping style of patients undergoing pacemaker implantation.

  7. Analyzing intra-abdominal pressures and outcomes in patients undergoing emergency laparotomy

    Directory of Open Access Journals (Sweden)

    Khan Shehtaj

    2010-01-01

    Full Text Available Background : Studies have documented the impact of intra-abdominal hypertension (IAH on virtually every organ. However, it still remains strangely underdiagnosed. The aims of the study were to assess, in patients undergoing emergency laparotomy, whether intra-abdominal pressure (IAP is an independent predictor of morbidity and mortality, to evaluate the effects of IAH, and to identify hidden cases of abdominal compartment syndrome (ACS. Materials and Methods : The study comprised 197 patients undergoing emergency laparotomy. IAP was measured preoperatively and then postoperatively at 0, 6, and 24 hours. Duration of hospital stay, occurrence of burst abdomen, and mortality were noted as outcomes. Results : At admission, incidence of IAH was 80%. No significant association was found between IAP and occurrence of burst abdomen (P > 0.1. IAP was found to be a significant predictor of mortality in patients undergoing laparotomy (P < 0.001. Elevated IAP was found to affect all the organ systems adversely. The incidence of post-op ACS was 3.05% in the general population and 13.16% in trauma patients. The mortality rate for this subgroup was 100%. Conclusions : IAP is a significant predictor of mortality in patients undergoing laparotomy. IAH has detrimental effects on various organ systems. A more frequent monitoring with prompt decompression may be helpful in decreasing the mortality rate. Further studies are required to establish a screening protocol in patients undergoing laparotomy to detect and manage cases of IAH and ACS.

  8. Postoperative Infection Rates in Patients with a Negative Baseline Urine Culture Undergoing Ureteroscopic Stone Removal

    DEFF Research Database (Denmark)

    Martov, Alexey; Gravas, Stavros; Etemadian, Masoud;

    2015-01-01

    Abstract Purpose: To examine the effects of antibiotic prophylaxis on postoperative infection rate in patients with negative urine cultures undergoing ureteroscopy (URS). Patients and Methods: Using the Clinical Research Office of the Endourological Society (CROES) URS Global Study database...... in both groups. Factors predictive of postoperative UTI or fever were female gender, Crohn's and cardiovascular disease, a high stone burden, and an ASA score of II or higher. Conclusions: In patients with a negative baseline urine culture undergoing URS for ureteral or renal stones, rates......, patients with a negative baseline urine culture undergoing URS for ureteral stones (n=1141) or kidney stones (n=184) not receiving antibiotic prophylaxis were matched with those who were predefined by risk factors, including gender, American Society of Anesthesiologists (ASA) score, and ureteral stent...

  9. The prevalence of iron deficiency anaemia in patients undergoing bariatric surgery.

    Science.gov (United States)

    Khanbhai, M; Dubb, S; Patel, K; Ahmed, A; Richards, T

    2015-01-01

    As bariatric surgery rates continue to climb, anaemia will become an increasing concern. We assessed the prevalence of anaemia and length of hospital stay in patients undergoing bariatric surgery. Prospective data (anaemia [haemoglobin bariatric surgery. Results from a prospective database of 1530 patients undergoing elective general surgery were used as a baseline. Fifty-seven patients (14%) were anaemic pre-operatively, of which 98% were females. Median MCV (fL) and overall median ferritin (μg/L) was lower in anaemic patients (83 vs. 86, p=0.001) and (28 vs. 61, psurgery patients, prevalence of anaemia was similar (14% vs. 16%) but absolute iron deficiency was more common in those undergoing bariatric surgery; microcytosis pbariatric surgery. In bariatric patients with anaemia there was an overall increased length of hospital stay. Copyright © 2013 Asian Oceanian Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

  10. Total intravenous anaesthesia versus inhalational anaesthesia for adults undergoing transabdominal robotic assisted laparoscopic surgery

    DEFF Research Database (Denmark)

    Herling, Suzanne Forsyth; Dreijer, Bjørn; Wrist Lam, Gitte

    2017-01-01

    BACKGROUND: Rapid implementation of robotic transabdominal surgery has resulted in the need for re-evaluation of the most suitable form of anaesthesia. The overall objective of anaesthesia is to minimize perioperative risk and discomfort for patients both during and after surgery. Anaesthesia...... for patients undergoing robotic assisted surgery is different from anaesthesia for patients undergoing open or laparoscopic surgery; new anaesthetic concerns accompany robotic assisted surgery. OBJECTIVES: To assess outcomes related to the choice of total intravenous anaesthesia (TIVA) or inhalational...... anaesthesia for adults undergoing transabdominal robotic assisted laparoscopic gynaecological, urological or gastroenterological surgery. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2016 Issue 5), Ovid MEDLINE (1946 to May 2016), Embase via OvidSP (1982 to May 2016...

  11. Routine pre-operative focused ultrasonography by anesthesiologists in patients undergoing urgent surgical procedures

    DEFF Research Database (Denmark)

    Bøtker, M T; Vang, M L; Grøfte, T;

    2014-01-01

    with focused ultrasonography in patients undergoing urgent surgical procedures. Methods We performed pre-operative focused cardiopulmonary ultrasonography in patients aged 18 years or above undergoing urgent surgical procedures at pre-defined study days. Known and unexpected cardiopulmonary pathology...... was recorded, and subsequent changes in the anesthesia technique or supportive actions were registered. Results A total of 112 patients scheduled for urgent surgical procedures were included. Their mean age (standard deviation) was 62 (21) years. Of these patients, 24% were American Society....... Unexpected pathology leading to changes in anesthesia technique or supportive actions was only disclosed in a group of patients above the age of 60 years and/or in ASA class ≥ 3. Conclusion Focused cardiopulmonary ultrasonography disclosed unexpected pathology in patients undergoing urgent surgical...

  12. Ethical aspects of undergoing a predictive genetic testing for Huntington's disease.

    Science.gov (United States)

    Andersson, Petra Lilja; Juth, Niklas; Petersén, Åsa; Graff, Caroline; Edberg, Anna-Karin

    2013-03-01

    The aim of this study was to describe the experiences of undergoing a presymptomatic genetic test for the hereditary and fatal Huntington's disease, using a case study approach. The study was based on 18 interviews with a young woman and her husband from the decision to undergo the test, to receiving the results and trying to adapt to them, which were analysed using a life history approach. The findings show that the process of undergoing a presymptomatic test involves several closely connected ethical and medical questions, such as the reason for the test, the consequences of the test results and how health-care services can be developed to support people in this situation.

  13. Evaluation of dental anxiety in patients undergoing dentoalveolar surgery with laser treatment.

    Science.gov (United States)

    Ugurlu, Faysal; Cavus, Onur; Kaya, Alper; Sener, Cem B

    2013-04-01

    The purpose of this study was to evaluate dental anxiety in patients undergoing apicectomy procedures performed with conventional instruments or an erbium-doped yttrium aluminum garnet (Er:YAG) laser. Twenty-eight patients undergoing apicectomy were divided into two groups; roots were removed with an Er:YAG laser in group A (n=14) and with conventional instruments in group B (n=14). All patients completed preoperative State-Trait Anxiety Inventories (STAI) and postoperative questionnaires. Although state anxiety, trait anxiety, and postoperative questionnaire scores were lower in patients undergoing Er:YAG laser treatment than in those treated with conventional instruments, the differences were not statistically significant. Surgical instruments affect the anxiety levels of dental patients. Even with the STAI scores being lower for patients treated with Er:YAG, use of the Er:YAG laser alone cannot contribute to the resolution of dental anxiety. A patient's individual condition is the major factor influencing that patient's anxiety level.

  14. Influence of Music on Preoperative Anxiety and Physiologic Parameters in Women Undergoing Gynecologic Surgery.

    Science.gov (United States)

    Labrague, Leodoro J; McEnroe-Petitte, Denise M

    2016-04-01

    The aim of this study was to determine the influence of music on anxiety levels and physiologic parameters in women undergoing gynecologic surgery. This study employed a pre- and posttest experimental design with nonrandom assignment. Ninety-seven women undergoing gynecologic surgery were included in the study, where 49 were allocated to the control group (nonmusic group) and 48 were assigned to the experimental group (music group). Preoperative anxiety was measured using the State Trait Anxiety Inventory (STAI) while noninvasive instruments were used in measuring the patients' physiologic parameters (blood pressure [BP], pulse [P], and respiration [R]) at two time periods. Women allocated in the experimental group had lower STAI scores (t = 17.41, p music during the preoperative period in reducing anxiety and unpleasant symptoms in women undergoing gynecologic surgery.

  15. Remote ischemic preconditioning in cyanosed neonates undergoing cardiopulmonary bypass: a randomized controlled trial.

    Science.gov (United States)

    Jones, Bryn O; Pepe, Salvatore; Sheeran, Freya L; Donath, Susan; Hardy, Pollyanna; Shekerdemian, Lara; Penny, Daniel J; McKenzie, Ian; Horton, Stephen; Brizard, Christian P; d'Udekem, Yves; Konstantinov, Igor E; Cheung, Michael M H

    2013-12-01

    The myocardial protective effect of remote ischemic preconditioning has been demonstrated in heterogeneous groups of patients undergoing cardiac surgery. No studies have examined this technique in neonates. The present study was performed to examine the remote ischemic preconditioning efficacy in this high-risk patient group. A preliminary, randomized, controlled trial was conducted to investigate whether remote ischemic preconditioning in cyanosed neonates undergoing cardiac surgery confers protection against cardiopulmonary bypass. Two groups of neonates undergoing cardiac surgery were recruited for the present study: patients with transposition of the great arteries undergoing the arterial switch procedure and patients with hypoplastic left heart syndrome undergoing the Norwood procedure. The subjects were randomized to the remote ischemic preconditioning or sham control groups. Remote ischemic preconditioning was induced by four 5-minute cycles of lower limb ischemia and reperfusion using a blood pressure cuff. Troponin I and the biomarkers for renal and cerebral injury were measured pre- and postoperatively. A total of 39 neonates were recruited-20 with transposition of the great arteries and 19 with hypoplastic left heart syndrome. Of the 39 neonates, 20 were randomized to remote ischemic preconditioning and 19 to the sham control group. The baseline demographics appeared similar between the randomized groups. The cardiopulmonary bypass and crossclamp times were not significantly different between the 2 groups. The troponin I levels were not significantly different at 6 hours after cardiopulmonary bypass nor were the postoperative inotrope requirements. Markers of renal (neutrophil gelatinase-associated lipocalin) and cerebral injury (S100b, neuron-specific enolase) were not significantly different between the 2 groups. Our data suggest that remote ischemic preconditioning in hypoxic neonates undergoing cardiopulmonary bypass surgery does not provide

  16. Kinetics of plasma membrane and mitochondrial alterations in cells undergoing apoptosis

    Energy Technology Data Exchange (ETDEWEB)

    Lizard, G.; Fournel, S.; Genestier, L.; Dhedin, N. [Hospital Edouard Herriot, Lyon (France)] [and others

    1995-11-01

    Programmed cell death or apoptosis is characterized by typical morphological alterations. By transmission electron microscopy, apoptotic cells are identified by condensation of the chromatin in tight apposition to the nuclear envelope, alteration of the nuclear envelope and fragmentation of the nucleus, whereas integrity of the plasma membrane and organelles is preserved. Conversely cells undergoing necrosis display and early desintegration of cytoplasmic membrane and swelling of mitochondria. In this study we assessed by flow cytometry the sequential alterations of forward angle light scatter, 90{degrees} light scatter, and fluorescence associated with fluorescein diacetate, rhodamine 123, and propidium iodide in two human B cell lines undergoing apoptosis induced by the topoisomerase II inhibitor VP-16. The kinetics of these modifications were compared to those of cells undergoing necrosis induced by the topoisomerase II inhibitor VP-16. The kinetics of these modifications were compared to those of cells undergoing necrosis induced by sodium azide. At the same time intervals, cells were examined by transmission electron microscopy and by UV microscopy after staining with Hoechst 33342. We report that sequential changes in light scatters and fluorescein diacetate are similar in cells undergoing apoptosis or necrosis, whereas apoptosis is characterized by a slightly delayed decrease of mitochondrial activity as assessed by rhodamine 123 staining. Surprisingly, a part of cells undergoing apoptosis displayed an early uptake of propidium iodide followed by a condensation and then a fragmentation of their nuclei. It is concluded that uptake of propidium iodide is a very early marker of cell death which does not discriminate between necrosis and apoptosis. Along with biochemical criteria, nuclear morphology revealed by staining with Hoechst 33342 would seem to be of the most simple and most discriminative assay of apoptosis. 33 refs., 5 figs., 1 tab.

  17. Tolerability of 2.5% Lidocaine/Prilocaine Hydrogel in Children Undergoing Cryotherapy for Molluscum Contagiosum.

    Science.gov (United States)

    Gobbato, André A M; Babadópulos, Tainah; Gobbato, Cintia A R S; Moreno, Ronilson A; Gagliano-Jucá, Thiago; De Nucci, Gilberto

    2016-05-01

    The tolerability of a 2.5% lidocaine/prilocaine hydrogel (Nanorap, Biolab Indústria Farmacêutica Ltd., Sao Paulo, Brazil) was evaluated in 20 children ages 2 to 11 years undergoing cryotherapy for molluscum contagiosum (MC). The product was well tolerated, with only two children presenting with eczema at the application site. These adverse reactions were considered unlikely to be related to the test product, because a patch test was negative in one of the individuals and the other event occurred in only one of the two treated areas. Nanorap is an efficacious and well-tolerated option for topical anesthesia in children undergoing cryotherapy for MC.

  18. Health-related quality of life in children and adolescents undergoing surgery for pectus excavatum

    DEFF Research Database (Denmark)

    Jacobsen, E Brammer; Thastum, M; Jeppesen, Johanne Højhus

    2010-01-01

    INTRODUCTION: This study evaluated health-related quality of life (HRQoL) in children and adolescents undergoing cosmetic surgery for pectus excavatum (PE) compared to a group of healthy children. METHODS: The Intervention Group consisted of 172 children and adolescents undergoing surgery for PE...... between 2003 and 2005, aged 8-20 years; 86% were males. A postoperative follow-up study was conducted one to three years after surgery. None of the children had had the metal bar removed when they answered the questionnaires. The Control Group consisted of healthy schoolchildren (n=387), 201 females...

  19. Signs of knee osteoarthritis common in 620 patients undergoing arthroscopic surgery for meniscal tear

    DEFF Research Database (Denmark)

    Pihl, Kenneth; Englund, Martin; Lohmander, L. Stefan

    2017-01-01

    Background and purpose - Recent evidence has questioned the effect of arthroscopic knee surgery for middle-aged and older patients with degenerative meniscal tears with or without concomitant radiographic knee osteoarthritis (OA). We investigated the prevalence of early or more established knee OA...... and patients' characteristics in a cohort of patients undergoing arthroscopic surgery for a meniscal tear. Patients and methods - 641 patients assigned for arthroscopy on suspicion of meniscus tear were consecutively recruited from February 2013 through January 2015. Of these, 620 patients (mean age 49 (18...... established knee OA was present in 43% of patients undergoing knee arthroscopy for meniscal tear....

  20. Severe aortic arch calcification predicts mortality in patients undergoing peritoneal dialysis

    OpenAIRE

    Ching-Fang Wu; Yee-Fan Lee; Wen-Jeng Lee; Chi-Ting Su; Lukas Jyuhn-Hsiarn Lee; Kwan-Dun Wu; Pau-Chung Chen; Tze-Wah Kao

    2017-01-01

    Vascular calcification can predict cardiovascular (CV) morbidity and mortality in patients with end-stage renal disease. We evaluated the prevalence, association factors, and outcomes of chest X-ray-detected aortic arch calcification (AoAC) in patients undergoing peritoneal dialysis (PD). Methods: We included 190 patients undergoing PD (mean age, 52.6 ± 14.3 years) for whom chest radiographs were available. AoAC revealed by chest X-ray was graded from 0 to 3 according to an AoAC score (AoA...

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

    Science.gov (United States)

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

    2011-08-01

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

  2. Association of systemic collagen type IV formation with survival among patients undergoing hemodialysis

    DEFF Research Database (Denmark)

    Leeming, Diana Julie; Karsdal, Morten A; Rasmussen, Lars M;

    2013-01-01

    The 7S domain of collagen type IV (P4NP_7S) assessed in plasma represents systemic collagen type IV formation. The objective of the study was to investigate the association of systemic collagen type IV formation with survival among patients undergoing hemodialysis.......The 7S domain of collagen type IV (P4NP_7S) assessed in plasma represents systemic collagen type IV formation. The objective of the study was to investigate the association of systemic collagen type IV formation with survival among patients undergoing hemodialysis....

  3. Ganirelix for luteolysis in poor responder patients undergoing IVF treatment: a Scandinavian multicenter 'extended pilot study'

    DEFF Research Database (Denmark)

    Nilsson, Lena; Andersen, A.N.; Lindenberg, Svend

    2010-01-01

    To enhance oocyte yield and pregnancy outcome in poor responder women undergoing IVF treatment, daily low dose GnRH antagonist administration was given during the late luteal phase to induce luteolysis and possibly secure a more synchronous cohort of recruitable follicles. An open extended pilot ...

  4. Current trends in patients with chronic total occlusions undergoing coronary CT angiography

    NARCIS (Netherlands)

    M.P. Opolski (Maksymilian P.); B.T. Hartaigh (Bríain ó); D.S. Berman (Daniel S.); M.J. Budoff (Matthew J.); S. Achenbach (Stephan); M. Al-Mallah (Mouaz); D. Andreini (Daniele); F. Cademartiri (Filippo); H.-J. Chang (Hyuk-Jae); K. Chinnaiyan (Kavitha); B.J.W. Chow (Benjamin); M. Hadamitzky (Martin); J. Hausleiter (Jörg); G. Feuchtner (Gudrun); Y.-J. Kim (Yong-Jin); P.A. Kaufmann (Philipp A.); J. Leipsic (Jonathon); E. Maffei (Erica); G. Pontone (Gianluca); G.L. Raff (Gilbert); L.J. Shaw (Leslee); T.C. Villines (Todd); J.K. Min (James)

    2015-01-01

    textabstractObjective: Data describing the prevalence, characteristics and management of coronary chronic total occlusions (CTOs) in patients undergoing coronary CT angiography (CCTA) have not been reported. The purpose of this study was to determine the prevalence, characteristics and treatment str

  5. Current trends in patients with chronic total occlusions undergoing coronary CT angiography

    NARCIS (Netherlands)

    M.P. Opolski (Maksymilian P.); B.T. Hartaigh (Bríain ó); D.S. Berman (Daniel); M.J. Budoff (Matthew J.); S. Achenbach (Stephan); M. Al-Mallah (Mouaz); D. Andreini (Daniele); F. Cademartiri (Filippo); H.-J. Chang (Hyuk-Jae); K. Chinnaiyan (Kavitha); B.J.W. Chow (Benjamin); M. Hadamitzky (Martin); J. Hausleiter (Jörg); G.M. Feuchtner (Gudrun); Y.-J. Kim (Yong-Jin); P.A. Kaufmann (Philipp A.); J. Leipsic (Jonathon); E. Maffei (Erica); G. Pontone (Gianluca); G.L. Raff (Gilbert); L.J. Shaw (Leslee J.); T.C. Villines (Todd); J.K. Min (James)

    2015-01-01

    textabstractObjective Data describing the prevalence, characteristics and management of coronary chronic total occlusions (CTOs) in patients undergoing coronary CT angiography (CCTA) have not been reported. The purpose of this study was to determine the prevalence, characteristics and treatment stra

  6. Orthostatic hypotension during postoperative continuous thoracic epidural bupivacaine-morphine in patients undergoing abdominal surgery

    DEFF Research Database (Denmark)

    Crawford, M E; Møiniche, S; Orbæk, Janne;

    1996-01-01

    Fifty patients undergoing colonic surgery received combined thoracic epidural and general anesthesia followed by continuous epidural bupivacaine 0.25% and morphine 0.05 mg/mL, 4 mL/h, for 96 h postoperatively plus oral tenoxicam 20 mg daily. Heart rate (HR) and arterial blood pressure (BP) were...

  7. Recovery of older patients undergoing ambulatory anaesthesia with isoflurane or sevoflurane.

    LENUS (Irish Health Repository)

    Mahajan, V A

    2007-06-01

    Delayed recovery of cognitive function is a well-recognized phenomenon in older patients. The potential for the volatile anaesthetic used to contribute to alterations in postoperative cognitive function in older patients following minor surgical procedures has not been determined. We compared emergence from isoflurane and sevoflurane anaesthesia in older surgical patients undergoing urological procedures of short duration.

  8. Stress and neutron scattering measurements on linear polymer melts undergoing steady elongational flow

    DEFF Research Database (Denmark)

    Hassager, Ole; Mortensen, Kell; Bach, Anders

    2012-01-01

    We use small-angle neutron scattering to measure the molecular stretching in polystyrene melts undergoing steady elongational flow at large stretch rates. The radius of gyration of the central segment of a partly deuterated polystyrene molecule is, in the stretching direction, increasing with the...

  9. Radiological findings in patients undergoing revision endoscopic sinus surgery: a retrospective case series study

    Directory of Open Access Journals (Sweden)

    Eweiss Ahmed Z

    2011-05-01

    Full Text Available Abstract Background Functional endoscopic sinus surgery (FESS is now a well-established strategy for the treatment of chronic rhinosinusitis which has not responded to medical treatment. There is a wide variation in the practice of FESS by various surgeons within the UK and in other countries. Objectives To identify anatomic factors that may predispose to persistent or recurrent disease in patients undergoing revision FESS. Methods Retrospective review of axial and coronal CT scans of patients undergoing revision FESS between January 2005 and November 2008 in a tertiary referral centre in South West of England. Results The CT scans of 63 patients undergoing revision FESS were reviewed. Among the patients studied, 15.9% had significant deviation of the nasal septum. Lateralised middle turbinates were present in 11.1% of the studied sides, and residual uncinate processes were identified in 57.1% of the studied sides. There were residual cells in the frontal recess in 96% of the studied sides. There were persistent other anterior and posterior ethmoidal cells in 92.1% and 96% of the studied sides respectively. Conclusions Analysis of CT scans of patients undergoing revision FESS shows persistent structures and non-dissected cells that may be responsible for persistence or recurrence of rhinosinusitis symptoms. Trials comparing the outcome of conservative FESS techniques with more radical sinus dissections are required.

  10. Inspiratory Muscle Training and Functional Capacity in Patients Undergoing Cardiac Surgery

    OpenAIRE

    André Luiz Lisboa Cordeiro; Thiago Araújo de Melo; Daniela Neves; Julianne Luna; Mateus Souza Esquivel; André Raimundo França Guimarães; Daniel Lago Borges; Jefferson Petto

    2016-01-01

    Abstract Introduction: Cardiac surgery is a highly complex procedure which generates worsening of lung function and decreased inspiratory muscle strength. The inspiratory muscle training becomes effective for muscle strengthening and can improve functional capacity. Objective: To investigate the effect of inspiratory muscle training on functional capacity submaximal and inspiratory muscle strength in patients undergoing cardiac surgery. Methods: This is a clinical randomized controlled tri...

  11. Willingness to undergo HIV testing among factory workers in Surabaya, Indonesia.

    Science.gov (United States)

    Sasaki, Yuri; Arifin, Andryansyah; Ali, Moazzam; Kakimoto, Kazuhiro

    2011-10-01

    The objective of this study is to investigate workers' perceptions of HIV testing in the workplace in Indonesia. In a cross-sectional study, we used a self-administered questionnaire in Surabaya, Indonesia. A convenient sample of 536 workers was chosen from two factories with similar sample characteristics from March through June 2008. Of these workers, 433 (response rate: 80.8%) answered questions about their willingness to undergo HIV testing. More than 40% of workers were willing to undergo HIV testing. Not knowing where to get tested (adjusted odds ratio [AOR] = 0.40, confidence interval [CI] = 0.18-0.89) and not feeling the need to be tested for HIV (AOR = 0.02, CI = 0.01-0.04) were negatively associated with willingness to undergo HIV testing. HIV prevention in the workplace needs to reach out to individuals who are not willing to undergo HIV testing - workers unaware of where to get tested for HIV and not feeling the need to get tested - through education, information, and communication in the workplace in light of the stigma and discrimination associated with HIV. High-impact voluntary counseling and testing (VCT) strategies need to be quickly developed to improve HIV prevention and access to care in the workplace.

  12. Relationship Between Reverse Remodeling and Cardiopulmonary Exercise Capacity in Heart Failure Patients Undergoing Cardiac Resynchronization Therapy

    NARCIS (Netherlands)

    Mastenbroek, Mirjam H; van t Sant, Jetske; Versteeg, Henneke; Cramer, MJ; Doevendans, Pieter A; Pedersen, Susanne S; Meine, Mathias

    2016-01-01

    BACKGROUND: Studies on the relationship between left ventricular reverse remodeling and cardiopulmonary exercise capacity in heart failure patients undergoing cardiac resynchronization therapy (CRT) are scarce and inconclusive. METHODS AND RESULTS: Eighty-four patients with a 1st-time CRT-defibrilla

  13. Postoperative Respiratory Exercises Reduce the Risk of Developing Pulmonary Complications in Patients Undergoing Lobectomy.

    Science.gov (United States)

    Rodriguez-Larrad, Ana; Vellosillo-Ortega, Juan Manuel; Ruiz-Muneta, Carlos; Abecia-Inchaurregui, Luis Carlos; Seco, Jesús

    2016-07-01

    To evaluate the effects of an intensive postoperative physiotherapy program focused on respiratory exercises in patients undergoing lobectomy by open thoracotomy. Quasi-experimental study. Tertiary referral academic hospital. 208 patients undergoing lobectomy by open thoracotomy. Control group patients (n=102) received standard medical/nursing care, and experimental group patients (n=106) added to the standard clinical pathway a daily physiotherapy program focused on respiratory exercises until discharge. Analyzed outcomes were the frequency of postoperative pulmonary complications (PPCs) more amenable to physiotherapy (pneumonia, atelectasis and respiratory insufficiency) and length of hospital stay (LOS). Both groups were comparable regarding preoperative and surgical characteristics. Incidence of PPCs was 20.6% in control and 6.6% in experimental group (P=.003). Median (IQR) LOS in control group was 14 (7) days (Huber M estimator 14.21) and 12 (6) days (Huber M estimator 12.81) in experimental. Logistic regression model identified the evaluated physiotherapy program (P=.017; EXP [B] 95% CI 0.081-0.780) and % FEV1 (P=.042; EXP [B] 95% CI 0.941-0.999) as protective factors for the development of PPCs in patients undergoing lobectomy. Implementing a postoperative intensive physiotherapy program focused on respiratory exercises reduces the risk of PPCs and resultant LOS on patients undergoing lobectomy. Copyright © 2016 SEPAR. Published by Elsevier Espana. All rights reserved.

  14. Protective Antigen (PA) and Toxin Neutralization (TNA) Antibody Patterns in Anthrax Vaccinees Undergoing Serial Plasmapheresis

    Science.gov (United States)

    2005-03-28

    Undergoing Serial Plasmapheresis Phillip R. Pittman,1 Susan F. Leitman,2 Julio G. Barrera Oro,3 Sarah L. Norris,4 Nina M. Marano,5 Manmohan V. Ranadive...plasmapheresis on serum proteins and immunoglobulins. Transfusion 15:467–472. 12. Gold, H. 1936 . Studies on anthrax. Clinical report of ten human cases

  15. Long-term outcomes in patients with rheumatologic disorders undergoing percutaneous coronary intervention

    DEFF Research Database (Denmark)

    Nochioka, Kotaro; Biering-Sørensen, Tor; Hansen, Kim Wadt;

    2017-01-01

    AIMS: Rheumatologic disorders are characterised by inflammation and an increased risk of coronary artery disease (CAD). However, the association between rheumatologic disorders and long-term prognosis in CAD patients undergoing percutaneous coronary intervention (PCI) is unknown. Thus, we aimed t...

  16. Systematic Review of Peri-Operative Nutritional Supplementation in Patients Undergoing Pancreaticoduodenectomy

    Directory of Open Access Journals (Sweden)

    Kolitha Sanjaya Goonetilleke

    2006-01-01

    Full Text Available Background: Although nutritional supplementation is established in surgicalpractice, studies on feeding patients undergoing pancreaticoduodenectomy utilize widely disparate protocols, include small numbers of patients and have disparate endpoints. The aim of this study is to carry out a systematic review of peri-operative nutritional supplementation in patients undergoing pancreaticoduodenectomy in order to identify consistent themes. Methods :Searches of the MEDLINE and EMBASE databases yielded 10 studies examining nutritional support in 571 patients undergoing pancreaticoduodenectomy. Data were retrieved on: proportion of pre-operative weight loss, biochemical parameters (preoperative albumin and the presence of jaundice, type and duration of nutritional support and clinical outcome (morbidity, mortality and hospital stay. Results: Pre-operative percentage weight loss was similar in all studies evaluated. Routine post-operative total parenteral nutrition (TPN was associated with a higher incidence of complications. Enteral nutrition reduced infective complications. Cyclical nutrition was associated with a lower incidence of postoperative gastric stasis. Conclusion :Clear themes emerge from this systematic review. Patients undergoing pancreaticoduodenectomy are nutritionally depleted at the time of surgery and the preoperative period may present a window for intervention. Routine TPN is not beneficial. Routine post-operative enteral nutritional support, delivered on a cyclical basis appears to be the optimal mode of delivery.

  17. IV Iron: To Give or to Hold in the Presence of Infection in Adults Undergoing Hemodialysis.

    Science.gov (United States)

    Hain, Debra; Braun, Mauro

    2015-01-01

    Intravenous (IV) iron is often given to treat iron deficiency anemia in adults undergoing hemodialysis. Evidence supports an association between IV iron and infection exits, which often create a clinical dilemma: whether to give or to hold in the presence of infection. This article presents the best available evidence regarding the risk of IV iron and infection along with nephrology nursing practice implications.

  18. Predicting who will undergo surgery after physiotherapy for female stress urinary incontinence

    NARCIS (Netherlands)

    Labrie, J.; Lagro-Janssen, A. L. M.; Fischer, K.; Berghmans, L. C. M.; van der Vaart, C. H.

    2015-01-01

    To predict who will undergo midurethral sling surgery (surgery) after initial pelvic floor muscle training (physiotherapy) for stress urinary incontinence in women. This was a cohort study including women with moderate to severe stress incontinence who were allocated to the physiotherapy arm from a

  19. Perception of control, coping and psychological stress of infertile women undergoing IVF

    DEFF Research Database (Denmark)

    Gourounti, Kleanthi; Anagnostopoulos, Fotios; Potamianos, Grigoris;

    2012-01-01

    to control for the effects of demographic variables. This cross-sectional study included 137 women with fertility problems undergoing IVF in a public hospital. All participants completed questionnaires that measured fertility-related stress, state anxiety, depressive symptomatology, perception of control...

  20. Dropout rates in couples undergoing in vitro fertilization and intrauterine insemination

    NARCIS (Netherlands)

    Bensdorp, Alexandra J.; Tjon-Kon-Fat, Raissa; Verhoeve, Harold; Koks, Carolien; Hompes, Peter; Hoek, Annemieke; de Bruin, Jan Peter; Cohlen, Ben; Hoozemans, Diederik; Broekmans, Frank; van Bomme, Peter; Smeenk, Jesper; Mol, Ben W. J.; van der Veen, Fulco; van Wely, Madelon

    2016-01-01

    Objective: To compare dropout rates in couples undergoing conventional in vitro fertilization with single embryo transfer (IVF-SET), in vitro fertilization in a modified natural cycle (IVF-MNC) or intrauterine insemination with ovarian stimulation (IUI-OS). Study design: Secondary analysis of a mult

  1. Football training in men with prostate cancer undergoing androgen deprivation therapy

    DEFF Research Database (Denmark)

    Uth, Jacob; Hornstrup, Therese; Christensen, Jesper F

    2016-01-01

    PURPOSE: To investigate the activity profile of football training and its short-term effects on bone mass, bone turnover markers (BTMs) and postural balance in men with prostate cancer (PCa) undergoing androgen deprivation therapy (ADT). METHODS: This was a randomised 12-week study in which men...

  2. Organizational Climate in Its Semiotic Aspect: A Postmodern Community College Undergoes Renewal

    Science.gov (United States)

    Ayers, David F.

    2005-01-01

    A study at a community college undergoing renewal provided an opportunity to explore how members of various institutional subsystems differ in the ways they make meaning of organizational climate conditions. The researcher identifies and describes competing discourses relating to the signs and symbols of power, collaboration, technology, and…

  3. Specific psychosocial issues of individuals undergoing genetic counseling for cancer - a literature review

    NARCIS (Netherlands)

    Eijzenga, W.; Hahn, D.E.E.; Aaronson, N.K.; Kluijt, I.; Bleiker, E.M.A.

    2014-01-01

    Approximately 25 % of individuals undergoing genetic counseling for cancer experiences clinically relevant levels of distress, anxiety and/or depression. However, these general psychological outcomes that are used in many studies do not provide detailed information on the specific psychosocial probl

  4. Predicting who will undergo surgery after physiotherapy for female stress urinary incontinence

    NARCIS (Netherlands)

    Labrie, J.; Lagro-Janssen, A.; Fischer, K.; Berghmans, L.C.; Vaart, C.H. van der

    2015-01-01

    INTRODUCTION AND HYPOTHESIS: To predict who will undergo midurethral sling surgery (surgery) after initial pelvic floor muscle training (physiotherapy) for stress urinary incontinence in women. METHODS: This was a cohort study including women with moderate to severe stress incontinence who were allo

  5. Associations between dietary patterns and semen quality in men undergoing IVF/ICSI treatment

    NARCIS (Netherlands)

    Vujkovic, M.; de Vries, J. H.; Dohle, G. R.; Bonsel, G. J.; Lindemans, J.; Macklon, N. S.; van der Spek, P. J.; Steegers, E. A. P.; Steegers-Theunissen, R. P. M.

    2009-01-01

    This study investigates whether dietary patterns, substantiated by biomarkers, are associated with semen quality. In 161 men of subfertile couples undergoing in vitro fertilization treatment in a tertiary referral clinic in Rotterdam, the Netherlands, we assessed nutrient intakes and performed princ

  6. Multiparametric MRI in men with clinical suspicion of prostate cancer undergoing repeat biopsy

    DEFF Research Database (Denmark)

    Boesen, Lars; Nørgaard, Nis; Løgager, Vibeke

    2017-01-01

    for detection of csPCa in men undergoing repeat biopsies. Material and Methods MpMRI was performed prior to re-biopsy in 289 prospectively enrolled patients. All underwent repeat TRUSbx followed by targeted biopsies (MRITB) of any mpMRI-identified lesion. MpMRI suspicion grade, PSA level, and density (PSAd...

  7. Specific psychosocial issues of individuals undergoing genetic counseling for cancer - a literature review

    NARCIS (Netherlands)

    W. Eijzenga; D.E.E. Hahn; N.K. Aaronson; I. Kluijt; E.M.A. Bleiker

    2013-01-01

    Approximately 25 % of individuals undergoing genetic counseling for cancer experiences clinically relevant levels of distress, anxiety and/or depression. However, these general psychological outcomes that are used in many studies do not provide detailed information on the specific psychosocial probl

  8. Current trends in patients with chronic total occlusions undergoing coronary CT angiography

    NARCIS (Netherlands)

    M.P. Opolski (Maksymilian P.); B.T. Hartaigh (Bríain ó); D.S. Berman (Daniel); M.J. Budoff (Matthew J.); S. Achenbach (Stephan); M. Al-Mallah (Mouaz); D. Andreini (Daniele); F. Cademartiri (Filippo); H.-J. Chang (Hyuk-Jae); K. Chinnaiyan (Kavitha); B.J.W. Chow (Benjamin); M. Hadamitzky (Martin); J. Hausleiter (Jörg); G.M. Feuchtner (Gudrun); Y.-J. Kim (Yong-Jin); P.A. Kaufmann (Philipp A.); J. Leipsic (Jonathon); E. Maffei (Erica); G. Pontone (Gianluca); G.L. Raff (Gilbert); L.J. Shaw (Leslee J.); T.C. Villines (Todd); J.K. Min (James)

    2015-01-01

    textabstractObjective Data describing the prevalence, characteristics and management of coronary chronic total occlusions (CTOs) in patients undergoing coronary CT angiography (CCTA) have not been reported. The purpose of this study was to determine the prevalence, characteristics and treatment stra

  9. Current trends in patients with chronic total occlusions undergoing coronary CT angiography

    NARCIS (Netherlands)

    M.P. Opolski (Maksymilian P.); B.T. Hartaigh (Bríain ó); D.S. Berman (Daniel S.); M.J. Budoff (Matthew J.); S. Achenbach (Stephan); M. Al-Mallah (Mouaz); D. Andreini (Daniele); F. Cademartiri (Filippo); H.-J. Chang (Hyuk-Jae); K. Chinnaiyan (Kavitha); B.J.W. Chow (Benjamin); M. Hadamitzky (Martin); J. Hausleiter (Jörg); G. Feuchtner (Gudrun); Y.-J. Kim (Yong-Jin); P.A. Kaufmann (Philipp A.); J. Leipsic (Jonathon); E. Maffei (Erica); G. Pontone (Gianluca); G.L. Raff (Gilbert); L.J. Shaw (Leslee); T.C. Villines (Todd); J.K. Min (James)

    2015-01-01

    textabstractObjective: Data describing the prevalence, characteristics and management of coronary chronic total occlusions (CTOs) in patients undergoing coronary CT angiography (CCTA) have not been reported. The purpose of this study was to determine the prevalence, characteristics and treatment str

  10. Useful predictors of ovarian stimulation response in women undergoing in vitro fertilization

    NARCIS (Netherlands)

    van der Stege, JG; van der Linden, PJQ

    2001-01-01

    Eighty-seven patients undergoing in vitro fertilization were studied to evaluate the prognostic value of different tests in predicting ovarian stimulation response. We studied basal follicle-stimulating hormone (FSH) value on cycle day 3, the clomiphene citrate (CC) challenge test and serum estradio

  11. Increased concentrations of L-lactate in the rectal lumen in patients undergoing cardiopulmonary bypass

    DEFF Research Database (Denmark)

    Perner, A; Jørgensen, V L; Poulsen, T D

    2005-01-01

    Gut ischaemia may contribute to morbidity in patients after cardiopulmonary bypass (CPB), but little is known about the metabolic state of the large bowel in such patients. Therefore we estimated the concentrations of L-lactate and Pco(2) in rectal mucosa in patients undergoing cardiac surgery wi...

  12. Comparison of paravertebral and interpleural block in patients undergoing modified radical mastectomy

    Directory of Open Access Journals (Sweden)

    Pankaj Kundra

    2013-01-01

    Conclusion: To conclude, lung functions are well-preserved in patients undergoing modified radical mastectomy under general anesthesia supplemented with paravertebral or IPB. IPB is as effective as PVB for post-operative pain relief. PVB has the added advantage of achieving a more complete block.

  13. Risk factors and prognosis of postpericardiotomy syndrome in patients undergoing valve surgery

    NARCIS (Netherlands)

    van Osch, Dirk; Dieleman, Jan M.; Bunge, Jeroen J.; van Dijk, Diederik; Doevendans, Pieter A.; Suyker, Willem J.; Nathoe, Hendrik M.

    OBJECTIVE: The study aim was to investigate the long-term prognosis and risk factors of postpericardiotomy syndrome (PPS). METHODS: We performed a single-center cohort study in 822 patients undergoing nonemergent valve surgery. Risk factors of PPS were evaluated using multivariable logistic

  14. Automated Data Collection for Determining Statistical Distributions of Module Power Undergoing Potential-Induced Degradation

    DEFF Research Database (Denmark)

    Hacke, Peter; Spataru, Sergiu

    We propose a method for increasing the frequency of data collection and reducing the time and cost of accelerated lifetime testing of photovoltaic modules undergoing potential-induced degradation (PID). This consists of in-situ measurements of dark current-voltage curves of the modules at elevate...

  15. Polymer refilling of presbyopic human lenses in vitro restores the ability to undergo accommodative changes

    NARCIS (Netherlands)

    Koopmans, SA; Terwee, B; Haitjema, HJ; Kooijman, AC; Barkhof, J

    2003-01-01

    PURPOSE. Because presbyopia is thought to be accompanied by increased lens sclerosis this study was conducted to investigate whether refilling the capsule of the presbyopic human lens with a soft polymer would restore the ability of the lens to undergo accommodative changes. METHODS. Accommodative f

  16. Different duration strategies of perioperative antibiotic prophylaxis in adult patients undergoing cardiac surgery : an observational study

    NARCIS (Netherlands)

    Hamouda, Khaled; Oezkur, Mehmet; Sinha, Bhanu; Hain, Johannes; Menkel, Hannah; Leistner, Marcus; Leyh, Rainer; Schimmer, Christoph

    2015-01-01

    Background: All international guidelines recommend perioperative antibiotic prophylaxis (PAB) should be routinely administered to patients undergoing cardiac surgery. However, the duration of PAB is heterogeneous and controversial. Methods: Between 01.01.2011 and 31.12.2011, 1096 consecutive cardiac

  17. Clinical impact of intracoronary abciximab in patients undergoing primary percutaneous coronary intervention

    DEFF Research Database (Denmark)

    Piccolo, Raffaele; Gu, Youlan L; Iversen, Allan Zeeberg

    2012-01-01

    The aim of this study was to perform an individual patient-level pooled analysis of randomised trials, comparing intracoronary versus intravenous abciximab bolus use in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI)....

  18. Experience with daptomycin daily dosing in ICU patients undergoing continuous renal replacement therapy.

    Science.gov (United States)

    Preiswerk, B; Rudiger, A; Fehr, J; Corti, N

    2013-04-01

    For critically ill patients undergoing continuous renal replacement therapy (CRRT), daptomycin dosing recommendations are scarce. We, therefore, retrospectively assessed routinely measured daptomycin plasma concentrations, daptomycin dose administered and microbiological data in 11 critically ill patients with Gram-positive infections that had received daptomycin once daily. The retrospective analysis included critically ill patients treated at the intensive care unit (ICU) who had daptomycin plasma concentrations measured. Daptomycin dose ranged from 3 to 8 mg/kg/q24 h in patients undergoing CRRT (n = 7) and 6 to 10 mg/kg/q24 h in patients without CRRT (n = 4). Peak and trough concentrations showed a high intra- and inter-patient variability in both groups, independent of the dosage per kg body weight. No drug accumulation was detected in CRRT patients with once-daily daptomycin dosing. Causative pathogens were Enterococcus faecium (n = 6), coagulase-negative Staphylococcus (n = 2), Staphylococcus aureus (n = 2) and unknown in one patient. Microbiological eradication was successful in 8 of 11 patients. Two of three patients with unsuccessful microbiological eradication and fatal outcome had an Enterococcus faecium infection. In critically ill patients undergoing CRRT, daptomycin exposure with once-daily dosing was similar to ICU patients with normal renal function, but lower compared to healthy volunteers. Our data suggest that daptomycin once-daily dosing is appropriate in patients undergoing CRRT.

  19. Preoperative Thyroid Ultrasound Is Indicated in Patients Undergoing Parathyroidectomy for Primary Hyperparathyroidism

    Directory of Open Access Journals (Sweden)

    Cletus A. Arciero, Zita S. Shiue, Jeremy D. Gates, George E. Peoples, Alan P. B. Dackiw, Ralph P. Tufano, Steven K. Libutti, Martha A. Zeiger, Alexander Stojadinovic

    2012-01-01

    Full Text Available Background: Primary hyperaparathyroidism (pHPT is often accompanied by underlying thyroid pathology that can confound preoperative parathyroid localization studies and complicate intra-operative decision making. The aim of this study was to examine the utility of preoperative thyroid ultrasonography (US in patients prior to undergoing parathyroidectomy for pHPT.Methods: An Institutional Review Board approved prospective study was undertaken from January 2005 through July 2008. All patients with pHPT meeting inclusion criteria (n=94 underwent preoperative thyroid ultrasound in addition to standard 99mTc-sestamibi scintigraphy for parathyroid localization. Demographics, operative management and final pathology were examined in all cases.Results: Fifty-four of the 94 patients (57% were noted to have a thyroid nodule on preoperative US, of which 30 (56% underwent further examination with fine needle aspiration biopsy. Alteration of the operative plan attributable to underlying thyroid pathology occurred in 16 patients (17%, with patients undergoing either total thyroidectomy (n=9 or thyroid lobectomy (n=7. Thyroid cancer was noted in 33% of patients undergoing thyroid resection, and 6% of all patients with HPT.Conclusions: The routine utilization of preoperative thyroid ultrasound in patients prior to undergoing parathyroid surgery for pHPT is indicated. The added information from this non-invasive modality facilitates timely management of co-incidental, and sometimes malignant, thyroid pathology.

  20. Reduction of the inflammatory response in patients undergoing minimally invasive coronary artery bypass grafting

    NARCIS (Netherlands)

    Gu, YJ; Mariani, MA; van Oeveren, W; Grandjean, JG; Boonstra, PW

    1998-01-01

    Background. The aim of this prospective study was to determine whether the inflammation-associated clinical morbidity as well as the subclinical markers of the inflammatory response are reduced in patients who undergo minimally invasive coronary artery bypass grafting without cardiopulmonary bypass.

  1. Organizational Climate in Its Semiotic Aspect: A Postmodern Community College Undergoes Renewal

    Science.gov (United States)

    Ayers, David F.

    2005-01-01

    A study at a community college undergoing renewal provided an opportunity to explore how members of various institutional subsystems differ in the ways they make meaning of organizational climate conditions. The researcher identifies and describes competing discourses relating to the signs and symbols of power, collaboration, technology, and…

  2. The effect of peer support group on self-transcendence in patients undergoing haemodialysis

    Directory of Open Access Journals (Sweden)

    Maryam Jadid Milani

    2017-03-01

    Full Text Available Introduction: Self-transcendence helps patients undergoing haemodialysis to organize the variety of challenges caused by the disease in order to make them feel well. This study  was   conducted  to determine the effect of counterpart group on improving self-transcendence level in patients undergoing haemodialysis. Materials and Methods: This clinical trial was conducted with two groups of intervention and control, with 55 patients undergoing hemodialysis. The samples were divided in 2 groups of intervention and control through block randomization. Two-hour counterpart group sessions were held for eight weeks for intervention group. The session's topics were based on the patients’ needs and interests. Research tools were questionnaire, demographic information and "Reed’s Self-Transcendence Scale (STS". The descriptive and inferential statistics were used for data analysis using the SPSS v18. Results: There was a significant difference between self-transcendence scores in two groups of intervention and control (P<0.05. A significant increase in the level of self-transcendence in both groups was seen at the end of the study compared to basal status (P<0.05. Conclusions: According to the study results, attending the counterpart groups improved  self-transcendence in patients undergoing haemodialysis. The results can be used in nursing education and management. Training Self-transcendence evaluation is recommended for other chronic diseases with the emphasize on participating in counterpart groups for assessing its efficiency.

  3. Identification of two phytotoxins, blumenol A and grasshopper ketone, in the allelopathic Japanese rice variety Awaakamai.

    Science.gov (United States)

    Kato-Noguchi, Hisashi; Tamura, Kazuya; Sasaki, Hiroaki; Suenaga, Kiyotake

    2012-05-01

    Aqueous methanol extracts of the traditional rice (Oryza sativa) variety Awaakamai, which is known to have the greatest allelopathic activity among Japanese traditional rice varieties, inhibited the growth of roots and shoots of cress (Lepidium sativum), lettuce (Lactuca sativa), timothy (Phleum pratense), Digitaria sanguinalis, Lolium multiflorum and Echinochloa crus-galli. Increasing the extract concentration increased the inhibition, suggesting that the extract of Awaakamai contains growth inhibitory substances. The extract of Awaakamai was purified and two main growth inhibitory substances were isolated and determined by spectral data as blumenol A and grasshopper ketone. Blumenol A and grasshopper ketone, respectively, inhibited the growth of cress shoots and roots at concentrations greater than 10 and 30 μmol/L. The concentrations required for 50% growth inhibition on cress roots and shoots were 84 and 27 μmol/L, respectively, for blumenol A, and 185 and 76 μmol/L, respectively, for grasshopper ketone. These results suggest that blumenol A and grasshopper ketone may contribute to the growth inhibitory effect of Awaakamai and may play an important role in the allelopathy of Awaakamai. Copyright © 2012 Elsevier GmbH. All rights reserved.

  4. Investigating a Potential Auxin-Related Mode of Hormetic/Inhibitory Action of the Phytotoxin Parthenin.

    Science.gov (United States)

    Belz, Regina G

    2016-01-01

    Parthenin is a metabolite of Parthenium hysterophorus and is believed to contribute to the weed's invasiveness via allelopathy. Despite the potential of parthenin to suppress competitors, low doses stimulate plant growth. This biphasic action was hypothesized to be auxin-like and, therefore, an auxin-related mode of parthenin action was investigated using two approaches: joint action experiments with Lactuca sativa, and dose-response experiments with auxin/antiauxin-resistant Arabidopsis thaliana genotypes. The joint action approach comprised binary mixtures of subinhibitory doses of the auxin 3-indoleacetic acid (IAA) mixed with parthenin or one of three reference compounds [indole-3-butyric acid (IBA), 2,3,5-triiodobenzoic acid (TIBA), 2-(p-chlorophenoxy)-2-methylpropionic acid (PCIB)]. The reference compounds significantly interacted with IAA at all doses, but parthenin interacted only at low doses indicating that parthenin hormesis may be auxin-related, in contrast to its inhibitory action. The genetic approach investigated the response of four auxin/antiauxin-resistant mutants and a wildtype to parthenin or two reference compounds (IAA, PCIB). The responses of mutant plants to the reference compounds confirmed previous reports, but differed from the responses observed for parthenin. Parthenin stimulated and inhibited all mutants independent of resistance. This provided no indication for an auxin-related action of parthenin. Therefore, the hypothesis of an auxin-related inhibitory action of parthenin was rejected in two independent experimental approaches, while the hypothesis of an auxin-related stimulatory effect could not be rejected.

  5. Selected phytotoxins and organic extracts from endophytic fungus Edenia gomezpompae as light reaction of photosynthesis inhibitors.

    Science.gov (United States)

    Macías-Rubalcava, Martha Lydia; Ruiz-Velasco Sobrino, María Emma; Meléndez-González, Claudio; King-Díaz, Beatriz; Lotina-Hennsen, Blas

    2014-09-05

    In a search for natural herbicides, we investigated the action mechanism of the naphthoquinone spiroketals, isolated from the endophytic fungus Edenia gomezpompae: preussomerins EG1 (1) and EG4 (2), and palmarumycins CP17 (3), and CP2 (4) on the photosynthesis light reactions. The naphthoquinone spiroketals 1-4 inhibited the ATP synthesis in freshly lysed spinach thylakoids from water to MV, and they also inhibited the non-cyclic electron transport in the basal, phosphorylating and uncoupled conditions from water to MV. Therefore, they act as Hill reaction inhibitors. The results suggested that naphthoquinone spiroketals 1-4 have two interactions and inhibition site on the PSII electron transport chain. The first one involves the water splitting enzyme inhibition; and, the second on the acceptor site of PSII in a similar way that herbicide Diuron, studied by polaroghaphy and corroborated by fluorescence of the chlorophyll a of PSII. The culture medium and mycelium organic extracts from four morphological variants of E. gomezpompae were phytotoxic, and the culture medium extracts were more potent than mycelium extracts. They also act as Hill reaction inhibitors. Copyright © 2014 Elsevier B.V. All rights reserved.

  6. Phytotoxic Effects and a Phytotoxin from the Invasive Plant Xanthium italicum Moretti

    Directory of Open Access Journals (Sweden)

    Hua Shao

    2012-04-01

    Full Text Available The allelopathic effects of different parts of the plant Xanthium italicum Moretti were evaluated by conducting bioassays against two dicot plants, amaranth (Amaranthus mangostanus L. and lettuce (Lectuca sativa L., and two monocot plants, wheat (Triticum aestivum Linn and ryegrass (Lolium multiforum. Leaf and fruit extract possessed the strongest biological activity, killing all seeds of four test species at 0.05 g/mL concentration. Fruits were chosen for further investigation because of their high biomass. This led to the isolation and identification of a phytotoxin—Xanthinosin—a known sesquiterpene lactone. Xanthinosin significantly affected seedling growth of all test species at 160 µM concentration. Cultivating seeds in 800 μM xanthinosin solution resulted in a great decrease in seedling growth of all test species, especially for the two dicot plants, amaranth and lettuce, whose root length was inhibited by 78% and 89%, respectively. By comparison, the numbers were 69% lower for wheat, and 66% for ryegrass, two monocot plants. When treated with 4 mM xanthinosin solution, seed germination of all test plants was almost completely inhibited. The possibility of utilizing xanthinosin as an eco-friendly herbicide was discussed.

  7. Naturally occurring phytotoxins in allelopathic plants help reduce herbicide dose in wheat.

    Science.gov (United States)

    Khaliq, Abdul; Matloob, Amar; Tanweer, Asif; Khan, Muhammad Bismillah

    2012-01-01

    Field studies were carried out to evaluate the influence of allelopathic plant water extracts applied alone or tank-mixed with a reduced herbicide dose on the weeds of wheat. Water extracts of sorghum (Sorghum bicolor (L.) Moench.) + sunflower (Helianthus annuus L.) + mulberry (Morus alba L.) were used alone (each at 20 L ha(-1)) or combined with iodo + mesosulfuron (3.6 and 7.2 g active ingredient (a.i.) ha(-1); 25 and 50% of the recommended dose, respectively). The recommended dose of herbicide, a weedy check and a weed-free treatment were included for comparison. Allelopathic water extracts alone suppressed the density of canary grass (Phalaris minor Retz.) and wild oat (Avena fatua L.) by 34-42%, and dry weight by 59-67%. The mixture of allelopathic plant water extracts combined with reduced doses of iodo + mesosulfuron gave weed control equal to the recommended dose of the herbicide. Integration of plant water extracts with reduced herbicide rates provide effective weed control and a wheat yield comparable to using the recommended herbicide dose.

  8. Agropyrenol and agropyrenal, phytotoxins from Ascochyta agropyrina var. nana, a fungal pathogen of Elitrigia repens.

    Science.gov (United States)

    Andolfi, Anna; Cimmino, Alessio; Vurro, Maurizio; Berestetskiy, Alexander; Troise, Ciro; Zonno, Maria Chiara; Motta, Andrea; Evidente, Antonio

    2012-07-01

    A strain of Ascochyta agropyrina var. nana, a fungal pathogen of the perennial weed Elytrigia repens, produced several toxins in a liquid medium, and its primary toxin, named agropyrenol, was characterized as a substituted salicylaldehyde on the basis of its chemical and spectroscopic properties. Its absolute stereochemistry was determined by Mosher's method. Two other minor metabolites were isolated from the same culture and named agropyrenal and agropyrenone, respectively. They were characterized as a trisubstituted naphthalene carbaldehyde and a pentasubstituted 3H-benzofuranone, respectively, using the same techniques. When assayed on leaves of several weed plants, i.e., Mercurialis annua, Chenopodium album and Setaria viridis, agropyrenol proved to be phytotoxic, causing the appearance of necrotic lesions, agropyrenal was less active, while agropyrenone was inactive. None of the compounds showed antibiotic, fungicidal or zootoxic activity.

  9. Investigation and analysis of incidence of awareness in patients undergoing cardiac surgery in Beijing, China.

    Science.gov (United States)

    Wang, Yun; Yue, Yun; Sun, Yong-hai; Wu, An-shi; Wu, Qi-wei; Zhang, Yong-qian; Feng, Chun-sheng

    2005-07-20

    Awareness under general anesthesia is a serious complication which leads to psychiatric disorders. The incidence of awareness in patients undergoing cardiac surgery has been reported in as many as 1.5% - 23% in foreign countries. But so far, medical literature about awareness during cardiac surgery is still rare in China. Therefore, we investigated the incidence of awareness in patients undergoing different kinds of cardiac surgery, the phases when awareness occurred and the effect of cardiopulmonary bypass on the incidence of awareness in coronary artery bypass grafting in Beijing. Patients' recall of awareness during cardiac surgery was assessed. One hundred patients undergoing coronary artery bypass grafting (CABG) in Chaoyang Hospital, Beijing, one hundred patients undergoing CABG and one hundred patients undergoing valve replacement or septal defect repair in Fuwai Hospital, Beijing, were interviewed 3-6 days after surgery. Every report about patients on recall of awareness was recorded. An independent research team, blinded to patients' surgery and anesthesia, assessed every report of awareness. The incidence of awareness of patients received CABG under cardiopulmonary bypass (CPB), off -pump CABG, septal repair or valve replacement under CPB was 4.7% (5 of 106 cases), 9.6% (9 of 94 cases) and 4% (4 of 100 cases), respectively. CPB did not greatly affect the incidence of awareness during the period of CABG (P > 0.05). The incidence of awareness of patients who received CABG under CPB did not increase significantly, in comparison with that of patients who received septal repair or valve replacement under CPB in Fuwai Hospital (P > 0.05). Awareness easily occurred before bypass grafting or CPB. Awareness mainly occurs before bypass grafting or CPB in cardiac surgery. Most cases with awareness have auditory perceptions. CPB is not a main factor which affects the incidence of awareness of CABG. Surgical types do not affect the incidence of awareness of patients

  10. Investigation and analysis of incidence of awareness in patients undergoing cardiac surgery in Beijing, China

    Institute of Scientific and Technical Information of China (English)

    WANG Yun; YUE Yun; SUN Yong-hai; WU An-shi; WU Qi-wei; ZHANG Yong-qian; FENG Chun-sheng

    2005-01-01

    Background Awareness under general anesthesia is a serious complication which leads to psychiatric disorders. The incidence of awareness in patients undergoing cardiac surgery has been reported in as many as 1.5%-23% in foreign countries. But so far, medical literature about awareness during cardiac surgery is still rare in China. Therefore, we investigated the incidence of awareness in patients undergoing different kinds of cardiac surgery, the phases when awareness occured and the effect of cardiopulmonary bypass on the incidence of awareness in coronary artery bypass grafting in Beijing.Methods Patients' recall of awareness during cardiac surgery was assessed. One hundred patients undergoing coronary artery bypass grafting (CABG) in Chaoyang Hospital, Beijing, one hundred patients undergoing CABG and one hundred patients undergoing valve replacement or septal defect repair in Fuwai Hospital, Beijing, were interviewed 3-6 days after surgery. Every report obout patients on recall of awareness was recorded. An independent research team, blinded to patients' surgery and anesthesia, assessed every report of awareness.Results The incidence of awareness of patients received CABG under cardiopulmonary bypass (CPB), off -pump CABG, septal repair or valve replacement under CPB was 4.7% (5 of 106 cases), 9.6% (9 of 94 cases) and 4% (4 of 100 cases), respectively. CPB did not greatly affect the incidence of awareness during the period of CABG (P>0.05). The incidence of awareness of patients who received CABG under CPB did not increase significantly, in comparison with that of patients who received septal repair or valve replacement under CPB in Fuwai Hospital (P>0.05). Awareness easily occurred before bypass grafting or CPB.Conclusions Awareness mainly occurs before bypass grafting or CPB in cardiac surgery. Most cases with awareness have auditory perceptions. CPB is not a main factor which affects the incidence of awareness of CABG. Surgical types do not affect the

  11. Role of dissection of secondary branches of splenic pedicle in portal hypertension cases undergoing splenectomy

    Institute of Scientific and Technical Information of China (English)

    LIU Ying-bin; ZHANG Zhi-ping; WU Xiang-song; FEI Xiao-zhou; QUAN Zhi-wei; Li Song-gang; LI Ji-yu; CAO Li-ping; PENG Shu-you; KONG Ying; WANG Xuan; WANG Jian-wei; LI Jiang-tao; WANG Yong; CHEN Yan; CHEN De-qing; WENG Wei-hong

    2008-01-01

    Background It is well known that conventional splenectomy,which requires careful handling and ligation of tissue of the splenic hilum,can easily cause complications such as splenic fever and pancreatic fistula.Here,we use the technique of dissection of the secondary branches of the splenic pedicle to handle the hilum in the portal hypertension patients who are subjected to splenectomy.Methods We retrospectively compared and analyzed the complications,postoperative hospital stay,operative time,and occurrence of hemorrhage in 121 patients with portal hypertension undergoing splenectomy and devascularization of the gastric cardia from January 1999 to December 2007.The selected cases consisted of 51 patients undergoing conventional splenectomy and 70 patients undergoing dissection of secondary branches of the splenic pedicle.In addition,we analyzed the relationship between size of the spleen and occurrence of complications.Results The incidence of pancreatic fistula and splenic fever (0/70 and 9/70) was lower in patients undergoing dissection of secondary branches of the splenic pedicle as compared with that of the conventional group (5/51 and 18/51 respectively).In addition,there was no significant difference in operative time and volume of blood loss between two groups.The spleen thickness of those patients who had pancreatic fistula and splenic fever was significantly greater than those without complications.Conclusions These results indicate that dissection of secondary branches of the splenic pedicle in portal hypertension patients undergoing splenectomy can decrease the incidence of splenic fever and pancreatic fistula,and shorten the postoperative hospital stay,especially in the patients with a large spleen.So dissection of secondary branches of the splenic pedicle is a valuable technique for splenectomy.

  12. Assessing Cardiovascular Health Using Life's Simple 7 in a Chinese Population Undergoing Stroke Prevention

    Institute of Scientific and Technical Information of China (English)

    Qiong Yang; Bin Zhang; Pan Deng; Lu Chen; Jing-Ran Wang; Dong-Sheng Fan

    2015-01-01

    Background:The American Heart Association/American Stroke Association proposed a metric called Life's Simple 7 (LS7) to define cardiovascular health (CVH).The presence of a large number of ideal components of CVH is associated with lower cardiovascular disease and all-cause mortality.We aimed to assess CVH using LS7 in a Chinese population undergoing primary and secondary stroke prevention.Methods:Patients with either ischemic stroke or cardiovascular risk factors were enrolled in the study from October 2010 to July 2013.LS7 components were scored as poor (0 points),intermediate (1 point),or ideal (2 points).The overall LS7 score was categorized as inadequate (0-4),average (5-9),or optimal (10-14) CVH.The Chi-square test,Mann-Whitney U-test,and Kruskal-Wallis test were used.Results:In total,706 patients were enrolled.(1) The distribution of the overall LS7 score (n =255) indicated that 9.4%,82.4%,and 8.2% of the patients had inadequate,average,and optimal CVH,respectively.The proportion of patients with optimal CVH undergoing secondary stroke prevention was lower than that for patients undergoing primary stroke prevention (3.8% vs.12.8%,P =0.005).The vast majority of participants (76.1%) presented with ≤2 ideal health components.(2) The proportions of patients with poor,intermediate,and ideal status,respectively,for the following LS7 components were assessed:Total cholesterol (n =275; 5.1%,73.8%,and 21.1%),blood pressure (n =351 ;32.5%,59.0%,and 8.5%),blood glucose (n =280; 9.3%,39.6%,and 51.1%),physical activity (n =540; 90.7%,8.7%,and 0.6%),diet (n =524;0.2%,92.4%,and 7.4%),smoking (n =619; 20.7%,2.9%,and 76.4%),and body mass index (n =259; 6.6%,35.5%,and 57.9%).Conclusions:Few Chinese patients undergoing stroke prevention had optimal CVH (determined using LS7).Additionally,fewer patients undergoing secondary prevention had optimal CVH than those undergoing primary prevention.In particular,physical activity

  13. Comparison of Robotic vs. Standard Surgical Procedure on Postoperative Nursing Care of Women Undergoing Total Abdominal Hysterectomy.

    Science.gov (United States)

    Best, Janie; Day, Luanne; Ingram, Lori; Musgrave, Barbara; Rushing, Holli; Schooley, Brenda

    2014-01-01

    This exploratory study was conducted to determine if the postoperative course is different for women undergoing robotic-assisted total abdominal hysterectomy (TAH) compared to women undergoing traditional (open) TAH. This study adds to the evidence regarding potential benefits and complications of robotic-assisted gynecologic surgery, and identifies specific areas for further research.

  14. The correlation of anemia and contrast-induced nephropathy in patients with chronic kidney disease undergoing percutaneous coronary intervention

    Institute of Scientific and Technical Information of China (English)

    刘远辉

    2014-01-01

    Objective To investigate the correlation of anemia and contrast-induced nephropathy(CIN)in patients with chronic kidney disease(CKD)undergoing percutaneous coronary intervention(PCI).Methods A total of 292 patients with CKD undergoing PCI admitted to Guangdong General Hospital from October 2010 to December 2012were consecutively enrolled in this study.Anemia was

  15. Pulmonary vein orientation assessment: Is it necessary in patients undergoing contact force sensing guided radiofrequency catheter ablation of atrial fibrillation

    Directory of Open Access Journals (Sweden)

    Pim Gal

    2015-09-01

    Conclusions: This study shows that in patients undergoing PVI with the CFC ablation system, PV orientation does not affect CF and is not associated with AF free survival. PV orientation assessment does not appear to be necessary in patients undergoing CFC PVI.

  16. Health related quality of life in 2002 and 2015 in patients undergoing hemodialysis

    DEFF Research Database (Denmark)

    de Place Knudsen, Signe; Eidemak, I.; Molsted, Stig

    2016-01-01

    Health related quality of life (HRQOL) has become a recognized outcome in studies of the treatment of patients undergoing hemodialysis (HD). The aim of this study was to assess changes in HRQOL reported by two different samples of patients undergoing HD in the same dialysis center in 2002 and 2015....... Two samples of patients from the same Danish dialysis center completed the HRQOL questionnaire Kidney Disease Quality of Life version 1.3 in 2002 (n = 71) and 2015 (n = 81), respectively. The associations between KDQOL summery scores and the time frame were analyzed in multivariable regression...... analyses. The 2015 sample of patients were older compared to the 2002 sample (66 ± 13 vs. 59 ± 16 years, p = 0.003, respectively), they comprised more obese patients (20.6 vs. 3.2%, p = 0.002) and more patients with hypoalbuminemia (66.7 vs. 42.9%, p = 0.006). After confounder adjustment the time period...

  17. Management of patients with hematological malignancies undergoing coronary artery bypass grafting

    Directory of Open Access Journals (Sweden)

    Deepak Borde

    2013-01-01

    Full Text Available The number of patients with a previously diagnosed malignancy who need cardiac surgery is increasing. Patients with hematological malignancies represent only 0.38% of all patients undergoing cardiac surgery. The literature in this subset of patients is limited to only a few retrospective case series, with limited number of patients undergoing emergency cardiac surgery. We describe three cases with hematological malignancies namely chronic myelogenous leukemia, acute promyelocytic leukemia and chronic lymphocytic leukemia presenting for coronary artery bypass grafting (CABG. Two patients were taken up for emergency CABG in view of ongoing ischemia, one of them was on preoperative intra-aortic balloon pump support. No mortality was observed. Two patients needed transfusion of blood products which was guided by thromboelastography. One patient developed superficial sternal wound infection requiring antibiotic therapy.

  18. Preoperative ambulatory inspiratory muscle training in patients undergoing esophagectomy. A pilot study.

    Science.gov (United States)

    Agrelli, Taciana Freitas; de Carvalho Ramos, Marisa; Guglielminetti, Rachel; Silva, Alex Augusto; Crema, Eduardo

    2012-01-01

    A major decline in pulmonary function is observed on the first day after upper abdominal surgery. This decline can reduce vital and inspiratory capacity and can culminate in restrictive lung diseases that cause atelectasis, reduced diaphragm movement, and respiratory insufficiency. The objective of this study was to evaluate the efficacy of preoperative ambulatory respiratory muscle training in patients undergoing esophagectomy. The sample consisted of 20 adult patients (14 men [70%] and 6 women [30%]) with a diagnosis of advanced chagasic megaesophagus. A significant increase in maximum inspiratory pressure was observed after inspiratory muscle training when compared with baseline values (from -55.059 ± 18.359 to -76.286 ± 16.786). Preoperative ambulatory inspiratory muscle training was effective in increasing respiratory muscle strength in patients undergoing esophagectomy and contributed to the prevention of postoperative complications.

  19. Low prevalence of significant carotid artery disease in Iranian patients undergoing elective coronary artery bypass

    Directory of Open Access Journals (Sweden)

    Karimi Fatemeh

    2007-01-01

    Full Text Available Abstract Background Coronary artery bypass grafting ranks as one of the most frequent operations worldwide. The presence of carotid artery stenosis may increase the stroke rate in the perioperative period. Routine preoperative noninvasive assessment of the carotid arteries are recommended in many institutions to reduce the stroke rate. Methods 271 consecutive patients undergoing coronary artery bypass grafting at Shaheed Madani hospital of Tabriz, Iran (age, 58.5 Y; 73.1% male underwent preoperative ultrasonography for assessment of carotid artery wall thickness. Results Plaque in right common, left common, right internal and left internal carotid arteries was detected in 4.8%, 7.4%, 43.2% and 42.1% of patients respectively. 5 patients (1.8% had significant ( Conclusion Consecutive Iranian patients undergoing elective coronary artery bypass surgery show a very low prevalence of significant carotid artery disease.

  20. Recurrent Pseudomembranous Colitis in an Ovarian Cancer Patient Undergoing Carboplatin Chemotherapy.

    Science.gov (United States)

    Allen, Valerie A; Manahan, Kelly J; Geisler, John P

    2016-01-01

    Background. Diarrhea is a common problem in ovarian cancer patients undergoing chemotherapy and Clostridium difficile infection has been identified as a cause. The proper diagnosis and treatment of diarrhea are critical to patient care, especially to prevent the serious complications from a severe Clostridium difficile infection (CDI). Case. We present a heavily pretreated ovarian cancer patient who developed recurrent pseudomembranous colitis while receiving carboplatin chemotherapy. Despite treatment with oral metronidazole for fourteen days, the patient's diarrhea relapsed and colonoscopy revealed extensive pseudomembranous colitis. The infection eventually resolved with the combination of oral vancomycin and metronidazole. Conclusions. Diarrhea is a common problem in patients undergoing chemotherapy for ovarian cancer. Management requires obtaining the proper diagnosis. Clostridium difficile associated pseudomembranous colitis must be part of the differential diagnosis. Treatment must be sufficient to prevent relapses of the Clostridium difficile infection to prevent serious consequences in an already vulnerable patient population.

  1. Recurrent Pseudomembranous Colitis in an Ovarian Cancer Patient Undergoing Carboplatin Chemotherapy

    Directory of Open Access Journals (Sweden)

    Valerie A. Allen

    2016-01-01

    Full Text Available Background. Diarrhea is a common problem in ovarian cancer patients undergoing chemotherapy and Clostridium difficile infection has been identified as a cause. The proper diagnosis and treatment of diarrhea are critical to patient care, especially to prevent the serious complications from a severe Clostridium difficile infection (CDI. Case. We present a heavily pretreated ovarian cancer patient who developed recurrent pseudomembranous colitis while receiving carboplatin chemotherapy. Despite treatment with oral metronidazole for fourteen days, the patient’s diarrhea relapsed and colonoscopy revealed extensive pseudomembranous colitis. The infection eventually resolved with the combination of oral vancomycin and metronidazole. Conclusions. Diarrhea is a common problem in patients undergoing chemotherapy for ovarian cancer. Management requires obtaining the proper diagnosis. Clostridium difficile associated pseudomembranous colitis must be part of the differential diagnosis. Treatment must be sufficient to prevent relapses of the Clostridium difficile infection to prevent serious consequences in an already vulnerable patient population.

  2. Size Dependent Pore Formation in Germanium Nanowires Undergoing Reversible Delithiation Observed by In Situ TEM

    Energy Technology Data Exchange (ETDEWEB)

    Lu, Xiaotang; He, Yang; Mao, Scott X.; Wang, Chong-min; Korgel, Brian A.

    2016-12-22

    Germanium (Ge) nanowires coated with an amorphous silicon (Si) shell undergoing lithiation and delithiation were studied using in situ transmission electron microscopy (TEM). Delithiation creates pores in nanowires with diameters larger than ~25 nm, but not in smaller diameter nanowires. The formation of pores in Ge nanowires undergoing delithiation has been observed before in in situ TEM experiments, but there has been no indication that a critical diameter exists below which pores do not form. Pore formation occurs as a result of fast lithium diffusion compared to vacancy migration. We propose that a short diffusion path for vacancies to the nanowire surface plays a role in limiting pore formation even when lithium diffusion is fast.

  3. Nurses’ experiences of working in organizations undergoing restructuring: A metasynthesis of qualitative research studies

    DEFF Research Database (Denmark)

    Sørensen, Dorthe; Jensen, Anne Sofie Bøtcher

    2017-01-01

    experience working in organizations undergoing structural changes. Design: The review is designed as a metasynthesis and follows the guidelines put forth by Sandelowski and Barroso for synthesizing qualitative research. Data sources: From January to April 2015, literature searches were conducted......Background: Health care organizations worldwide undergo continual reconfiguration and structural changes in order to optimize the use of resources, reduce costs, and improve the quality of treatment. Objective: The objective of this study was to synthesize qualitative studies of how nurses...... in the CINAHL, PubMed, ProQuest, and Web of Science databases for the period from 1994 to 2014. Review methods: A total of 762 articles were found and screened, 12 of which were included in the review after being appraised using a specially designed reading guide. The inclusion criteria were qualitative studies...

  4. Prevalence of hepatitis C in patients with renal disease undergoing hemodialysis treatment

    Directory of Open Access Journals (Sweden)

    Marcos Frank Bastiani

    2014-10-01

    Full Text Available Introduction and Objective: This study aimed at determining the prevalence of hepatitis C among 649 patients diagnosed with chronic or acute kidney disease − patients were undergoing hemodialysis treatment at a large hemodialysis center in Porto Alegre-RS, from January through December, 2012 –, as well as relating our data to that presented in the national census, reporting cases of coinfection by hepatitis C and human immunodeficiency virus (HIV, and defining the demographic profile of these patients. Method: An observational cross-sectional study was conducted and data was obtained from information in patients’ electronic medical records. Result and conclusion: The prevalence of hepatitis C in this study was 10.17% of the sampled population. However, further analysis of other liver centers would be required to estimate an accurate prevalence rate of infection caused by the hepatitis C virus in patients undergoing hemodialysis in Porto Alegre.

  5. Seriously clowning: Medical clowning interaction with children undergoing invasive examinations in hospitals.

    Science.gov (United States)

    Tener, Dafna; Ofir, Shoshi; Lev-Wiesel, Rachel; Franco, Nessia L; On, Avi

    2016-04-01

    This qualitative study examined the subjective experience of children undergoing an invasive examination in the hospital when accompanied by a medical clown. In-depth semi-structured interviews were conducted with nine such children and nine of their accompanying parents. The children were patients in two outpatient departments (Pediatric Gastroenterology and a Center for the Sexually Abused) in a hospital in Israel. Interviews were coded thematically using an Atlas.ti software program. Analysis of the interviews indicated that the intervention of the clown positively changed the children's perceptions of the hospital, of experiencing the examination, and of their life narrative. Medical clowns thus appear to be a central, meaningful, and therapeutic source for children undergoing invasive examinations in hospital, as well as for their parents. Therefore, it may be advisable to incorporate medical clowns as an integral part of medical teams performing invasive procedures and to include the clowns in all stages of the hospital visit.

  6. Prevention and Control of Perioperative Incision Infection in Patients Undergoing Day Cataract Surgery

    Institute of Scientific and Technical Information of China (English)

    Chunyan Yang; Aihuan Chen; Yinghuan Wang; Xiaoqun Fang; Ronghua Ye; Jingyi Lin

    2014-01-01

    Purpose:.To explore the effects of the prevention and control of perioperative incision infection on the quality of day cataract surgery.Methods:.The nursing care and efficacy of 5087 patients un-dergoing day cataract surgery between October 2012 and Oc-tober 2013 were retrospectively reviewed. The disinfection and isolation guidance was established for perioperative prevention and control of infection,.topical administration of ocular a-gents, reexamination and healthcare instruction, and alterna-tive measures were taken.Results: All 5087 patients successfully underwent day surgery of phacoemulsification combined with intraocular lens im-plantation. All cases recovered without incision infection.Conclusion: Preoperative preparation, and intraoperative and postoperative prevention and control of infection serve as vital measures for effectively avoiding the incidence of incision in-fection in patients undergoing day cataract surgery. (Eye Science 2014; 29:182-185)

  7. Molecular Dynamics Simulations of Polymer Networks Undergoing Sequential Cross-Linking and Scission Reactions

    DEFF Research Database (Denmark)

    Rottach, Dana R.; Curro, John G.; Budzien, Joanne;

    2007-01-01

    The effects of sequential cross-linking and scission of polymer networks formed in two states of strain are investigated using molecular dynamics simulations. Two-stage networks are studied in which a network formed in the unstrained state (stage 1) undergoes additional cross-linking in a uniaxia......The effects of sequential cross-linking and scission of polymer networks formed in two states of strain are investigated using molecular dynamics simulations. Two-stage networks are studied in which a network formed in the unstrained state (stage 1) undergoes additional cross...... good agreement with the predictions of Flory and Fricker. It was found that the fractional stress reduction upon removal of the first-stage cross-links could be accurately calculated from the slip tube model of Rubinstein and Panyukov modified to use the theoretical transfer functions of Fricker.  ...

  8. Changes in preoperative characteristics in patients undergoing radical prostatectomy - a 16-year nationwide analysis

    DEFF Research Database (Denmark)

    Røder, Martin Andreas; Brasso, Klaus; Christensen, Ib Jarle;

    2013-01-01

    . Our hypothesis was that an increasing amount of men undergo RP for lower risk PCa. MATERIAL AND METHODS: All patients operated from 1995 to 2011 were identified via patient files and registries. Changes over time in age at surgery, preoperative PSA, clinical T-category, biopsy Gleason score (GS....... This effect is most likely attributed to an increasing use of PSA as marker for early prostate cancer diagnosis in Denmark and new international guidelines for Gleason grading and scoring.......-risk patients increased significantly. The proportion of patients age 70 or above increased from 2% to 13% in the period studies. CONCLUSION: Significant preoperative stage- and Gleason grade migration was found in this complete Danish nationwide cohort of patients undergoing RP during the past 16 years...

  9. Postoperative infection and natural killer cell function following blood transfusion in patients undergoing elective colorectal surgery

    DEFF Research Database (Denmark)

    Jensen, L S; Andersen, A J; Christiansen, P M

    1992-01-01

    The frequency of infection in 197 patients undergoing elective colorectal surgery and having either no blood transfusion, transfusion with whole blood, or filtered blood free from leucocytes and platelets was investigated in a prospective randomized trial. Natural killer cell function was measured...... before operation and 3, 7 and 30 days after surgery in 60 consecutive patients. Of the patients 104 required blood transfusion; 48 received filtered blood and 56 underwent whole blood transfusion. Postoperative infections developed in 13 patients transfused with whole blood (23 per cent, 95 per cent...... function was significantly (P less than 0.001) impaired up to 30 days after surgery in patients transfused with whole blood. These data provide a strong case against the use of whole blood transfusion in patients undergoing elective colorectal surgery. Udgivelsesdato: 1992-Jun...

  10. Knee extensor muscle strength in middle-aged and older individuals undergoing arthroscopic partial meniscectomy

    DEFF Research Database (Denmark)

    Hall, Michelle; Juhl, Carsten B; Lund, Hans

    2015-01-01

    for a meniscal tear and used either a healthy control group or the contralateral leg to compare knee extensor muscle strength were included. Methodological quality was assessed using guidelines from the Centre for Reviews and Dissemination. RESULTS: Eleven studies, including predominately males were included (n......OBJECTIVE: People with meniscal tears are at high risk to develop or progress knee osteoarthritis. Knee extensor weakness is considered a risk factor for osteoarthritis and is often reported in these individuals. The purpose of this systematic review and meta-analysis was to investigate knee...... extensor strength in people undergoing an arthroscopic partial meniscectomy (APM). METHODS: Six databases (MEDLINE, CINAHL, SportDISCUS, EMBASE, PEDro and AMED) were searched up to June 22(nd) , 2014. Studies that measured knee extensor muscle strength in people aged 30 years and older undergoing APM...

  11. Does physical activity improve quality of life in cancer patients undergoing chemotherapy?

    Science.gov (United States)

    Kripp, Melanie; Heußer, Anna-Lena; Belle, Sebastian; Gerhardt, Axel; Merx, Kirsten; Hofmann, Wolf-Karsten; Hofheinz, Ralf-Dieter

    2015-01-01

    Improved cancer treatments have resulted in prolonged survival. Nevertheless, tumor symptoms and side effects still compromise physical activity and quality of life (QoL). We conducted an anonymous survey among cancer patients undergoing chemotherapy using standardized questionnaires: the 'Freiburger Fragebogen zur körperlichen Aktivität' (Freiburg Questionnaire on Physical Activity) and European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30. Two main questions were addressed: were there differences (1) in physical activity and QoL between patients who do not believe that sport could improve their QoL and those who believe it could (group A vs. B); and (2) in QoL between patients with a total activity (TA) cancer patients undergoing chemotherapy. © 2015 S. Karger GmbH, Freiburg.

  12. CUTANEOUS MANIFESTATIONS IN PATIENTS UNDERGOING HAEMODIALYSIS FOR END STAGE RENAL DISEASE

    Directory of Open Access Journals (Sweden)

    Gupta

    2015-04-01

    Full Text Available OBJECTIVE: To determine the frequency of cutaneous lesions in patients of chronic kidney disease (CKD undergoing haemodialysis. MATERIALS AND METHODS: 100 patients of CKD undergoing haemodialysis in the renal dialysis unit of R. L. Jalappa Hospital, Kolar . An informed consent was taken. Detailed history was taken and examination were carried out, noted and entered in a structured proforma. RESULTS: Out of 100 patients evaluated, 94% had skin changes. 68% patients were males and 32% were females. The most prevalent finding was pallor in 84% followed by xerosis present in 72% patients. Platynychia was seen in 48% with other findings being pigmentation chan ges, sparse hair and various nail changes. CONCLUSION: Chronic kidney disease is associated with complex array of cutaneous manifestations caused either by disease or treatment. The commonest are pallor, xerosis and platynychia in our study.

  13. Evaluation of self-esteem in cancer patients undergoing chemotherapy treatment

    Directory of Open Access Journals (Sweden)

    Marilia Aparecida Carvalho Leite

    2015-12-01

    Full Text Available Objective: to evaluate the self-esteem of cancer patients undergoing chemotherapy. Method: descriptive analytical cross-sectional study with a quantitative approach. Around 156 patients that attended an oncology unit of a mid-sized hospital participated in the study. Results: we found a higher frequency of patients with high self-esteem, but some of them showed average or low self-esteem. The scale showed a Cronbach's alpha value of 0.746, by considering its acceptable internal consistency for the evaluated items. No independent variables showed significant associations with self-esteem. Conclusion: the cancer patients evaluated have presented high self-esteem; thus, it becomes crucial for nursing to plan the assistance of patients undergoing chemotherapy treatments, which enables actions and strategies that meet their physical and psychosocial conditions, aiming to maintain and rehabilitate these people's emotional aspects.

  14. Kinetics of salivary pH after acidic beverage intake by patients undergoing orthodontic treatment.

    Science.gov (United States)

    Turssi, Cecilia P; Silva, Carolina S; Bridi, Enrico C; Amaral, Flavia Lb; Franca, Fabiana Mg; Basting, Roberta T

    2015-01-01

    The saliva of patients undergoing orthodontic treatment with fixed appliances can potentially present a delay in the diluting, clearing, and buffering of dietary acids due to an increased number of retention areas. The aim of this clinical trial was to compare salivary pH kinetics of patients with and without orthodontic treatment, following the intake of an acidic beverage. Twenty participants undergoing orthodontic treatment and 20 control counterparts had their saliva assessed for flow rate, pH, and buffering capacity. There was no significant difference between salivary parameters in participants with or without an orthodontic appliance. Salivary pH recovery following acidic beverage intake was slower in the orthodontic subjects compared to controls. Patients with fixed orthodontic appliances, therefore, seem to be at higher risk of dental erosion, suggesting that dietary advice and preventive care need to be implemented during orthodontic treatment.

  15. Can children undergoing ophthalmologic examinations under anesthesia be safely anesthetized without using an IV line?

    OpenAIRE

    Vigoda M; Latiff A; Murray T; Tutiven J; Berrocal A; Gayer S

    2011-01-01

    Michael M Vigoda, Azeema Latiff, Timothy G Murray, Jacqueline L Tutiven, Audina M Berrocal, Steven GayerBascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USAPurpose: To document that with proper patient and procedure selection, children undergoing general inhalational anesthesia for ophthalmologic exams (with or without photos, ultrasound, laser treatment, peri-ocular injection of chemotherapy, suture removal, and/or replacement of ocular prosthesis) can b...

  16. Single-Beat Noninvasive Imaging of Ventricular Endocardial and Epicardial Activation in Patients Undergoing CRT

    OpenAIRE

    Thomas Berger; Bernhard Pfeifer; Friedrich F Hanser; Florian Hintringer; Gerald Fischer; Michael Netzer; Thomas Trieb; Markus Stuehlinger; Wolfgang Dichtl; Christian Baumgartner; Otmar Pachinger; Michael Seger

    2011-01-01

    BACKGROUND: Little is known about the effect of cardiac resynchronization therapy (CRT) on endo- and epicardial ventricular activation. Noninvasive imaging of cardiac electrophysiology (NICE) is a novel imaging tool for visualization of both epi- and endocardial ventricular electrical activation. METHODOLOGY/PRINCIPAL FINDINGS: NICE was performed in ten patients with congestive heart failure (CHF) undergoing CRT and in ten patients without structural heart disease (control group). NICE is a f...

  17. PREVENTION OF SURGICAL WOUND INFECTION IN OBESE WOMEN UNDERGOING CAESAREAN SECTION: A RANDOMISED CONTROLLED TRIAL

    DEFF Research Database (Denmark)

    Hyldig, Nana; Vinter, Christina Anne; Kruse, Marie;

    2016-01-01

    Aim: Obese women undergoing caesarean section are at increased risk of surgical wound infection, which may lead to reduced quality of life, and increased health care cost. The aim is to evaluate the effect of incisional Negative Pressure Wound Therapy applied prophylactically in obese women......: The study is on-going. We expect to find a 50% reduction of wound infection when using iNPWT compared to standard dressings in this high-risk subpopulation....

  18. Family-Related Opinions and Stressful Situations Associated with Psychological Distress in Women Undergoing Infertility Treatment

    Directory of Open Access Journals (Sweden)

    Jiro Takaki

    2014-09-01

    Full Text Available The purpose of this study is to investigate how family-related opinions and stressful situations are related to psychological distress in women undergoing infertility treatment. The subjects in this cross-sectional study were recruited from female patients undergoing infertility treatment (n = 2540 at 70 infertility treatment institutions in Japan. Because of non-participation or missing data, the number of subjects included in the analysis was 635 (response rate, 25.0%. The family-related opinions and stressful situations were evaluated using the original questions. Psychological distress was assessed using a self-report measure, the Kessler Six-question Psychological Distress Scale (K6. The K6 scores of the following participants were significantly (p < 0.05 and independently high: those with more frequent miscarriage/stillbirth/abortions, those with repeated miscarriages as the cause of infertility, those with infertility of unknown causes, those living with no child, those having a low joint income with their partner, those with the opinion that “women should devote themselves to their household duties” those who had considered stopping treatment, those without the opinion that “married life without children is favorable” and those who had experienced stressful situations such as inadequate explanation by doctors, frustration of multiple failed attempts, differences of opinion with the partner, and lack of knowledge regarding when to stop treatment. Family-related opinions and stressful situations associated with psychological distress in women undergoing infertility treatment are outlined. The results of this study may contribute to the prevention of and care for psychological distress in female patients undergoing infertility treatment.

  19. Cortisol levels and sleep patterns in infants with orofacial clefts undergoing surgery

    Directory of Open Access Journals (Sweden)

    Mueller AA

    2014-10-01

    Full Text Available Andreas A Mueller,1,2 Nadeem Kalak,3 Katja Schwenzer-Zimmerer,1,2 Edith Holsboer-Trachsler,3 Serge Brand3,4 1Craniomaxillofacial Surgery, University of Basel and University Hospital of Basel, Basel, Switzerland; 2Hightech Research Center of Craniomaxillofacial Surgery, University of Basel, Basel, Switzerland; 3Psychiatric Clinics of the University of Basel, Center for Affective, Stress, and Sleep Disorders, Basel, Switzerland; 4Department of Sport and Health Science, Division of Sport Science, University of Basel, Basel, Switzerland Background: Traumatic events during early infancy might damage infants’ psychobiological functioning, such as sleep and cortisol secretion. Infants born with orofacial clefts (OFCs undergo functional, anatomical, and aesthetic surgery. The aim of the present study was to determine whether infants with OFC and undergoing OFC surgery show deteriorated sleep and cortisol secretion compared with healthy controls and with their presurgery status.Methods: A total of 27 infants with OFC (mean age: 22 weeks and 30 healthy controls (mean age: 23 weeks took part in the study. For infants with OFC, sleep actigraphy was performed and saliva cortisol was analyzed 5 days before, during, and 5 days after surgery. For controls, sleep and saliva cortisol were assessed similarly, except for the period taken up with surgery.Results: Compared with healthy controls, infants with OFC undergoing OFC surgery did not differ in sleep and cortisol secretion. Their sleep and cortisol secretion did deteriorate during the perisurgical period but recovered 5 days postsurgery. Conclusion: In infants with OFC undergoing corrective surgery, the pattern of results for sleep and cortisol suggests that OFC surgery does not seem to constitute a traumatic event with long-term consequences. Keywords: cortisol, sleep, orofacial cleft, surgery, infants

  20. Olmesartan, other antihypertensives, and chronic diarrhea among patients undergoing endoscopic procedures: a case-control study.

    Science.gov (United States)

    Greywoode, Ruby; Braunstein, Eric D; Arguelles-Grande, Carolina; Green, Peter H R; Lebwohl, Benjamin

    2014-09-01

    To investigate a recent association between the use of the angiotensin receptor-blocker (ARB) olmesartan and a severe enteropathy resembling celiac disease. We searched our endoscopy database for all outpatient esophagogastroduodenoscopy (EGD) or colonoscopy examinations in patients aged at least 50 years during the period January 1, 2007, to March 31, 2013. Cases were those whose examination indication was diarrhea, and controls were those whose examination indication was esophageal reflux (EGD) or colorectal cancer screening (colonoscopy). We compared cases with controls with regard to the proportion of those listing olmesartan among their medications. Secondary exposures were the proportion of those taking nonolmesartan ARBs or other antihypertensive medications. We also examined biopsy results to determine whether there were histologic changes associated with the use of olmesartan. We identified 2088 patients undergoing EGD and 12,428 patients undergoing colonoscopy meeting inclusion criteria. On multivariate analysis, there was no statistically significant association between olmesartan and diarrhea among those undergoing EGD (odds ratio, 1.99; 95% CI, 0.79-5.00) or colonoscopy (odds ratio, 0.63; 95% CI, 0.23-1.74). Review of pathology reports of the EGD and colonoscopy groups showed no association between the use of olmesartan and the histologic diagnosis of celiac disease (P=.61) or microscopic colitis (P=1.0), respectively. Our findings suggest that neither olmesartan nor other ARBs were associated with diarrhea among patients undergoing endoscopy. The spruelike enteropathy recently associated with olmesartan is likely a rare adverse effect and milder presentations are unlikely. Copyright © 2014 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  1. Dexmedetomidine for monitored anesthesia care in patients undergoing liberation procedure for multiple sclerosis: An observational study

    Directory of Open Access Journals (Sweden)

    Saurabh Anand

    2012-01-01

    Full Text Available Background: It has been postulated that Multiple sclerosis (MS stems from a narrowing in the veins that drain blood from the brain, known medically as chronic cerebrospinal venous insufficiency, or CCSVI. It has been proposed that balloon angioplasty should alleviate the symptoms of MS. This procedure is also known as "The Liberation Procedure." Accordingly, a clinical study was undertaken to determine the effects of dexmedetomidine in patients undergoing the liberation procedure. Aims: To assess the effectiveness of dexmedetomidine in providing adequate sedation and pain relief for patients undergoing the liberation procedure. Settings and design: A prospective, nonrandomized observational study of 60 consecutive adult patients undergoing the liberation procedure under monitored anesthesia care (MAC who will receive dexmedetomidine as an anesthetic agent. Methods: A total of 60 adult patients were enrolled in the study. Dexmedetomidine was administered to all patients in a loading dose of 1 mcg/kg, which was followed by a maintenance dose of 0.2-0.5 mcg/kg/h. The evaluation of quality of sedation was based on Ramsay Sedation and the quality of analgesia was assessed using the visual analog scale. The following parameters were measured continuously: heart rate, mean arterial pressure and hemoglobin oxygen saturation. Patients were asked to answer the question, "How would you rate your experience with the sedation you have received during surgery?" using a seven-point Likert-like verbal rating scale. Statistical analysis: Repeated measurements were analyzed by repeated measures ANOVA for HR and BP. Results: Most of our patients were satisfied with their sedation. In most of the patients, MAP and HR dropped after the bolus dose of dexmedetomidine, and the drop was statistically significant. Conclusions: Dexmedetomidine can be used as a sole sedative agent in patients undergoing the liberation procedure.

  2. Absorbed doses on patients undergoing tomographic exams for pre-surgery planning of dental implants

    Energy Technology Data Exchange (ETDEWEB)

    Zenobio, M.A.F. [Centro de Desenvolvimento da Tecnologia Nuclear, Comissao Nacional de Energia Nuclear, Caixa Postal 941, CEP 30123-970 Belo Horizonte, MG (Brazil)]. E-mail: silvata@cdtn.br; da Silva, T.A. [Centro de Desenvolvimento da Tecnologia Nuclear, Comissao Nacional de Energia Nuclear, Caixa Postal 941, CEP 30123-970 Belo Horizonte, MG (Brazil)]. E-mail: madelon@cdtn.br

    2007-06-15

    The thermoluminescent (TL) dosimetry was used to measure entrance skin absorbed doses at anatomical points close to critical organs of patients undergoing tomographic techniques as part of a pre-surgery planning for dental implants. The dosimetric procedure was applied in 19 patients, and absorbed doses could be measured with a combined uncertainty down to 14%. Results showed that patient doses may be increased by a factor of 20 in the helical computed tomography compared to panoramic and spiral conventional tomographic exams.

  3. [Evaluation of psychological fear in children undergoing head-up tilt test].

    Science.gov (United States)

    Chu, Wei-Hong; Wu, Li-Jia; Wang, Cheng; Lin, Ping; Li, Fang; Zhu, Li-Ping; Ran, Jing; Zou, Run-Mei; Liu, De-Yu

    2014-03-01

    To investigate the effects of different tilt angles of head-up tilt test (HUTT) and different responses to HUTT on the psychological fear in children undergoing the test. HUTT was performed on children with unexplained syncope or pre-syncope (107 cases: 52 males and 55 females), aged 5.5-17.8 years (mean 12.0±2.8 years). All subjects were randomly assigned to undergo HUTT at an angle of 60°, 70° or 80°; the negative cases underwent sublingual nitroglycerin-provocation HUTT at the same tilt angle. The Wong-Baker Faces Pain Rating Scale was used for self-assessment of psychological fear in subjects during HUTT at the end point of the test. The positive rate, hemodynamic changes and distribution of response types showed no significant differences between children at tilt angles of 60°, 70° and 80° (P>0.05). The greater the tilt angle, the higher the degree of psychological fear in children undergoing the test, but there were no significant differences between them (P>0.05). The degree of psychological fear in children who showed a positive response to HUTT (n=76) was significantly higher than that in children who showed a negative response (n=31) (Ppsychological fear in children undergoing the test, and the degree of psychological fear increases in children tested at tilt angles from 60° to 80°, but the differences have no statistical significance. A positive response to HUTT can significantly increase the psychological fear in children.

  4. Functional outcome of patients undergoing replantation of hand at wrist level-7 year experience

    OpenAIRE

    Ravi Kumar Mahajan; Seema Mittal

    2013-01-01

    Background: Replantation is defined as reattachment of amputated limb using neurovascular and musculoskeletal structures in order to obtain recovery of limb. Re-vascularisation involves all the above steps in case of limb injuries that result in a near total amputation. Aim and Objective : To study the functional outcome of patients undergoing replantation of hand at wrist level. Material and Methods: This is a retrospective study of patients who underwent replantation of total amputation of ...

  5. Hemostatic function to regulate perioperative bleeding in patients undergoing spinal surgery: A prospective observational study

    OpenAIRE

    KIMURA, Atsushi; Ohmori, Tsukasa; Sakata, Asuka; Endo, Teruaki; Inoue, Hirokazu; Nishimura, Satoshi; Takeshita, Katsushi

    2017-01-01

    Although bleeding is a common complication of surgery, routine laboratory tests have been demonstrated to have a low ability to predict perioperative bleeding. Better understanding of hemostatic function during surgery would lead to identification of high-risk patients for bleeding. Here, we aimed to elucidate hemostatic mechanisms to determine perioperative bleeding. We prospectively enrolled 104 patients undergoing cervical spinal surgery without bleeding diathesis. Blood sampling was perfo...

  6. Antibody Production in Response to Staphylococcal MS-1 Phage Cocktail in Patients Undergoing Phage Therapy

    OpenAIRE

    Maciej Żaczek; Marzanna Łusiak-Szelachowska; Ewa Jończyk-Matysiak; Beata Weber-Dąbrowska; Ryszard Międzybrodzki; Barbara Owczarek; Agnieszka Kopciuch; Wojciech Fortuna; Paweł Rogóż; Andrzej Górski

    2016-01-01

    In this study, we investigated the humoral immune response (through the release of IgG, IgA, and IgM antiphage antibodies) to a staphylococcal phage cocktail in patients undergoing experimental phage therapy at the Phage Therapy Unit, Medical Center of the Ludwik Hirszfeld Institute of Immunology and Experimental Therapy in Wrocław, Poland. We also evaluated whether occurring antiphage antibodies had neutralizing properties towards applied phages (K rate). Among 20 examined patients receiving...

  7. Renal Impairment and Prognosis of Patients with Atrial Fibrillation Undergoing Coronary Intervention - The AFCAS Trial.

    Directory of Open Access Journals (Sweden)

    Heli M Lahtela

    Full Text Available Renal impairment is a well-known risk factor for cardiovascular complications, but the effect of different stages of renal impairment on thrombotic/thromboembolic and bleeding complications in patients with atrial fibrillation (AF undergoing percutaneous coronary intervention (PCI remains largely unknown. We sought to evaluate the incidence and clinical impact of four stages of renal impairment in patients with AF undergoing PCI.We assessed renal function by estimated glomerular filtration rate (eGFR and outcomes in 781 AF patients undergoing PCI by using the data from a prospective European multicenter registry. End-points included all-cause mortality, major adverse cardiac and cerebrovascular events (MACCE and bleeding events at 12 months.A total of 195 (25% patients had normal renal function (eGFR ≥90 mL/min, 290 (37% mild renal impairment (eGFR 60-89, 263 (34% moderate renal impairment (eGFR 30-59 and 33 (4% severe renal impairment (eGFR <30. Degree of renal impairment remained an independent predictor of mortality and MACCE in an adjusted a Cox regression model. Even patients with mild renal impairment had a higher risk of all-cause mortality (HR 2.25, 95%CI 1.02-4.98, p=0.04 and borderline risk for MACCE (HR 1.56, 95%CI 0.98- 2.50, p=0.06 compared to those with normal renal function.Renal impairment is common in patients with AF undergoing PCI and even mild renal impairment has an adverse prognostic effect in these patients requiring multiple antithrombotic medications.

  8. Signs of knee osteoarthritis common in 620 patients undergoing arthroscopic surgery for meniscal tear

    OpenAIRE

    Pihl, Kenneth; Englund, Martin; Lohmander, L Stefan; Jørgensen, Uffe; Nissen, Nis; Schjerning, Jeppe; Thorlund, Jonas Bloch

    2016-01-01

    Background and purpose - Recent evidence has questioned the effect of arthroscopic knee surgery for middle-aged and older patients with degenerative meniscal tears with or without concomitant radiographic knee osteoarthritis (OA). We investigated the prevalence of early or more established knee OA and patients' characteristics in a cohort of patients undergoing arthroscopic surgery for a meniscal tear. Patients and methods - 641 patients assigned for arthroscopy on suspicion of meniscus tear ...

  9. Epidemiology of viral hepatitis among patients undergoing hemodialysis at nephrology center Benghazi

    OpenAIRE

    Vinay Rao; Prasannalakshmi Rao

    2014-01-01

    Introduction: During hemodialysis, patients are at-risk of acquiring blood-borne viruses and pathogenic bacteria. Within dialysis units, prevention of infection is of paramount importance. The nursing staff must take adequate precaution to prevent the spread of infection within this high-risk environment. Patients and Methods: All patients undergoing hemodialysis for the period of 7 days were interviewed once during dialysis, using a closed-ended questionnaire. Patients′ files were checked fo...

  10. Risk factors for laboratory-confirmed bloodstream infection in neonates undergoing surgical procedures

    Directory of Open Access Journals (Sweden)

    Roberta Maia de Castro Romanelli

    Full Text Available Background Healthcare Associated Infections constitute an important problem in Neonatal Units and invasive devices are frequently involved. However, studies on risk factors of newborns who undergo surgical procedures are scarce. Objective To identify risk factors for laboratory-confirmed bloodstream infection in neonates undergoing surgical procedures. Methods This case–control study was conducted from January 2008 to May 2011, in a referral center. Cases were of 21 newborns who underwent surgery and presented the first episode of laboratory-confirmed bloodstream infection. Control was 42 newborns who underwent surgical procedures without notification of laboratory-confirmed bloodstream infection in the study period. Information was obtained from the database of the Hospital Infection Control Committee Notification of infections and related clinical data of patients that routinely collected by trained professionals and follow the recommendations of Agência Nacional de Vigilância Sanitária and analyzed with Statistical Package for Social Sciences. Results During the study period, 1141 patients were admitted to Neonatal Unit and 582 Healthcare Associated Infections were reported (incidence-density of 25.75 Healthcare Associated Infections/patient-days. In the comparative analysis, a higher proportion of laboratory-confirmed bloodstream infection was observed in preterm infants undergoing surgery (p = 0.03 and use of non-invasive ventilation was a protective factor (p = 0.048. Statistically significant difference was also observed for mechanical ventilation duration (p = 0.004, duration of non-invasive ventilation (p = 0.04, and parenteral nutrition duration (p = 0.003. In multivariate analysis duration of parenteral nutrition remained significantly associated with laboratory-confirmed bloodstream infection (p = 0.041. Conclusions Shortening time on parenteral nutrition whenever possible and preference for non-invasive ventilation in neonates

  11. Multidisciplinary Management of Complicated Crown-Root Fracture of an Anterior Tooth Undergoing Apexification

    OpenAIRE

    Merve Mese; Merve Akcay; Bilal Yasa; Huseyin Akcay

    2015-01-01

    The purpose of this case report was to present the multidisciplinary management of a subgingival crown-root fracture of a patient undergoing apexification treatment. A 12-year-old male patient was referred to the pediatric dentistry clinic with an extensive tooth fracture of the right permanent maxillary lateral incisor. Clinical and radiographic examinations revealed the presence of a complicated crown-root fracture, which had elongated to the buccal subgingival area. The dental history disc...

  12. Erectile Dysfunction Among HIV Patients Undergoing Highly Active Antiretroviral Therapy: Dyslipidemia as a Main Risk Factor

    Directory of Open Access Journals (Sweden)

    Gustavo Romero‐Velez, MD

    2014-04-01

    Conclusions: ED is highly prevalent in HIV patients. Dyslipidemia should be considered as a risk factor for ED in HIV patients. Romero‐Velez G, Lisker‐Cervantes A, Villeda‐Sandoval CI, Sotomayor de Zavaleta M, Olvera‐Posada D, Sierra‐Madero JG, Arreguin‐Camacho LO, and Castillejos‐Molina RA. Erectile dysfunction among HIV patients undergoing highly active antiretroviral therapy: Dyslipidemia as a main risk factor. Sex Med 2014;2:24–30.

  13. Effects of recreational soccer in men with prostate cancer undergoing androgen deprivation therapy

    DEFF Research Database (Denmark)

    Uth, Jacob; Schmidt, Jakob Friis; Christensen, Jesper Frank

    2013-01-01

    Androgen deprivation therapy (ADT) is a cornerstone in the treatment of advanced prostate cancer. Adverse musculoskeletal and cardiovascular effects of ADT are widely reported and investigations into the potential of exercise to ameliorate the effects of treatment are warranted. The 'Football Club...... (FC) Prostate' study is a randomized trial comparing the effects of soccer training with standard treatment approaches on body composition, cardiovascular function, physical function parameters, glucose tolerance, bone health, and patient-reported outcomes in men undergoing ADT for prostate cancer....

  14. Interhospital Transport of Children Undergoing Cardiopulmonary Resuscitation: A Practical and Ethical Dilemma.

    Science.gov (United States)

    Noje, Corina; Fishe, Jennifer N; Costabile, Philomena M; Klein, Bruce L; Hunt, Elizabeth A; Pronovost, Peter J

    2017-10-01

    To discuss risks and benefits of interhospital transport of children in cardiac arrest undergoing cardiopulmonary resuscitation. Narrative review. Not applicable. Transporting children in cardiac arrest with ongoing cardiopulmonary resuscitation between hospitals is potentially lifesaving if it enables access to resources such as extracorporeal support, but may risk transport personnel safety. Research is needed to optimize outcomes of patients transported with ongoing cardiopulmonary resuscitation and reduce risks to the staff caring for them.

  15. "Wet diapers--dry patients": an effective dressing for patients undergoing arthroscopic shoulder surgery.

    Science.gov (United States)

    Kapila, Atul; Bhargava, Amit; Funk, Len; Copeland, Stephen; Levy, Ofer

    2005-02-01

    Shoulder arthroscopy is very commonly associated with postoperative leakage of irrigation fluid. This causes apprehension to patients and their relatives and leads to frequent change of dressings. We describe a simple and effective diaper dressing for patients undergoing arthroscopic shoulder surgery. It is highly absorbent, cost-effective, and easy to apply. We have used this dressing successfully in more than 1,500 shoulder arthroscopies over the last 3 years with no adverse reaction.

  16. Comparison of two antiplatelet therapy strategies in patients undergoing transcatheter aortic valve implantation.

    Science.gov (United States)

    Durand, Eric; Blanchard, Didier; Chassaing, Stephan; Gilard, Martine; Laskar, Marc; Borz, Bogdan; Lafont, Antoine; Barbey, Christophe; Godin, Matthieu; Tron, Christophe; Zegdi, Rachid; Chatel, Didier; Le Page, Olivier; Litzler, Pierre-Yves; Bessou, Jean-Paul; Danchin, Nicolas; Cribier, Alain; Eltchaninoff, Hélène

    2014-01-15

    Dual antiplatelet therapy is commonly used in patients undergoing transcatheter aortic valve implantation (TAVI), but the optimal antiplatelet regimen is uncertain and remains to be determined. The objective of this study was to compare 2 strategies of antiplatelet therapy in patients undergoing TAVI. A strategy using monoantiplatelet therapy (group A, n = 164) was prospectively compared with a strategy using dual antiplatelet therapy (group B, n = 128) in 292 consecutive patients undergoing TAVI. The primary end point was a combination of mortality, major stroke, life-threatening bleeding (LTB), myocardial infarction, and major vascular complications at 30 days. All adverse events were adjudicated according to the Valve Academic Research Consortium. The primary end point occurred in 22 patients (13.4%) in the group A and in 30 patients (23.4%) in the group B (hazard ratio 0.51, 95% confidence interval 0.28 to 0.94, p = 0.026). LTB (3.7% vs 12.5%, p = 0.005) and major bleedings (2.4% vs 13.3%, p antiplatelet therapy persisted after multivariate adjustment and propensity score analysis (hazard ratio 0.53, 95% confidence interval 0.28 to 0.95, p = 0.033). In conclusion, a strategy using mono versus dual antiplatelet therapy in patients undergoing TAVI reduces LTB and major bleedings without increasing the risk of stroke and myocardial infarction. The results of our study question the justification of dual antiplatelet therapy and require confirmation in a randomized trial. Copyright © 2014 Elsevier Inc. All rights reserved.

  17. Determinants of outcome for patients undergoing lumbar discectomy: a pilot study.

    LENUS (Irish Health Repository)

    Hickey, Oonagh T

    2010-08-01

    One-third of patients who undergo lumbar discectomy continue to suffer from persistent pain postoperatively. Greater preoperative warmth thresholds and greater preoperative cerebrospinal fluid concentrations of stable serum nitric oxide metabolites are associated with a worse outcome. The principal objective of this study was to examine the relationship between patient outcome (defined using the Modified Stauffer-Coventry evaluating criteria) and preoperative pain perception threshold to an electrical stimulus.

  18. Sleep disturbances and changes in urinary 6-sulphatoxymelatonin levels in patients with breast cancer undergoing lumpectomy

    DEFF Research Database (Denmark)

    Voigt Hansen, Melissa; Madsen, M T; Wildschiødtz, Gordon

    2013-01-01

    Sleep disturbances and changes in self-reported discomfort and melatonin secretion are common in the post-operative period. We aimed to study the distribution of sleep stages in the perioperative period and evaluate changes in secretion of the melatonin metabolite aMT6s and subjective parameters ...... of sleepiness, pain, general well-being and fatigue in patients undergoing surgery for breast cancer....

  19. Recurrent Pseudomembranous Colitis in an Ovarian Cancer Patient Undergoing Carboplatin Chemotherapy

    OpenAIRE

    2016-01-01

    Background. Diarrhea is a common problem in ovarian cancer patients undergoing chemotherapy and Clostridium difficile infection has been identified as a cause. The proper diagnosis and treatment of diarrhea are critical to patient care, especially to prevent the serious complications from a severe Clostridium difficile infection (CDI). Case. We present a heavily pretreated ovarian cancer patient who developed recurrent pseudomembranous colitis while receiving carboplatin chemotherapy. Despite...

  20. A Pilot Study of Ketamine versus Midazolam/Fentanyl Sedation in Children Undergoing GI Endoscopy

    OpenAIRE

    Lightdale, Jenifer R; Mitchell, Paul D; Fredette, Meghan E.; Mahoney, Lisa B.; Zgleszewski, Steven E.; Lisa Scharff; Fox, Victor L

    2011-01-01

    Background. Ketamine sedation has been found superior by physician report to traditional sedation regimens for pediatric endoscopy. Goal. To objectively compare sedation with ketamine versus midazolam/fentanyl for children undergoing gastrointestinal endoscopy. Study. Patients received one of two regimens and were independently monitored using a standardized rating scale. Results. There were 2 episodes of laryngospasm during ketamine sedation. Univariate analyses showed patients sedated with ...

  1. The Investigation of Nail Disorders in Patients with Chronic Renal Failure Undergoing Hemodialysis

    OpenAIRE

    Perihan Öztürk; Neslihan Dokur; Ergül Kurutaş; Ekrem Doğan; Tuğba Karakaş; Murat Kalender; Hasan Ekerbiçer

    2012-01-01

    Objective: Nail changes are often observed in patients with end-stage renal disease. These changes may occur due to chronic renal failure itself or to the treatment. This study aims to investigate the frequency of nail findings in patients undergoing hemodialysis therapy and to compare with healthy controls. Methods: One hundred and four patients with chronic renal failure treated with hemodialysis, and 104 healthy controls without any dermatological and sistemic diseases, were examined fo...

  2. Measuring preoperative anxiety in patients undergoing elective surgery in Czech Republic

    OpenAIRE

    Pavlína Homzová; Renáta Zeleníková

    2015-01-01

    Aim: The main aim of the study was to measure preoperative anxiety in patients in the Czech Republic before elective surgery, using the Visual Analogue Scale for Anxiety (VAS-A). Design: A cross-sectional descriptive study. Methods: The sample consisted of 344 patients undergoing elective surgery. The day before surgery patients completed a questionnaire consisting of demographic data, the Amsterdam Preoperative Anxiety and Information Scale (APAIS) and the VAS-A. Spearman correlation was use...

  3. Gastrointestinal symptoms in patients undergoing peritoneal dialysis: Multivariate analysis of correlated factors

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    AIM: To investigate gastrointestinal (GI) symptoms in peritoneal dialysis (PD) patients and to explore related factors contributing to GI symptoms. METHODS: One hundred and twelve patients undergoing PD participated in the study. The gastrointestinal symptom rating scale was used for measuring GI symptoms. Information on age, height, weight, body mass index, disease leading to chronic renal failure, history of corticosteroid therapy, presence of predialytic GI symptoms, daily dosage of pills, and duration, ...

  4. Effects of Low-Flow Sevoflurane Anesthesia on Pulmonary Functions in Patients Undergoing Laparoscopic Abdominal Surgery

    OpenAIRE

    Cihan Doger; Kadriye Kahveci; Dilsen Ornek; Abdulkadir But; Mustafa Aksoy; Derya Gokcinar; Didem Katar

    2016-01-01

    Objective. The aim of this prospective, randomized study was to investigate the effects of low-flow sevoflurane anesthesia on the pulmonary functions in patients undergoing laparoscopic cholecystectomy. Methods. Sixty American Society of Anesthesiologists (ASA) physical status classes I and II patients scheduled for elective laparoscopic cholecystectomy were included in the study. Patients were randomly allocated to two study groups: high-flow sevoflurane anesthesia group (Group H, n = 30) an...

  5. Is EuroSCORE applicable to Indian patients undergoing cardiac surgery?

    Directory of Open Access Journals (Sweden)

    Malik Madhur

    2010-01-01

    Full Text Available Indian patients undergoing cardiac surgery have different demographics, clinical profile as well as risk profile, compared to the western population. The purpose of this study was to validate the European System for Cardiac Operative Risk Evaluation (EuroSCORE risk stratification model in Indian patients undergoing cardiac surgery in a single cardiac center. Data from 1000 consecutive adult patients undergoing cardiac surgery (coronary artery bypass grafting or valve surgery were prospectively collected as per the EuroSCORE model. The model′s validity was assessed on the basis of its calibration power (Hosmer-Lemeshow test and discriminatory power [area under receiver operating characteristic curve]. The patients were divided into three risk groups on the basis of their EuroSCORE. The Hosmer-Lemeshow test revealed a good calibration power (P = 0.73 and the area under the ROC curve was 0.8278, suggesting a good discriminative power. The predicted mortality was similar to observed mortality in low- and moderate-risk patients but the observed mortality in high-risk patients (15.6% was double that of predicted mortality (7.5%. The risk factors prevalent in European population were not observed in Indian population. EuroSCORE accurately predicts mortality in low and moderate-risk Indian patients undergoing cardiac surgery but is less predictive for high-risk Indian patients. Updating and improvisation of EuroSCORE by incorporation of risk factors associated with rheumatic valvular heart disease which is more prevalent in India, may enable it to accurately predict mortality in high-risk patients also.

  6. Compressive cryotherapy versus cryotherapy alone in patients undergoing knee surgery: a meta-analysis

    OpenAIRE

    Song, Mingzhi; Sun, Xiaohong; Tian, Xiliang; Zhang, Xianbin; Shi, Tieying; SUN, RAN; Dai, Wei

    2016-01-01

    Aim This study aims to conduct a meta-analysis to identify and compare the effectiveness of compressive cryotherapy and cryotherapy alone for patients undergoing knee surgery. Background Postoperative management is an important guarantee for the success of surgery. Cryotherapy and compression are two common nursing techniques after knee surgery, and are considered to be effective for postoperative clinical symptoms such as local pain and swelling. However, no previous meta-analyses have compa...

  7. Management of gallstones and gallbladder disease in patients undergoing gastric bypass

    Institute of Scientific and Technical Information of China (English)

    Bernabé; M; Quesada; Gustavo; Kohan; Hernán; E; Roff; Carlos; M; Canullán; Luis; T; Chiappetta; Porras

    2010-01-01

    The appropriate management of gallstones and gallbladder disease in patients undergoing gastric bypass remains unknown.Several therapeutic modalities are used and include performing cholecystectomy on all patients at the time of gastric bypass,performing concomitant cholecystectomy only when patients have gallstones and performing cholecystectomy only in the presence of both symptoms and gallstones.Some groups administer ursodeoxycholic acid for gallstone prevention in the postoperative period.All treatment...

  8. Using media to improve the informed consent process for youth undergoing pediatric endoscopy and their parents

    Science.gov (United States)

    Yeh, Debra M.; Chun, Stanford; Terrones, Laura; Huang, Jeannie S.

    2017-01-01

    Background and study aims Youth undergoing pediatric endoscopic procedures and their parents demonstrate suboptimal comprehension of the informed consent (IC) process. We developed informational videos discussing key IC elements for pediatric endoscopy and evaluated their effects on youth and parental comprehension of the IC process. Patients and methods A randomized controlled trial of the video intervention was performed among youth undergoing endoscopy and their parents at an academic children’s hospital. Randomization occurred at the time of enrollment using permutated blocks. Following the IC process with the proceduralist, subjects underwent structured interviews to assess IC comprehension. An Informed Consent Overall Score (ICOS: range 0 – 4) for comprehension was calculated. Results Seventy-seven pairs of children and their parents participated. Intervention recipients (N = 37 pairs) demonstrated higher ICOS scores as compared to control counterparts (mean (standard deviation): 3.6 (0.7) v. 2.9 (0.9), intervention v. control parents, P < 0.0001 and 2.7 (1.1) v. 1.7 (1.1), intervention v. control youth, P < 0.0001). Conclusions A media intervention addressing key elements of the IC process for pediatric endoscopy was effective in improving comprehension of IC for youth undergoing endoscopic procedures and their parents. PMID:28191495

  9. Fragmented QRS for Risk Stratification in Patients Undergoing First Diagnostic Coronary Angiography

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    Eyuboglu, Mehmet; Ekinci, Mehmet Akif; Karakoyun, Suleyman; kucuk, Ugur; Senarslan, Omer; Akdeniz, Bahri

    2016-01-01

    Background Only a small proportion of patients referred for coronary angiography with suspected coronary artery disease (CAD) have the diagnosis of obstructive CAD confirmed by the exam. For this reason, further strategies for risk stratification are necessary. Objective To investigate the relationship of the presence of fragmented QRS (fQRS) on admission electrocardiogram with angiographically detected CAD and CAD severity in patients without known vascular diseases and myocardial fibrosis, undergoing first diagnostic coronary angiography. Methods We enrolled 336 consecutive patients undergoing coronary angiography for suspected CAD. The patients were divided into two groups according to the presence or absence of fQRS on admission. We compared the groups regarding the presence and severity of CAD. Results Seventy-nine (23.5%) patients had fQRS on admission. There was not a statistically significant difference between patients with fQRS (41.8%) and non-fQRS (30.4%), regarding the presence of CAD (p = 0.059). However, there was a statistically significant difference between patients with fQRS and non-fQRS regarding the presence of stenotic CAD (40.5% vs. 10.5%, p22 compared to patients with SYNTAX score ≤22. Conclusions Our findings suggest that fQRS may be an indicator of early-stage myocardial damage preceding the appearance of fibrosis and scar, and may be used for risk stratification in patients undergoing first diagnostic coronary angiography PMID:27849256

  10. Dose audit for patients undergoing two common radiography examinations with digital radiology systems.

    Science.gov (United States)

    İnal, Tolga; Ataç, Gökçe

    2014-01-01

    We aimed to determine the radiation doses delivered to patients undergoing general examinations using computed or digital radiography systems in Turkey. Radiographs of 20 patients undergoing posteroanterior chest X-ray and of 20 patients undergoing anteroposterior kidney-ureter-bladder radiography were evaluated in five X-ray rooms at four local hospitals in the Ankara region. Currently, almost all radiology departments in Turkey have switched from conventional radiography systems to computed radiography or digital radiography systems. Patient dose was measured for both systems. The results were compared with published diagnostic reference levels (DRLs) from the European Union and International Atomic Energy Agency. The average entrance surface doses (ESDs) for chest examinations exceeded established international DRLs at two of the X-ray rooms in a hospital with computed radiography. All of the other ESD measurements were approximately equal to or below the DRLs for both examinations in all of the remaining hospitals. Improper adjustment of the exposure parameters, uncalibrated automatic exposure control systems, and failure of the technologists to choose exposure parameters properly were problems we noticed during the study. This study is an initial attempt at establishing local DRL values for digital radiography systems, and will provide a benchmark so that the authorities can establish reference dose levels for diagnostic radiology in Turkey.

  11. Metabolic syndrome in patients with prostate cancer undergoing intermittent androgen-deprivation therapy

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    Rezaei, Mohammadali Mohammadzadeh; Rezaei, Mohammadhadi Mohammadzadeh; Ghoreifi, Alireza; Kerigh, Behzad Feyzzadeh

    2016-01-01

    Introduction: The presence of metabolic syndrome in men with prostate cancer (PCa) undergoing androgen-deprivation therapy (ADT), especially intermittent type, has not been completely evaluated. The aim of this study is to evaluate metabolic syndrome in men with PCa undergoing intermittent ADT. Methods: In this longitudinal study, we studied the prevalence of metabolic syndrome and its components in 190 patients who were undergoing intermittent ADT. The metabolic syndrome was defined according to the Adult Treatment Panel III criteria. All metabolic parameters, including lipid profile, blood glucose, blood pressures, and waist circumferences of the patients were measured six and 12 months after treatment. Results: Mean age of the patients was 67.5 ± 6.74 years. The incidence of metabolic syndrome after six and 12 months was 6.8% and 14.7%, respectively. Analysis of various components of the metabolic syndrome revealed that patients had significantly higher overall prevalence of hyperglycemia, abdominal obesity, and hypertriglyceridemia in their six- and 12-month followups, but blood pressure has not been changed in the same period except for diastolic blood pressure after six months. Conclusions: Although there was an increased risk of metabolic syndrome in patients receiving intermittent ADT, it was lower than other studies that treated the same patients with continuous ADT. Also it seems that intermittent ADT has less metabolic complications than continuous ADT and could be used as a safe alternative in patients with advanced and metastatic PCa. PMID:27695584

  12. Comparison of propofol versus sevoflurane on thermoregulation in patients undergoing transsphenoidal pituitary surgery: A preliminary study

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    Tumul Chowdhury

    2012-01-01

    Full Text Available Purpose: General anesthesia causes inhibition of thermoregulatory mechanisms. Propofol has been reported to cause more temperature fall, but in case of deliberate mild hypothermia, both sevoflurane and propofol were comparable. Thermoregulation is found to be disturbed in cases of pituitary tumors. We aimed to investigate which of the two agents, sevoflurane or propofol, results in better preservation of thermoregulation in patients undergoing transsphenoidal excision of pituitary tumors. Methods: Twenty-six patients scheduled to undergo transsphenoidal removal of pituitary adenomas were randomly allocated to receive propofol or sevoflurane anesthesia. Baseline esophageal temperature was noted. Times for temperature to fall by 1°C or 35°C and to return to baseline were also comparable ( P>0.05. After that warmer was started at 43°C and time to rise to baseline was noted. Duration of surgery, total blood loss, and total fluid intake were also noted. If any, side effects such as delayed arousal and recovery from muscle relaxant were noted. Results: The demographics of the patients were comparable. Duration of surgery and total blood loss were comparable in the two groups. The time for temperature to fall by 1°C or 35°C and time to return to baseline was also comparable ( P>0.05. No side effects related to body temperature were noted. Conclusion: Both propofol and sevoflurane show similar effects in maintaining thermal homeostasis in patients undergoing transsphenoidal pituitary surgery.

  13. Prospective Randomized Controlled Trial of Liberal Vs Restricted Perioperative Fluid Management in Patients Undergoing Pancreatectomy.

    Science.gov (United States)

    Grant, Florence; Brennan, Murray F; Allen, Peter J; DeMatteo, Ronald P; Kingham, T Peter; D'Angelica, Michael; Fischer, Mary E; Gonen, Mithat; Zhang, Hao; Jarnagin, William R

    2016-10-01

    The aim of this study is to examine, by a prospective randomized controlled trial, the influence of liberal (LIB) vs restricted (RES) perioperative fluid administration on morbidity following pancreatectomy. Randomized controlled trials in patients undergoing major intra-abdominal surgery have challenged the historical use of LIB fluid administration, suggesting that a more restricted regimen may be associated with fewer postoperative complications. Patients scheduled to undergo pancreatic resection were consented for randomization to a LIB (n = 164) or RES (n = 166) perioperative fluid regimen. Sample size was designed with 80% power to decrease Grade 3 complications from 35% to 21%. Between July 2009 and July 2015, we randomized 330 patients undergoing pancreaticoduodenectomy (PD, n = 218), central (n = 16), or distal pancreatectomy (DP, n = 96). Patients were equally distributed for all demographic and intraoperative characteristics. Intraoperatively, LIB patients received crystalloid 12 mL/kg/h and RES patients 6 mL/kg/h. Cumulative crystalloid given (median, range, mL) days 0 to 3 was LIB: 12,252 (6600 to 21,365), RES 7808 (2700 to 16,274) P LIB and 27% of RES patients (P = 0.6). Median length of stay was 7 and 5 days for PD and DP, respectively, in both arms. In a high volume institution, major perioperative complications from pancreatic resection were not significantly influenced by fluid regimens that differed approximately 1.6-fold.

  14. Smoker's Paradox in Patients With ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention.

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    Gupta, Tanush; Kolte, Dhaval; Khera, Sahil; Harikrishnan, Prakash; Mujib, Marjan; Aronow, Wilbert S; Jain, Diwakar; Ahmed, Ali; Cooper, Howard A; Frishman, William H; Bhatt, Deepak L; Fonarow, Gregg C; Panza, Julio A

    2016-04-22

    Prior studies have found that smokers undergoing thrombolytic therapy for ST-segment elevation myocardial infarction have lower in-hospital mortality than nonsmokers, a phenomenon called the "smoker's paradox." Evidence, however, has been conflicting regarding whether this paradoxical association persists in the era of primary percutaneous coronary intervention. We used the 2003-2012 National Inpatient Sample databases to identify all patients aged ≥18 years who underwent primary percutaneous coronary intervention for ST-segment elevation myocardial infarction. Multivariable logistic regression was used to compare in-hospital mortality between smokers (current and former) and nonsmokers. Of the 985 174 patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention, 438 954 (44.6%) were smokers. Smokers were younger, were more often men, and were less likely to have traditional vascular risk factors than nonsmokers. Smokers had lower observed in-hospital mortality compared with nonsmokers (2.0% versus 5.9%; unadjusted odds ratio 0.32, 95% CI 0.31-0.33, Pparadox also applies to ST-segment elevation myocardial infarction patients undergoing primary percutaneous coronary intervention. © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  15. Inspiratory Muscle Training and Functional Capacity in Patients Undergoing Cardiac Surgery

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    André Luiz Lisboa Cordeiro

    Full Text Available Abstract Introduction: Cardiac surgery is a highly complex procedure which generates worsening of lung function and decreased inspiratory muscle strength. The inspiratory muscle training becomes effective for muscle strengthening and can improve functional capacity. Objective: To investigate the effect of inspiratory muscle training on functional capacity submaximal and inspiratory muscle strength in patients undergoing cardiac surgery. Methods: This is a clinical randomized controlled trial with patients undergoing cardiac surgery at Instituto Nobre de Cardiologia. Patients were divided into two groups: control group and training. Preoperatively, were assessed the maximum inspiratory pressure and the distance covered in a 6-minute walk test. From the third postoperative day, the control group was managed according to the routine of the unit while the training group underwent daily protocol of respiratory muscle training until the day of discharge. Results: 50 patients, 27 (54% males were included, with a mean age of 56.7±13.9 years. After the analysis, the training group had significant increase in maximum inspiratory pressure (69.5±14.9 vs. 83.1±19.1 cmH2O, P=0.0073 and 6-minute walk test (422.4±102.8 vs. 502.4±112.8 m, P=0.0031. Conclusion: We conclude that inspiratory muscle training was effective in improving functional capacity submaximal and inspiratory muscle strength in this sample of patients undergoing cardiac surgery.

  16. Anti-Phospholipid Antibodies in Patients Undergoing Total Joint Replacement Surgery

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    Melissa Simpson

    2012-01-01

    Full Text Available Background. Patients undergoing joint replacement remain at increased risk for venous thromboembolism (VTE compared to other types of surgery, regardless of thromboprophylactic regimen. The pathophysiologic processes rendering this group of patients at risk for VTE are multifactorial. Procedure-specific and patient-specific exposures play a role in the postoperative development of VTE, including the development of anti-phospholipid antibodies (aPL. Methods. We measured three aPL (anti-cardiolipin, anti-β2 glycoprotein, and lupus anticoagulant in 123 subjects undergoing total knee or hip arthroplasty to describe the presence of these antibodies preoperatively and to describe the rate of postoperative seroconversion among those people who were negative preoperatively. Postoperative antibodies were measured at day 7, 14, and 21. Results. The prevalence of aPL antibodies in the preoperative period was 44%, positive subjects were more likely to be smokers (P=0.05 and were less likely to have undergone a previous arthroplasty procedure (P=0.002. Subjects seroconverted in a 21 day postoperative period at a rate of 79%. Conclusions. These pilot data suggest that the prevalence of aPL in this population both preoperatively and postoperatively is higher than previously expected. Further studies are needed to describe aPL in a larger population and to establish their clinical significance in populations undergoing joint replacement surgeries.

  17. Tension and drag forces of flexible risers undergoing vortex-induced vibration

    Science.gov (United States)

    Song, Lei-jian; Fu, Shi-xiao; Li, Man; Gao, Yun; Ma, Lei-xin

    2017-03-01

    This paper presents the results of an experimental investigation on the variation in the tension and the distribution of drag force coefficients along flexible risers under vortex-induced vibration (VIV) in a uniform flow for Reynolds numbers ( Re) up to 2.2×105. The results show that the mean tension is proportional to the square of the incoming current speed, and the tension coefficient of a flexible riser undergoing VIV can be up to 12. The mean drag force is uniformly and symmetrically distributed along the axes of the risers undergoing VIV. The corresponding drag coefficient can vary between 1.6 and 2.4 but is not a constant value of 1.2, as it is for a fixed cylinder in the absence of VIV. These experimental results are used to develop a new empirical prediction model to estimate the drag force coefficient for flexible risers undergoing VIV for Reynolds number on the order of 105, which accounts for the effects of the incoming current speed, the VIV dominant modal number and the frequency.

  18. Inspiratory Muscle Training and Functional Capacity in Patients Undergoing Cardiac Surgery

    Science.gov (United States)

    Cordeiro, André Luiz Lisboa; de Melo, Thiago Araújo; Neves, Daniela; Luna, Julianne; Esquivel, Mateus Souza; Guimarães, André Raimundo França; Borges, Daniel Lago; Petto, Jefferson

    2016-01-01

    Introduction Cardiac surgery is a highly complex procedure which generates worsening of lung function and decreased inspiratory muscle strength. The inspiratory muscle training becomes effective for muscle strengthening and can improve functional capacity. Objective To investigate the effect of inspiratory muscle training on functional capacity submaximal and inspiratory muscle strength in patients undergoing cardiac surgery. Methods This is a clinical randomized controlled trial with patients undergoing cardiac surgery at Instituto Nobre de Cardiologia. Patients were divided into two groups: control group and training. Preoperatively, were assessed the maximum inspiratory pressure and the distance covered in a 6-minute walk test. From the third postoperative day, the control group was managed according to the routine of the unit while the training group underwent daily protocol of respiratory muscle training until the day of discharge. Results 50 patients, 27 (54%) males were included, with a mean age of 56.7±13.9 years. After the analysis, the training group had significant increase in maximum inspiratory pressure (69.5±14.9 vs. 83.1±19.1 cmH2O, P=0.0073) and 6-minute walk test (422.4±102.8 vs. 502.4±112.8 m, P=0.0031). Conclusion We conclude that inspiratory muscle training was effective in improving functional capacity submaximal and inspiratory muscle strength in this sample of patients undergoing cardiac surgery. PMID:27556313

  19. Use of quantitative lung scintigraphy to predict postoperative pulmonary function in lung cancer patients undergoing lobectomy.

    Science.gov (United States)

    Win, Thida; Laroche, Clare M; Groves, Ashley M; White, Carol; Wells, Francis C; Ritchie, Andrew J; Tasker, Angela D

    2004-10-01

    In patients with non-small cell lung cancer, the only realistic chance of cure is surgical resection. However, in some of these patients there is such poor respiratory reserve that surgery can result in an unacceptable quality of life. In order to identify these patients, various pulmonary function tests and scintigraphic techniques have been used. The current American College of Physicians and British Thoracic Society guidelines do not recommend the use of quantitative ventilation-perfusion scintigraphy to predict postoperative function in lung cancer patients undergoing lobectomy. These guidelines may have been influenced by previous scintigraphic studies performed over a decade ago. Since then there have been advances in both surgical techniques and scintigraphic techniques, and the surgical population has become older and more female represented. We prospectively performed spirometry and quantitative ventilation-perfusion scintigraphy on 61 consecutive patients undergoing lobectomy for lung cancer. Spirometry was repeated one-month postsurgery. Both a simple segment counting technique alone and scintigraphy were used to predict the postoperative lung function. There was statistically significant correlation (p lung function using both the simple segment counting technique and the scintigraphic techniques. However, the correlation using simple segment counting was of negligible difference compared to scintigraphy. In keeping with current American Chest Physician and British Thoracic Society guidelines, our results suggest that quantitative ventilation-perfusion scintigraphy is not necessary in the preoperative assessment of lung cancer patients undergoing lobectomy. The simple segmenting technique can be used to predict postoperative lung function in lobectomy patients.

  20. Radiation assessment to paediatric with F-18-FDG undergo whole-body PET/CT examination

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    Dhalisa, H., E-mail: dhalisa82@gmail.com; Rafidah, Z. [Kluster Oncology Science and Radiology, Advanced Medical Dental Institute, Universiti Sains Malaysia (USM), Bertam, Penang (Malaysia); Mohamad, A. S. [Department of Nuclear Medicine, National Cancer Institute, No 4 Jalan P7, Presint 7, Putrajaya (Malaysia)

    2016-01-22

    This study was carried out on wholebody radiation dose assessment to paediatrics patient who undergo PET/CT scanner at Institut Kanser Negara. Consist of 68 patients with varies of malignancies and epilepsy disease case covering age between 2 years to 12 years old. This is a retrospective study from 2010-2014. The use of PET/CT scanner as an advanced tool has been proven to give an extra radiation dose to the patient. It is because of the radiation exposure from the combination of both CT and PET scans rather than a single CT or PET scan. Furthermore, a study on radiation dose to paediatric patient undergoing PET/CT is rare in Malaysia. So, the aim of this study is to estimate the wholebody effective dose to paediatric patient in Malaysia. Effective dose from PET scan was calculated based on the activity of F18 FDG and dose coefficient reported in International Commission on Radiological Protection (ICRP) Publication 106. Effective dose from CT was determined using k coefficient as reported in ICRP publication 102 and Dose Length Product (DLP) value. The average effective dose from PET and CT were found to be 7.05mSv and 5.77mSv respectively. The mean wholebody effective dose received by a patient with combined PETCT examination was 12.78mSv. These results could be used as reference for dosimetry of a patient undergoing PETCT examination in Malaysia.

  1. Perioperative Endocrine Therapy for Patients with Cushing's Syndrome Undergoing Retroperitoneal Laparoscopic Adrenalectomy

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    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.

  2. Successful afatinib treatment of advanced non-small-cell lung cancer patients undergoing hemodialysis.

    Science.gov (United States)

    Imai, Hisao; Kaira, Kyoichi; Naruse, Ichiro; Hayashi, Hideki; Iihara, Hirotoshi; Kita, Yutaro; Mizusaki, Naoki; Asao, Takayuki; Itoh, Yoshinori; Sugiyama, Tadashi; Minato, Koichi; Yamada, Masanobu

    2017-01-01

    The treatment for patients with lung cancer undergoing hemodialysis, who are frequently elderly and have poor performance status, becomes a more important subject. However, the feasibility of afatinib in patients with chronic renal failure undergoing hemodialysis has not, so far, been reported. Here, afatinib was administered to three patients with NSCLC harboring EGFR mutation and chronic renal failure undergoing hemodialysis. Pharmacokinetic (PK) data of afatinib supported the safety of afatinib treatment. After receiving their written informed consent from all patients, they were administered 30 mg afatinib daily with HD three times a week. We performed PK analyses of afatinib on days 1, 2, 10, and 11 after initial administration of afatinib. All three patients exhibited a partial response without any serious adverse events during the administration of afatinib. These PK data were similar to those of patients with normal organ function, which were previously reported. Our findings may be particularly useful given the current opportunity to use afatinib as a first-line treatment for EGFR-mutated NSCLC patients, providing an additional option for patients with impaired renal function.

  3. A systematic review of sleep disorders in patients with chronic kidney disease undergoing hemodialysis

    Science.gov (United States)

    Fonseca, Nina Teixeira; Urbano, Jessica Julioti; Nacif, Sergio Roberto; Silva, Anderson Soares; Peixoto, Roger Andre Oliveira; Urbano, Giovanni Julioti; Oliveira, Ezequiel Fernandes; Santos, Israel Reis; Oliveira, Claudia Santos; Insalaco, Giuseppe; Oliveira, Luis Vicente Franco

    2016-01-01

    The purpose of this study was to conduct a systematic review of the available evidence on sleep disorders in patients with end stage renal disease (ESRD) undergoing hemodialysis (HD). [Subjects and Methods] Two independent reviewers performed a computer-assisted search of the MEDLINE, SciELO, LILACS, and BIREME Virtual Health Library medical databases from their inception to November 2015. [Results] One thousand one hundred twenty-six articles were found that met the inclusion criteria. Articles were excluded if they were not in English, the patients did not undergo HD, or the studies were not cross-sectional or clinical trials. After reading the full text, a further 300 studies were excluded because they did not use polysomnography. The remaining 18 studies with ESRD patients undergoing HD comprised 8 clinical trials and 10 cross-sectional studies. This systematic review followed the criteria outlined by the PRISMA declaration. [Conclusion] In this systematic review, a high prevalence of sleep disorders was observed in ESRD, including sleep-disordered breathing. This knowledge may enable health professionals to devise new strategies for the diagnosis and treatment of these patients, in order to reduce morbidity and mortality and improve their quality of life. PMID:27512289

  4. Comparison of neostigmine and sugammadex for hemodynamic parameters in cardiac patients undergoing noncardiac surgery.

    Science.gov (United States)

    Kizilay, Deniz; Dal, Didem; Saracoglu, Kemal T; Eti, Zeynep; Gogus, Fevzi Y

    2016-02-01

    The aim of this study is to compare the hemodynamic effects of neostigmine-atropine combination and sugammadex in patients with cardiac problems undergoing noncardiac surgery. Prospective randomized study. In the operating room. Ninety patients with a class 2 or 3 cardiovascular disease according to the New York Heart Association classification and aged between 18 and 75 years undergoing noncardiac surgery were randomized. Group N (n = 45) received 0.03 mg/kg IV neostigmine when T2 appeared as measured with a nerve muscle stimulator. When heart rate was 5 beats/min (±10 beats/min) lower than the heart rate before administration of the medication, 0.5 mg IV atropine sulfate was given. Group S (n = 45) received 3 mg/kg IV sugammadex when T2 appeared as measured with a nerve muscle stimulator. Heart rate, mean systolic and diastolic blood pressures, and electrocardiographic alterations including the QTc (QT Fredericia and QT Bazett) were recorded. There were no significant differences between and within the groups in terms of QTc values. Sugammadex group had a significant decrease on heart rate 1 minute after the medication when compared to the measurement before the medication (P Sugammadex group had lower systolic, diastolic, and mean blood pressures and heart rate when compared to neostigmine group (P sugammadex might be preferred as it provides more hemodynamic stability compared to neostigmine-atropine combination to reverse rocuronium-induced neuromuscular blockage in cardiac patients undergoing noncardiac surgery. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Perioperative concerns in pediatric patients undergoing different types of scoliosis correction surgery: A retrospective observational study

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    Anjolie Chhabra

    2013-01-01

    Patients and Methods: After taking parental consent, data were collected retrospectively for 33 patients who underwent 37 procedures (four patients had both anterior and posterior procedures on 2 days of the week mainly from August 2008 to February 2010 at a tertiary care institution. Results: Children undergoing GR surgery were younger (8.1 ± 2.1 years than patients undergoing AR (12.9 ± 1.7 years or posterior fusion (14.2 ± 2.2 years. AR children had a significantly higher Cobb′s angle and more rigid curves. (P = 0.057 Associated congenital abnormalities especially neurological were commoner in the GR children. Surgical duration and blood loss was significantly more for PF (2207.5 ± 1224.13 ml than GR (456 ± 337.5 ml, or AR (642.85 ± 304.72 ml, (P = 0.0002. PF patients needed Intensive care unit (ICU care mainly due to the blood loss and prolonged surgery (35%. AR performed via thoracotomy was associated with the need for mechanical ventilation in 28.6%. The GR patients had major intraoperative hemodynamic events and 20% needed ICU care. Conclusions: Post-operative ventilation may be required in 20-35% patients undergoing procedures for scoliosis correction. Despite GR insertion involving lesser blood loss; younger age, congenital abnormalities, positioning, and surgical manipulation resulted in life threatening events in these patients.

  6. Uncertainty, the Overbearing Lived Experience of the Elderly People Undergoing Hemodialysis: A Qualitative Study

    Science.gov (United States)

    Sahaf, Robab; Sadat Ilali, Ehteram; Peyrovi, Hamid; Akbari Kamrani, Ahmad Ali; Spahbodi, Fatemeh

    2017-01-01

    ABSTRACT Background: The chronic kidney disease is a major health concern. The number of the elderly people with chronic renal failure has increased across the world. Dialysis is an appropriate therapy for the elderly, but it involves certain challenges. The present paper reports uncertainty as part of the elderly experiences of living with hemodialysis. Methods: This qualitative study applied Max van Manen interpretative phenomenological analysis to explain and explore experiences of the elderly with hemodialysis. Given the study inclusion criteria, data were collected using in-depth unstructured interviews with nine elderly undergoing hemodialysis, and then analyzed according to Van Manen 6-stage methodological approach. Results: One of the most important findings emerging in the main study was “uncertainty”, which can be important and noteworthy, given other aspects of the elderly life (loneliness, despair, comorbidity of diseases, disability, and mental and psychosocial problems). Uncertainty about the future is the most psychological concerns of people undergoing hemodialysis. Conclusion: The results obtained are indicative of the importance of paying attention to a major aspect in the life of the elderly undergoing hemodialysis, uncertainty. A positive outlook can be created in the elderly through education and increased knowledge about the disease, treatment and complications. PMID:28097174

  7. Music and ambient operating room noise in patients undergoing spinal anesthesia.

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    Ayoub, Chakib M; Rizk, Laudi B; Yaacoub, Chadi I; Gaal, Dorothy; Kain, Zeev N

    2005-05-01

    Previous studies have indicated that music decreases intraoperative sedative requirements in patients undergoing surgical procedures under regional anesthesia. In this study we sought to determine whether this decrease in sedative requirements results from music or from eliminating operating room (OR) noise. A secondary aim of the study was to examine the relationship of response to intraoperative music and participants' culture (i.e., American versus Lebanese). Eighty adults (36 American and 54 Lebanese) undergoing urological procedures with spinal anesthesia and patient-controlled IV propofol sedation were randomly assigned to intraoperative music, white noise, or OR noise. We found that, controlling for ambient OR noise, intraoperative music decreases propofol requirements (0.004 +/- 0.002 mg . kg(-1) . min(-1) versus 0.014 +/- 0.004 mg . kg(-1) . min(-1) versus 0.012 +/- 0.002 mg . kg(-1) . min(-1); P = 0.026). We also found that, regardless of group assignment, Lebanese patients used less propofol as compared with American patients (0.005 +/- 0.001 mg . kg(-1) . min(-1) versus 0.017 +/- 0.003 mg . kg(-1) . min(-1); P = 0.001) and that, in both sites, patients in the music group required less propofol (P noise, intraoperative music decreases propofol requirements of both Lebanese and American patients who undergo urological surgery under spinal anesthesia.

  8. Blood Pressure and Heart Rate Alterations through Music in Patients Undergoing Cataract Surgery in Greece

    Science.gov (United States)

    Merakou, Kyriakoula; Varouxi, Georgia; Barbouni, Anastasia; Antoniadou, Eleni; Karageorgos, Georgios; Theodoridis, Dimitrios; Koutsouri, Aristea; Kourea-Kremastinou, Jenny

    2015-01-01

    INTRODUCTION Music has been proposed as a safe, inexpensive, nonpharmacological antistress intervention. The purpose of this study was to determine whether patients undergoing cataract surgery while listening to meditation music experience lower levels of blood pressure and heart rate. METHODS Two hundred individuals undergoing cataract surgery participated in the study. Hundred individuals listened to meditation music, through headphones, before and during the operation (intervention group) and 100 individuals received standard care (control group). Patients stress coping skills were measured by the Sense of Coherence Scale (SOC Scale). Systolic and diastolic blood pressure and heart rate were defined as outcome measures. RESULTS According to the SOC Scale, both groups had similar stress coping skills (mean score: 127.6 for the intervention group and 127.3 for the control group). Before entering the operating room (OR) as well as during surgery the rise in systolic and diastolic pressures was significantly lower in the intervention group (P blood pressure at both time recordings was recorded (P music influenced patients’ preoperative stress with regard to systolic blood pressure. This kind of music can be used as an alternative or complementary method for blood pressure stabilizing in patients undergoing cataract surgery. PMID:26106264

  9. Pharmacodynamic Effect of Clopidogrel in Patients Undergoing Transcatheter Aortic Valve Implantation

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    Petr Tousek

    2013-01-01

    Full Text Available The aim of this study was to analyze periprocedural and mid-term effect of clopidogrel on platelet function using the VerifyNow P2Y12 point-of-care assay in patients undergoing TAVI. Platelet reactivity was measured at the beginning of the procedure after 300 mg clopidogrel bolus administration and during the follow-up (at 1 month after the procedure in 52 patients undergoing TAVI using the Medtronic CoreValve prosthesis (Medtronic CoreValve. A cutoff value of 240 PRU was used to identify nonresponders to clopidogrel treatment with high residual platelet reactivity (HRPR. Baseline HRPR was identified in 80% of patients and in 72% of patients during 6-month follow-up. There was no significant difference in the pharmacodynamic effects of clopidogrel on platelet reactivity from baseline to 6-months follow-up (297±57 vs. 275±62; P=0.058. Ischemic event occurred only in 3 patients (5.8% from the study group. In conclusion, majority of patients undergoing TAVI had high residual platelet reactivity after pretreatment with 300 mg of clopidogrel and during the 6-month follow-up at dual antiplatelet treatment. The noneffectiveness of clopidogrel in the TAVI population raises the question of the routine use of dual antiplatelet treatment in this setting.

  10. Effect of virtual reality distraction on pain among patients with hand injury undergoing dressing change.

    Science.gov (United States)

    Guo, Chunlan; Deng, Hongyan; Yang, Jian

    2015-01-01

    To assess the effect of virtual reality distraction on pain among patients with a hand injury undergoing a dressing change. Virtual reality distraction can effectively alleviate pain among patients undergoing a dressing change. Clinical research has not addressed pain control during a dressing change. A randomised controlled trial was performed. In the first dressing change sequence, 98 patients were randomly divided into an experimental group and a control group, with 49 cases in each group. Pain levels were compared between the two groups before and after the dressing change using a visual analog scale. The sense of involvement in virtual environments was measured using the Pearson correlation coefficient analysis, which determined the relationship between the sense of involvement and pain level. The difference in visual analog scale scores between the two groups before the dressing change was not statistically significant (t = 0·196, p > 0·05), but the scores became statistically significant after the dressing change (t = -30·792, p virtual environment and pain level during the dressing was statistically significant (R(2) = 0·5538, p Virtual reality distraction can effectively alleviate pain among patients with a hand injury undergoing a dressing change. Better results can be obtained by increasing the sense of involvement in a virtual environment. Virtual reality distraction can effectively relieve pain without side effects and is not reliant on a doctor's prescription. This tool is convenient for nurses to use, especially when analgesics are unavailable. © 2014 John Wiley & Sons Ltd.

  11. Evaluation of the frequency and accuracy of gonad shield placement in patients undergoing pelvic radiography

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    Karami, V.; Zabihzadeh, Mansour; Sarikhani, S. [Ahvaz Jundishapur University of Medical Sciences, Ahvaz (Iran, Islamic Republic of)

    2016-11-01

    Gonad shielding has been advocated to reduce radiation exposure in patients undergoing pelvic radiography. The aim of this study is to evaluate the frequency and accuracy of gonad shield placement in patients undergoing pelvic radiography. A retrospective study was performed on 1230 anteroposterior (AP) pelvic radiographs of 939 children under 16 years old. All the radiographs were reviewed to determine the frequency of gonad shielding and to evaluate whether gonad shields were correctly positioned when they are used. The gonad shield was present in 82 radiographs (30 girls and 52 boys) and was completely disregarded in 1148 radiographs. From 82 images which shield was present, the gonad shields adequately positioned in 28 radiographs (3 girls and 25 boys) and in the remaining 54 radiographs, the shield did not adequately protected the gonads due to incorrect placement of the shield. The inaccuracy placement and absence of gonad shields were more common in girls than boys (P-value < 0.05). More care should be taken to correctly positioning of the gonad shields in boys and its usage should be encouraged. However, the practice of ovarian shielding is not an effective way to reduce radiation exposure in girls undergoing pelvis radiography. (author)

  12. Perioperative outcomes of patients with hypertrophic cardiomyopathy undergoing non-cardiac surgery.

    Science.gov (United States)

    Dhillon, Ashwat; Khanna, Ashish; Randhawa, Mandeep Singh; Cywinski, Jacek; Saager, Leif; Thamilarasan, Maran; Lever, Harry M; Desai, Milind Y

    2016-10-15

    Due to their unique pathophysiological profile, patients with hypertrophic cardiomyopathy (HCM) undergoing non-cardiac surgery require additional attention to perioperative management. We sought to compare perioperative outcomes of patients with HCM undergoing non-cardiac surgery with a matched group patients without HCM. This observational cohort study conducted at a tertiary care centre included patients with HCM (n=92, age 67 years, 54% men) undergoing intermediate-risk and high-risk non-cardiac surgeries between 1/2007 and 12/2013 (excluding surgery) who were 1:2 matched (based on age, gender, type and time of non-cardiac surgery) with patients without HCM (n=184, median age 65 years, 53% men). A composite endpoint (30-day postoperative death, myocardial infarction, stroke, in-hospital decompensated congestive heart failure (CHF) and rehospitalisation within 30 days) and postoperative atrial fibrillation (AF) were recorded. There was a significantly lower incidence of intraoperative hypotension/tachycardia in patients with HCM versus those without HCM (pcardiac surgery, high anaesthesia risk score and intraoperative duration of hypotension were independently associated with 30-day composite events (pcardiac surgeries have a low perioperative event rate, at an experienced centre. However, they have a higher risk of composite events versus matched patients without HCM. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  13. Uncertainty, the Overbearing Lived Experience of the Elderly People Undergoing Hemodialysis: A Qualitative Study

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    Robab Sahaf

    2017-01-01

    Full Text Available Background: The chronic kidney disease is a major health concern. The number of the elderly people with chronic renal failure has increased across the world. Dialysis is an appropriate therapy for the elderly, but it involves certain challenges. The present paper reports uncertainty as part of the elderly experiences of living with hemodialysis. Methods: This qualitative study applied Max van Manen interpretative phenomenological analysis to explain and explore experiences of the elderly with hemodialysis. Given the study inclusion criteria, data were collected using in-depth unstructured interviews with nine elderly undergoing hemodialysis, and then analyzed according to Van Manen 6-stage methodological approach. Results: One of the most important findings emerging in the main study was “uncertainty”, which can be important and noteworthy, given other aspects of the elderly life (loneliness, despair, comorbidity of diseases, disability, and mental and psychosocial problems. Uncertainty about the future is the most psychological concerns of people undergoing hemodialysis. Conclusion: The results obtained are indicative of the importance of paying attention to a major aspect in the life of the elderly undergoing hemodialysis, uncertainty. A positive outlook can be created in the elderly through education and increased knowledge about the disease, treatment and complications.

  14. Relationship between cobalamin deficiency and delirium in elderly patients undergoing cardiac surgery

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    Sevuk U

    2015-08-01

    Full Text Available Utkan Sevuk,1 Erkan Baysal,2 Nurettin Ay,3 Yakup Altas,2 Rojhat Altindag,2 Baris Yaylak,2 Vahhac Alp,3 Ertan Demirtas4 1Department of Cardiovascular Surgery, Diyarbakir Gazi Yasargil Education and Research Hospital, Diyarbakir, 2Department of Cardiology, Diyarbakir Gazi Yasargil Education and Research Hospital, Diyarbakir, 3Department of General Surgery, Diyarbakir Gazi Yasargil Education and Research Hospital, Diyarbakir, 4Department of Cardiovascular Surgery, Liv Hospital, Ankara, Turkey Background: Delirium is common after cardiac surgery and is independently associated with increased morbidity, mortality, prolonged hospital stays, and higher costs. Cobalamin (vitamin B12 deficiency is a common cause of neuropsychiatric symptoms and affects up to 40% of elderly people. The relationship between cobalamin deficiency and the occurrence of delirium after cardiac surgery has not been examined in previous studies. We examined the relationship between cobalamin deficiency and delirium in elderly patients undergoing coronary artery bypass grafting (CABG surgery.Material and methods: A total of 100 patients with cobalamin deficiency undergoing CABG were enrolled in this retrospective study. Control group comprised 100 patients without cobalamin deficiency undergoing CABG. Patients aged 65 years or over were included. Diagnosis of delirium was made using Intensive Care Delirium Screening Checklist. Delirium severity was measured using the Delirium Rating Scale-revised-98.Results: Patients with cobalamin deficiency had a significantly higher incidence of delirium (42% vs 26%; P=0.017 and higher delirium severity scores (16.5±2.9 vs 15.03±2.48; P=0.034 than patients without cobalamin deficiency. Cobalamin levels were significantly lower in patients with delirium than patients without delirium (P=0.004. Delirium severity score showed a moderate correlation with cobalamin levels (Ρ=-0.27; P=0.024. Logistic regression analysis demonstrated that

  15. Obstructive sleep apnea affects the clinical outcomes of patients undergoing percutaneous coronary intervention

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    Zhang JJ

    2016-05-01

    Full Text Available Jun-jie Zhang,1,2,* Xiao-fei Gao,1,* Zhen Ge,1,2 Xiao-Min Jiang,1 Ping-xi Xiao,1,2 Nai-liang Tian,1,2 Jing Kan,2 Chi-Hang Lee,3 Shao-Liang Chen1,2 1Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, 2Department of Cardiology, Nanjing Heart Center, Nanjing, People’s Republic of China; 3Department of Cardiology, National University Heart Center, Singapore *These authors contributed equally to this work Background: There is a paucity of evidence regarding the association between obstructive sleep apnea (OSA and patients undergoing percutaneous coronary intervention (PCI for coronary artery disease. We sought to investigate whether OSA affects the clinical outcomes of patients undergoing PCI.Patients and methods: All enrolled individuals treated with PCI were evaluated for OSA by polysomnography. The primary end point was defined as major adverse cardiac events (MACEs at 2 years, including cardiac death, myocardial infarction (MI, and/or target vessel revascularization.Results: A total of 340 consecutive patients undergoing PCI were assigned to the OSA (n=152, apnea–hypopnea index ≥15 and non-OSA (n=188, apnea–hypopnea index <15 groups. The incidence of OSA in patients with coronary artery disease undergoing PCI was 44.7%. Patients in the OSA group had more three-vessel disease (34.9%, increased number of total implanted stents (3.3±2.0, and longer total stent length (83.8±53.1 mm when compared to the non-OSA group (23.4%, P=0.020; 2.8±1.9, P=0.007; 68.7±48.4, P=0.010. After a median follow-up of 2 years, the incidence of MACEs was significantly higher in patients with OSA (25.0% vs 16.0%, P=0.038, mainly driven by the increased periprocedural MI (19.2% vs 11.2%, P=0.038 in the OSA group. By Cox regression multivariable analysis, the independent predictor of MACEs was OSA (hazard ratio: 1.962, 95% confidence interval: 1.036–3.717, P=0.039.Conclusion: There was a high prevalence of moderate-to-severe OSA

  16. Role of concomitant tricuspid surgery in moderate functional tricuspid regurgitation in patients undergoing left heart valve surgery.

    Science.gov (United States)

    Mahesh, Balakrishnan; Wells, Francis; Nashef, Samer; Nair, Sukumaran

    2013-01-01

    Functional tricuspid regurgitation (FTR) is frequently present in patients undergoing aortic, and particularly mitral valve, surgery. Untreated FTR may lead to right heart failure. Reoperative cardiac surgery for late FTR is associated with high morbidity and mortality. Therefore, severe FTR has emerged as a Class I indication for concomitant tricuspid valve surgery in patients undergoing left valve surgery. Concomitant tricuspid valve surgery during left heart valve surgery to address moderate and mild FTR is controversial. This review addresses this issue and proposes an algorithm for the treatment of FTR in patients undergoing left heart valve surgery.

  17. Application of asymmetric flow-field flow fractionation to the characterization of colloidal dispersions undergoing aggregation.

    Science.gov (United States)

    Lattuada, Marco; Olivo, Carlos; Gauer, Cornelius; Storti, Giuseppe; Morbidelli, Massimo

    2010-05-18

    The characterization of complex colloidal dispersions is a relevant and challenging problem in colloidal science. In this work, we show how asymmetric flow-field flow fractionation (AF4) coupled to static light scattering can be used for this purpose. As an example of complex colloidal dispersions, we have chosen two systems undergoing aggregation. The first one is a conventional polystyrene latex undergoing reaction-limited aggregation, which leads to the formation of fractal clusters with well-known structure. The second one is a dispersion of elastomeric colloidal particles made of a polymer with a low glass transition temperature, which undergoes coalescence upon aggregation. Samples are withdrawn during aggregation at fixed times, fractionated with AF4 using a two-angle static light scattering unit as a detector. We have shown that from the analysis of the ratio between the intensities of the scattered light at the two angles the cluster size distribution can be recovered, without any need for calibration based on standard elution times, provided that the geometry and scattering properties of particles and clusters are known. The nonfractionated samples have been characterized also by conventional static and dynamic light scattering to determine their average radius of gyration and hydrodynamic radius. The size distribution of coalescing particles has been investigated also through image analysis of cryo-scanning electron microscopy (SEM) pictures. The average radius of gyration and the average hydrodynamic radius of the nonfractionated samples have been calculated and successfully compared to the values obtained from the size distributions measured by AF4. In addition, the data obtained are also in good agreement with calculations made with population balance equations.

  18. Prognostic Models in Adults Undergoing Physical Therapy for Rotator Cuff Disorders: Systematic Review.

    Science.gov (United States)

    Braun, Cordula; Hanchard, Nigel C; Batterham, Alan M; Handoll, Helen H; Betthäuser, Andreas

    2016-07-01

    Rotator cuff-related disorders represent the largest subgroup of shoulder complaints. Despite the availability of various conservative and surgical treatment options, the precise indications for these options remain unclear. The purpose of this systematic review was to synthesize the available research on prognostic models for predicting outcomes in adults undergoing physical therapy for painful rotator cuff disorders. The MEDLINE, EMBASE, CINAHL, Cochrane CENTRAL, and PEDro databases and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) up to October 2015 were searched. The review included primary studies exploring prognostic models in adults undergoing physical therapy, with or without other conservative measures, for painful rotator cuff disorders. Primary outcomes were pain, disability, and adverse events. Inclusion was limited to prospective investigations of prognostic factors elicited at the baseline assessment. Study selection was independently performed by 2 reviewers. A pilot-tested form was used to extract data on key aspects of study design, characteristics, analyses, and results. Risk of bias and applicability were independently assessed by 2 reviewers using the Prediction Study Risk of Bias Assessment tool (PROBAST). Five studies were included in the review. These studies were extremely heterogeneous in many aspects of design, conduct, and analysis. The findings were analyzed narratively. All included studies were rated as at high risk of bias, and none of the resulting prognostic models was found to be usable in clinical practice. There are no prognostic models ready to inform clinical practice in the context of the review question, highlighting the need for further research on prognostic models for predicting outcomes in adults who undergo physical therapy for painful rotator cuff disorders. The design and conduct of future studies should be receptive to developing methods. © 2016 American Physical Therapy

  19. Comparison of Two Doses of Dexmedetomidine on Haemodynamic Stability in Patients Undergoing Laparoscopic Surgeries

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    Amruta S. Pathak

    2016-07-01

    Full Text Available Background: Dexmedetomidine has gained its popularity in providing stable haemodynamics, with significant post operative analgesia and sedation in patients undergoing laparoscopic surgeries. Two different doses of dexmedetomidine boluses were used pre-operatively and studied the intra and postoperative effects. Aim & Objectives: To compare two doses (1.0 µg/kg or 0.7µg/kg of dexmedetomidine infusion administered pre-operatively with regards to their haemodynamic, sedative and analgesic effect in patients undergoing laparoscopic surgeries. To study the effect of intravenous dexmedetomidine on postoperative analgesia. Material and Methods: 84 patients were randomly divided into two groups of 42 each. Group A received injection dexmedetomidine 1µg/kg, while group B received 0.7µg/kg; as an intravenous bolus dose in 48 ml NS over 15 min in preanesthesia room. Parameters assessed were Heart Rate (HR, Systolic Blood Pressure (SBP, Diastolic Blood Pressure (DBP, Mean Arterial Blood Pressure (MABP, Saturation of Oxygen (SpO , End Tidal 2 Carbon Dioxide (Et CO , Respiratory Rate (RR; 2 perioperatively, at regular intervals. In the postoperative period, intramuscular injection diclofenac 75 mg was used as a rescue analgesic. Postoperative pain and level of sedation were gauged with Visual Analog Scale (VAS score and Ramsay scale respectively. Observations and Results: The hemodynamic stability, level of sedation achieved were better with Group A. The duration of post extubation analgesia observed in group A was significantly (P= 0.01 more. The adverse events noted in both the groups were very few. Conclusion: We hereby conclude that dexmedetomidine in a dose of 1µg/kg as pre operative bolus dose in patients undergoing lapararoscopic surgeries gives better haemodynamic stability, post operative analgesia, sedation and reduction in the dose of inhalational anesthetic agent compared to 0.7µg/kg dose without increase in the incidence of adverse effects.

  20. Malnutrition risk predicts surgical outcomes in patients undergoing gastrointestinal operations: Results of a prospective study.

    Science.gov (United States)

    Ho, Judy W C; Wu, Arthur H W; Lee, Michelle W K; Lau, So-ying; Lam, Pui-shan; Lau, Wai-shan; Kwok, Sam S S; Kwan, Rosa Y H; Lam, Cheuk-fan; Tam, Chun-kit; Lee, Suk-on

    2015-08-01

    Patients undergoing gastrointestinal operations are at risk of malnutrition which may increase the chance of adverse surgical outcomes. This prospective study aimed at correlating nutritional status of patients having gastrointestinal operations with their short-term surgical outcomes captured by a territory-wide Surgical Outcomes Monitoring and Improvement Program. The preoperative malnutrition risk of Chinese adult patients undergoing elective/emergency ultra-major/major gastrointestinal operations in two surgical departments over a 12-month period were assessed by Chinese version of Malnutrition Universal Screening Tool. Their perioperative risk factors and clinical outcomes, including length of hospital stay, mortality and morbidity, were retrieved from the above mentioned program. Correlation of malnutrition risk with clinical outcomes was assessed by logistic regression analysis after controlling for known confounders. 943 patients (58% male; mean age 65.9 ± 14.8 years) underwent gastrointestinal operations (40.3% emergency operation; 52.7% ultra-major procedures; 66.9% bowel resections) had analyzable data. 15.8% and 17.1% of patients were at medium and high risk of malnutrition, respectively. Malnutrition risk score according to the screening tool was an independent predictor of length of hospital stay, 30-day mortality, 60-day mortality and minor medical complications. Similar correlations were found for various sub-scores of malnutrition risk. Weight loss sub-score was predictive of 30-day mortality, 60-day mortality and minor medical complications. Body mass index was predictive of mortality (30- and 60- day) whereas the acute disease sub-score was predictive of length of hospital stay. Preoperative malnutrition was an important predictor of poor clinical outcomes in patients undergoing gastrointestinal operations in Hong Kong. Copyright © 2014 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  1. Instrument to assess educational programs for parents of children with congenital heart disease undergoing cardiac surgery.

    Science.gov (United States)

    Pino Armijo, Paola; Ramírez León, Muriel; Clavería Rodríguez, Cristian

    2017-10-01

    To design and validate an instrument to assess the relevance of educational programs for parents of children with congenital heart disease (CHD) undergoing cardiac surgery. In October 2011, an instrument was designed based on Kaufman's model and on the bibliography, and a survey was developed in the form of a checklist with 32 close-ended questions about received education and desired education, categorized into 5 items: educator, time, place, means, and content. The survey was reviewed by 4 academic professionals and 9 experts in the care of children with CHD, and the checklist was extended to include 42 close-ended questions and 5 open questions. The instrument was administered on the day before discharge to the parents of children with CHD undergoing cardiac surgery at the Department of Pediatrics between February and August 2013. The survey was self-administered by the first participants and administered by the investigator among the remaining participants. Fifty-five children met inclusion criteria; a total of 60 parents took part in the study. Agreement was observed between received education and desired education, which was statistically significant only in terms of education provided by a cardiologist (p= 0.000, K= 0.659) and in the hall (p= 0.000, K= 0.655). Statistically significant differences were observed between the 19 self-administered surveys and the 41 surveys administered by the investigator. Among the latter, a greater level of completion was observed for all items. A validated instrument was developed to assess the relevance of educational programs for parents of children with CHD undergoing cardiac surgery. This survey should be administered by a health care provider for a better understanding of information.

  2. Not All Sounds Have Negative Effects on Children Undergoing Cardiac Surgery.

    Science.gov (United States)

    Abd-Elshafy, Sayed Kaoud; Khalaf, Ghada Shalaby; Abo-Kerisha, Mohamed Zackareia; Ahmed, Nadia Taha; Abd El-Aziz, Mervat Anwer; Mohamed, Mona Aly

    2015-10-01

    This study was designed to evaluate the role of music therapy on the level of stress in children undergoing repair of congenital heart disease. Prospective, randomized, double-blind, controlled clinical trial. Children's university hospital. Fifty children aged 4 to 12 years undergoing repair of congenital heart disease. Patients were randomized into 2 equal groups (control group and music group); in the control group, patients listened to a blank CD, and in the music group, patients listened to a recorded CD of music and songs preferred by the child. Demographic data, clinical data, and preoperative vital signs were recorded. Baseline stress markers (blood glucose and cortisol levels) were sampled. Patients were assessed intraoperatively until extubation for vital signs and stress markers and after extubation for pain and sedation scales. An interview was conducted within the first postoperative week with the patients and their parents for assessment of post-traumatic stress disorder and negative postoperative behavior changes. There were no significant differences in demographic characteristics, clinical data, vital signs, preoperative and at-extubation blood glucose levels, and preoperative blood cortisol levels between groups. Significant differences were found between groups in blood glucose levels and cortisol levels at all intraoperative times, but only in cortisol blood levels at extubation. Significant differences were found in pain score, sedation score, occurrence of child post-traumatic stress disorder, and occurrence of negative postoperative behavior. Listening to favorable music by children undergoing repair for congenital heart disease resulted in less stress and more relaxation. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. Sedation-associated hiccups in adults undergoing gastrointestinal endoscopy and colonoscopy

    Institute of Scientific and Technical Information of China (English)

    Chien Cheng Liu; Cheng Yuan Lu; Chih Fang Changchien; Ping Hsin Liu; Daw Shyong Perng

    2012-01-01

    AIM:To investigate whether the incidence of hiccups in patients undergoing esophagogastroduodenoscopy (EGD) or same-day bidirectional endoscopy (EGD and colonoscopy; BDE) with sedation is different from those without sedation in terms of quantity,duration and typical onset time.METHtODS:Consecutive patients scheduled for elective EGD or same-day BDE at the gastrointestinal endoscopy unit or the health examination center were allocated to two groups:EGD without sedation (Group A)and BDE with sedation (Group B).The use of sedation was based on the patients' request.Anesthesiologists participated in this study by administrating sedative drugs as usual.A single experienced gastroenterologist performed both the EGD and the colonoscopic examinations for all the patients.The incidence,duration and onset time of hiccups were measured in both groups.In addition,the association between clinical variables and hiccups were analyzed.RESULTS:A total of 435 patients were enrolled in the study.The incidences of hiccups in the patients with and without sedation were significantly different (20.5% and 5.1%,respectively).The use of sedation for patients undergoing endoscopy was still significantly associated with an increased risk of hiccups (adjusted odds ratio:8.79,P < 0.001) after adjustment.The incidence of hiccups in males under sedation was high (67.4%).The sedated patients who received 2 mg midazolam developed hiccups more frequently compared to those receiving 1 mg midazolam (P =0.0028).The patients with the diagnosis of gastroesophageal reflux disease (GERD) were prone to develop hiccups (P =0.018).CONCLUSION:Male patients undergoing EGD or BDE with sedation are significantly more likely to suffer from hiccups compared to those without sedation.Midazolam was significantly associated with an increased risk of hiccups.Furthermore,patients with GERD are prone to develop hiccups.

  4. Procedural Predictors of Outcome in Patients Undergoing Endovascular Therapy for Acute Ischemic Stroke

    Energy Technology Data Exchange (ETDEWEB)

    Rai, Ansaar T., E-mail: ansaar.rai@gmail.com; Jhadhav, Yahodeep; Domico, Jennifer [West Virginia University Health Sciences Center, Interventional Neuroradiology (United States); Hobbs, Gerald R. [West Virginia University Health Sciences Center, Department of Community Medicine (United States)

    2012-12-15

    Purpose: To identify factors impacting outcome in patients undergoing interventions for acute ischemic stroke (AIS). Materials and Methods: This was a retrospective analysis of patients undergoing endovascular therapy for AIS secondary during a 30 month period. Outcome was based on modified Rankin score at 3- to 6-month follow-up. Recanalization was defined as Thrombolysis in myocardial infarction score 2 to 3. Collaterals were graded based on pial circulation from the anterior cerebral artery either from an ipsilateral injection in cases of middle cerebral artery (MCA) occlusion or contralateral injection for internal carotid artery terminus (ICA) occlusion as follows: no collaterals (grade 0), some collaterals with retrograde opacification of the distal MCA territory (grade 1), and good collaterals with filling of the proximal MCA (M2) branches or retrograde opacification up to the occlusion site (grade 2). Occlusion site was divided into group 1 (ICA), group 2 (MCA with or without contiguous M2 involvement), and group 3 (isolated M2 or M3 branch occlusion). Results: A total of 89 patients were studied. Median age and National Institutes of health stroke scale (NIHSS) score was 71 and 15 years, respectively. Favorable outcome was seen in 49.4% of patients and mortality in 25.8% of patients. Younger age (P = 0.006), lower baseline NIHSS score (P = 0.001), successful recanalization (P < 0.0001), collateral support (P = 0.0008), distal occlusion (P = 0.001), and shorter procedure duration (P = 0.01) were associated with a favorable outcome. Factors affecting successful recanalization included younger age (P = 0.01), lower baseline NIHSS score (P = 0.05), collateral support (P = 0.01), and shorter procedure duration (P = 0.03). An ICA terminus occlusion (P < 0.0001), lack of collaterals (P = 0.0003), and unsuccessful recanalization (P = 0.005) were significantly associated with mortality. Conclusion: Angiographic findings and preprocedure variables can help

  5. Effect of Desmopressin on Platelet Aggregation and Blood Loss in Patients Undergoing Valvular Heart Surgery

    Institute of Scientific and Technical Information of China (English)

    Lei Jin; Hong-Wen Ji

    2015-01-01

    Background:Blood loss after cardiac surgery can be caused by impaired platelet (PLT) function after cardiopulmonary bypass.Desmopressin or 1-deamino-8-D-arginine vasopressin (DDAVP) is a synthetic analog of vasopressin.DDAVP can increase the level of von Willebrand factor and coagulation factor Ⅷ,thus it may enhance PLT function and improve coagulation.In this study,we assessed the effects of DDAVP on PLT aggregation and blood loss in patients undergoing cardiac surgery.Methods:A total of 102 patients undergoing valvular heart surgery (from October 2010 to June 2011) were divided into DDAVP group (n =52) and control group (n =50).A dose of DDAVP (0.3 μtg/kg) was administered to the patients intravenously when they were being re-warmed.At the same time,an equal volume of saline was given to the patients in the control group.PLT aggregation rate was measured with the AggRAM four-way PLT aggregation measurement instrument.The blood loss and transfusion,hemoglobin levels,PLT counts,and urine outputs at different time were recorded and compared.Results:The postoperative blood loss in the first 6 h was significantly reduced in DDAVP group (202 ± 119 ml vs.258 ± 143 ml,P =0.023).The incidence of fresh frozen plasma (FFP) transfusion was decreased postoperatively in DDAVP group (3.8% vs.12%,P =0.015).There was no significant difference in the PLT aggregation,urine volumes,red blood cell transfusions and blood loss after 24 h between two groups.Conclusions:A single dose of DDAVP can reduce the first 6 h blood loss and FFP transfusion postoperatively in patients undergoing valvular heart surgery,but has no effect on PLT aggregation.

  6. Luteal blood flow in patients undergoing GnRH agonist long protocol

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    Takasaki Akihisa

    2011-01-01

    Full Text Available Abstract Background Blood flow in the corpus luteum (CL is closely related to luteal function. It is unclear how luteal blood flow is regulated. Standardized ovarian-stimulation protocol with a gonadotropin-releasing hormone agonist (GnRHa long protocol causes luteal phase defect because it drastically suppresses serum LH levels. Examining luteal blood flow in the patient undergoing GnRHa long protocol may be useful to know whether luteal blood flow is regulated by LH. Methods Twenty-four infertile women undergoing GnRHa long protocol were divided into 3 groups dependent on luteal supports; 9 women were given ethinylestradiol plus norgestrel (Planovar orally throughout the luteal phase (control group; 8 women were given HCG 2,000 IU on days 2 and 4 day after ovulation induction in addition to Planovar (HCG group; 7 women were given vitamin E (600 mg/day orally throughout the luteal phase in addition to Planovar (vitamin E group. Blood flow impedance was measured in each CL during the mid-luteal phase by transvaginal color-pulsed-Doppler-ultrasonography and was expressed as a CL-resistance index (CL-RI. Results Serum LH levels were remarkably suppressed in all the groups. CL-RI in the control group was more than the cutoff value (0.51, and only 2 out of 9 women had CL-RI values Conclusion Patients undergoing GnRHa long protocol had high luteal blood flow impedance with very low serum LH levels. HCG administration improved luteal blood flow impedance. This suggests that luteal blood flow is regulated by LH.

  7. Timed Stair Climbing is the Single Strongest Predictor of Perioperative Complications in Patients Undergoing Abdominal Surgery

    Science.gov (United States)

    Reddy, Sushanth; Contreras, Carlo M; Singletary, Brandon; Bradford, T Miller; Waldrop, Mary G; Mims, Andrew H; Smedley, W Andrew; Swords, Jacob A; Thomas N, Wang; Martin J, Heslin

    2016-01-01

    Background Current methods to predict patients' peri-operative morbidity utilize complex algorithms with multiple clinical variables focusing primarily on organ-specific compromise. The aim of the present study is to determine the value of a timed stair climb (SC) in predicting peri-operative complications for patients undergoing abdominal surgery. Study Design From March 2014 to July 2015, 362 patients attempted SC while being timed prior to undergoing elective abdominal surgery. Vital signs were measured before and after SC. Ninety day post-operative complications were assessed by the Accordion Severity Grading System. The prognostic value of SC was compared to the ACS NSQIP risk calculator. Results A total of 264 (97.4%) patients were able to complete SC. SC time directly correlated to changes in both mean arterial pressure and heart rate as an indicator of stress. An Accordion grade 2 or higher complication occurred in 84 (25%) patients. There were 8 mortalities (2.4%). Patients with slower SC times had an increased complication rate (P<0.0001). In multivariable analysis SC time was the single strongest predictor of complications (OR=1.029, P<0.0001), and no other clinical co-morbidity reached statistical significance. Receiver operative characteristic curves predicting post-operative morbidity by SC time was superior to that of the ACS risk calculator (AUC 0.81 vs. 0.62, P<0.0001). Additionally slower patients had a greater deviation from predicted length of hospital stay (P=0.034) Conclusions SC provides measurable stress, accurately predicts post-operative complications, and is easy to administer in patients undergoing abdominal surgery. Larger patient populations with a diverse group of operations will be needed to further validate the use of SC in risk prediction models. PMID:26920993

  8. Comprehensive geriatric assessment can predict postoperative morbidity and mortality in elderly patients undergoing elective surgery.

    Science.gov (United States)

    Kim, Kwang-Il; Park, Kay-Hyun; Koo, Kyung-Hoi; Han, Ho-Seong; Kim, Cheol-Ho

    2013-01-01

    The proportion of elderly patients who undergo surgery has rapidly increased; however, clinical indicators predicting outcomes are limited. Our aim was to evaluate the significance of comprehensive geriatric assessment (CGA) in elderly patients undergoing elective surgery. We studied 141 consecutive elderly patients (age: 78.0±6.5 years old, male: 41.1%) who were referred to our geriatric department for surgical risk evaluation. CGA was performed to evaluate physical health, functional status, psychological health, and social support. The primary composite outcome of this study was in-hospital death or post-discharge institutionalization. In-hospital adverse events, such as delirium, pressure ulcers, pneumonia, and urinary tract infections, were also evaluated. The associations between CGA and in-hospital adverse events, in-hospital death, and post-discharge institutionalization were investigated. There were 32 adverse outcomes (6 in-hospital deaths and 26 post-discharge institutionalizations). Compared with the patients who were discharged to their homes, patients with adverse outcomes were characterized by poor nutritional status and prior strokes. However, there was no significant difference in surgical risk or anesthesia type. The CGA results showed that patients with adverse outcomes were associated with functional dependency and poor nutrition. The cumulative number of impairments in the CGA domain was significantly associated with adverse outcomes, in-hospital events, and prolonged hospital stays. In multiple logistic regression analysis, cumulative impairment in CGA was independently associated with surgical outcomes in elderly patients undergoing elective surgery. Preoperative CGA can identify elderly patients at greater risk for mortality, post-discharge institutionalization, adverse in-hospital events, and prolonged length of hospital stay.

  9. Unnecessary axillary surgery for patients with node-negative breast cancer undergoing total mastectomy.

    Science.gov (United States)

    Olaya, Windy; Morgan, John W; Lum, Sharon S

    2011-09-01

    To identify factors associated with the use of axillary lymph node dissection (ALND) as the initial axillary staging in node-negative breast cancer patients undergoing total mastectomy. California Cancer Registry study. Academic research. Women treated with total mastectomy for Tis, T1, or T2 node-negative breast carcinoma treated between January 1, 2004, and December 31, 2008. Proportions of patients who underwent ALND without prior sentinel lymph node dissection were compared by demographic characteristics. Of 18,238 women treated with total mastectomy for Tis, T1, or T2 node-negative breast carcinoma, 35.1% underwent initial axillary staging by ALND without prior sentinel lymph node dissection. On multivariable analyses, patients were significantly more likely to undergo ALND if they had T2 disease or were 65 years or older, were hormone receptor negative, of Hispanic or Asian/Pacific Islander race/ethnicity, of lower socioeconomic quintile, operated on during earlier years of the study period, and not treated by a hospital cancer program approved by the American College of Surgeons. More than one-third of patients in California who underwent total mastectomy for treatment of early-stage node-negative breast carcinoma received ALND without prior sentinel lymph node dissection; furthermore, certain subsets of patients have higher odds of undergoing ALND alone. To avoid the unnecessary morbidity of ALND in early-stage breast carcinoma, further research is required to elucidate how tumor, patient, and system factors can be modified to improve delivery of optimal breast cancer care.

  10. Wnt and the cancer niche: paracrine interactions with gastrointestinal cancer cells undergoing asymmetric cell division.

    Science.gov (United States)

    Xin, Hong-Wu; Ambe, Chenwi M; Ray, Satyajit; Kim, Bo-Kyu; Koizumi, Tomotake; Wiegand, Gordon W; Hari, Danielle; Mullinax, John E; Jaiswal, Kshama R; Garfield, Susan H; Stojadinovic, Alexander; Rudloff, Udo; Thorgeirsson, Snorri S; Avital, Itzhak

    2013-01-01

    Stem-like cancer cells contribute to cancer initiation and maintenance. Stem cells can self-renew by asymmetric cell division (ACD). ACD with non-random chromosomal cosegregation (ACD-NRCC) is one possible self-renewal mechanism. There is a paucity of evidence supporting ACD-NRCC in human cancer. Our aim was to investigate ACD-NRCC and its potential interactions with the cancer niche (microenvironment) in gastrointestinal cancers. We used DNA double and single labeling approaches with FACS to isolate live cells undergoing ACD-NRCC. Gastrointestinal cancers contain rare subpopulations of cells capable of ACD-NRCC. ACD-NRCC was detected preferentially in subpopulations of cells previously suggested to be stem-like/tumor-initiating cancer cells. ACD-NRCC was independent of cell-to-cell contact, and was regulated by the cancer niche in a heat-sensitive paracrine fashion. Wnt pathway genes and proteins are differentially expressed in cells undergoing ACD-NRCC vs. symmetric cell division. Blocking the Wnt pathway with IWP2 (WNT antagonist) or siRNA-TCF4 resulted in suppression of ACD-NRCC. However, using a Wnt-agonist did not increase the relative proportion of cells undergoing ACD-NRCC. Gastrointestinal cancers contain subpopulations of cells capable of ACD-NRCC. Here we show for the first time that ACD-NRCC can be regulated by the Wnt pathway, and by the cancer niche in a paracrine fashion. However, whether ACD-NRCC is exclusively associated with stem-like cancer cells remains to be determined. Further study of these findings might generate novel insights into stem cell and cancer biology. Targeting the mechanism of ACD-NRCC might engender novel approaches for cancer therapy.

  11. Contrast-induced nephropathy in postmenopausal women undergoing percutaneous coronary intervention for acute myocardial infarction.

    Science.gov (United States)

    Ma, Guizhou; Yu, Danqing; Cai, Zhixiong; Ni, Chumin; Xu, Ronghe; Lan, Bin; Chen, Ping; Zhu, Zhidan

    2010-07-01

    Contrast-induced nephropathy (CIN) is a complex syndrome of acute kidney injury induced by exposure to intravascular contrast media. CIN occurs frequently in patients undergoing urgent percutaneous coronary intervention (PCI) and is associated with poor outcomes, making it a major challenge faced by interventional cardiologists. It has been suggested that female sex is a risk factor for development of CIN following PCI. However, no data exist in the literature concerning the risks of postmenopausal women with acute myocardial infarction (AMI) developing CIN after undergoing urgent PCI. To explore the incidence, risk factors and in-hospital outcomes of CIN in this special population, we analyzed 69 postmenopausal women with AMI treated with urgent PCI. CIN was defined as a relative increase of >25% or an absolute increase of >or=0.5 mg/dL in serum creatinine concentration from the baseline value 72 h after exposure to contrast medium. We found 1) the incidence of CIN was 37.68%; 2) patients with CIN had worse in-hospital outcomes, including longer hospital stay and more in-hospital adverse events; and 3) in multivariate logistic analysis, independent risk factors for CIN included a longer menopausal duration and the implantation of an intra-aortic balloon pump (an indirect indicator of hemodynamic instability). These results indicate that CIN is a frequent complication associated with worse in-hospital outcomes in postmenopausal women with AMI who are undergoing urgent PCI, particularly those with longer menopausal duration and hemodynamic instability. It is therefore necessary to pay more attention to preventive strategies for renal protection in this special population.

  12. Psychological characteristics, eating behavior, and quality of life assessment of obese patients undergoing weight loss interventions.

    Science.gov (United States)

    Miras, A D; Al-Najim, W; Jackson, S N; McGirr, J; Cotter, L; Tharakan, G; Vusirikala, A; le Roux, C W; Prechtl, C G; Scholtz, S

    2015-03-01

    Bariatric surgery is the most effective treatment for obesity. However, not all patients have similar weight loss following surgery and many researchers have attributed this to different pre-operative psychological, eating behavior, or quality-of-life factors. The aim of this study was to determine whether there are any differences in these factors between patients electing to have bariatric surgery compared to less invasive non-surgical weight loss treatments, between patients choosing a particular bariatric surgery procedure, and to identify whether these factors predict weight loss after bariatric surgery. This was a prospective study of 90 patients undergoing gastric bypass, vertical sleeve gastrectomy, or adjustable gastric banding and 36 patients undergoing pharmacotherapy or lifestyle interventions. All patients completed seven multi-factorial psychological, eating behavior, and quality-of-life questionnaires prior to choosing their weight loss treatment. Questionnaire scores, baseline body mass index, and percent weight loss at 1 year after surgical interventions were recorded. Surgical patients were younger, had a higher body mass index, and obesity had a higher impact on their quality of life than on non-surgical patients, but they did not differ in the majority of eating behavior and psychological parameters studied. Patients opting for adjustable gastric banding surgery were more anxious, depressed, and had more problems with energy levels than those choosing vertical sleeve gastrectomy, and more work problems compared to those undergoing gastric bypass. Weight loss after bariatric surgery was predicted by pre-operative scores of dietary restraint, disinhibition, and pre-surgery energy levels. The results of this study generate a number of hypotheses that can be explored in future studies and accelerate the development of personalized weight loss treatments. © The Finnish Surgical Society 2014.

  13. Impact of obesity on recovery and pulmonary functions of obese women undergoing major abdominal gynecological surgeries.

    Science.gov (United States)

    Moustafa, Ahmed A M; Abdelazim, Ibrahim A

    2016-06-01

    To determine impact of obesity on recovery parameters and pulmonary functions of women undergoing major abdominal gynecological surgeries. Eighty women undergoing major gynecological surgeries were included in this study. Anesthesia was induced by remifentanil bolus, followed by propofol and cisatracurium to facilitate oro-tracheal intubation and was maintained by balanced anesthesia of remifentanil intravenous infusion and sevoflurane in oxygen and air. Time from discontinuation of maintenance anesthesia to fully awake were recorded at 1-min intervals and time from discontinuation of anesthesia until patient was transferred to post-anesthesia care unit (PACU) and discharged from PACU was also recorded. Pulmonary function tests were performed before surgery and repeated 4 h, days 1, 2 and 3 post-operative for evaluation of forced vital capacity, forced expiratory volume in 1 s and peak expiratory flow rate. Occurrence of post-operative complications, re-admission to ICU, hospital stay and morbidities were also recorded. Induction of anesthesia using remifentanil bolus injection resulted in significant decrease of heart rate and arterial pressures compared to pre-operative and pre-induction values. Recovery times were significantly shorter in obese compared to morbidly obese women. Post-operative pulmonary function tests showed significant deterioration compared to pre-operative measures but showed progressive improvement through first 3 post-operative days. Hospital stay was significantly shorter for obese compared to morbid obese women. Obesity delays recovery from general anesthesia, adversely affects pulmonary functions and increases post-operative complications. Remifentanil infusion and sevoflurane could be appropriate combination for obese and morbidly obese women undergoing major surgeries.

  14. Desflurane reinforces the efficacy of propofol target-controlled infusion in patients undergoing laparoscopic cholecystectomy.

    Science.gov (United States)

    Chen, Po-Nien; Lu, I-Cheng; Chen, Hui-Ming; Cheng, Kuang-I; Tseng, Kuang-Yi; Lee, King-Teh

    2016-01-01

    Whether low-concentration desflurane reinforces propofol-based intravenous anesthesia on maintenance of anesthesia for patients undergoing laparoscopic cholecystectomy is to be determined. The aim of this study was to investigate whether propofol-based anesthesia adding low-concentration desflurane is feasible for laparoscopic cholecystectomy. Fifty-two patients undergoing laparoscopic cholecystectomy were enrolled in the prospective, randomized, clinical trial. Induction of anesthesia was achieved in all patients with fentanyl 2 μg/kg, lidocaine 1 mg/kg, propofol 2 mg/kg, and rocuronium 0.8 mg/kg to facilitate tracheal intubation and to initiate propofol target-controlled infusion (TCI) to effect site concentration (Ce: 4 μg/mL with infusion rate 400 mL/h). The patients were then allocated into either propofol TCI based (group P) or propofol TCI adding low-concentration desflurane (group PD) for maintenance of anesthesia. The peri-anesthesia hemodynamic responses to stimuli were measured. The perioperative psychomotor test included p-deletion test, minus calculation, orientation, and alert/sedation scales. Group PD showed stable hemodynamic responses at CO2 inflation, initial 15 minutes of operation, and recovery from general anesthesia as compared with group P. There is no significant difference between the groups in operation time and anesthesia time, perioperative psychomotor functional tests, postoperative vomiting, and pain score. Based on our findings, the anesthetic technique combination propofol and desflurane for the maintenance of general anesthesia for laparoscopic cholecystectomy provided more stable hemodynamic responses than propofol alone. The combined regimen is recommended for patients undergoing laparoscopic cholecystectomy.

  15. Effect of exercise on the caloric intake of breast cancer patients undergoing treatment

    Directory of Open Access Journals (Sweden)

    C.L. Battaglini

    2008-08-01

    Full Text Available The purpose of this study was to examine the effects of an exercise intervention on the total caloric intake (TCI of breast cancer patients undergoing treatment. A secondary purpose was to determine whether or not a relationship existed between changes in TCI, body fat composition (%BF, and fatigue during the study, which lasted 6 months. Twenty females recently diagnosed with breast cancer, scheduled to undergo chemotherapy or radiation, were assigned randomly to an experimental (N = 10 or control group (N = 10. Outcome measures included TCI (3-day food diary, %BF (skinfolds, and fatigue (revised Piper Fatigue Scale. Each exercise session was conducted as follows: initial cardiovascular activity (6-12 min, followed by stretching (5-10 min, resistance training (15-30 min, and a cool-down (approximately 8 min. Significant changes in TCI were observed among groups (F1,18 = 8.582; P = 0.009, at treatments 2 and 3, and at the end of the study [experimental (1973 ± 419, control (1488 ± 418; experimental (1946 ± 437, control (1436 ± 429; experimental (2315 ± 455, control (1474 ± 294, respectively]. A significant negative correlation was found (Spearman rho(18 = -0.759; P < 0.001 between TCI and %BF and between TCI and fatigue levels (Spearman rho(18 = -0.541; P = 0.014 at the end of the study. In conclusion, the results of this study suggest that an exercise intervention administered to breast cancer patients undergoing medical treatment may assist in the mitigation of some treatment side effects, including decreased TCI, increased fatigue, and negative changes in body composition.

  16. The minimally invasive approach is associated with reduced surgical site infections in obese patients undergoing proctectomy.

    Science.gov (United States)

    Pasam, R T; Esemuede, I O; Lee-Kong, S A; Kiran, R P

    2015-12-01

    While laparoscopic colorectal resection may be underused in technically challenging circumstances, the minimally invasive approach may in fact maximally benefit patients at the greatest risk of complications. Obesity and proctectomy pose particular technical challenges during laparoscopic resection and are also associated with the greatest risks of complications, especially surgical site infections (SSIs). We evaluated the role of laparoscopy in minimizing SSI in such patients. From the American College of Surgeons-National Surgical Quality Improvement Program database, outcomes for obese [body mass index (BMI) ≥ 30 kg/m(2)] and non-obese (BMI laparoscopy on SSI for obese patients undergoing proctectomy. OC patients were more likely than OP, LC, and LP, respectively, to undergo emergency operation and have an American Society of Anesthesiologists (ASA) score of 3-5. Overall SSI rates after OC, OP, LC, and LP were 15.2, 17.6, 8.6, and 10.1 %, respectively (p obese patients, the rates were 18.7, 22.3, 10.7, and 13.3 % (p obesity, proctectomy, younger age, race, steroid use, diabetes, chronic obstructive pulmonary disease, prior wound infection, transfusion history, previous operation within 30 days, coronary artery or vascular disease, ASA class 3-5, tobacco use, resident involvement, male gender, albumin Laparoscopy reduced the risk of SSI by at least 35 % across all BMI classes and procedures, an effect that persisted on multivariate analysis even in obese patients undergoing proctectomy. In colorectal surgery, an already high-risk outlier for SSI, obesity and proctectomy are associated with the highest risk of SSI. Despite the particular technical challenges of laparoscopy in these circumstances, the minimally invasive approach attenuates the risk of SSI in these high-risk patients and thus should be strongly considered during treatment planning.

  17. Inter-individual differences in cytokine release in patients undergoing cardiac surgery with cardiopulmonary bypass

    Science.gov (United States)

    Roth-Isigkeit, A; Hasselbach, L; Ocklitz, E; Brückner, S; Ros, A; Gehring, H; Schmucker, P; Rink, L; Seyfarth, M

    2001-01-01

    Cardiac surgery with cardiopulmonary bypass (CPB) leads to a systemic inflammatory response with secretion of cytokines (e.g. IL-6, TNF-α, IL-1β and sIL-2R). The objective of the following study was to investigate in vitro and in vivo cytokine responses and white blood cell counts (WBC) of patients with high versus low cytokine secretion after a coronary artery bypass grafting (CABG) procedure. Twenty male patients undergoing elective CABG surgery with CPB under general anaesthesia were enrolled in the study. On the day of surgery (postoperatively), serum levels of TNF-α and IL-1β were significantly higher in patients of the high IL-6 level group compared to the respective values in the patient group with low IL-6 levels. The inter-individual differences in IL-6 release in patients undergoing CABG surgery with CPB were accompanied by differences in the release of other cytokines, such as TNF-α, IL-1β and sIL-2R. To understand whether genetic background plays a role in influencing cytokine plasma levels under surgical stress, we examined the distribution of polymorphic elements within the promoter regions of the TNF-α and IL-6 genes, and determined their genotype regarding the BAT2 gene and TNF-β intron polymorphisms. Our preliminary data suggests that regulatory polymorphisms in or near the TNF locus, more precisely the allele set 140/150 of the BAT2 microsatellite marker combined with the G allele at −308 of the TNF-α gene, could be one of the genetic constructions providing for a less sensitive response to various stimuli. Our results suggest: (1) close relationships between cytokine release in the postoperative period, and (2) inter-individually varying patterns of cytokine release in patients undergoing CABG surgery with CPB. PMID:11472429

  18. Effects of handholding and providing information on anxiety in patients undergoing percutaneous vertebroplasty.

    Science.gov (United States)

    Kim, Bong-Hee; Kang, Hee-Young; Choi, Eun-Young

    2015-12-01

    This study evaluated the effects of handholding and spoken information provided on the anxiety of patients undergoing percutaneous vertebroplasty under local anaesthesia. A surgical intervention usually entails physical discomfort and psychological burden. Furthermore, patients under local anaesthesia are conscious during the surgical intervention, which leads to more anxiety, as patients are aware of their surroundings in the operating theatre. A quasi-experimental design with a nonequivalent control group was utilised. Amsterdam preoperative anxiety scale assessed psychological anxiety, while blood pressure and pulse were measured to evaluate physiological anxiety. Participants were 94 patients undergoing percutaneous vertebroplasty in a spine hospital in Gwangju Metropolitan City, South Korea. Thirty patients were assigned to Experimental Group I, 34 to the Experimental Group II and 30 to the control group. During a surgical intervention, nurses held the hands of those in Experimental Group I and provided them with spoken information. Patients in Experimental Group II experienced only handholding. Psychological anxiety in Experimental Group I was low compared to those in Experimental Group II and the control group. In addition, there were significant decreases in systolic blood pressure in both Experimental Groups compared to the control group. Handholding and spoken information provided during a surgical intervention to mitigate psychological anxiety, and handholding to mitigate physiological anxiety can be used in nursing interventions with patients undergoing percutaneous vertebroplasty. Handholding and providing nursing information are possibly very useful interventions that are easily implemented by circulating nurses during a surgical intervention. In particular, handholding is a simple, economical and appropriate way to help patient in the operating theatre. © 2015 John Wiley & Sons Ltd.

  19. The myocardial protective effect of dexmedetomidine in high-risk patients undergoing aortic vascular surgery

    Directory of Open Access Journals (Sweden)

    Rabie Soliman

    2016-01-01

    Full Text Available Objective: The aim of the study was to assess the effect of dexmedetomidine in high-risk patients undergoing aortic vascular surgery. Design: A randomized prospective study. Setting: Cairo University, Egypt. Materials and Methods: The study included 150 patients undergoing aortic vascular surgery. Intervention: The patients were classified into two groups (n = 75. Group D: The patients received a loading dose of 1 μg/kg dexmedetomidine over 15 min before induction and maintained as an infusion of 0.3 μg/kg/h to the end of the procedure. Group C: The patients received an equal volume of normal saline. The medication was prepared by the nursing staff and given to anesthetist blindly. Measurements: The monitors included the heart rate, mean arterial blood pressure, central venous pressure, electrocardiogram (ECG, serum troponin I level, end-tidal sevoflurane, and total dose of morphine in addition transthoracic echocardiography to the postoperative in cases with elevated serum troponin I level. Main Results: The dexmedetomidine decreased heart rate and minimized the changes in blood pressure compared to control group (P < 0.05. Furthermore, it decreased the incidence of myocardial ischemia reflected by troponin I level, ECG changes, and the development of new regional wall motion abnormalities (P < 0.05. Dexmedetomidine decreased the requirement for nitroglycerin and norepinephrine compared to control group (P < 0.05. The incidence of hypotension and bradycardia was significantly higher with dexmedetomidine (P < 0.05. Conclusion: The dexmedetomidine is safe and effective in patients undergoing aortic vascular surgery. It decreases the changes in heart rate and blood pressure during the procedures. It provides cardiac protection in high-risk patients reflected by decreasing the incidence of myocardial ischemia and serum level of troponin. The main side effects of dexmedetomidine were hypotension and bradycardia.

  20. Comparison of pain scores between patients undergoing panretinal photocoagulation using navigated or pattern scan laser systems

    Directory of Open Access Journals (Sweden)

    Umit Ubeyt Inan

    2016-02-01

    Full Text Available ABSTRACT Purpose: To compare the pain responses of patients with proliferative diabetic retinopathy (PDR undergoing panretinal photocoagulation (PRP using either pattern scan laser (PASCAL or navigated laser photocoagulation (NAVILAS. Methods: Patients diagnosed with PDR were randomly assigned to undergo either PASCAL or NAVILAS photocoagulation treatment. PRP was performed using the multi-shot mode with a spot size of 200-400 µm and a pulse duration of 30 ms to obtain a white-grayish spot on the retina. Parameters were identical in both procedures. After 30 min of PRP application, patients were asked to verbally describe their pain perception as either "none," "mild," "moderate," "severe," or "very severe" using a verbal rating scale (VRS and visual analog scale (VAS by indicating a score from "0" to "10," representing the severity of pain from "no pain" to "severe pain." Results: A total of 60 eyes of 60 patients (20 females and 40 males diagnosed with PDR were treated. The mean age of patients was 62.22 ± 9.19 years, and the mean diabetes duration was 195.47 ± 94.54 months. The mean number of laser spots delivered during PRP was 389.47 ± 71.52 in the NAVILAS group and 392.70 ± 54.33 in the PASCAL group (p=0.57. The difference in pain responses between patients in the NAVILAS and PASCAL groups was significant with regard to the mean VRS (1.10 ± 0.67 and 1.47 ± 0.69, respectively; p=0.042 and mean VAS (2.13 ± 1.17 and 2.97 ± 1.35, respectively; p=0.034 scores. Conclusions: Pain responses in patients undergoing PRP with a 30-ms pulse duration were significantly milder in the NAVILAS group than in the PASCAL group.

  1. Desflurane reinforces the efficacy of propofol target-controlled infusion in patients undergoing laparoscopic cholecystectomy

    Directory of Open Access Journals (Sweden)

    Po-Nien Chen

    2016-01-01

    Full Text Available Whether low-concentration desflurane reinforces propofol-based intravenous anesthesia on maintenance of anesthesia for patients undergoing laparoscopic cholecystectomy is to be determined. The aim of this study was to investigate whether propofol-based anesthesia adding low-concentration desflurane is feasible for laparoscopic cholecystectomy. Fifty-two patients undergoing laparoscopic cholecystectomy were enrolled in the prospective, randomized, clinical trial. Induction of anesthesia was achieved in all patients with fentanyl 2 μg/kg, lidocaine 1 mg/kg, propofol 2 mg/kg, and rocuronium 0.8 mg/kg to facilitate tracheal intubation and to initiate propofol target-controlled infusion (TCI to effect site concentration (Ce: 4 μg/mL with infusion rate 400 mL/h. The patients were then allocated into either propofol TCI based (group P or propofol TCI adding low-concentration desflurane (group PD for maintenance of anesthesia. The peri-anesthesia hemodynamic responses to stimuli were measured. The perioperative psychomotor test included p-deletion test, minus calculation, orientation, and alert/sedation scales. Group PD showed stable hemodynamic responses at CO2 inflation, initial 15 minutes of operation, and recovery from general anesthesia as compared with group P. There is no significant difference between the groups in operation time and anesthesia time, perioperative psychomotor functional tests, postoperative vomiting, and pain score. Based on our findings, the anesthetic technique combination propofol and desflurane for the maintenance of general anesthesia for laparoscopic cholecystectomy provided more stable hemodynamic responses than propofol alone. The combined regimen is recommended for patients undergoing laparoscopic cholecystectomy.

  2. Pharmacokinetics of ertapenem in critically ill patients with acute renal failure undergoing extended daily dialysis.

    Science.gov (United States)

    Burkhardt, Olaf; Hafer, Carsten; Langhoff, Anita; Kaever, Volkhard; Kumar, Vipul; Welte, Tobias; Haller, Hermann; Fliser, Danilo; Kielstein, Jan T

    2009-01-01

    Extended (daily) dialysis (EDD) is an increasingly popular mode of renal replacement therapy in the ICU (intensive care unit) as it combines the advantages of intermittent haemodialysis (IHD) and continuous renal replacement therapy (CRRT), i.e. excellent detoxification accompanied by cardiovascular tolerability. The aim of this study was to evaluate pharmacokinetics (PK) of ertapenem, the newest carbapenem with once-daily dosing, in critically ill patients with anuric acute renal failure (ARF) undergoing EDD. In a single-centre, prospective, open-label study six ICU patients with ARF undergoing EDD were treated with 1 g ertapenem given as a single intravenous dose. EDD was performed using a high-flux dialyzer (polysulphone, 1.3 m(2)). Blood and dialysate flow were 160 mL/min, and the length of treatment was 480 min. Plasma samples were collected at different time-points up to 24 h after medication. Drug concentrations were determined by a validated LC-MS method. Free drug concentrations were estimated using a two-class binding site equation. After a single dose of 1000 mg free ertapenem, protein-unbound plasma concentrations exceeded a MIC(90) value of 2 mg/L for >20 h after dosing. The clearance of the tested dialyzer was 38.5 +/- 14.2 mL/min. In contrast to patients undergoing regular IHD, in which a dose reduction is required, our data suggest that in patients treated with EDD a standard dose of ertapenem (1 g/day), i.e. dose for patients without renal failure, is required to maintain adequate plasma drug levels.

  3. Role of frailty and sarcopenia in predicting outcomes amongpatients undergoing gastrointestinal surgery

    Institute of Scientific and Technical Information of China (English)

    2016-01-01

    According to the United States census bureau 20%of Americans will be older than 65 years in 2030 andhalf of them will need an operation - equating to about36 million older surgical patients. Older adults areprone to complications during gastrointestinal cancertreatment and therefore may need to undergo specialpretreatment assessments that incorporate frailty andsarcopenia assessments. A focused, structured literaturereview on PubMed and Google Scholar was performedto identify primary research articles, review articles,as well as practice guidelines on frailty and sarcopeniaamong patients undergoing gastrointestinal surgery.The initial search identified 450 articles; after eliminatingduplicates, reports that did not include surgical patients,case series, as well as case reports, 42 publicationson the impact of frailty and/or sarcopenia on outcomeof patients undergoing gastrointestinal surgery wereincluded. Frailty is defined as a clinically recognizablestate of increased vulnerability to physiologic stressorsresulting from aging. Frailty is associated with adecline in physiologic reserve and function acrossmultiple physiologic systems. Sarcopenia is a syndromecharacterized by progressive and generalized loss ofskeletal muscle mass and strength. Unlike cachexia,which is typically associated with weight loss due tochemotherapy or a general malignancy-related cachexiasyndrome, sarcopenia relates to muscle mass ratherthan simply weight. As such, while weight reflectsnutritional status, sarcopenia - the loss of muscle mass- is a more accurate and quantitative global marker offrailty. While chronologic age is an important element inassessing a patient's peri-operative risk, physiologic ageis a more important determinant of outcomes. Geriatricassessment tools are important components of the preoperativework-up and can help identify patients whosuffer from frailty. Such data are important, as frailtyand sarcopenia have repeatedly been demonstratedamong the strongest

  4. The Need for Guidelines in Asplenic Patients Undergoing Total Joint Arthroplasty: A Case Report

    Directory of Open Access Journals (Sweden)

    S. R. Shaarani

    2012-01-01

    Full Text Available There are currently no guidelines for splenectomy patient undergoing total joint arthroplasty. We present a case history of a 63-year-old man with a history of splenectomy that underwent a total knee arthroplasty with standard intravenous antibiotic prophylaxis. Two weeks postoperatively, he developed a prosthetic joint infection and followed the standard antimicrobial management with intravenous and oral antibiotics prior to having revision surgery. We propose that there are guidelines to properly manage these patients in the pre- and perioperative setting following an orthopaedic procedure.

  5. Proteomic analysis of S-nitrosylated proteins in Arabidopsis thaliana undergoing hypersensitive response

    DEFF Research Database (Denmark)

    Romero-Puertas, Maria C; Campostrini, Natascia; Mattè, Alessandro

    2008-01-01

    metabolism, signaling and antioxidant defense. The study of the effects of S-nitrosylation on the activity of the identified proteins and its role during the execution of the disease resistance response will help to understand S-nitrosylation function and significance in plants....... is the identification of the proteins that are subjected to this PTM. By using a proteomic approach involving 2-DE and MS we characterized, for the first time, changes in S-nitrosylated proteins in Arabidopsis thaliana undergoing HR. The 16 S-nitrosylated proteins identified are mostly enzymes serving intermediary...

  6. Unsteady 2D potential-flow forces on a thin variable geometry airfoil undergoing arbitrary motion

    DEFF Research Database (Denmark)

    Gaunaa, M.

    2006-01-01

    In this report analytical expressions for the unsteady 2D force distribution on a variable geometry airfoil undergoing arbitrary motion are derived under the assumption of incompressible, irrotational, inviscid flow. The airfoil is represented by itscamberline as in classic thin-airfoil theory...... of the present theory in problems employing the eigenvalue approach, such as stabilityanalysis. The analytical expressions for the forces simplify to all previously known steady and unsteady thin-airfoil solutions. Apart from the obvious applications within active load control/reduction, the current theory can...

  7. Patients undergoing radical prostatectomy have a better survival than the background population

    DEFF Research Database (Denmark)

    Andreas Røder, Martin; Brasso, Klaus; Drimer Berg, Kasper;

    2013-01-01

    INTRODUCTION: The objective of this study was to investigate standardised relative survival and mortality ratio for patients undergoing radical prostatectomy for localized prostate cancer at our institution. MATERIAL AND METHODS: Between 1995 and 2010, a total of 1,350 consecutive patients underw...... better than expected in the age-matched background population. This finding is likely explained by selection bias. Although the results indicate an excellent outcome in terms of cancer control, the efficacy of prostatectomy for localized prostate cancer remains at debate....

  8. Pseudo-outbreak of pseudomonas aeruginosa in HIV-infected patients undergoing fiberoptic bronchoscopy

    DEFF Research Database (Denmark)

    Kolmos, H J; Lerche, A; Kristoffersen, Kirsten Lydia

    1994-01-01

    Pseudomonas aeruginosa was isolated from bronchoalveolar lavage fluid from 8 consecutive patients undergoing bronchoscopy at an infectious diseases unit. None of the patients developed signs of respiratory tract infection that could be ascribed to the organism. The source of contamination...... was the suction channels of 2 fiberoptic bronchoscopes which, due to a lapse in routine procedures, were not cleansed manually prior to disinfection with glutaraldehyde. Although rarely of pathogenetic importance, the possible presence of P. aeruginosa in lavage fluids should never be discounted, as it may...

  9. Polarization Switching in Ferroelectric Thin Films Undergoing First-Order Phase Transitions

    Directory of Open Access Journals (Sweden)

    L. A. Bakaleinikov

    2010-01-01

    Full Text Available The main switching properties in ferroelectrics undergoing first-order phase transitions are simulated within the framework of the extended Ishibashi dipole-lattice model including the dipole-dipole interaction in a two-dimensional case for ferroelectric nanoscale objects. The peculiarities of the temperature dependence of the switching rate and the pyroelectric coefficient are discussed in the range of coexistence of the metastable states. The used coefficients of the long-range and short-range interactions between the dipoles are taken from the dielectric and structure measurements in BaTiO3.

  10. The effects of clown intervention on worries and emotional responses in children undergoing surgery.

    Science.gov (United States)

    Fernandes, Sara Costa; Arriaga, Patrícia

    2010-04-01

    This study investigated whether clown intervention could reduce preoperative worries and the affective responses of children undergoing minor surgery. Parental anxiety was also tested. Child's age, previous hospitalization, and temperament were tested as predictors of the child's responses during this preoperative phase. Seventy children were assigned to one of two groups: children accompanied by their parents and a pair of clowns or, those accompanied by the parents but without the clowns. The results emphasized the relevance of clown intervention on the reduction of preoperative worries and emotional responses, not only in children but also in their parents.

  11. β-Blocker-Associated Risks in Patients With Uncomplicated Hypertension Undergoing Noncardiac Surgery.

    Science.gov (United States)

    Jørgensen, Mads E; Hlatky, Mark A; Køber, Lars; Sanders, Robert D; Torp-Pedersen, Christian; Gislason, Gunnar H; Jensen, Per Føge; Andersson, Charlotte

    2015-12-01

    Perioperative β-blocker strategies are important to reduce risks of adverse events. Effectiveness and safety may differ according to patients' baseline risk. To determine the risk of major adverse cardiovascular events (MACEs) associated with long-term β-blocker therapy in patients with uncomplicated hypertension undergoing noncardiac surgery. Association study based on in-hospital records and out-of-hospital pharmacotherapy use using a Danish nationwide cohort of patients with uncomplicated hypertension treated with at least 2 antihypertensive drugs (β-blockers, thiazides, calcium antagonists, or renin-angiotensin system [RAS] inhibitors) undergoing noncardiac surgery between 2005 and 2011. Various antihypertensive treatment regimens, chosen as part of usual care. Thirty-day risk of MACEs (cardiovascular death, nonfatal ischemic stroke, nonfatal myocardial infarction) and all-cause mortality, assessed using multivariable logistic regression models and adjusted numbers needed to harm (NNH). The baseline characteristics of the 14,644 patients who received β-blockers (65% female, mean [SD] age, 66.1 [12.0] years) were similar to those of the 40,676 patients who received other antihypertensive drugs (57% female, mean [SD] age, 65.9 [11.8] years). Thirty-day MACEs occurred in 1.3% of patients treated with β-blockers compared with 0.8% of patients not treated with β-blockers (P risks of MACEs in 2-drug combinations with RAS inhibitors (odds ratio [OR], 2.16 [95% CI, 1.54-3.04]), calcium antagonists (OR, 2.17 [95% CI, 1.48-3.17]), and thiazides (OR, 1.56 [95% CI, 1.10-2.22]), compared with the reference combination of RAS inhibitors and thiazides. Results were similar for all-cause mortality. Risk of MACEs associated with β-blocker use seemed especially pronounced for patients at least 70 years old (number needed to harm [NNH], 140 [95% CI, 86-364]), for men (NNH, 142 [95% CI, 93-195]), and for patients undergoing acute surgery (NNH, 97 [95% CI, 57

  12. Nonlinear analysis of flexible beams undergoing large rotations Via symbolic computations

    Directory of Open Access Journals (Sweden)

    Yuan Xiaofeng

    2001-01-01

    Full Text Available In this paper, a two-stage approach is presented for analyzing flexible beams undergoing large rotations. In the first stage, the symbolic forms of equations of motion and the Jacobian matrix are generated by means of MATLAB and written into a MATLAB script file automatically, where the flexible beams are described by the unified formulation presented in our previous paper. In the second stage, the derived equations of motion are solved by means of implicit numerical methods. Several comparison computations are performed. The two-stage approach proves to be much more efficient than pure numerical one.

  13. The laboratory of clinical virology in monitoring patients undergoing monoclonal antibody therapy.

    Science.gov (United States)

    Cavallo, R

    2011-12-01

    The relevant efficacy of monoclonal antibodies (mAbs) has resulted in the successful treatment of several diseases, although susceptibility to infections remains a major problem. This review summarizes aspects of the literature regarding viral infections and mAbs, specifically addressing the risk of infection/reactivation, the measures that can reduce this risk, and the role played by the laboratory of clinical virology in monitoring patients undergoing mAb therapy. © 2011 The Author. Clinical Microbiology and Infection © 2011 European Society of Clinical Microbiology and Infectious Diseases.

  14. Automated Data Collection for Determining Statistical Distributions of Module Power Undergoing Potential-Induced Degradation

    DEFF Research Database (Denmark)

    Hacke, Peter; Spataru, Sergiu

    We propose a method for increasing the frequency of data collection and reducing the time and cost of accelerated lifetime testing of photovoltaic modules undergoing potential-induced degradation (PID). This consists of in-situ measurements of dark current-voltage curves of the modules at elevated...... stress temperature, their use to determine the maximum power at 25°C standard test conditions (STC), and distribution statistics for determining degradation rates as a function of stress level. The semi-continuous data obtained by this method clearly show degradation curves of the maximum power...

  15. Lymphoscintigraphy as an adjunctive procedure in the perioperative assessment of patients undergoing microlymphaticovenous anastomoses

    Energy Technology Data Exchange (ETDEWEB)

    Sacks, G.A.; Sandler, M.P.; Born, M.L.; Clanton, J.A.; Franklin, J.D.; Partain, C.L.

    1983-07-01

    Microlymphaticovenous anastomoses provide a potential for reducing lymphedema of the upper extremity complicating radical mastectomy or irradiation. Lymphoscintigraphy with technetium isotopes is a valuable investigative modality in the perioperative evaluation of patients undergoing this surgical procedure. The radionuclide studies provide information regarding structural change and physiologic derangement with a low radiation dose to the patient. It is a simple, painless procedure requiring minimal skill and no surgical intervention. In addition, a reproducible method for preparing a radiocolloid suitable for lymphatic imaging using an approved drug as a precursor has been developed.

  16. Management of Patients with Hernia or Incisional Hernia Undergoing Surgery for Morbid Obesity

    Directory of Open Access Journals (Sweden)

    Ramon Vilallonga

    2011-01-01

    Full Text Available Morbidly obese patients (MOPs are predisposed to developing abdominal wall hernias with the potential complication of small bowel obstruction and other morbidity. We report our experience in treating morbidly obese patients. Hernia prophylaxis has been attempted as a means of decreasing the incisional hernia risk associated with weight loss surgery. The controversy regarding the optimal time and method of repair of abdominal wall hernias in patients undergoing open or laparoscopic gastric bypass is discussed with emphasis placed on either a simultaneous repair or splits of the omentum, and of leaving a plug in the hernia defect, to allow time to perform a delayed repair.

  17. Heat transfer model of semi-transparent ceramics undergoing laser-assisted machining

    Energy Technology Data Exchange (ETDEWEB)

    Pfefferkorn, F.E. [University of Wisconsin-Madison (United States). Department of Mechanical Engineering; Incropera, F.P. [University of Notre Dame, IN (United States). College of Engineering; Yung C. Shin [Purdue University, West Lafayette, IN (United States). School of Mechanical Engineering

    2005-05-01

    A three-dimensional, unsteady heat transfer model has been developed for predicting the temperature field in partially-stabilized zirconia (PSZ) undergoing laser-assisted machining. The semi-transparent PSZ is treated as optically thick within a spectral band from approximately 0.5 to 8 {mu}m. After comparing the diffusion approximation and the discrete ordinates method for predicting internal radiative transfer, suitability of the diffusion approximation is established from a comparison of model predictions with surface temperature measurements. The temperature predictions are in good agreement with measured values during machining. Parametric calculations reveal that laser power and feedrate have the greatest effect on machining temperatures. (author)

  18. Effects of recreational soccer in men with prostate cancer undergoing androgen deprivation therapy

    DEFF Research Database (Denmark)

    Uth, Jacob; Schmidt, Jakob Friis; Christensen, Jesper Frank;

    2013-01-01

    (FC) Prostate' study is a randomized trial comparing the effects of soccer training with standard treatment approaches on body composition, cardiovascular function, physical function parameters, glucose tolerance, bone health, and patient-reported outcomes in men undergoing ADT for prostate cancer.......Androgen deprivation therapy (ADT) is a cornerstone in the treatment of advanced prostate cancer. Adverse musculoskeletal and cardiovascular effects of ADT are widely reported and investigations into the potential of exercise to ameliorate the effects of treatment are warranted. The 'Football Club...

  19. American-built hardware for ASPT undergoes pre-delivery preparations

    Science.gov (United States)

    1974-01-01

    American-built hardware for the joint U.S.-USSR Apollo Soyuz Test Project (ASTP) mission undergoes pre-delivery preparations in the giant clean room at Rockwell International Corporation's Space Division at Downey, California. The U.S. portion of the ASTP docking system is in the right foreground. In the right background is the cylindrical-shaped Docking Module, which is designed to link the Apollo and Soyuz spacecraft when they dock in Earth orbit. In the left background is the Apollo Command Module which will carry the three American astronauts into Earth orbit.

  20. A randomized, blinded comparison of chloral hydrate and midazolam sedation in children undergoing echocardiography.

    Science.gov (United States)

    Wheeler, D S; Jensen, R A; Poss, W B

    2001-07-01

    The objective of this prospective, randomized, and blinded study was to compare the use of chloral hydrate versus oral midazolam sedation in children undergoing echocardiography. No adverse effects (nausea, vomiting, paradoxical agitation, or significant deviations from baseline vital signs) were noted with either medication. No differences were noted in onset of sedation between the 2 groups, however, the time to complete recovery was significantly shorter with midazolam than with chloral hydrate. The children in the chloral hydrate group had a significantly deeper level of sedation and were more likely to receive a more nearly comprehensive echocardiographic evalation.

  1. Transient Intraoperative Central Diabetes Insipidus in Moyamoya Patients Undergoing Revascularization Surgery: A Mere Coincidence?

    Science.gov (United States)

    Hong, Joe C; Ramos, Emilio; Copeland, Curtis C; Ziv, Keren

    2016-04-15

    We present 2 patients with Moyamoya disease undergoing revascularization surgery who developed transient intraoperative central diabetes insipidus with spontaneous resolution in the immediate postoperative period. We speculate that patients with Moyamoya disease may be predisposed to a transient acute-on-chronic insult to the arginine vasopressin-producing portion of their hypothalamus mediated by anesthetic agents. We describe our management, discuss pertinent literature, and offer possible mechanisms of this transient insult. We hope to improve patient safety by raising awareness of this potentially catastrophic complication.

  2. Quality of life among women with sexual dysfunction undergoing hemodialysis: a cross-sectional observational study

    Directory of Open Access Journals (Sweden)

    Santos Paulo

    2012-08-01

    Full Text Available Abstract Background Sexual function among women undergoing hemodialysis (HD is under-studied and there is no consensus about the effect of sexual dysfunction (SD on their quality of life (QoL. We aimed to determine the prevalence of SD and to compare QoL between women undergoing maintenance HD with and without SD. Methods We included female end-stage renal disease (ESRD patients undergoing HD during June 2011 in the only renal unit in the north of Ceará state, northeastern Brazil. The criteria for inclusion were age between 18 and 55, at least three months on dialysis and being sexually active. Women using antidepressant medication were excluded. We used the Female Sexual Function Index (FSFI, which evaluates six domains of sexual function, including desire, arousal, lubrication, orgasm, satisfaction and pain. The patients were classified as presenting SD if the total FSFI score was less than 26. For QoL evaluation, we used the validated Brazilian version of SF-36. This is a widely used 36-item questionnaire covering eight dimensions of QoL. Demographic data, time on dialysis, underlying etiology of ESRD, and laboratory measures were assessed in unit records. Results Of a total of 58 women, 46 (79.3% presented SD. There were lower scores related to physical functioning (48.2 vs. 71.2; p = 0.007, bodily pain (45 vs. 67.5; p = 0.010, vitality (52.1 vs. 69.1; p = 0.026 and social functioning (57.2 vs. 76.1; p = 0.034 among women with SD compared to women without SD. Physical functioning and role-physical presented positive linear correlation with FSFI scores, respectively, r = 0.322 (p = 0.013 and r = 0.345 (p = 0.007. Conclusion The prevalence of SD among women on HD is very high, reaching nearly 80%. Women on HD with SD had worse QoL, especially physical aspects of QoL, when compared to women without SD. Therefore, approaches aiming to improve QoL among women undergoing HD should be considered.

  3. Advanced thymic cancer treated with carboplatin and paclitaxel in a patient undergoing hemodialysis.

    Science.gov (United States)

    Miura, Satoru; Kagamu, Hiroshi; Sakai, Takehito; Nozaki, Koichiro; Asakawa, Katsuaki; Moro, Hiroshi; Okajima, Masaaki; Watanabe, Satoshi; Yamamoto, Suguru; Iino, Noriaki; Goto, Shin; Kazama, Junichiro James; Yoshizawa, Hirohisa; Narita, Ichiei

    2015-01-01

    A 53-year-old man with an asymptomatic anterior mediastinal tumor undergoing hemodialysis was referred to our institution. He was diagnosed with thymic basaloid carcinoma based on the findings of a chest tomography-guided biopsy and successfully treated with carboplatin (300 mg/m(2)/day) and paclitaxel (200 mg/m(2)/day) on day 1 for six three-week cycles. To our knowledge, this is the first report regarding the efficiency of a carboplatin dose-definition method based on the body surface area with paclitaxel in a hemodialysis patient. This report may therefore be useful for treating hemodialysis patients who are candidates for carboplatin and paclitaxel therapy.

  4. Intra-operative haemodynamic volatility in a patient undergoing retroperitoneal cyst excision

    Directory of Open Access Journals (Sweden)

    Thrivikrama Padur Tantry

    2012-01-01

    Full Text Available Excision of a suspected retroperitoneal, duodenal duplication cyst was performed in a pre-operatively normotensive patient under combined epidural and general anaesthesia. Intraoperatively, the cystic tumour was discovered to be a retroperitoneal mass, free from duodenal or adrenal origin. Development of severe arrhythmias, ST segment changes and hypertensive spikes during cyst handling and dissection suggested the possibility of a catecholamine-secreting tumour. These were managed effectively with pharmacological agents. Subsequently, histopathology of the specimen revealed a paraganglioma. Vasoactive tumour has to be suspected in every patient undergoing anaesthesia for retroperitoneal cystic lesion.

  5. A systematic review of the effectiveness of warming interventions for women undergoing cesarean section.

    Science.gov (United States)

    Munday, Judy; Hines, Sonia; Wallace, Karen; Chang, Anne M; Gibbons, Kristen; Yates, Patsy

    2014-12-01

    Women undergoing cesarean section are vulnerable to adverse effects associated with inadvertent perioperative hypothermia, but there has been a lack of synthesized evidence for temperature management in this population. This systematic review aimed to synthesize the best available evidence in relation to preventing hypothermia in mothers undergoing cesarean section surgery. Randomized controlled trials meeting the inclusion criteria (adult patients of any ethnic background, with or without comorbidities, undergoing any mode of anesthesia for any type of cesarean section) were eligible for consideration. Active or passive warming interventions versus usual care or placebo, aiming to limit or manage core heat loss in women undergoing cesarean section were considered. The primary outcome was maternal core temperature. A comprehensive search with no language restrictions was undertaken of multiple databases from their inception until May 2012. Two independent reviewers using the standardized critical appraisal instrument for randomized controlled trials from the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instruments (JBI-MASTARI) assessed retrieved papers for methodological quality and conducted data collection. Where possible, results were combined in a fixed effects meta-analysis using the Cochrane Collaboration Review Manager software. Due to heterogeneity for one outcome, random effects meta-analysis was also used. A combined total of 719 participants from 12 studies were included. Intravenous fluid warming was found to be effective at maintaining maternal temperature and preventing shivering. Warming devices, including forced air warming and under-body carbon polymer mattresses, were effective at preventing hypothermia. However, effectiveness increased if the devices were applied preoperatively. Preoperative warming devices reduced shivering and improved neonatal temperatures at birth. Intravenous fluid warming did not improve

  6. Impact of Triple Therapy in Elderly Patients with Atrial Fibrillation Undergoing Percutaneous Coronary Intervention.

    Directory of Open Access Journals (Sweden)

    Antonia Sambola

    Full Text Available Selecting an ideal antithrombotic therapy for elderly patients with atrial fibrillation (AF undergoing percutaneous coronary intervention (PCI can be challenging since they have a higher thromboembolic and bleeding risk than younger patients. The current study aimed to assess the efficacy and safety of triple therapy (TT: oral anticoagulation plus dual antiplatelet therapy: aspirin plus clopidogrel in patients ≥75 years of age with atrial fibrillation (AF undergoing percutaneous coronary intervention (PCI.A prospective multicenter study was conducted from 2003 to 2012 at 6 Spanish teaching hospitals. A cohort study of consecutive patients with AF undergoing PCI and treated with TT or dual antiplatelet therapy (DAPT was analyzed. All outcomes were evaluated at 1-year of follow-up.Five hundred and eighty-five patients, 289 (49% of whom were ≥75 years of age (79.6±3.4 years; 33% women were identified. TT was prescribed in 55.9% of patients at discharge who had a higher thromboembolic risk (CHA2DS2VASc score: 4.23±1.51 vs 3.76±1.40, p = 0.007 and a higher bleeding risk (HAS-BLED ≥3: 88.6% vs 79.2%, p = 0.02 than those on DAPT. Therefore, patients on TT had a lower rate of thromboembolism than those on DAPT (0.6% vs 6.9%, p = 0.004; HR 0.08, 95% CI: 0.01-0.70, p = 0.004. Major bleeding events occurred more frequently in patients on TT than in those on DAPT (11.7% vs 2.4%, p = 0.002; HR 5.2, 95% CI: 1.53-17.57, p = 0.008. The overall mortality rate was similar in both treatment groups (11.9% vs 13.9%, p = 0.38; however, after adjustment for confounding variables, TT was associated with a reduced mortality rate (HR 0.33, 95% CI: 0.12-0.86, p = 0.02.In elderly patients with AF undergoing PCI, the use of TT compared to DAPT was associated with reduced thromboembolism and mortality rates, although a higher rate of major bleeding.

  7. Difficult peritonitis cases in children undergoing chronic peritoneal dialysis: relapsing, repeat, recurrent and zoonotic episodes.

    Science.gov (United States)

    Bakkaloglu, Sevcan A; Warady, Bradley A

    2015-09-01

    Despite technological improvements in dialysis connectology and dialysis technique, peritonitis remains the most common and most significant complication of peritoneal dialysis (PD) in children. Most children undergoing chronic PD experience none or only one peritonitis episode, while others have multiple episodes or episodes secondary to unusual organisms. Knowledge of potential risk factors and likely patient outcome is imperative if treatment is to be optimized. In this review we will, in turn, describe episodes of peritonitis that are characterized as either relapsing, recurrent, repeat or zoonosis-related to highlight the clinical issues that are commonly encountered by clinicians treating these infections.

  8. Population pharmacokinetics of daptomycin in adult patients undergoing continuous renal replacement therapy.

    Science.gov (United States)

    Xu, Xiaoying; Khadzhynov, Dmytro; Peters, Harm; Chaves, Ricardo L; Hamed, Kamal; Levi, Micha; Corti, Natascia

    2017-03-01

    The objective of this population pharmacokinetic (PK) analysis was to provide guidance for the dosing interval of daptomycin in patients undergoing continuous renal replacement therapy (CRRT). A previously published population PK model for daptomycin was updated with data from patients undergoing continuous veno-venous haemodialysis (CVVHD; n = 9) and continuous veno-venous haemodiafiltration (CVVHDF; n = 8). Model-based simulations were performed to compare the 24 h AUC, Cmax and Cmin of daptomycin following various dosing regimens (4, 6, 8, 10, and 12 mg kg(-1) every [Q] 24 h and Q48 h), with the safety and efficacy exposure references for Staphylococcus aureus bacteraemia/right-sided infective endocarditis. The previously developed daptomycin structural population PK model could reasonably describe data from the patients on CRRT. The clearance in patients undergoing CVVHDF and CVVHD was estimated at 0.53 and 0.94 l h(-1) , respectively, as compared with 0.75 l h(-1) in patients with creatinine clearance (CrCl) ≥ 30 ml min(-1) . Daptomycin Q24 h dosing in patients undergoing CRRT resulted in optimal exposure for efficacy, with AUC comparable to that in patients with CrCl ≥ 30 ml min(-1) . In contrast, Q48 h dosing was associated with considerably lower AUC24-48h in all patients for doses up to 12 mg kg(-1) and is therefore inappropriate. Q24 h dosing of daptomycin up to 12 mg kg(-1) provides comparable drug exposure in patients on CVVHD and in those with CrCl ≥ 30 ml min(-1) . Daily daptomycin use up to 8 mg kg(-1) doses are appropriate for patients on CVVHDF, but higher doses may increase the risk of toxicity. © 2016 The Authors. British Journal of Clinical Pharmacology published by John Wiley & Sons Ltd on behalf of British Pharmacological Society.

  9. Methylprednisolone in patients undergoing cardiopulmonary bypass (SIRS): a randomised, double-blind, placebo-controlled trial.

    Science.gov (United States)

    Whitlock, Richard P; Devereaux, P J; Teoh, Kevin H; Lamy, Andre; Vincent, Jessica; Pogue, Janice; Paparella, Domenico; Sessler, Daniel I; Karthikeyan, Ganesan; Villar, Juan Carlos; Zuo, Yunxia; Avezum, Álvaro; Quantz, Mackenzie; Tagarakis, Georgios I; Shah, Pallav J; Abbasi, Seyed Hesameddin; Zheng, Hong; Pettit, Shirley; Chrolavicius, Susan; Yusuf, Salim

    2015-09-26

    Cardiopulmonary bypass initiates a systemic inflammatory response syndrome that is associated with postoperative morbidity and mortality. Steroids suppress inflammatory responses and might improve outcomes in patients at high risk of morbidity and mortality undergoing cardiopulmonary bypass. We aimed to assess the effects of steroids in patients at high risk of morbidity and mortality undergoing cardiopulmonary bypass. The Steroids In caRdiac Surgery (SIRS) study is a double-blind, randomised, controlled trial. We used a central computerised phone or interactive web system to randomly assign (1:1) patients at high risk of morbidity and mortality from 80 hospital or cardiac surgery centres in 18 countries undergoing cardiac surgery with the use of cardiopulmonary bypass to receive either methylprednisolone (250 mg at anaesthetic induction and 250 mg at initiation of cardiopulmonary bypass) or placebo. Patients were assigned with block randomisation with random block sizes of 2, 4, or 6 and stratified by centre. Patients aged 18 years or older were eligible if they had a European System for Cardiac Operative Risk Evaluation of at least 6. Patients were excluded if they were taking or expected to receive systemic steroids in the immediate postoperative period or had a history of bacterial or fungal infection in the preceding 30 days. Patients, caregivers, and those assessing outcomes were masked to allocation. The primary outcomes were 30-day mortality and a composite of death and major morbidity (ie, myocardial injury, stroke, renal failure, or respiratory failure) within 30 days, both analysed by intention to treat. Safety outcomes were also analysed by intention to treat. This study is registered with ClinicalTrials.gov, number NCT00427388. Patients were recruited between June 21, 2007, and Dec 19, 2013. Complete 30-day data was available for all 7507 patients randomly assigned to methylprednisolone (n=3755) and to placebo (n=3752). Methylprednisolone, compared

  10. Modelling a sector undergoing structural change: The case of Danish energy supply

    DEFF Research Database (Denmark)

    Klinge Jacobsen, Henrik

    2000-01-01

    been linked to a macroeconometric model of the Danish economy. It is argued that analysing sectors that undergo radical changes, for example, the energy supply sector should be undertaken by using a model that describes the technological and organisational changes in production along with implications......This paper examines structural change in the power and heat producing sector (energy supply) and its implications for the economy. An integrated approach is used to describe the interactions between this sector and the rest of the economy. Thus, a very detailed model of the sector for Denmark has...

  11. Knee injury and obesity in patients undergoing total knee replacement: a retrospective study in 115 patients

    DEFF Research Database (Denmark)

    Jensen, Claus Hjorth; Rofail, S

    1999-01-01

    The prevalence of obesity and previous knee injury was assessed in a retrospective study of 115 patients under-going total knee replacement due to osteoarthritis. Obesity was considered a contributing factor in the development of osteoarthritis in 37% of the patients, and 33% of the patients had...... had an injury to the knee in question. Unilateral osteoarthritis was significantly more frequent than bilateral osteoarthritis among patients with a history of previous knee injury. The association of previous injury to the knee and unilateral osteoarthritis was stronger in men than women. Aggressive...... treatment of patients with knee injuries seems warranted....

  12. Prophylactic salpingectomy in women undergoing hysterectomy for benign gynaecological disease - a new Danish recommendation

    DEFF Research Database (Denmark)

    Sloth, Sigurd Beier; Gimbel, Helga; Jørgensen, Annemette

    , 282, 158) met the inclusion criteria. The quality of evidence for all critical and important outcomes was rated very low. For the critical outcomes evidence from one OS showed fewer reoperations (RR 0.33 95% CI 0.1 to 1.06) and operations on salpinx (RR 0.15 95% CI 0.01 to 2.46) after hysterectomy...... with concomitant bilateral salpingectomy compared to women undergoing hysterectomy without bilateral salpingectomy. Based on the available evidence, the balance between benefits and harms and patient values and preferences, the guideline panel gave a weak recommendation for concomitant bilateral salpingectomy...

  13. Blood glucose management in the patient undergoing cardiac surgery: A review

    Institute of Scientific and Technical Information of China (English)

    Pingle; Reddy; Brian; Duggar; John; Butterworth

    2014-01-01

    Both diabetes mellitus and hyperglycemia per se are associated with negative outcomes after cardiac surgery. In this article, we review these associations, the possible mechanisms that lead to adverse outcomes, and the epidemiology of diabetes focusing on those patients requiring cardiac surgery. We also examine outpatient and perioperative management of diabetes with the same focus. Finally, we discuss our own efforts to improve glycemic management of patients undergoing cardiac surgery at our institution, including keys to success, results of implementation, and patient safety concerns.

  14. Outcomes of patients with cirrhosis undergoing non-hepatic surgery: Risk assessment and management

    Institute of Scientific and Technical Information of China (English)

    Farida Millwala; Geoffrey C Nguyen; Paul J Thuluvath

    2007-01-01

    The reported mortality rates in patients with cirrhosis undergoing various non-transplant surgical procedures range from 8.3% to 25%. This wide range of mortality rates is related to severity of liver disease, type of surgery, demographics of patient population, expertise of the surgical, anesthesia and intensive care unit team and finally, reporting bias. In this article, we will review the pathophysiology, morbidity and mortality associated with non-hepatic surgery in patients with cirrhosis, and then recommend an algorithm for risk assessment and evidence based management strategy to optimize postsurgical outcomes.

  15. Neovascular events in eyes with central retinal vein occlusion undergoing serial bevacizumab or ranibizumab intravitreal injections: A retrospective review

    Directory of Open Access Journals (Sweden)

    Francis Char DeCroos

    2014-01-01

    Conclusion: Neovascular events occur in eyes with CRVO undergoing serial anti-VEGF therapy, and these events may be delayed compared to the natural history of CRVO-associated neovascularization. Iris neovascularization occurred most frequently.

  16. Foreign Language Classroom Anxiety Among China Chinese Students Undergoing The Laureate English Programme in INTI International University, Malaysia

    Directory of Open Access Journals (Sweden)

    Meghavaani d/o Ampalagan

    2014-10-01

    Full Text Available The purpose of this study was to investigate the relationship between foreign language classroom anxiety (communication apprehension, test anxiety and fear of negative evaluation among  Mainland Chinese students undergoing the Laureate English Programme

  17. The Effects of Preoperative Oral Pregabalin and Perioperative Intravenous Lidocaine Infusion on Postoperative Morphine Requirement in Patients Undergoing Laparatomy

    Directory of Open Access Journals (Sweden)

    Senniye Ulgen Zengin

    2015-01-01

    Full Text Available OBJECTIVES: To evaluate and compare the effects of preoperative oral pregabalin and perioperative intravenous lidocaine infusion on postoperative morphine requirement, adverse effects, patients’ satisfaction, mobilization, time to first defecation and time to discharge in patients undergoing laparotomy.

  18. Role of calf muscle stimulation in the prevention of DVT in Indian patients undergoing surgeries for fractures around the hip

    Directory of Open Access Journals (Sweden)

    Aman Goyal

    2012-01-01

    Conclusion: The role of peroperative calf muscle electrostimulation for DVT prophylaxis remains controversial. The risk of developing DVT in patients undergoing surgeries around the hip joint is very less in patients analysed in our series.

  19. The influence of sarcopenia on survival and surgical complications in ovarian cancer patients undergoing primary debulking surgery

    NARCIS (Netherlands)

    Rutten, I.J.; Ubachs, J.; Kruitwagen, R.F.P.M.; Dijk, D.P. van; Beets-Tan, R.G.; Massuger, L.F.A.G.; Oude Damink, S.W.; Gorp, T. Van

    2017-01-01

    BACKGROUND: Sarcopenia, severe skeletal muscle loss, has been identified as a prognostic factor in various malignancies. This study aims to investigate whether sarcopenia is associated with overall survival (OS) and surgical complications in patients with advanced ovarian cancer undergoing primary

  20. A novel protocol for antibiotic prophylaxis based on preoperative kidney function in patients undergoing open heart surgery under cardiopulmonary bypass.

    Science.gov (United States)

    Odaka, Mizuho; Minakata, Kenji; Toyokuni, Hideaki; Yamazaki, Kazuhiro; Yonezawa, Atsushi; Sakata, Ryuzo; Matsubara, Kazuo

    2015-08-01

    This study aimed to develop and assess the effectiveness of a protocol for antibiotic prophylaxis based on preoperative kidney function in patients undergoing open heart surgery. We established a protocol for antibiotic prophylaxis based on preoperative kidney function in patients undergoing open heart surgery. This novel protocol was assessed by comparing patients undergoing open heart surgery before (control group; n = 30) and after its implementation (protocol group; n = 31) at Kyoto University Hospital between July 2012 and January 2013. Surgical site infections (SSIs) were observed in 4 control group patients (13.3 %), whereas no SSIs were observed in the protocol group patients (P protocol group (P protocol significantly decreased the total antibiotic dose used in the perioperative period (P protocol group patients required this additional change in the antibiotic regimen (P protocol based on preoperative kidney function effectively prevents SSIs in patients undergoing open heart surgery.

  1. Hospital Episode Statistics data analysis of postoperative venous thromboembolus in patients undergoing urological surgery: a review of 126,891 cases

    NARCIS (Netherlands)

    Dyer, J.; Wyke, S.; Lynch, C.

    2013-01-01

    INTRODUCTION: Current guidelines on venous thromboembolism (VTE) prevention do not reflect the potential varying risk for patients undergoing different urological procedures. Our study aimed to establish the procedure specific rate of postoperative VTE in patients undergoing urological surgery. METH

  2. Ultra Low-Dose Naloxone and Tramadol/Acetaminophen in Elderly Patients Undergoing Joint Replacement Surgery: A Pilot Study

    OpenAIRE

    Imasogie, Ngozi N; Sudha Singh; Watson, James T.; Debbie Hurley; Patricia Morley-Forster

    2009-01-01

    OBJECTIVE: A pilot study was conducted to assess whether both the rationale and feasibility exist for future randomized clinical trials to evaluate the combined use of naloxone infusion and tramadol/acetaminophen as opioid-sparing drugs in elderly patients undergoing lower extremity joint replacement surgery.DESIGN: Ten patients 70 years of age or older undergoing either total knee (n=7) or total hip (n=3) arthroplasty were treated prospectively. Each patient received two tablets of tramadol/...

  3. Super obese 33-week parturient undergoing an urgent laparoscopic bowel resection: A case report and review of anesthetic implications

    Directory of Open Access Journals (Sweden)

    Yury Khelemsky

    2011-01-01

    Full Text Available Approximately two percent of women undergo non-obstetric surgery during their pregnancies. The following case report describes the anesthetic management of a super obese parturient in her third trimester of pregnancy undergoing urgent laparoscopic (converted to open bowel resection. Such a case, which has not been previously reported, has multiple clinical implications for both mother and fetus and was further complicated by super obesity (BMI>50 and laparoscopy. The anesthetic implications for this patient population are reviewed.

  4. Does preoperative gabapentin affects the characteristics of post-dural puncture headache in parturients undergoing cesarean section with spinal anesthesia?

    OpenAIRE

    Walid Hamed Nofal; Mohamed Sidky Mahmoud; Azza Atef Abd Al Alim

    2014-01-01

    Background: Gabapentin is effective for treating different types of headache including post-dural puncture headache (PDPH), also used for prophylaxis against migraine. We studied the effect of pre-operative administration of gabapentin on the characteristics of PDPH in parturients undergoing cesarean section (CS) under spinal anesthesia. Materials and Methods: Women undergoing elective cesarean section under spinal anesthesia were randomized to receive preoperative gabapentin 600 mg or placeb...

  5. A graded prognostic assessment scale to predict overall survival in patients diagnosed with brain metastases undergoing Gamma-knife radiosurgery

    OpenAIRE

    Shahzadi, Sohrab; Azimi, Parisa; Bitaraf, Mohammad Ali; Azar, Maziar; Alikhani, Mazdak; Zali, Alireza; Sadeghi, Sohrab; Salmanian, Soraya

    2012-01-01

    Abstract: Background: The present study aims to evaluate the Graded Prognostic Assessment (GPA) score for predicting overall survival in patients diagnosed with brain metastases undergoing Gamma-knife radiosurgery. Methods: This was a cross sectional study conducted on the patients diagnosed with brain metastases undergoing Gamma-knife radiosurgery during 2003 to 2011. Clinical and radiological parameters were evaluated, and the GPA score were determined. Kaplan–Meier and log-rank tests were ...

  6. [Evolution and quality of the diet of women with severe and morbid obesity undergoing gastric bypass].

    Science.gov (United States)

    Rebolledo, Annabella; Basfi-fer, Karen; Rojas, Pamela; Codoceo, Juana; Inostroza, Jorge; Carrasco, Fernando; Ruz, Manuel

    2009-03-01

    Evolution and quality of the diet of women with severe and morbid obesity undergoing gastric bypass. The objective of this study was to evaluate the changes of dietary intake and quality of the diet in patients undergoing gastric bypass. In forty-four women with severe and morbid obesity it was assessed their nutrient intakes before and 6, 12, and 18 months after gastric bypass by using three-day food records. Vitamin and mineral intakes from supplements were strictly controlled though personalized records. With the exceptions of calcium and vitamin A, energy and nutrient intakes were significantly decreased at 6, 12, and 18 month after bypass compared to the pre-surgery period. Dietary intakes of calcium, iron, zinc, copper, folic acid, vitamin C, and vitamin E were below 100% of adequacy from the 6th month after the surgery and thereafter. This situation is reverted when nutrient intakes supplied by supplements are taken into account. Although a "U" shape trend was observed in the nutrient intakes results during the experimental period, in most cases the differences between the observed values at month 12 and 18 were not significant. In conclusion, these patients had important reductions of their energy and nutrient intakes as result of gastric bypass. Routine supplements may correct this situation, nevertheless, the anatomical alterations inherent to this type of surgery may cause that total nutrient intakes reaching adequacy values slightly above 100%, may not necessarily be able to avoid the development of nutritional deficiencies.

  7. The myocardial protective effect of dexmedetomidine in high-risk patients undergoing aortic vascular surgery

    Science.gov (United States)

    Soliman, Rabie; Zohry, Gomaa

    2016-01-01

    Objective: The aim of the study was to assess the effect of dexmedetomidine in high-risk patients undergoing aortic vascular surgery. Design: A randomized prospective study. Setting: Cairo University, Egypt. Materials and Methods: The study included 150 patients undergoing aortic vascular surgery. Intervention: The patients were classified into two groups (n = 75). Group D: The patients received a loading dose of 1 μg/kg dexmedetomidine over 15 min before induction and maintained as an infusion of 0.3 μg/kg/h to the end of the procedure. Group C: The patients received an equal volume of normal saline. The medication was prepared by the nursing staff and given to anesthetist blindly. Measurements: The monitors included the heart rate, mean arterial blood pressure, central venous pressure, electrocardiogram (ECG), serum troponin I level, end-tidal sevoflurane, and total dose of morphine in addition transthoracic echocardiography to the postoperative in cases with elevated serum troponin I level. Main Results: The dexmedetomidine decreased heart rate and minimized the changes in blood pressure compared to control group (P vascular surgery. It decreases the changes in heart rate and blood pressure during the procedures. It provides cardiac protection in high-risk patients reflected by decreasing the incidence of myocardial ischemia and serum level of troponin. The main side effects of dexmedetomidine were hypotension and bradycardia. PMID:27716690

  8. The pharmacokinetics of propofol in ICU patients undergoing long-term sedation.

    Science.gov (United States)

    Smuszkiewicz, Piotr; Wiczling, Paweł; Przybyłowski, Krzysztof; Borsuk, Agnieszka; Trojanowska, Iwona; Paterska, Marta; Matysiak, Jan; Kokot, Zenon; Grześkowiak, Edmund; Bienert, Agnieszka

    2016-11-01

    The aim of this study was to characterize the pharmacokinetics (PK) of propofol in ICU patients undergoing long-term sedation and to assess the influence of routinely collected covariates on the PK parameters. Propofol concentration-time profiles were collected from 29 patients. Non-linear mixed-effects modelling in NONMEM 7.2 was used to analyse the observed data. The propofol pharmacokinetics was best described with a three-compartment disposition model. Non-parametric bootstrap and a visual predictive check were used to evaluate the adequacy of the developed model to describe the observations. The typical value of the propofol clearance (1.46 l/min) approximated the hepatic blood flow. The volume of distribution at steady state was high and was equal to 955.1 l, which is consistent with other studies involving propofol in ICU patients. There was no statistically significant covariate relationship between PK parameters and opioid type, SOFA score on the day of admission, APACHE II, predicted death rate, reason for ICU admission (sepsis, trauma or surgery), gender, body weight, age, infusion duration and C-reactive protein concentration. The population PK model was developed successfully to describe the time-course of propofol concentration in ICU patients undergoing prolonged sedation. Despite a very heterogeneous group of patients, consistent PK profiles were observed. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  9. Polygamy and Risk of Coronary Artery Disease in Men Undergoing Angiography: An Observational Study

    Science.gov (United States)

    Lotfi, Amir; Al-Murayeh, Mushabab; Al-kaabi, Salem; Al-Faifi, Salem M.; Alama, Mohamed N.; Hersi, Ahmad S.; Dixon, Ciaran M.; Ahmed, Waleed; Al-Shehri, Mohamed; Youssef, Ali; Elimam, Ahmed Moustafa; Abougalambou, Ayman S.; Murad, Waheed; Alsheikh-Ali, Alawi A.

    2017-01-01

    Epidemiologic evidence suggests a link between psychosocial risk factors such as marital status and coronary artery disease (CAD). Polygamy (multiple concurrent wives) is a distinct marital status practiced in many countries in Asia and the Middle East, but its association with CAD is not well defined. We conducted a multicenter, observational study of consecutive patients undergoing coronary angiography during the period from April 1, 2013, to March 30, 2014. Of 1,068 enrolled patients, 687 were married men. Polygamy was reported in 32% of married men (1 wife: 68%, 2 wives: 19%, 3 wives: 10%, and 4 wives: 3%). When stratified by number of wives, significant baseline differences were observed in age, type of community (rural versus urban), prior coronary artery bypass grafting (CABG), and household income. After adjusting for baseline differences, there was a significant association between polygamy and CAD (adjusted OR 4.6 [95% CI 2.5, 8.3]), multivessel disease (MVD) (adjusted OR 2.6 [95% CI 1.8, 3.7]), and left main disease (LMD) (adjusted OR 3.5 [95% CI 2.1, 5.9]). Findings were consistent when the number of wives was analyzed as a continuous variable. In conclusion, among married men undergoing coronary angiography for clinical indications, polygamy is associated with the presence of significant CAD, MVD, and LMD. PMID:28250991

  10. Influence of calcitriol treatment on nutritional status, inflammation and oxidative stress of patients undergoing maintenance hemodialysis

    Institute of Scientific and Technical Information of China (English)

    Lin-Fang Zhang; Hong-Li Yan; Xin Chen

    2015-01-01

    Objective:To analyze influences of calcitriol treatment on nutritional status, inflammation and oxidative stress of patients undergoing maintenance hemodialysis.Methods:A total of 132 patients undergoing maintenance hemodialysis in our hospital were enrolled and randomly divided into observation group and control group. The observation group (n=66 cases) underwent calcitriol treatment, while control group (n=66 cases) underwent routine treatment. Nutrition status, micro inflammation and oxidative stress of the two groups were compared. Results: (1) After treatment, patients’ TSF, MAC, AMC, Hb levels of the observation group were higher than that of the control group (P<0.05); (2) After treatment, TGF-beta 1, CTGF levels of the observation group was significantly lower than that of the control group (P<0.05), but BMP-7 level was higher than control group (P<0.05). (3) Patients’ MPO, CAT, NO, TAC levels of the observation group were higher than control group (P<0.05).Conclusion:For patients with maintenance hemodialysis, Calcitriol can optimize patients' nutritional status, reduce systemic inflammatory response, enhance antioxidant capacity.

  11. Cryopreservation of very low numbers of spermatozoa from male patients undergoing infertility treatment using agarose capsules.

    Science.gov (United States)

    Hatakeyama, Shota; Tokuoka, Susumu; Abe, Hiroyuki; Araki, Yasuyuki; Araki, Yasuhisa

    2017-07-01

    This study tried to cryopreserve low numbers of spermatozoa from men undergoing infertility treatments by inserting into agarose capsules. The capsules were transferred into a drop of cryoprotectant solution and injected 3-4 motile spermatozoa that were selected by the swim-up method by conventional intracytoplasmic sperm injection. These capsules were put on a Cryotop(®) and frozen in liquid nitrogen vapor, and then submerged into liquid nitrogen and subsequently thawed and recovered. The motile spermatozoa in the capsules were counted. Eventually, we cryopreserved 2142 motile spermatozoa in 702 agarose capsules from 26 male patients and 1356 (63%) spermatozoa maintained their motility after thawing. The spermatozoa motility rates after thawing (MRAT) ranged from 20.0% (5/25) to 95.1% (58/61) among patients. The median MRAT was 68.3% (interquartile range 46.1-75.7). The total number of motile spermatozoa collected by swim-up method strongly correlated with MRAT (r = 0.746). It was possible to cryopreserve spermatozoa from male patients undergoing infertility treatment using agarose capsules. However, there were wide differences in MRAT among patients. It seems the spermatozoa from semen where there were many motile spermatozoa may have higher freezing resistance. Further studies using this method in cryptozoospermic semen, testicular and epididymal spermatozoa are required.

  12. Examine the Relationship between Mindfulness and Drug Craving in Addicts Undergoing Methadone Maintenance Treatment.

    Directory of Open Access Journals (Sweden)

    Ali Ardame

    2014-03-01

    Full Text Available The aim of this study was examination the relationship between mindfulness and drug craving in addicts undergoing methadone maintenance treatment.The subjects of this research were 80 addicts undergoing methadone maintenance treatment selected through available sampling from four addiction treatment center in Ahvaz from March 2012 to September 2012. Two questionnaires to examine the variables of this study were the five facets mindfulness questionnaire (FFMQ and hero-in craving questionnaire (HCQ. The data were analyzed using SPSS version 16.The Pearson correlational results indicated significant reverse relation between mindfulness factors and craving sub scales (P<0.05. Besides, the regression results indicated that four factors of mindfulness such as observation, describing, acting with awareness and non-reactivity to inner experience can totally predict 48 percent of craving variance (P<0.01 .There is a reverse relation between mindfulness and craving. Therefore we advise the researchers in addiction fields that in line with various studies that indicated effectiveness of mindfulness based interventions in improving various psychological problems, be researcher in effectiveness of this intervention in addiction fields. Moreover, we advise the addiction therapists to use mindfulness based interventions and technics in order to reduction of emotional and cognitive problems co morbidities with addiction such as craving that is one of potential factors affecting survival and relapse to drug abuse.

  13. Incidental visceral and renal artery stenosis in patients undergoing coronary angiography.

    Science.gov (United States)

    Bageacu, S; Cerisier, A; Isaaz, K; Nourissat, A; Barral, X; Favre, J-P

    2011-03-01

    The study aimed to examine the association between incidentally discovered mesenteric artery stenosis, renal artery stenosis (RAS) and coronary artery disease in patients undergoing coronary angiography. We performed a prospective analysis of consecutive patients undergoing routine cardiac catheterisation. Abdominal aortograms in lateral and antero-posterior view were obtained to assess arterial stenosis of the coeliac axis, superior mesenteric artery and renal arteries. Significant arterial stenosis was defined as a narrowing of at least 50% compared with the normal artery. Demographic data and cardiovascular risk factors were analysed. The prevalence of visceral artery stenosis (VAS) was 63/450 (14%) including 48/450 (10.6%) cases of coeliac axis stenosis and 15/450 (3.3%) cases of superior mesenteric artery stenosis. Female sex (p = 0.01), older age (p = 0.03) and the presence of coronary artery disease (p = 0.05) were significant predictors for the presence of VAS in univariate analysis. The determinants for VAS in multivariate analysis were female sex and three-vessel coronary artery disease, while two- and three-vessel coronary artery disease was significant for RAS. Screening for VAS and RAS in female patients older than 60 years with more than two diseased coronary segments could have a high diagnostic value. Copyright © 2010 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

  14. Changes in Coagulation and Fibrinolytic Indices in Women with Polycystic Ovarian Syndrome Undergoing Controlled Ovarian Hyperstimulation

    Directory of Open Access Journals (Sweden)

    Ying Huang

    2014-01-01

    Full Text Available Background. Polycystic ovarian syndrome (PCOS women undergoing in vitro fertilization and embryo transfer (IVF-ET treatment always attain a low cumulative pregnancy rate disaccording with the satisfactory number of oocytes. Objective. We aim to evaluate the status of coagulation and fibrinolytic system in PCOS patients undergoing controlled ovarian hyperstimulation (COH process. Method. Of the 97 women, 30 patients with PCOS composed the study group; 67 women of child-bearing age with normal endocrine function composed the control group. All participants underwent GnRH agonist standard long protocol, and plasma HCY, FVIII, FX, and D-dimer levels as well as hormone parameters were measured at day of full downregulation, hCG priming, and embryos transfer. Results. On day of full downregulation, FX levels were significantly higher in PCOS group (P<0.01. On hCG priming day, FX and estrogen levels in PCOS group were higher than in the control group and FVIII levels were significantly lower on day of embryos transfer whereas FX and E2 levels were significantly higher in PCOS group. Conclusion. Hypercoagulable state during peri-implantation phase would probably lead to poor microcirculation of endometrium and be one of the most important disadvantages of successful implantation and subsequent clinical pregnancy.

  15. Body mass index, conversion rate and complications among patients undergoing robotic surgery for endometrial carcinoma.

    Science.gov (United States)

    Cunningham, Mary J; Dorzin, Esther; Nguyen, Loan; Anderson, Elizabeth; Bunn, W Douglas

    2015-12-01

    A retrospective cohort study was performed to evaluate the relationship of BMI to conversion rate in patients undergoing robotic surgery for endometrial cancer. Secondary outcomes were operative times, number of lymph nodes retrieved, and complications. Women with endometrial cancer scheduled for robotic surgery from September 2008 to September 2012 were included. Women were divided into three groups based on BMI, and conversion rates to laparotomy were compared. Descriptive and comparative analyses were performed among non-obese, obese, and morbidly obese women who completed robotic surgery. 298 women were scheduled for robotic surgery for endometrial carcinoma: 87 non-obese (BMI 19-29, μ 25.23), 110 obese (BMI 30-39, μ 34.21), and 101 morbidly obese (BMI 40-71, μ 47.38). Conversion to laparotomy occurred in 18 patients (6%), with no difference in conversion rate between BMI categories. Direct comparison between converted and completed robotic patients showed no significant differences in preoperative characteristics, except that patients who required conversion had a higher number of previous abdominal surgeries. Patients completing robotic surgery underwent node dissections at similar rates in all three BMI categories. Operating room time, but not surgical time, was increased in morbidly obese patients. There were no significant differences in complications, performance of lymphadenectomy, or lymph node yields between BMI categories. Increase in BMI was not associated with an increase in rate of conversion to laparotomy or complication rate in patients undergoing robotic surgery for endometrial carcinoma. Node dissections were pathologically equivalent between BMI categories.

  16. Hypovitaminosis D in Patients Undergoing Shoulder Arthroplasty: A Single-Center Analysis.

    Science.gov (United States)

    Inkrott, Bradley P; Koberling, Jessica L; Noel, Curtis R

    2016-07-01

    Vitamin D is recognized as an essential component in bone health, muscle function, and immune system regulation. This study sought to characterize the prevalence of hypovitaminosis D in patients undergoing total shoulder arthroplasty (TSA), reverse total shoulder arthroplasty (RSA), and shoulder hemiarthroplasty (HA). Between September 2013 and December 2014, a total of 218 patients undergoing TSA, RSA, and HA by a single surgeon were screened for hypovitaminosis D and retrospectively reviewed. Demographic variables and risk factors were recorded. Overall, 93 shoulder arthroplasty patients (43%) were vitamin D insufficient (hypovitaminosis D (odds ratio [OR], 8.234, Phypovitaminosis D. Almost half (43%) of the study population was insufficient, and both the absence of supplementation prior to serum testing and BMI of 30 kg/m(2) or greater were found to be predictive of lower serum 25-hydroxyvitamin D levels. Given the extent of vitamin D involvement in normal musculoskeletal physiology, routine preoperative evaluation is merited. [Orthopedics. 2016; 39(4):e651-e656.].

  17. Validation of different staging systems for hepatocellular carcinoma in a cohort of 249 patients undergoing radiotherapy

    Science.gov (United States)

    Lu, Hui-Rong; Li, Ye-Fei; Liang, Shi-Xiong; Zhang, Chun-Yan

    2017-01-01

    There is no consensus on predicting prognosis for hepatocellular carcinoma patients undergoing radiotherapy. This study aims to evaluate the validity of different staging systems. Overall, 249 hepatocellular carcinoma patients were evaluated retrospectively. All patients were classified by different staging systems. The cumulative survival rates were calculated using the Kaplan-Meier method, and survival curves were compared using the log-rank test. Harrell's concordance index (c-index) was calculated. The 1-, 3-, and 5-year overall survival rates were 58%, 31% and 20%, respectively. Significant differences in overall survival were observed between stages I and II of the Okuda staging system (p=0.004), between scores of 3 and 4 of Cancer of the Liver Italian Program prognostic score (p=0.009), between Chinese University Prognostic Index low-risk and intermediate-risk groups (p=0.01), between 1 and 2 points of the Japan Integrated Staging score (p=0.037), between stages III and IV of American Joint Committee on Cancer 1997 TNM staging system (p=0.011), between stages II and III of American Joint Committee on Cancer 2002 TNM staging system (p=0.026) and between stages I and II of Guangzhou 2001 staging system (p=0.000). In conclusion, the Okuda staging system, Chinese University Prognostic Index, and Chinese Guangzhou 2001 staging system were more discriminative than the other staging systems in the prognostic stratification for hepatocellular carcinoma patients undergoing radiotherapy. PMID:28147327

  18. Visual Performance in Patients with Neovascular Age-Related Macular Degeneration Undergoing Treatment with Intravitreal Ranibizumab

    Directory of Open Access Journals (Sweden)

    Sarah Sabour-Pickett

    2013-01-01

    Full Text Available Purpose. To assess visual function and its response to serial intravitreal ranibizumab (Lucentis, Genentech in patients with neovascular age-related macular degeneration (nv-AMD. Methods. Forty-seven eyes of 47 patients with nv-AMD, and corrected distance visual acuity (CDVA logMAR 0.7 or better, undergoing intravitreal injections of ranibizumab, were enrolled into this prospective study. Visual function was assessed using a range of psychophysical tests, while mean foveal thickness (MFT was determined by optical coherence tomography (OCT. Results. Group mean (±sd MFT reduced significantly from baseline (233 (±59 to exit (205 (±40 (P=0.001. CDVA exhibited no change between baseline and exit visits (P=0.48 and P=0.31, resp.. Measures of visual function that did exhibit statistically significant improvements (P<0.05 for all included reading acuity, reading speed, mesopic and photopic contrast sensitivity (CS, mesopic and photopic glare disability (GD, and retinotopic ocular sensitivity (ROS at all eccentricities. Conclusion. Eyes with nv-AMD undergoing intravitreal ranibizumab injections exhibit improvements in many parameters of visual function. Outcome measures other than CDVA, such as CS, GD, and ROS, should not only be considered in the design of studies investigating nv-AMD, but also in treatment and retreatment strategies for patients with the condition.

  19. The effect of live classical piano music on the vital signs of patients undergoing ophthalmic surgery.

    Science.gov (United States)

    Camara, Jorge G; Ruszkowski, Joseph M; Worak, Sandra R

    2008-06-25

    Music and surgery. To determine the effect of live classical piano music on vital signs of patients undergoing ophthalmic surgery. Retrospective case series. 203 patients who underwent various ophthalmologic procedures in a period during which a piano was present in the operating room of St. Francis Medical Center. [Note: St. Francis Medical Center has recently been renamed Hawaii Medical Center East.] Demographic data, surgical procedures, and the vital signs of 203 patients who underwent ophthalmic procedures were obtained from patient records. Blood pressure, heart rate, and respiratory rate measured in the preoperative holding area were compared with the same parameters taken in the operating room, with and without exposure to live piano music. A paired t-test was used for statistical analysis. Mean arterial pressure, heart rate, and respiratory rate. 115 patients who were exposed to live piano music showed a statistically significant decrease in mean arterial blood pressure, heart rate, and respiratory rate in the operating room compared with their vital signs measured in the preoperative holding area (P piano music showed a statistically significant increase in mean arterial blood pressure (P piano music lowered the blood pressure, heart rate, and respiratory rate in patients undergoing ophthalmic surgery.

  20. Efficacy of microwave ablation for severe secondary hyperparathyroidism in subjects undergoing hemodialysis.

    Science.gov (United States)

    Diao, Zongli; Wang, Liyan; Li, Dishan; Liu, Wenhu

    2017-11-01

    Severe secondary hyperparathyroidism (SHPT) is a serious problem in patients undergoing hemodialysis. The efficacy and safety of microwave ablation (MWA), a minimally invasive treatment, for severe SHPT are as yet unclear. To clarify the role of MWA, we administered it to patients with severe SHPT and assessed its efficacy and safety. This was a prospective, single-center, single-arm, clinical trial. We enrolled patients with severe SHPT attending our hemodialysis center who met the inclusion and exclusion criteria. We then assessed primary outcome measures (serum concentrations of intact parathyroid hormone) and secondary outcome measures (serum concentrations of calcium and phosphorus). Twenty-six patients were enrolled in this study, 10 of whom (38.46%) were responsive to MWA and 16 (61.54%) of whom were not. The main complication was hypocalcemia (10 cases, 38.46%), which had occurred in all cases by one week after administration of MWA. Responding patients with hypocalcemia all achieved normal serum calcium concentrations within seven months and non-responding patients within three months. There were no changes in serum phosphorus concentrations after MWA in either responders or non-responders. Microwave ablation is relatively ineffective in patients with severe SHPT undergoing maintaining hemodialysis and should not be the initial therapy in such cases.