WorldWideScience

Sample records for single parenteral injection

  1. Compatibility of verapamil hydrochloride injection in commonly used large-volume parenterals.

    Science.gov (United States)

    Cutie, M R; Lordi, N G

    1980-05-01

    The visual and chemical compatibilities of verapamil hydrochloride injection in 10 commonly used large-volume solutions packaged in glass, polyolefin, or polyvinyl chloride containers were studied. The mixtures, each containing 40 mg/liter of verapamil hydrochloride, were stored away from light for up to 48 hours at 25 degrees C. The solutions were examined visually for haze, precipitate formation, color change, and evolution of gas immediately after mixing and at 0.25, 1, 3, 8, 24, and 48 hours. Spectrophotometry and thin-layer chromatography were used to test for drug decomposition or chemical incompatibilities. All test methods used showed that no significant degradation of verapamil hydrochloride had taken place in the solutions or through contact with the containers. Slightly higher spectrophotometric readings for dextrose-containing solutions, though within experimental error, could have indicated the presence of dextrose degradation products. Evidence from this study suggests that verapamil hydrocholoride is compatible with the large-volume parenterals studied.

  2. Intra-parenchymal brainstem haemorrhage secondary to iatrogenic needle injury after a parenteral injection in a cat.

    Science.gov (United States)

    Brocal, Josep; Guevar, Julien; Stalin, Catherine; Durand, Alexane; Gutierrez-Quintana, Rodrigo

    2016-01-01

    A 6-month-old female domestic shorthair cat was presented with acute onset non-ambulatory right hemiparesis and horizontal nystagmus following an injection attempt in the neck, during which the cat did not cooperate. Magnetic resonance imaging (MRI) revealed a well-defined intra-axial lesion on the right side of the myelencephalon. The lesion was T2-weighted hypointense and T1-weighted hypointense to isointense to grey matter, non-contrast enhancing, with perilesional oedema and signal void on T2*-weighted images. A linear hyperintense lesion in the muscles of the right dorsolateral aspect of the neck on short tau inversion recovery images was also observed. These MRI findings were consistent with iatrogenic brainstem haemorrhage and a muscle needle tract. The cat made a good recovery with just mild residual neurological deficits 6 weeks after the injury. To our knowledge, this is the first report of an iatrogenic brainstem needle injury in a cat and the first report of a central nervous system iatrogenic trauma after a parenteral injection. Care should be taken with neck parenteral injections, especially in the cranial cervical area.

  3. Preformulation studies of ceftriaxone for pediatric non-parenteral administration as an alternative to existing injectable formulations.

    Science.gov (United States)

    Kauss, Tina; Marchivie, Mathieu; Phoeung, Thida; Gaubert, Alexandra; Désiré, Amélie; Tonelli, Giovanni; Boyer, Chantal; Langlois, Marie-Hélène; Cartwright, Anthony; Gomes, Melba; White, Nicholas; Gaudin, Karen

    2017-06-15

    Ceftriaxone, a third generation cephalosporin, has a wide antibacterial spectrum that has good CNS penetration, which makes it potentially suitable for initial treatment of severe neonatal pediatric infections providing suitable formulation. We evaluated its physicochemical and technical characteristics to assess its potential for development as a non-parenteral dosage form. As ceftriaxone is marked only for injectable use, these data are not available. Using HPLC and Karl Fischer titration, sensitivity of ceftriaxone to water, feasibility and impact of pharmaceutical processes and compatibility with common pharmaceutical excipients were assessed. X-ray diffraction studies gave deeper insight into the mechanisms involved in degradation. Chemometrical analysis of near infrared spectra enabled classification of ceftriaxone powder according to exposure conditions or processes applied. The results showed that ceftriaxone was not highly hygroscopic, could be processed in all climatic zones, but should be packaged protected against humidity. Controlling water presence in formulation was shown critical, as ceftriaxone degraded in the presence of water content above 2.4% w/w. To improve flowability, a critical parameter for dry dosage form development, granulation (wet and dry techniques, providing complete drying and moderate force compaction respectively) was shown feasible. Compression with moderate forces was possible, but grinding and high compression forces significantly affected long term ceftriaxone stability and should be avoided. Based on these results, development of ceftriaxone non-parenteral solid or liquid non-aqueous forms appears feasible. Copyright © 2017. Published by Elsevier B.V.

  4. Tunneling spin injection into single layer graphene.

    Science.gov (United States)

    Han, Wei; Pi, K; McCreary, K M; Li, Yan; Wong, Jared J I; Swartz, A G; Kawakami, R K

    2010-10-15

    We achieve tunneling spin injection from Co into single layer graphene (SLG) using TiO₂ seeded MgO barriers. A nonlocal magnetoresistance (ΔR(NL)) of 130  Ω is observed at room temperature, which is the largest value observed in any material. Investigating ΔR(NL) vs SLG conductivity from the transparent to the tunneling contact regimes demonstrates the contrasting behaviors predicted by the drift-diffusion theory of spin transport. Furthermore, tunnel barriers reduce the contact-induced spin relaxation and are therefore important for future investigations of spin relaxation in graphene.

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

    Directory of Open Access Journals (Sweden)

    Sharef W. Sharef

    2015-05-01

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

  6. Relationship between turnover rate and oxidation rate of alanine in the post-absorptive state and during parenteral nutrition before and after surgery

    NARCIS (Netherlands)

    Sauerwein, H. P.; Michels, R. P.; Cejka, V.

    1985-01-01

    The influence of total parenteral nutrition and stomach resection on alanine turnover rate and alanine oxidation rate was measured in ten patients after single injection of U-14 C-alanine. Sequential studies were done in three patients. During parenteral nutrition alanine turnover was significantly

  7. Discharge characteristics of a double injection-valve single-pump injection system

    Science.gov (United States)

    Lee, Dana W; Marsh, E T

    1937-01-01

    The discharge characteristics of two similar injection valves operated by a single-cylinder fuel-injection pump were determined with an apparatus that measured the quantity of fuel discharged from each valve during every 0.5 degrees of pump rotation. It was found that similar discharges took place from the two valves at all pump speeds when the valve-opening pressures, the nozzle-orifice diameters, and the injection-tube lengths were the same for both valves. Under these conditions, the effects of changing the pump speed, the pump throttle setting, or the nozzle orifice diameter were very similar to those occurring with a single-injection valve. By a proper selection of discharge-orifice areas and valve-opening pressures it was possible to obtain a great many combinations of discharge quantities, discharge rates, and injection timings for the two valves. A series of tests using injection tubes of unequal lengths for the two valves showed that under these conditions the injection timing and the fuel quantity discharged from each valve varies widely and erratically with changes in the pump speed.

  8. Performance characterization of pneumatic single pellet injection system

    International Nuclear Information System (INIS)

    Schuresko, D.D.; Milora, S.L.; Hogan, J.T.; Foster, C.A.; Combs, S.K.

    1982-01-01

    The Oak Ridge National Laboratory single-shot pellet injector, which has been used in plasma fueling experiments on ISX and PDX, has been upgraded and extensively instrumented in order to study the gas dynamics of pneumatic pellet injection. An improved pellet transport line was developed which utilizes a 0.3-cm-diam by 100-cm-long guide tube. Pellet gun performance was characterized by measurements of breech and muzzle dynamic pressures and by pellet velocity and mass determinations. Velocities up to 1.4 km/s were achieved for intact hydrogen pellets using hydrogen propellant at 5-MPa breech pressure. These data have been compared with new pellet acceleration calculations which include the effects of propellant friction, heat transfer, time-dependent boundary conditions, and finite gun geometry. These results provide a basis for the extrapolation of present-day pneumatic injection system performance to velocities in excess of 2 km/s

  9. Total parenteral nutrition

    Science.gov (United States)

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

  10. Total parenteral nutrition - infants

    Science.gov (United States)

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

  11. Cost-Utility of a Single-Injection Combined Corticosteroid-Hyaluronic Acid Formulation vs a 2-Injection Regimen of Sequential Corticosteroid and Hyaluronic Acid Injections.

    Science.gov (United States)

    Belzile, Etienne L; Deakon, Robert T; Vannabouathong, Christopher; Bhandari, Mohit; Lamontagne, Martin; McCormack, Robert

    2017-01-01

    Research has shown early and sustained relief with a combination therapy of a corticosteroid (CS) and hyaluronic acid (HA) in knee osteoarthritis (OA) patients. This can be administered via a single injection containing both products or as separate injections. The former may be more expensive when considering only product cost, but the latter incurs the additional costs and time of a second procedure. The purpose of this study was to compare the cost-utility of the single injection with the 2-injection regimen. The results of this analysis revealed that the single-injection formulation of a CS and HA may be cost-effective, assuming a willingness-to-pay of $50 000 per quality-adjusted life year gained, for symptomatic relief of OA symptoms. This treatment may also be more desirable to patients who find injections to be inconvenient or unpleasant.

  12. Efficacy of a single ultrasound-guided injection for the treatment of hip osteoarthritis.

    LENUS (Irish Health Repository)

    Atchia, Ismaël

    2011-01-01

    Intra-articular injection is effective for osteoarthritis, but the best single injection strategy is not known, nor are there established predictors of response. The objectives of this study were to assess and predict response to a single ultrasound-guided injection in moderate to severe hip osteoarthritis.

  13. Efficacy, Safety, and Preparation of Standardized Parenteral Nutrition Regimens: Three-Chamber Bags vs Compounded Monobags-A Prospective, Multicenter, Randomized, Single-Blind Clinical Trial.

    Science.gov (United States)

    Yu, Jianchun; Wu, Guohao; Tang, Yun; Ye, Yingjiang; Zhang, Zhongtao

    2017-08-01

    Parenteral nutrition (PN) covering the need for carbohydrates, amino acids, and lipids can either be compounded from single nutrients or purchased as an industrially manufactured ready-to-use regimen. This study compares a commercially available 3-chamber bag (study group) with a conventionally compounded monobag regarding nutrition efficacy, safety, and regimen preparation time. This prospective, randomized, single-blind study was conducted at 5 Chinese hospitals from October 2010-October 2011. Postsurgical patients requiring PN for at least 6 days were randomly assigned to receive the study or control regimen. Plasma concentrations of prealbumin and C-reactive protein (CRP), regimen preparation time, length of hospital stay (LOS), 30-day mortality, safety laboratory parameters, and adverse events (AEs) were recorded. In total, 240 patients (121 vs 119 in study and control groups) participated in this study. Changes in prealbumin concentrations during nutrition support (Δ Prealb(StudyGroup) = 2.65 mg/dL, P values were comparable. Regimen preparation time was significantly reduced in the study group by the use of 3-chamber bags (t (StudyGroup) = 4.90 ± 4.41 minutes vs t (ControlGroup) = 12.13 ± 5.62 minutes, P bag was comparable to the compounded regimen and safe in use. Time savings during regimen preparation indicates that use of 3-chamber bags simplifies the process of regimen preparation.

  14. Increasing energy efficiency of a gasoline direct injection engine through optimal synchronization of single or double injection strategies

    International Nuclear Information System (INIS)

    Costa, Michela; Sorge, Ugo; Allocca, Luigi

    2012-01-01

    Highlights: ► Advantages of split injection in a GDI engine are studied through numerical simulation. ► At high load and speed, rich conditions, split injection does not improve engine performance. ► At moderate load and speed, lean conditions, double injection improves charge stratification. ► Optimal double injection increases work, reduces HC and increases NO. - Abstract: The greatest fuel efficiency advantages of gasoline direct injection (GDI) engines are achieved under the so-called mixed mode boosting, where mixture characteristics are properly adapted to the specific working condition. In particular, in the medium range of load and speed, overall lean mixtures are suitable of being used in the so-called direct injection stratified charge operation. Present paper reports the results of numerical optimization analyses aimed at increasing the energetic efficiency of a GDI engine equipped with a high pressure multi-hole injector under both single and double injection events. In moderate-load moderate-speed lean conditions, the single or double injection synchronization in the working cycle is effected through a procedure that couples a 3D numerical model of the in-cylinder processes with an optimization tool. The choice of both the start of the injection events and the time of spark advance is realized to maximize the engine work. The optimal double injection solution is shown to increase the engine energy efficiency with respect to the case injection is realized in one shot, thus confirming that split injections improve the quality of the charge stratification under lean operation. The effect on the major pollutants is also discussed.

  15. Experimental investigations of a single cylinder genset engine with common rail fuel injection system

    Directory of Open Access Journals (Sweden)

    Gupta Paras

    2014-01-01

    Full Text Available Performance and emissions characteristics of compression ignition (CI engines are strongly dependent on quality of fuel injection. In an attempt to improve engine combustion, engine performance and reduce the exhaust emissions from a single cylinder constant speed genset engine, a common rail direct injection (CRDI fuel injection system was deployed and its injection timings were optimized. Results showed that 34°CA BTDC start of injection (SOI timings result in lowest brake specific fuel consumption (BSFC and smoke opacity. Advanced injection timings showed higher cylinder peak pressure, pressure rise rate, and heat release rate due to relatively longer ignition delay experienced.

  16. Optimal sampling strategies to assess inulin clearance in children by the inulin single-injection method

    NARCIS (Netherlands)

    van Rossum, Lyonne K.; Mathot, Ron A. A.; Cransberg, Karlien; Vulto, Arnold G.

    2003-01-01

    Glomerular filtration rate in patients can be determined by estimating the plasma clearance of inulin with the single-injection method. In this method, a single bolus injection of inulin is administered and several blood samples are collected. For practical and convenient application of this method

  17. Injection molded nanofluidic chips: Fabrication method and functional tests using single-molecule DNA experiments

    DEFF Research Database (Denmark)

    Utko, Pawel; Persson, Karl Fredrik; Kristensen, Anders

    2011-01-01

    We demonstrate that fabrication of nanofluidic systems can be greatly simplified by injection molding of polymers. We functionally test our devices by single-molecule DNA experiments in nanochannels.......We demonstrate that fabrication of nanofluidic systems can be greatly simplified by injection molding of polymers. We functionally test our devices by single-molecule DNA experiments in nanochannels....

  18. Electroluminescence from single nanowires by tunnel injection: an experimental study

    OpenAIRE

    Zimmler, Mariano A.; Bao, Jiming; Shalish, Ilan; Yi, Wei; Yoon, Joonah; Narayanamurti, Venkatesh; Capasso, Federico

    2007-01-01

    We present a hybrid light-emitting diode structure composed of an n-type gallium nitride nanowire on a p-type silicon substrate in which current is injected along the length of the nanowire. The device emits ultraviolet light under both bias polarities. Tunnel-injection of holes from the p-type substrate (under forward bias) and from the metal (under reverse bias) through thin native oxide barriers consistently explains the observed electroluminescence behaviour. This work shows that the stan...

  19. Single-needle temporomandibular joint arthrocentesis with hyaluronic acid injections. Preliminary data after a five-injection protocol.

    Science.gov (United States)

    Manfredini, D; Guarda-Nardini, L; Ferronato, G

    2009-10-01

    The classical technique for temporomandibular joint (TMJ) arthrocentesis provides a double access to the joint space, which may lead to patient's postoperatory discomfort. For this reason, a less invasive, single-needle approach has been recently described, and the present investigation reports findings on a case series of patients with TMJ osteoarthritis treated with hyaluronic acid injections following a single needle arthrocentesis. METHODS. Fourteen consecutive patients with a diagnosis of TMJ osteoarthritis according to the Research Diagnostic Criteria for Temporo-mandibular Disorders were treated with a cycle of five weekly injections of hyaluronic acid after arthrocentesis. A number of subjective (pain at rest and mastication, masticatory efficiency, functional limitation, subjective efficacy of treatment, tolerability of treatment) and objective (maximum assisted and unassited mouth opening, protrusive and laterotrusive movements) outcome variables were assessed before and after the treatment period. At the end of the five-injection protocol, significant improvements were showed in almost all the subjective outcome variables. Tolerability of the treatment was good on a four-point ordinal scale since the time of the first injection. The present investigation suggested that the single needle technique for TMJ hyaluronic injection following arthrocentesis in osteoarthritic joints may have promising applications in the clinical setting, which have to be confirmed with future studies.

  20. Electroluminescence from single nanowires by tunnel injection: an experimental study

    Science.gov (United States)

    Zimmler, Mariano A.; Bao, Jiming; Shalish, Ilan; Yi, Wei; Yoon, Joonah; Narayanamurti, Venkatesh; Capasso, Federico

    2007-06-01

    We present a hybrid light-emitting diode structure composed of an n-type gallium nitride nanowire on a p-type silicon substrate in which current is injected along the length of the nanowire. The device emits ultraviolet light under both bias polarities. Tunnel injection of holes from the p-type substrate (under forward bias) and from the metal (under reverse bias) through thin native oxide barriers consistently explains the observed electroluminescence behaviour. This work shows that the standard p-n junction model is generally not applicable to this kind of device structure.

  1. Spread of dye after single thoracolumbar paravertebral injection in infants. A cadaveric study.

    Science.gov (United States)

    Albokrinov, Andrew A; Fesenko, Ulbolgan A

    2014-06-01

    Thoracolumbar paravertebral block (PVB) is one method of providing regional anaesthesia for abdominal wall surgery in children. It is common practice when performing a PVB for abdominal wall anaesthesia to inject a certain volume of local anaesthetic solution in the paravertebral space at several levels. This increases the duration of the procedure and makes it more invasive. To determine the character of dye spread in infants' paravertebral space, to check the feasibility of single injection PVB and to determine the optimal volume of injectate necessary to cover the paravertebral segments responsible for sensation of the lower abdomen. Experimental study. Single centre, University Hospital, April 2013 to August 2013. Twenty infant cadavers. Ultrasound-guided, single thoracolumbar paravertebral injections were performed on infant cadavers. The total number of paravertebral segments stained after dye injection and specific vertebral levels of cephalad and caudad spread of dye in the paravertebral space. Dye was present in the paravertebral spaces of all cadavers. Spread of dye within the paravertebral space was different depending on dye volume. Strong correlation was found between the volume of injectate and the number of paravertebral segments involved. The number of spinal nerve roots surrounded with dye corresponded with the number of paravertebral segments involved. T11, T12 and L1 nerve roots were stained in all cadavers. The optimal injectate volume to involve T10-L1 segments was defined as 0.2 to 0.3  ml  kg(-1). Single thoracolumbar paravertebral injection at T12-L1 level leads to caudad and cephalad spread of injectate in a dose-dependent manner. Single injection thoracolumbar paravertebral injections could be performed for lower abdomen anaesthesia in infants. We suggest that a single injection of 0.2 to 0.3  ml  kg(-1) of local anaesthetic in the thoracolumbar paravertebral space could provide adequate coverage of the dermatomes of the lower

  2. Use of parenteral testosterone in hypospadias cases

    Directory of Open Access Journals (Sweden)

    Vikram Satav

    2015-01-01

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

  3. Amplitude Noise Suppression and Orthogonal Multiplexing Using Injection-Locked Single-Mode VCSEL

    DEFF Research Database (Denmark)

    Lyubopytov, Vladimir; von Lerber, Tuomo; Lassas, Matti

    2017-01-01

    We experimentally demonstrate BER reduction and orthogonal modulation using an injection locked single-mode VCSEL. It allows us suppressing an amplitude noise of optical signal and/or double the capacity of an information channel....

  4. Multi-Element Lean Direct Injection Combustor Single Element Demonstration, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — We propose to demonstrate the feasibility in a single element of a Multi-Element Lean Direct Injection, ME-LDI, Combustion concept. The concept will have the...

  5. Use of parenteral testosterone in hypospadias cases

    OpenAIRE

    Vikram Satav; Vilas P Sabale; Sharad P Kankalia; Bhupender Kadyan; Abhirudra Mulay; Deepak Mane; Rohit Singh; Thakur Naveen

    2015-01-01

    Objectives: The aim was to evaluate the effect of parenteral testosterone on penile length, preputial hood, vascularity of dartos pedicle in patients with hypospadias. Materials and Methods: A total of 42 patients with hypospadias were included in this study. Injection aquaviron (oily solution each ml containing testosterone propionate 25 mg) was given deep intramuscularly in three doses with an interval of 3 weeks before reconstructive surgery at the dose of 2 mg/kg body weight. Preoperative...

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

    Science.gov (United States)

    Esposito, S; Mazzei, T; Novelli, A

    2001-12-01

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

  7. The effect of a parenteral ivermectin/closantel injection on the growth and reproductive development of early immature Fasciola hepatica in cattle.

    Science.gov (United States)

    Hanna, R E B; Cromie, L; Taylor, S M; Couper, A

    2006-11-30

    Sixteen calves approximately 6 months old were each infected with 500 metacercariae of Fasciola hepatica. Thirty-two days later they were weighed and divided into two groups, and on day 35 all calves in one of the groups were injected subcutaneously with an ivermectin/closantel combination. Both groups were sacrificed between days 70 and 72 to enable counting and examination of the flukes recovered from the bile ducts. Eggs released by the flukes were collected for incubation, hatching and estimation of egg viability. Flukes were counted, flat-fixed in 70% ethanol, stained with catechol and carmine and measured. The reproductive organs, namely testis, vitelline glands, ovary and uterus, were examined and scored on a 0-3 scale according to their state of development. This was visually assessed on the basis of size, distribution and staining density of their constituent tissues and the abundance of eggs in the uterus. A representative sample of flukes from each animal was fixed in formalin for histological sectioning to enable more detailed examination of the reproductive structures. Treatment of the immature flukes reduced the population in cattle by 42.6% as compared with the controls and as a result of the stunting effect due to the presence of closantel during early development the size of treated flukes was reduced by 43.9%. A bimodal pattern of size and reproductive score was also observed in flukes from treated cattle, suggesting that the stunting effect on individual flukes differed depending on whether or not they had gained access to the bile ducts or were still migrating in the hepatic parenchymal tissue at the time of drug exposure with the effect being greater once the fluke had gained access to the bile ducts. The mean reproductive score for untreated flukes was 8.76 and for treated flukes 5.64, a 35.6% reduction. This difference was highly significant (p<0.001). Egg shedding from treated flukes was significantly less than that from controls (p<0

  8. All-in-polymer injection molded device for single cell capture using multilevel silicon master fabrication

    DEFF Research Database (Denmark)

    Tanzi, S.; Larsen, S.T.; Matteucci, M.

    2012-01-01

    This work demonstrates a novel all-in-polymer device for single cell capture applicable for biological recordings. The chip is injection molded and comprises a "cornered" (non planar) aperture. It has been demonstrated how cornered apertures are straightforward to mold in PDMS [1,2]. In this stud...... defects during demolding. Capturing of single PC12 cells has been demonstrated.......This work demonstrates a novel all-in-polymer device for single cell capture applicable for biological recordings. The chip is injection molded and comprises a "cornered" (non planar) aperture. It has been demonstrated how cornered apertures are straightforward to mold in PDMS [1,2]. In this study...

  9. Parenteral approaches in malabsorption: Home parenteral nutrition.

    Science.gov (United States)

    Wanten, Geert J A

    2016-04-01

    Severe malabsorption of fluids and nutrients leads to intestinal failure (IF) where intravenous supplementation of nutrients and fluids is necessary to maintain health and/or growth. Long-term treatment of IF implies the start of intravenous support in the outpatient setting (home parenteral nutrition, HPN). Although HPN has proven lifesaving for many patients for more than four decades this strategy remains associated with complications that compromise the quality of life. Many problems relate to the presence of the venous access device and concern infections or vascular occlusion due to thrombosis. Patient training remains key to prevent these complications. Also metabolic problems may arise that involve liver function or composition or bone mineralization. While intestinal transplantation remains inferior to HPN as alternative treatment strategy in terms of survival, promising developments include the introduction of hormones that promote intestinal adaptation, mixed lipid emulsions that decrease liver problems and catheter lock solutions that prevent infections. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. 3D-CFD Simulation of Confined Cross-Flow Injection Process Using Single Piston Pump

    Directory of Open Access Journals (Sweden)

    M. Elashmawy

    2017-12-01

    Full Text Available Injection process into a confined cross flow is quite important for many applications including chemical engineering and water desalination technology. The aim of this study is to investigate the performance of the injection process into a confined cross-flow of a round pipe using a single piston injection pump. A computational fluid dynamics (CFD analysis has been carried out to investigate the effect of the locations of the maximum velocity and minimum pressure on the confined cross-flow process. The jet trajectory is analyzed and related to the injection pump shaft angle of rotation during the injection duty cycle by focusing on the maximum instant injection flow of the piston action. Results indicate a low effect of the jet trajectory within the range related to the injection pump operational conditions. Constant cross-flow was used and injection flow is altered to vary the jet to line flow ratio (QR. The maximum jet trajectory exhibits low penetration inside the cross-flow. The results showed three regions of the flow ratio effect zones with different behaviors. Results also showed that getting closer to the injection port causes a significant decrease on the locations of the maximum velocity and minimum pressure.

  11. Parenteral Nutrition and Lipids.

    Science.gov (United States)

    Raman, Maitreyi; Almutairdi, Abdulelah; Mulesa, Leanne; Alberda, Cathy; Beattie, Colleen; Gramlich, Leah

    2017-04-14

    Lipids have multiple physiological roles that are biologically vital. Soybean oil lipid emulsions have been the mainstay of parenteral nutrition lipid formulations for decades in North America. Utilizing intravenous lipid emulsions in parenteral nutrition has minimized the dependence on dextrose as a major source of nonprotein calories and prevents the clinical consequences of essential fatty acid deficiency. Emerging literature has indicated that there are benefits to utilizing alternative lipids such as olive/soy-based formulations, and combination lipids such as soy/MCT/olive/fish oil, compared with soybean based lipids, as they have less inflammatory properties, are immune modulating, have higher antioxidant content, decrease risk of cholestasis, and improve clinical outcomes in certain subgroups of patients. The objective of this article is to review the history of IVLE, their composition, the different generations of widely available IVLE, the variables to consider when selecting lipids, and the complications of IVLE and how to minimize them.

  12. The efficacy of multiple versus single hyaluronic acid injections: a systematic review and meta-analysis.

    Science.gov (United States)

    Concoff, Andrew; Sancheti, Parag; Niazi, Faizan; Shaw, Peter; Rosen, Jeffrey

    2017-12-21

    Intra-articular hyaluronic acid (IA-HA) is a common therapy used to treat knee pain and suppress knee inflammation in knee osteoarthritis (OA), typically prescribed in regimens ranging from a single injection to 5 weekly injections given once weekly. We conducted a systematic review to determine the efficacy of IA-HA, with subgroup analyses to explore the differences in knee pain and adverse events (AEs) across different dosing regimens. We conducted a systematic search of the literature to identify studies evaluating IA-HA for the management of knee OA compared to IA-saline. Primary outcome measure was the mean knee pain score at 13 Weeks (3 months) or 26 weeks (6 months). Secondary outcome was the number of treatment-related AEs and treatment-related serious adverse events (SAEs). We evaluated differences in levels of pain and AEs/SAEs between dosing regimens compared to IA-Saline. Thirty articles were included. Overall, IA-HA injections were associated with less knee pain compared to IA-Saline injections for all dosing regimens. 2-4 injections of IA-HA vs. IA-Saline produced the largest effect size at both 3-months and 6-months (Standard mean difference [SMD] = -0.76; -0.98 to -0.53, 95% CI, P injection studies yielded a non-significant treatment effect at 3 and 6 months, while ≥5 5 injections demonstrated a significant improvement in pain only at 6 months. Five or more injections of IA-HA were associated with a higher risk of treatment-related AEs compared to IA-Saline (Risk ratio [RR] = 1.67; 1.09 to 2.56 95% CI, p = 0.02), which was a result not seen within the 1 and 2-4 injection subgroups. Overall, 2-4 and ≥5 injection regimens provided pain relief over IA-Saline, while single injection did not. Intra-articular injections of HA used in a 2-4 injection treatment regimen provided the greatest benefit when compared to IA-Saline with respect to pain improvement in patients with knee OA, and was generally deemed safe with few to no

  13. [Hepatic complications in parenteral nutrition].

    Science.gov (United States)

    Müller, M J

    1996-01-01

    During parenteral nutrition hepatic complications are seen in about 15% of patients. They are characterized by steatosis, cholestasis and formation of sludge and bile stones. These hepatic complications depend on the duration as well as on the concept and mode of application of parenteral nutrition. They are more frequent after treatment periods of > 1-2 weeks, in response to a carbohydrate rich and low fat parenteral nutrition and in patients with extensive intestinal resection. Clinically, hepatic complications are frequently observed in new-borns and children, patients with inflammatory bowel disease, after ileum resection and in patients with hepatic malignancies. The exact pathophysiology of these phenomena is presently unknown. Enteral instead of parenteral nutrition, meeting the demand of nutrients, increasing fat supply (up to 50% of energy supply), "cyclic" parenteral nutrition and the addition of "semi-essential" nutrients (like L-glutamine, carnitin, cholin) are considered as possible strategies for the prevention and therapy of hepatic complications during parenteral nutrition.

  14. Single Cell Transfection through Precise Microinjection with Quantitatively Controlled Injection Volumes

    Science.gov (United States)

    Chow, Yu Ting; Chen, Shuxun; Wang, Ran; Liu, Chichi; Kong, Chi-Wing; Li, Ronald A.; Cheng, Shuk Han; Sun, Dong

    2016-04-01

    Cell transfection is a technique wherein foreign genetic molecules are delivered into cells. To elucidate distinct responses during cell genetic modification, methods to achieve transfection at the single-cell level are of great value. Herein, we developed an automated micropipette-based quantitative microinjection technology that can deliver precise amounts of materials into cells. The developed microinjection system achieved precise single-cell microinjection by pre-patterning cells in an array and controlling the amount of substance delivered based on injection pressure and time. The precision of the proposed injection technique was examined by comparing the fluorescence intensities of fluorescent dye droplets with a standard concentration and water droplets with a known injection amount of the dye in oil. Injection of synthetic modified mRNA (modRNA) encoding green fluorescence proteins or a cocktail of plasmids encoding green and red fluorescence proteins into human foreskin fibroblast cells demonstrated that the resulting green fluorescence intensity or green/red fluorescence intensity ratio were well correlated with the amount of genetic material injected into the cells. Single-cell transfection via the developed microinjection technique will be of particular use in cases where cell transfection is challenging and genetically modified of selected cells are desired.

  15. Ultrasound-guided single-penetration dual-injection block for leg and foot surgery

    DEFF Research Database (Denmark)

    Børglum, Jens; Johansen, Karina; Christensen, Karen Margrethe

    2014-01-01

    We describe a new approach to blocking the sciatic and saphenous nerves in the proximal thigh (level of the lesser trochanter or immediately below) using a single-penetration dual-injection (SPEDI) technique. The popliteal-sciatic approach necessitates repositioning of the leg exposing the poplit...

  16. Single intra-articular injection of high molecular weight hyaluronic acid for hip osteoarthritis.

    Science.gov (United States)

    Rivera, Fabrizio

    2016-03-01

    Intra-articular (IA) injection of hyaluronic acid (HA) into the hip joint appears to be safe and well tolerated but only a small number of randomized clinical trials in humans has been published. The objective of this prospective study was to evaluate the efficacy and safety of a single IA injection of high-molecular-weight (2800 kDa) HA (Coxarthrum) for hip osteoarthritis. All patients received a single IA administration of 2.5 % sodium hyaluronate (75 mg/3 mL) of high molecular weight. Fluoroscopy requires an iodized contrast medium (iopamidol, 1 ml) which highlights the capsule before administering HA. Patients were evaluated before IA injection (T0), after 3 months, after 6 months and after 1 year from injection. Results were evaluated by the Brief Pain Inventory (BPI II), Harris Hip Score and a visual analog scale of pain (pain VAS). All treated patients were considered for statistical analysis. Two hundred seven patients were included at T0. The mean age was 67 years (range 46-81). Regarding BPI severity score, changes in pain between T0 and the three following visits were statistically highly significant (p injection of Coxarthrum is effective from the third month and that the results are stable or continue to improve up to 1 year. IV.

  17. Total parenteral nutrition in diabetic rats

    International Nuclear Information System (INIS)

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

    1986-01-01

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

  18. Spatio-temporally controlled transfection by quantitative injection into a single cell.

    Science.gov (United States)

    Kwon, Hyosung; Park, Hang-soo; Yu, Jewon; Hong, Sunghoi; Choi, Yeonho

    2015-10-01

    Transfection-based cellular control has been widely used in biology; however, conventional transfection methods cannot control spatio-temporal differences in gene expression or the quantity of delivered materials such as external DNA or RNA. Here, we present a non-viral and spatio-temporally controlled transfection technique of a quantitative injection into a single cell. DNA was quantitatively injected into a single cell at a desired location and time, and the optimal gene delivery and expression conditions were determined based on the amount of the delivered DNA and the transfection efficacy. Interestingly, an injection of 1500 DNAs produced an about average 30% gene expression efficiency, which was the optimal condition, and gene expression was sustained for more than 14 days. In a single cell, fluorescent intensity and polymerase chain reaction (PCR) results were compared for the quantity of gene expression. The high coincidence of both results suggests that the fluorescence intensity can reveal gene expression level which was investigated by PCR. In addition, 3 multiple DNA genes were successfully expressed in a single cell with different ratio. Overall, these results demonstrate that spatio-temporally controlled transfection by quantitative transfection is a useful technique for regulating gene expression in a single cell, which suggests that this technique may be used for stem cell research, including the creation of induced pluripotent stem (iPS) cells. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. Impact of injection speed and volume on perceived pain during subcutaneous injections into the abdomen and thigh: a single-centre, randomized controlled trial.

    Science.gov (United States)

    Heise, T; Nosek, L; Dellweg, S; Zijlstra, E; Præstmark, K A; Kildegaard, J; Nielsen, G; Sparre, T

    2014-10-01

    The aim of this study was to assess pain associated with subcutaneous injection into the abdomen and thigh of different combinations of injection speeds and volumes. The study was a single-centre, one-visit, double-blinded, randomized controlled trial in 82 adults with type 1 or type 2 diabetes receiving daily injections of insulin or glucagon-like peptide-1 (GLP-1) agonists. Participants received 17 subcutaneous injections (12 in abdomen, 5 in thigh) of saline at different injection speeds (150, 300 and 450 µl/s), with different volumes (400, 800, 1200 and 1600 µl), and two needle insertions without any injection. Pain was evaluated on a 100-mm visual analogue scale (VAS) (0 mm no pain, 100 mm worst pain) and on a yes/no scale for pain acceptability. Injection speed had no impact on injection pain (p = 0.833). Injection of larger volumes caused significantly more pain [VAS least square mean differences 1600 vs. 400 µl, 7 · 2 mm (95% confidence interval - CI; 4.6-9.7; p technique to reduce their injection pain. Furthermore, these findings may have important implications for the development of new injection devices and drug formulations for clinical practice. © 2014 John Wiley & Sons Ltd.

  20. Ambiguity in measuring matrix diffusion with single-well injection/recovery tracer tests

    Science.gov (United States)

    Lessoff, S.C.; Konikow, Leonard F.

    1997-01-01

    Single-well injection/recovery tracer tests are considered for use in characterizing and quantifying matrix diffusion in dual-porosity aquifers. Numerical modeling indicates that neither regional drift in homogeneous aquifers, nor heterogeneity in aquifers having no regional drift, nor hydrodynamic dispersion significantly affects these tests. However, when drift is coupled simultaneously with heterogeneity, they can have significant confounding effects on tracer return. This synergistic effect of drift and heterogeneity may help explain irreversible flow and inconsistent results sometimes encountered in previous single-well injection/recovery tracer tests. Numerical results indicate that in a hypothetical single-well injection/recovery tracer test designed to demonstrate and measure dual-porosity characteristics in a fractured dolomite, the simultaneous effects of drift and heterogeneity sometimes yields responses similar to those anticipated in a homogeneous dual-porosity formation. In these cases, tracer recovery could provide a false indication of the occurrence of matrix diffusion. Shortening the shut-in period between injection and recovery periods may make the test less sensitive to drift. Using multiple tracers having different diffusion characteristics, multiple tests having different pumping schedules, and testing the formation at more than one location would decrease the ambiguity in the interpretation of test data.

  1. Single-frequency injection-seeded Q-switched Ho:YAG laser

    Science.gov (United States)

    Wang, Qing; Gao, Chunqing; Na, Quanxin; Zhang, Yixuan; Ye, Qing; Gao, Mingwei

    2017-04-01

    An injection-seeded Ho:YAG laser at 2090 nm with changeable pulse repetition frequency (PRF) is demonstrated. Containing a Ho:YAG nonplanar ring oscillator (NPRO) seed, a slave laser, and a single-pass amplifier, the laser delivered single-frequency pulses with energy ranging from 31.4 to 12.7 mJ. The corresponding pulse duration and PRF varied between 102-215 ns and 150-750 Hz, respectively. To the best of our knowledge, this is the highest PRF ever obtained from a single-frequency Ho:YAG laser.

  2. Injection of a single electron from static to moving quantum dots.

    Science.gov (United States)

    Bertrand, Benoit; Hermelin, Sylvain; Mortemousque, Pierre-André; Takada, Shintaro; Yamamoto, Michihisa; Tarucha, Seigo; Ludwig, Arne; Wieck, Andreas D; Bäuerle, Christopher; Meunier, Tristan

    2016-05-27

    We study the injection mechanism of a single electron from a static quantum dot into a moving quantum dot. The moving quantum dots are created with surface acoustic waves (SAWs) in a long depleted channel. We demonstrate that the injection process is characterized by an activation law with a threshold that depends on the SAW amplitude and on the dot-channel potential gradient. By sufficiently increasing the SAW modulation amplitude, we can reach a regime where the transfer has unity probability and is potentially adiabatic. This study points to the relevant regime to use moving dots in quantum information protocols.

  3. All-in-polymer injection molded device for single cell capture using multilevel silicon master fabrication

    DEFF Research Database (Denmark)

    Tanzi, S.; Larsen, S.T.; Matteucci, M.

    2012-01-01

    This work demonstrates a novel all-in-polymer device for single cell capture applicable for biological recordings. The chip is injection molded and comprises a "cornered" (non planar) aperture. It has been demonstrated how cornered apertures are straightforward to mold in PDMS [1,2]. In this study...... we demonstrate cornered apertures made in a thermoplastic polymer. One of the advantages of cornered apertures is the ease of microscopy under a standard inverted optical microscope, when using transparent materials. After the part is injection molded, the sealing of the chip is performed by thermal...

  4. Efficient spin-current injection in single-molecule magnet junctions

    Directory of Open Access Journals (Sweden)

    Haiqing Xie

    2018-01-01

    Full Text Available We study theoretically spin transport through a single-molecule magnet (SMM in the sequential and cotunneling regimes, where the SMM is weakly coupled to one ferromagnetic and one normal-metallic leads. By a master-equation approach, it is found that the spin polarization injected from the ferromagnetic lead is amplified and highly polarized spin-current can be generated, due to the exchange coupling between the transport electron and the anisotropic spin of the SMM. Moreover, the spin-current polarization can be tuned by the gate or bias voltage, and thus an efficient spin injection device based on the SMM is proposed in molecular spintronics.

  5. Assessment of nitrification potential in ground water using short term, single-well injection experiments.

    Science.gov (United States)

    Smith, R L; Baumgartner, L K; Miller, D N; Repert, D A; Böhlke, J K

    2006-01-01

    Nitrification was measured within a sand and gravel aquifer on Cape Cod, MA, using a series of single-well injection tests. The aquifer contained a wastewater-derived contaminant plume, the core of which was anoxic and contained ammonium. The study was conducted near the downgradient end of the ammonium zone, which was characterized by inversely trending vertical gradients of oxygen (270 to 0 microM) and ammonium (19 to 625 microM) and appeared to be a potentially active zone for nitrification. The tests were conducted by injecting a tracer solution (ambient ground water + added constituents) into selected locations within the gradients using multilevel samplers. After injection, the tracers moved by natural ground water flow and were sampled with time from the injection port. Rates of nitrification were determined from changes in nitrate and nitrite concentration relative to bromide. Initial tests were conducted with (15)N-enriched ammonium; subsequent tests examined the effect of adding ammonium, nitrite, or oxygen above background concentrations and of adding difluoromethane, a nitrification inhibitor. In situ net nitrate production exceeded net nitrite production by 3- to 6- fold and production rates of both decreased in the presence of difluoromethane. Nitrification rates were 0.02-0.28 mumol (L aquifer)(-1) h(-1) with in situ oxygen concentrations and up to 0.81 mumol (L aquifer)(-1) h(-1) with non-limiting substrate concentrations. Geochemical considerations indicate that the rates derived from single-well injection tests yielded overestimates of in situ rates, possibly because the injections promoted small-scale mixing within a transport-limited reaction zone. Nonetheless, these tests were useful for characterizing ground water nitrification in situ and for comparing potential rates of activity when the tracer cloud included non-limiting ammonium and oxygen concentrations.

  6. Assessment of nitrification potential in ground water using short term, single-well injection experiments

    Science.gov (United States)

    Smith, R.L.; Baumgartner, L.K.; Miller, D.N.; Repert, D.A.; Böhlke, J.K.

    2006-01-01

    Nitrification was measured within a sand and gravel aquifer on Cape Cod, MA, using a series of single-well injection tests. The aquifer contained a wastewater-derived contaminant plume, the core of which was anoxic and contained ammonium. The study was conducted near the downgradient end of the ammonium zone, which was characterized by inversely trending vertical gradients of oxygen (270 to 0 μM) and ammonium (19 to 625 μM) and appeared to be a potentially active zone for nitrification. The tests were conducted by injecting a tracer solution (ambient ground water + added constituents) into selected locations within the gradients using multilevel samplers. After injection, the tracers moved by natural ground water flow and were sampled with time from the injection port. Rates of nitrification were determined from changes in nitrate and nitrite concentration relative to bromide. Initial tests were conducted with 15N-enriched ammonium; subsequent tests examined the effect of adding ammonium, nitrite, or oxygen above background concentrations and of adding difluoromethane, a nitrification inhibitor. In situ net nitrate production exceeded net nitrite production by 3- to 6- fold and production rates of both decreased in the presence of difluoromethane. Nitrification rates were 0.02–0.28 μmol (L aquifer)−1 h−1 with in situ oxygen concentrations and up to 0.81 μmol (L aquifer)−1 h−1 with non-limiting substrate concentrations. Geochemical considerations indicate that the rates derived from single-well injection tests yielded overestimates of in situ rates, possibly because the injections promoted small-scale mixing within a transport-limited reaction zone. Nonetheless, these tests were useful for characterizing ground water nitrification in situ and for comparing potential rates of activity when the tracer cloud included non-limiting ammonium and oxygen concentrations.

  7. The acceptability of three vaccine injections given to infants during a single clinic visit in South Africa

    OpenAIRE

    Tabana, Hanani; Dudley, Lilian D.; Knight, Stephen; Cameron, Neil; Mahomed, Hassan; Goliath, Charlyn; Eggers, Rudolf; Wiysonge, Charles S.

    2016-01-01

    Abstract Background The Expanded Programme on Immunisation (EPI) has increased the number of antigens and injections administered at one visit. There are concerns that more injections at a single immunisation visit could decrease vaccination coverage. We assessed the acceptability and acceptance of three vaccine injections at a single immunisation visit by caregivers and vaccinators in South Africa. Methods A mixed methods exploratory study of caregivers and vaccinators at clinics in two prov...

  8. [Studies on calf salmonellosis. 4. Oral and parenteral immunization with live (Smd) and killed antigens].

    Science.gov (United States)

    Meyer, H; Steinbach, G; Hartmann, H; Hauke, H; Koch, H; Stelzner, A; Linde, K; Schmerbauch, A; Kiupel, H

    1977-01-01

    Reported are results obtained from studies into oral and parenteral immunisation of calf. The approaches had included the use of live (Smd) or dead antigen from Salmonella (S.) dublin and a combination of the two immunisation methods. Live antigen (Smd) was superior to thermally activated dead antigen, when the oral route was used to prevent S.-dublin injection of calves. The above findings were supported by results from analogous studies in which S. typhimurium and S. dublin or live antigen (Smd) or dead antigen, made of the two, had been applied to mice. (One single subcutaneous) parenteral administration did hardly reveal any difference in favour of live vaccine (Smd). Parenteral administration of live or dead antigen proved to be less effective than repeated oral immunisation, particularly when live vaccine (Smd) was used. Immunity not less than up to six months of age against S. dublin wild strain infection can be provided for young calves by oral immunisation, with Smd vaccine (5. 1010 to 1. 1011 live germs/d) being given on ten consecutive days. Calves orally immunised with live antigen (ten repetitive applications of Smd mutants) are likely to develop an antibody titre (H-agglutinins) against S. dublin. Parenteral boostering,using live antigen, has been accompanied by sensitisation due to oral live antigen administration as well as by dose dependence, as was seen from the bactericidal values. Sensitisation was established from orally immunised calves up to three months old (typical booster reaction). Some of it was attributabale to confrontation with wild strains of Salmonella. The H-agglutinin titres of animals aged threemonths in a calf herd with salmonelloses in which all animals had been orally Smd-immunised were close to those recorded from calves in stocks with no salmonellosis occurrence. Under the conditions of oral immunisation, there had obviously been no action of the wild strain which might have triggered intensive antibody formation.

  9. Manipulation and Immobilization of a Single Fluorescence Nanosensor for Selective Injection into Cells.

    Science.gov (United States)

    Hashim, Hairulazwan; Maruyama, Hisataka; Masuda, Taisuke; Arai, Fumihito

    2016-12-01

    Manipulation and injection of single nanosensors with high cell viability is an emerging field in cell analysis. We propose a new method using fluorescence nanosensors with a glass nanoprobe and optical control of the zeta potential. The nanosensor is fabricated by encapsulating a fluorescence polystyrene nanobead into a lipid layer with 1,3,3-trimethylindolino-6'-nitrobenzopyrylospiran (SP), which is a photochromic material. The nanobead contains iron oxide nanoparticles and a temperature-sensitive fluorescent dye, Rhodamine B. The zeta potential of the nanosensor switches between negative and positive by photo-isomerization of SP with ultraviolet irradiation. The positively-charged nanosensor easily adheres to a negatively-charged glass nanoprobe, is transported to a target cell, and then adheres to the negatively-charged cell membrane. The nanosensor is then injected into the cytoplasm by heating with a near-infrared (NIR) laser. As a demonstration, a single 750 nm nanosensor was picked-up using a glass nanoprobe with optical control of the zeta potential. Then, the nanosensor was transported and immobilized onto a target cell membrane. Finally, it was injected into the cytoplasm using a NIR laser. The success rates of pick-up and cell immobilization of the nanosensor were 75% and 64%, respectively. Cell injection and cell survival rates were 80% and 100%, respectively.

  10. Manipulation and Immobilization of a Single Fluorescence Nanosensor for Selective Injection into Cells

    Science.gov (United States)

    Hashim, Hairulazwan; Maruyama, Hisataka; Masuda, Taisuke; Arai, Fumihito

    2016-01-01

    Manipulation and injection of single nanosensors with high cell viability is an emerging field in cell analysis. We propose a new method using fluorescence nanosensors with a glass nanoprobe and optical control of the zeta potential. The nanosensor is fabricated by encapsulating a fluorescence polystyrene nanobead into a lipid layer with 1,3,3-trimethylindolino-6′-nitrobenzopyrylospiran (SP), which is a photochromic material. The nanobead contains iron oxide nanoparticles and a temperature-sensitive fluorescent dye, Rhodamine B. The zeta potential of the nanosensor switches between negative and positive by photo-isomerization of SP with ultraviolet irradiation. The positively-charged nanosensor easily adheres to a negatively-charged glass nanoprobe, is transported to a target cell, and then adheres to the negatively-charged cell membrane. The nanosensor is then injected into the cytoplasm by heating with a near-infrared (NIR) laser. As a demonstration, a single 750 nm nanosensor was picked-up using a glass nanoprobe with optical control of the zeta potential. Then, the nanosensor was transported and immobilized onto a target cell membrane. Finally, it was injected into the cytoplasm using a NIR laser. The success rates of pick-up and cell immobilization of the nanosensor were 75% and 64%, respectively. Cell injection and cell survival rates were 80% and 100%, respectively. PMID:27916931

  11. Manipulation and Immobilization of a Single Fluorescence Nanosensor for Selective Injection into Cells

    Directory of Open Access Journals (Sweden)

    Hairulazwan Hashim

    2016-12-01

    Full Text Available Manipulation and injection of single nanosensors with high cell viability is an emerging field in cell analysis. We propose a new method using fluorescence nanosensors with a glass nanoprobe and optical control of the zeta potential. The nanosensor is fabricated by encapsulating a fluorescence polystyrene nanobead into a lipid layer with 1,3,3-trimethylindolino-6′-nitrobenzopyrylospiran (SP, which is a photochromic material. The nanobead contains iron oxide nanoparticles and a temperature-sensitive fluorescent dye, Rhodamine B. The zeta potential of the nanosensor switches between negative and positive by photo-isomerization of SP with ultraviolet irradiation. The positively-charged nanosensor easily adheres to a negatively-charged glass nanoprobe, is transported to a target cell, and then adheres to the negatively-charged cell membrane. The nanosensor is then injected into the cytoplasm by heating with a near-infrared (NIR laser. As a demonstration, a single 750 nm nanosensor was picked-up using a glass nanoprobe with optical control of the zeta potential. Then, the nanosensor was transported and immobilized onto a target cell membrane. Finally, it was injected into the cytoplasm using a NIR laser. The success rates of pick-up and cell immobilization of the nanosensor were 75% and 64%, respectively. Cell injection and cell survival rates were 80% and 100%, respectively.

  12. Single injection thoracic paravertebral block (TPVB for breast surgery in morbidly obese patient

    Directory of Open Access Journals (Sweden)

    Anita Kulkarni

    2017-01-01

    Full Text Available Morbidly obese (MO patients with associated restrictive airway disease, obstructive sleep apnea, and coronary artery disease pose challenge to an anesthesiologist. Regional block combined with general anesthesia (GA is the anesthetic technique of choice as it will decrease the requirement of opioids, anesthetics, and postoperative respiratory depression. A MO patient for modified radical mastectomy was successfully managed with single-injection thoracic paravertebral block and conventional GA.

  13. Chemical castration by a single bilateral intra-testicular injection of ...

    African Journals Online (AJOL)

    ADEYEYE

    Sokoto Journal of Veterinary Sciences. (P-ISSN 1595-093X/ E-ISSN 2315-6201). Mohammed & James/Sokoto Journal of Veterinary Sciences (2013) 11(1): 62-65. http://dx.doi.org/10.4314/sokjvs.v11i1.10. Chemical castration by a single bilateral intra-testicular injection of chlorhexidine gluconate and cetrimide in bucks.

  14. Sonographic Guidance for Supraclavicular Brachial Plexus Blocks: Single vs. Double Injection Cluster Approach.

    Science.gov (United States)

    Choi, Jung Ju; Kwak, Hyun Jeong; Jung, Wol Seon; Chung, Seung Hyun; Lee, Mi Geum

    2017-09-01

    The cluster approach for supraclavicular brachial plexus block (SC-BPB) can be easily performed but may result in asymmetric local anesthetic (LA) spread. The authors hypothesized that the use of a cluster approach in each of the 2 planes would achieve better 3-dimensional LA distribution than the traditional single cluster approach. The purpose of the present study was to compare a double injection (DI) in 2 planes (one injection in each plane) with the traditional single injection (SI) cluster approach for ultrasound-guided SC-BPB. A randomized, controlled trial. Department of Anesthesiology and Pain Medicine, Gachon University Gil Medical Center. In the SI group (n = 18), 30 mL of LA was injected into the main neural cluster after penetrating the brachial plexus sheath laterally. In the DI group (n = 18), the needle penetrated the sheath in a downward direction at the first skin puncture, and 15 mL of LA was injected, and at the second skin puncture (behind the initial puncture site), the needle penetrated the sheath in an upward direction, and 15 mL was again injected. Ultrasound-guided SC-BPB was evaluated from immediately after the block every 5 minutes to 30 minutes by sensory and motor testing. The main outcome variables were procedural time; onset time (time for complete sensory and motor block of the median, radial, ulnar, and musculocutaneous nerves); and rate of blockage of all 4 nerves. Procedure times (medians [interquartile range]) were similar in the DI and SI groups (5.5 [4.75 - 8] vs. 5 [4 - 7] minutes, respectively; P = 0.137). Block onset time in the DI group was not significantly different from that in the SI group (10 [5 - 17.5] vs. 20 [6.25 - 30] minutes, P = 0.142). However, the rate of blockage of all 4 nerves was significantly higher in the DI group (94% vs. 67%, P = 0.035). Although the results of this study indicate LA distribution in the DI group was more evenly spread within brachial plexus sheaths than in the SI group, this was not

  15. Patient-rated suitability of a novel electronic device for self-injection of subcutaneous interferon beta-1a in relapsing multiple sclerosis: an international, single-arm, multicentre, Phase IIIb study.

    Science.gov (United States)

    Devonshire, Virginia; Arbizu, Txomin; Borre, Bjorn; Lang, Michael; Lugaresi, Alessandra; Singer, Barry; Verdun di Cantogno, Elisabetta; Cornelisse, Peter

    2010-04-30

    Multiple sclerosis (MS) currently requires long-term treatment with disease-modifying drugs, administered parenterally up to once daily. The need for regular self-injection can be a barrier to treatment for many patients. Autoinjectors can help patients overcome problems or concerns with self-injection and could, therefore, improve treatment adherence. This study was performed to assess the suitability of a new electronic device for the subcutaneous (sc) administration of interferon (IFN) beta-1a, 44 mcg three times weekly, for relapsing MS. In this Phase IIIb, multicentre, single-arm study, patients with relapsing MS who had been consistently self-injecting sc IFN beta-1a using an autoinjector for at least 6 weeks were taught to use the new device and self-administered treatment for 12 weeks thereafter. Patient-rated suitability of the device was assessed at the end of Week 12 using the Patient User Trial Questionnaire. Patient satisfaction with, and evaluation of, the injection process was assessed using the MS Treatment Concern Questionnaire. Trainers evaluated the device using the Trainer User Trial Questionnaire. At Week 12, 71.6% (73/102) of patients considered the device 'very suitable' or 'suitable' for self-injection; 92.2% (94/102) reported some degree of suitability and only 7.8% (8/102) found the device 'not at all suitable'. At Weeks 4, 8 and 12, most patients reported that injection preparation and clean-up, performing injections and ease of device use in the previous 4 weeks compared favourably with, or was equivalent to, their previous experience of self-injection. Injection-related pain, injection reactions and 'flu-like' symptoms remained stable over the 12 weeks. Each device feature was rated 'very useful' or 'useful' by at least 80% of patients. All trainers and 95.2% (99/104) of patients found device functions 'very easy' or 'easy' to use. Overall convenience was considered the most important benefit of the device. Most patients considered the

  16. A cost analysis of the establishment of a dedicated orthopaedic outpatient injection clinic at a single institution.

    Science.gov (United States)

    Curtin, M; O'Neill, S C; Keogh, P; Kenny, P

    2017-08-01

    Traditionally orthopaedic injections were performed in a theatre setting. A dedicated outpatient injection clinic was established at our institution to attempt to provide injections more cost effectively. Our aim was to perform a cost analysis of orthopaedic injections performed in theatre, compared to those performed in a dedicated OPD injection clinic. Patient data for all orthopaedic injections performed at a single institution from 2013 to 2014 was obtained using HIPE data. A detailed breakdown of costings for two scenarios; those performed in theatre and those in the dedicated OPD injection clinic was obtained from the hospital finance department. A unit cost per injection for theatre and OPD was derived from this financial information. A total of 487 injections were performed in 2013, with 491 performed in 2014. 134 (27.5%) injections were performed in the OPD in 2013 compared to 388 (79%) in 2014. The unit cost per injection was calculated as €52.13 for theatre and €23.85 for OPD, this represented a 115% decrease in cost per injection. The creation of a dedicated orthopaedic injection clinic resulted in considerable cost savings at our institution. We propose this may be a more cost-efficient model for delivery of injections in the orthopaedic setting.

  17. The acceptability of three vaccine injections given to infants during a single clinic visit in South Africa.

    Science.gov (United States)

    Tabana, Hanani; Dudley, Lilian D; Knight, Stephen; Cameron, Neil; Mahomed, Hassan; Goliath, Charlyn; Eggers, Rudolf; Wiysonge, Charles S

    2016-08-08

    The Expanded Programme on Immunisation (EPI) has increased the number of antigens and injections administered at one visit. There are concerns that more injections at a single immunisation visit could decrease vaccination coverage. We assessed the acceptability and acceptance of three vaccine injections at a single immunisation visit by caregivers and vaccinators in South Africa. A mixed methods exploratory study of caregivers and vaccinators at clinics in two provinces of South Africa was conducted. Quantitative and qualitative data were collected using questionnaires as well as observations of the administration of three-injection vaccination sessions. The sample comprised 229 caregivers and 98 vaccinators. Caregivers were satisfied with the vaccinators' care (97 %) and their infants receiving immunisation injections (93 %). However, many caregivers, (86 %) also felt that three or more injections were excessive at one visit. Caregivers had limited knowledge of actual vaccines provided, and reasons for three injections. Although vaccinators recognised the importance of informing caregivers about vaccination, they only did this sometimes. Overall, acceptance of three injections was high, with 97 % of caregivers expressing willingness to bring their infant for three injections again in future visits despite concerns about the pain and discomfort that the infant experienced. Many (55 %) vaccinators expressed concern about giving three injections in one immunisation visit. However, in 122 (95 %) observed three-injection vaccination sessions, the vaccinators administered all required vaccinations for that visit. The remaining seven vaccinations were not completed because of vaccine stock-outs. We found high acceptance by caregivers and vaccinators of three injections. Caregivers' poor understanding of reasons for three injections resulted from limited information sharing by vaccinators for caregivers. Acceptability of three injections may be improved through

  18. Parenteral nutrition in malnourished patients

    International Nuclear Information System (INIS)

    Lichvarova, I.

    2011-01-01

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

  19. Single injection of platelet-rich plasma as a novel treatment of carpal tunnel syndrome

    Directory of Open Access Journals (Sweden)

    Michael Alexander Malahias

    2015-01-01

    Full Text Available Both in vitro and in vivo experiments have confirmed that platelet-rich plasma has therapeutic effects on many neuropathies, but its effects on carpal tunnel syndrome remain poorly understood. We aimed to investigate whether single injection of platelet-rich plasma can improve the clinical symptoms of carpal tunnel syndrome. Fourteen patients presenting with median nerve injury who had suffered from mild carpal tunnel syndrome for over 3 months were included in this study. Under ultrasound guidance, 1-2 mL of platelet-rich plasma was injected into the region around the median nerve at the proximal edge of the carpal tunnel. At 1 month after single injection of platelet-rich plasma, Visual Analogue Scale results showed that pain almost disappeared in eight patients and it was obviously alleviated in three patients. Simultaneously, the disabilities of the arm, shoulder and hand questionnaire showed that upper limb function was obviously improved. In addition, no ultrasonographic manifestation of the carpal tunnel syndrome was found in five patients during ultrasonographic measurement of the width of the median nerve. During 3-month follow-up, the pain was not greatly alleviated in three patients. These findings show very encouraging mid-term outcomes regarding use of platelet-rich plasma for the treatment of carpal tunnel syndrome.

  20. Transcatheter aortic-valve implantation with one single minimal contrast media injection.

    Science.gov (United States)

    Arrigo, Mattia; Maisano, Francesco; Haueis, Sabine; Binder, Ronald K; Taramasso, Maurizio; Nietlispach, Fabian

    2015-06-01

    Performing transcatheter aortic valve implantation (TAVI) with the use of minimal contrast in patients at high-risk for acute kidney injury (AKI). Contrast-induced nephropathy (CIN) is a major cause of AKI following TAVI and is associated with increased morbidity and mortality. The amount of contrast media used increases the risk for CIN. Computed tomography was omitted during the screening process. For the procedure transfemoral access was default. The self-expanding CoreValve prosthesis was chosen in all patients to minimize the risk of annular rupture in case of oversizing. Valve sizing was based on echocardiography, aortography, calcification on fluoroscopy, as well as weight and height of the patient. A single contrast injection was performed to confirm correct position of the pigtail catheter at the level of the annulus. The pigtail then served as the marker for the device landing zone. Intraprocedural assessment of the implantation result relied on echocardiography and hemodynamics. Five patients with severe aortic stenosis and at high risk for developing CIN were included. Device success was achieved in all patients and no major complications occurred. The median dose of injected contrast media was 8 ml (4-9). All but one patient had improved renal function after the intervention compared to baseline. Our study shows feasibility of performing TAVI with a single minimal contrast media injection, using a self-expandable valve. This technique has the potential to reduce the incidence of CIN. © 2015 Wiley Periodicals, Inc.

  1. [Peribulbar anesthesia: efficacy of a single injection with a limited local anesthetic volume].

    Science.gov (United States)

    Clausel, H; Touffet, L; Havaux, M; Lamard, M; Savean, J; Cochener, B; Arvieux, C; Gueret, G

    2008-10-01

    Cataract surgery can be performed with peribulbar anesthesia. The classical technique consists of two injections of local anesthetics. The purpose of our study was to assess peribulbar anesthesia with a single injection and a limited volume of local anesthetics. After local ethics committee agreement and oral consent, patients scheduled for cataract surgery using peribulbar anesthesia were prospectively included. The lower temporal puncture was performed with a peribulbar needle with propofol sedation. The mixture of local anesthetics was administered with tactile control of orbital pressure. The puncture was followed by a 10-min compression of the ocular globe. Akinesia, analgesia, complications, and surgical conditions were noted. A total of 101 successive patients were included. We administered 1.2 mg/kg of propofol. The volume of local anesthetics administered was 5.0 +/- 0.9 ml. Ninety patients had akinesia at 10 min and 6.7% moderate chemosis. No puncture complication occurred. At the end of surgery, the pain noted by the patients was 0.4 +/- 2.1 out of 100 (range, 0-10). Surgical conditions were good for all patients. Peribulbar anesthesia performed with a single injection and a limited volume of local anesthetics allows cataract surgery in good conditions for the surgeon with very good analgesia for the patient.

  2. Opto-injection into single living cells by femtosecond near-infrared laser

    Science.gov (United States)

    Peng, Cheng

    This dissertation presents a novel technique to deliver membrane impermeable molecules into single living cells with the assistance of femtosecond (fs) near-infrared (NIR) laser pulses. This approach merges ultrafast laser technology with key biological, biomedical, and medical applications, such as gene transfection, gene therapy and drug delivery. This technique promises several major advantages, namely, very high transfection efficiency, high cell survival rate (≈100%) and fully preserved cell viabilities. It is also a promising method to deliver molecules into cells that are difficult or even completely resistant to established physical methods, such as microinjection by glass pipettes, electroporation, and biolistics. In this work, the system for fs NIR opto-injection was designed and built. Successful fs NIR opto-injection has been performed on several cell systems including single mammalian cells (bovine aortic endothelial cells), marine animal eggs (Spisula solidissima oocytes), and human cancer cells (fibrosarcoma HT1080) cultured in a tissue-like environment. The connections between laser parameters and cell responses were explored through further experiments and in-depth analyses, especially the relationship between dye uptake rate and incident laser intensity, and the relationship between pore size created on cell membranes and incident laser intensity. Dye uptake rate of the target cells was observed to depend on incident laser intensity. Pore size was found dependent on incident laser intensity. The conclusion was made that laser-induced breakdown and plasma-induced ablation in cell membrane are the physical principles that govern the process of fs NIR opto-injection.

  3. Symptomatic Spinal Epidural Lipomatosis After a Single Local Epidural Steroid Injection

    International Nuclear Information System (INIS)

    Tok, Chung Hong; Kaur, Shaleen; Gangi, Afshin

    2011-01-01

    Spinal epidural lipomatosis is a rare disorder that can manifest with progressive neurological deficits. It is characterized by abnormal accumulation of unencapsulated epidural fat commonly associated with the administration of exogenous steroids associated with a variety of systemic diseases, endocrinopathies, and Cushing syndrome (Fogel et al. Spine J 5:202–211, 2005). Occasionally, spinal epidural lipomatosis may occur in patients not exposed to steroids or in patients with endocrinopathies, primarily in obese individuals (Fogel et al. Spine J 5:202–211, 2005). However, spinal lumbar epidural lipomatosis resulting from local steroid injection has rarely been reported. We report the case of a 45-year-old diabetic man with claudication that was probably due to symptomatic lumbar spinal lipomatosis resulting from a single local epidural steroid injection.

  4. Reactive Power Injection Strategies for Single-Phase Photovoltaic Systems Considering Grid Requirements

    DEFF Research Database (Denmark)

    Yang, Yongheng; Wang, Huai; Blaabjerg, Frede

    2014-01-01

    .g. Germany and Italy. Those advanced features can be provided by next generation PV systems, and will be enhanced in the future to ensure an even efficient and reliable utilization of PV systems. In light of this, Reactive Power Injection (RPI) strategies for single-phase PV systems are explored...... like what the conventional power plants do today in the grid regulation participation. Requirements of ancillary services like Low-Voltage Ride-Through (LVRT) associated with reactive current injection and voltage support through reactive power control, have been in effectiveness in some countries, e...... in this paper. The RPI possibilities are: a) constant average active power control, b) constant active current control, c) constant peak current control and d) thermal optimized control strategy. All those strategies comply with the currently active grid codes, but are with different objectives. The proposed...

  5. Reactive Power Injection Strategies for Single-Phase Photovoltaic Systems Considering Grid Requirements

    DEFF Research Database (Denmark)

    Yang, Yongheng; Wang, Huai; Blaabjerg, Frede

    2014-01-01

    . Those advanced features can be provided by next-generation PV systems, and will be enhanced in the future to ensure an even efficient and reliable utilization of PV systems. In the light of this, Reactive Power Injection (RPI) strategies for single-phase PV systems are explored in this paper. The RPI...... like what the conventional power plants do today in the grid regulation participation. Requirements of ancillary services like Low-Voltage Ride-Through (LVRT) associated with reactive current injection and voltage support through reactive power control, have been in effectiveness in some countries...... possibilities are: a) constant average active power control, b) constant active current control, c) constant peak current control and d) thermal optimized control strategy. All those strategies comply with the currently active grid codes, but are with different objectives. The thermal optimized control strategy...

  6. Single injection 51Cr EDTA plasma clearance determination in children using capillary blood samples

    International Nuclear Information System (INIS)

    Broechner-Mortensen, J.; Christoffersen, J.

    1977-01-01

    The reliability of a determination of the total 51 Cr EDTA plasma clearance (e) (and with it the glomerular filtration rate), by a simplified single injection method (injected dose: 4.5 μCi per kg b.w.) using capillary blood samples (0.2 ml), was investigated in twenty children. Clearance values determined from capillary blood samples did not differ significantly from those measured simultaneously from venous blood samples, the mean ratio+-SD being 1.02+-0.06(n = 10). The reproducibility (total day-to-day variation) of E determined from capillary blood samples was 6.7% in children with decreased renal function (n = 3) and 6.9% in children with normal renal function (n = 7). The present data indicate that the use of capillary blood samples is an accurate and very precise approach for determination of E in children. (Auth.)

  7. Fat injection to correct contour deformities of the reconstructed breast: a single surgeon experience

    Directory of Open Access Journals (Sweden)

    Youssef Tahiri

    2015-06-01

    Full Text Available Aim: Autologous fat grafting has gained acceptance as a technique to improve aesthetic outcomes in breast reconstruction. The purpose of this study was to share our clinical experience using autologous fat injection to correct contour deformities during breast reconstruction. Methods: A single surgeon, prospectively maintained database of patients who underwent autologous fat injection during breast reconstruction from January 2008 to November 2013 at McGill University Health Center was reviewed. Patient characteristics, breast history, type of breast reconstruction, volume of fat injected, and complications were analyzed. Results: One hundred and twenty-four patients benefited from autologous fat injection from January 2008 to November 2013, for a total of 187 treated breasts. The patients were on average 49.3 years old (΁ 8.9 years. Fat was harvested from the medial thighs (20.5%, flanks (39.1%, medial thighs and flanks (2.9%, trochanters (13.3%, medial knees (2.7%, and abdomen (21.9%. An average of 49.25 mL of fat was injected into each reconstructed breast. A total of 187 breasts in 124 patients were lipo-infiltrated during the second stage of breast reconstruction. Thirteen breasts (in 12 separate patients were injected several years after having undergone lumpectomy and radiotherapy. Of the 187 treated breasts, 118 were reconstructed with expanders to implants, 45 with deep inferior epigastric perforator flaps, 9 with latissimus dorsi flaps with implants, 4 with transverse rectus abdominis myocutaneous flaps, and 13 had previously undergone lumpectomy and radiotherapy. Six complications were noted in the entire series, for a rate of 3.2%. All were in previously radiated breasts. Average follow-up time was 12 months (range: 2-36 months. Conclusion: Fat injection continues to grow in popularity as an adjunct to breast reconstruction. Our experience demonstrates a low complication rate as compared to most surgical interventions of the breast

  8. Ultrasound-Guided Single-Injection Infraclavicular Block Versus Ultrasound-Guided Double-Injection Axillary Block: A Noninferiority Randomized Controlled Trial.

    Science.gov (United States)

    Boivin, Ariane; Nadeau, Marie-Josée; Dion, Nicolas; Lévesque, Simon; Nicole, Pierre C; Turgeon, Alexis F

    2016-01-01

    Single-injection ultrasound-guided infraclavicular block is a simple, reliable, and effective technique. A simplified double-injection ultrasound-guided axillary block technique with a high success rate recently has been described. It has the advantage of being performed in a superficial and compressible location, with a potentially improved safety profile. However, its effectiveness in comparison with single-injection infraclavicular block has not been established. We hypothesized that the double-injection ultrasound-guided axillary block would show rates of complete sensory block at 30 minutes noninferior to the single-injection ultrasound-guided infraclavicular block. After approval by our research ethics committee and written informed consent, adults undergoing distal upper arm surgery were randomized to either group I, ultrasound-guided single-injection infraclavicular block, or group A, ultrasound-guided double-injection axillary block. In group I, 30 mL of 1.5% mepivacaine was injected posterior to the axillary artery. In group A, 25 mL of 1.5% mepivacaine was injected posteromedial to the axillary artery, after which 5 mL was injected around the musculocutaneous nerve. Primary outcome was the rate of complete sensory block at 30 minutes. Secondary outcomes were the onset of sensory and motor blocks, surgical success rates, performance times, and incidence of complications. All outcomes were assessed by a blinded investigator. The noninferiority of the double-injection ultrasound-guided axillary block was considered if the limits of the 90% confidence intervals (CIs) were within a 10% margin of the rate of complete sensory block of the infraclavicular block. At 30 minutes, the rate of complete sensory block was 79% in group A (90% CI, 71%-85%) compared with 91% in group I (90% CI, 85%-95%); the upper limit of CI of group A is thus included in the established noninferiority margin of 10%. The rate of complete sensory block was lower in group A (proportion

  9. Direct injection of functional single-domain antibodies from E. coli into human cells.

    Science.gov (United States)

    Blanco-Toribio, Ana; Muyldermans, Serge; Frankel, Gad; Fernández, Luis Ángel

    2010-12-08

    Intracellular proteins have a great potential as targets for therapeutic antibodies (Abs) but the plasma membrane prevents access to these antigens. Ab fragments and IgGs are selected and engineered in E. coli and this microorganism may be also an ideal vector for their intracellular delivery. In this work we demonstrate that single-domain Ab (sdAbs) can be engineered to be injected into human cells by E. coli bacteria carrying molecular syringes assembled by a type III protein secretion system (T3SS). The injected sdAbs accumulate in the cytoplasm of HeLa cells at levels ca. 10⁵-10⁶ molecules per cell and their functionality is shown by the isolation of sdAb-antigen complexes. Injection of sdAbs does not require bacterial invasion or the transfer of genetic material. These results are proof-of-principle for the capacity of E. coli bacteria to directly deliver intracellular sdAbs (intrabodies) into human cells for analytical and therapeutic purposes.

  10. Direct injection of functional single-domain antibodies from E. coli into human cells.

    Directory of Open Access Journals (Sweden)

    Ana Blanco-Toribio

    2010-12-01

    Full Text Available Intracellular proteins have a great potential as targets for therapeutic antibodies (Abs but the plasma membrane prevents access to these antigens. Ab fragments and IgGs are selected and engineered in E. coli and this microorganism may be also an ideal vector for their intracellular delivery. In this work we demonstrate that single-domain Ab (sdAbs can be engineered to be injected into human cells by E. coli bacteria carrying molecular syringes assembled by a type III protein secretion system (T3SS. The injected sdAbs accumulate in the cytoplasm of HeLa cells at levels ca. 10⁵-10⁶ molecules per cell and their functionality is shown by the isolation of sdAb-antigen complexes. Injection of sdAbs does not require bacterial invasion or the transfer of genetic material. These results are proof-of-principle for the capacity of E. coli bacteria to directly deliver intracellular sdAbs (intrabodies into human cells for analytical and therapeutic purposes.

  11. Performance of single cylinder, direct injection Diesel engine using water fuel emulsions

    International Nuclear Information System (INIS)

    Abu-Zaid, M.

    2004-01-01

    A single cylinder Diesel engine study of water-in-Diesel emulsions was conducted to investigate the effect of water emulsification on the engine performance and gases exhaust temperature. Emulsified Diesel fuels of 0, 5, 10, 15 and 20 water/Diesel ratios by volume, were used in a single cylinder, direct injection Diesel engine, operating at 1200-3300 rpm. The results indicate that the addition of water in the form of emulsion improves combustion efficiency. The engine torque, power and brake thermal efficiency increase as the water percentage in the emulsion increases. The average increase in the brake thermal efficiency for 20% water emulsion is approximately 3.5% over the use of Diesel for the engine speed range studied. The proper brake specific fuel consumption and gases exhaust temperature decrease as the percentage of water in the emulsion increases

  12. [Utility and advantages of single tracer subareolar injection in sentinel lymph node biopsy in breast cancer].

    Science.gov (United States)

    Armas, Fayna; Hernández, María Jesús; Vega, Víctor; Gutiérrez, Isabel; Jiménez, Concepción; Pavcovich, Marta; Báez, Beatriz; Pérez-Correa, Pedro; Núñez, Valentín

    2005-10-01

    Sentinel lymph node (SLN) biopsy is a reliable technique for determining axillary status in patients with early breast cancer. This technique is a minimally invasive procedure that can avoid the use of lymphadenectomy in patients without axillary involvement. We present a validation study of SLN biopsy with subareolar injection of 99mTc-nanocolloids. We studied 100 patients with early breast cancer (T1 and T2) over a 2-year period. All patients underwent deep subareolar-injection of 99mTc-nanocoloid for localization of the sentinel node. Images were obtained and when the sentinel node was seen, it was marked on the skin. All patients underwent tumor excision and radioguided SLN biopsy followed by complete lymphadenectomy. Histopathological analysis of sentinel nodes was performed by hematoxylin-eosin and immunohistochemistry with cytokeratins. The sentinel node was identified in all patients, and a mean of 1.95 sentinel nodes per patient were found. Lymphatic metastases in the sentinel node were found in 44 patients and in 15 of these tumoral spread was also found in the remaining axillary nodes. In the 56 remaining patients the sentinel node was free of metastasis, but in two of them a non-sentinel node was found to be positive (4.5% false negative rate). Sensitivity was 95.7% (44/46), specificity was 100% (54/54), the positive predictive value was 100% and the negative predictive value was 96.4% (54/56). SLN biopsy is an accurate alternative to complete axillary lymph node dissection in patients with early-stage breast cancer. This technique improves the staging of these patients and decreases the morbidity associated with lymphadenectomy. The advantages of subareolar injection are that a single injection site is required, the tumor does not have to be located by other techniques, it allows rapid visualization of the sentinel node and avoids the "shine through phenomenon" when the tumor is located near the axilla.

  13. Multiple PRP injections are more effective than single injections and hyaluronic acid in knees with early osteoarthritis: a randomized, double-blind, placebo-controlled trial.

    Science.gov (United States)

    Görmeli, Gökay; Görmeli, Cemile Ayşe; Ataoglu, Baybars; Çolak, Cemil; Aslantürk, Okan; Ertem, Kadir

    2017-03-01

    To compare the effectiveness of intraarticular (IA) multiple and single platelet-rich plasma (PRP) injections as well as hyaluronic acid (HA) injections in different stages of osteoarthritis (OA) of the knee. A total of 162 patients with different stages of knee OA were randomly divided into four groups receiving 3 IA doses of PRP, one dose of PRP, one dose of HA or a saline injection (control). Then, each group was subdivided into two groups: early OA (Kellgren-Lawrence grade 0 with cartilage degeneration or grade I-III) and advanced OA (Kellgren-Lawrence grade IV). The patients were evaluated before the injection and at the 6-month follow-ups using the EuroQol visual analogue scale (EQ-VAS) and International Knee Documentation Committee (IKDC) subjective scores. Adverse events and patient satisfaction were recorded. There was a statistically significant improvement in the IKDC and EQ-VAS scores in all the treatment groups compared with the control group. The knee scores of patients treated with three PRP injections were significantly better than those patients of the other groups. There was no significant difference in the scores of patients injected with one dose of PRP or HA. In the early OA subgroups, significantly better clinical results were achieved in the patients treated with three PRP injections, but there was no significant difference in the clinical results of patients with advanced OA among the treatment groups. The clinical results of this study suggest IA PRP and HA treatment for all stages of knee OA. For patients with early OA, multiple (3) PRP injections are useful in achieving better clinical results. For patients with advanced OA, multiple injections do not significantly improve the results of patients in any group. I.

  14. A closed-form analytical solution for thermal single-well injection-withdrawal tests

    Science.gov (United States)

    Jung, Yoojin; Pruess, Karsten

    2012-03-01

    Thermal single-well injection-withdrawal (SWIW) tests entail pumping cold water into a hot and usually fractured reservoir, and monitoring the temperature recovery during subsequent backflow. Such tests have been proposed as a potential means to characterize properties of enhanced geothermal systems (EGS), such as fracture spacing, connectivity, and porosity. In this paper we develop an analytical solution for thermal SWIW tests, using an idealized model of a single vertical fracture with linear flow geometry embedded in impermeable conductive wall rocks. The analytical solution shows that the time dependence of temperature recovery is dominated by the heat exchange between fracture and matrix rock, but strong thermal diffusivities of rocks as compared to typical solute diffusivities are not necessarily advantageous for characterizing fracture-matrix interactions. The effect of fracture aperture on temperature recovery during backflow is weak, particularly when the fracture aperture is smaller than 0.1 cm. The solution also shows that temperature recovery during backflow is independent of the applied injection and backflow rates. This surprising result implies that temperature recovery is independent of the height of the fracture, or the specific fracture-matrix interface areas per unit fracture length, suggesting that thermal SWIW tests will not be able to characterize fracture growth that may be achieved by stimulation treatments.

  15. Basal cardiomyopathy develops in rabbits with ventricular tachyarrhythmias induced by a single injection of adrenaline.

    Science.gov (United States)

    Ashida, Terunao; Takato, Tetsuya; Matsuzaki, Gen; Seko, Yoshinori; Fujii, Jun; Kawai, Sachio

    2014-01-01

    We have recently demonstrated that basal cardiomyopathy develops in rabbits with ventricular tachyarrhythmias that have been induced by electrical stimulation of the cervical vagus. This study investigated whether similar basal cardiomyopathy would develop in rabbits with ventricular tachyarrhythmias induced by a single injection of adrenaline. Adrenaline was intravenously infused for 10-360 seconds in anesthetized rabbits. Colloidal carbon was injected after adrenaline infusion. Wall movement velocity of the left ventricular base was assessed by tissue Doppler echocardiography. Animals were killed either 1 week or 3-4 weeks later. Pathological lesions were identified by deposits of carbon particles. Animals were divided into two groups according to the infused dose of adrenaline. The small-dose group (group S, n = 15) received 1-10 μg and the large-dose group (group L, n = 23) received 15-60 μg of adrenaline. Adrenaline infusion induced premature ventricular contractions followed by monomorphic ventricular tachycardias in 22 of 23 animals in group L, but in only 1 of 15 animals in group S. Wall movement velocity of the left ventricular base decreased just after adrenaline infusion, remained low after 1 week, and recovered to near-baseline levels after 3-4 weeks in group L. Unique cardiac lesions identified by deposits of carbon particles were frequently observed on the left ventricular basal portion, almost always associated with the mitral valve and papillary muscles, but were never observed in the apical area. Lesions involving all areas of the left ventricular basal portion were observed in 22 of 23 animals in group L, but in only 2 of 15 animals in group S. Basal cardiomyopathy developed in rabbits with ventricular tachycardias induced by a single injection of adrenaline.

  16. A comparison of a single or triple injection technique for ultrasound-guided infraclavicular block: a prospective randomized controlled study.

    Science.gov (United States)

    Desgagnés, Marie-Christine; Lévesque, Simon; Dion, Nicolas; Nadeau, Marie-Josée; Coté, Dany; Brassard, Jean; Nicole, Pierre C; Turgeon, Alexis F

    2009-08-01

    Good success rates have been reported with ultrasound-guided infraclavicular block using one or multiple injections of local anesthetic. We hypothesized that a separate injection of local anesthetics on each cord enhances the onset of complete sensory block. We designed this prospective randomized study to compare the rate of complete sensory block using one or three injections of local anesthetic. Patients scheduled for hand, wrist, or elbow surgery were included in this study. All blocks were performed under ultrasound guidance. In Group S (single injection), 30 mL of mepivacaine 1.5% was injected posterior to the axillary artery. In Group T (triple injections), 10 mL of mepivacaine 1.5% was injected on the posterior, medial, and lateral aspects of the axillary artery. Sensory block was evaluated every 3 min up to 30 min. The primary end point was the rate of complete sensory block at 15 min. Forty-nine and 51 patients were randomized in Groups S and T, respectively. The rate of complete sensory block was comparable at 15 min (Group S: 84%, Group T: 78%, P = 0.61) and at each time interval up to 30 min. There was no statistically significant difference in the rate of complications between the two groups. The success rate and the onset of complete sensory block after ultrasound-guided infraclavicular block are not enhanced by a triple injection of local anesthetic compared with a single injection posterior to the axillary artery.

  17. Single injection of clenbuterol into newly hatched chicks decreases abdominal fat pad weight in growing broiler chickens.

    Science.gov (United States)

    Ijiri, Daichi; Ishitani, Kanae; El-Deep, Mahmoud Mohamed Hamza; Kawaguchi, Mana; Shimamoto, Saki; Ishimaru, Yoshitaka; Ohtsuka, Akira

    2016-10-01

    The aim of the current study was to examine the effects of clenbuterol injection into newly hatched chicks on both the abdominal fat pad tissue weight and the skeletal muscle weight during subsequent growth. Twenty-seven 1-day-old chicks were divided into two groups, receiving either a single intraperitoneal (i.p.) injection of clenbuterol (0.1 mg/kg body weight) or phosphate-buffered saline (PBS). Body weight gain, feed intake and feed conversion ratio were not affected by clenbuterol injection during the 5-week experimental period, while the abdominal fat pad tissue weight of the clenbuterol-injected chicks was lower than that of the control chicks at 5 weeks post-injection. Plasma non-esterified fatty acid concentrations were significantly increased in the clenbuterol-injected chicks, while plasma triacylglycerol concentrations did not differ. Additionally, the enzymatic activity of fatty acid synthase was lower in the liver of the clenbuterol-injected chicks. Conversely, the skeletal muscle weights were not affected by clenbuterol injection. These results suggest that a single clenbuterol injection into 1-day-old chicks decreases the abdominal fat pad tissue weight, but may not affect skeletal muscle weights during growth. © 2015 Japanese Society of Animal Science. © 2015 Japanese Society of Animal Science.

  18. Effects of Stator Shroud Injection on the Aerodynamic Performance of a Single-Stage Transonic Axial Compressor

    International Nuclear Information System (INIS)

    Dinh, Cong-Truong; Ma, Sang-Bum; Kim, Kwang Yong

    2017-01-01

    In this study, stator shroud injection in a single-stage transonic axial compressor is proposed. A parametric study of the effect of stator shroud injection on aerodynamic performances was conducted using the three-dimensional Reynolds-averaged Navier-Stokes equations. The curvature, length, width, and circumferential angle of the stator shroud injector and the air injection mass flow rate were selected as the test parameters. The results of the parametric study show that the aerodynamic performances of the single-stage transonic axial compressor were improved by stator shroud injection. The aerodynamic performances were the most sensitive to the injection mass flow rate. Further, the total pressure ratio and adiabatic efficiency were the maximum when the ratio of circumferential angle was 10%.

  19. Effects of Stator Shroud Injection on the Aerodynamic Performance of a Single-Stage Transonic Axial Compressor

    Energy Technology Data Exchange (ETDEWEB)

    Dinh, Cong-Truong; Ma, Sang-Bum; Kim, Kwang Yong [Inha Univ., Incheon (Korea, Republic of)

    2017-01-15

    In this study, stator shroud injection in a single-stage transonic axial compressor is proposed. A parametric study of the effect of stator shroud injection on aerodynamic performances was conducted using the three-dimensional Reynolds-averaged Navier-Stokes equations. The curvature, length, width, and circumferential angle of the stator shroud injector and the air injection mass flow rate were selected as the test parameters. The results of the parametric study show that the aerodynamic performances of the single-stage transonic axial compressor were improved by stator shroud injection. The aerodynamic performances were the most sensitive to the injection mass flow rate. Further, the total pressure ratio and adiabatic efficiency were the maximum when the ratio of circumferential angle was 10%.

  20. Understanding the effect of single-fracture heterogeneity from single-well injection-withdrawal (SWIW) tests

    Science.gov (United States)

    Larsson, Martin; Doughty, Christine; Tsang, Chin-Fu; Niemi, Auli

    2013-12-01

    The single-well injection-withdrawal (SWIW) tracer test is a method used to estimate the tracer retardation properties of a fracture or fracture zone. The effects of single-fracture aperture heterogeneity on SWIW-test tracer breakthrough curves are examined by numerical modelling. The effects of the matrix diffusion and sorption are accounted for by using a particle tracking method through the addition of a time delay added to the advective transport time. For a given diffusion and sorption property ( P m) value and for a heterogeneous fracture, the peak concentration is larger compared to a homogeneous fracture. The cumulative breakthrough curve for a heterogeneous fracture is similar to that for a homogeneous fracture and a less sorptive/diffusive tracer. It is demonstrated that the fracture area that meets the flowing water, the specific flow-wetted surface (sFWS) of the fracture, can be determined by matching the observed breakthrough curve for a heterogeneous fracture to that for a homogeneous fracture with an equivalent property parameter. SWIW tests are also simulated with a regional pressure gradient present. The results point to the possibility of distinguishing the effect of the regional pressure gradient from that of diffusion through the use of multiple tracers with different P m values.

  1. Critical firing and misfiring boundary in a spark ignition methanol engine during cold start based on single cycle fuel injection

    International Nuclear Information System (INIS)

    Li, Zhaohui; Gong, Changming; Qu, Xiang; Liu, Fenghua; Sun, Jingzhen; Wang, Kang; Li, Yufeng

    2015-01-01

    The influence of the mass of methanol injected per cycle, ambient temperature, injection and ignition timing, preheating methods, and supplying additional liquefied petroleum gas (LPG) injection into the intake manifold on the critical firing and misfiring boundary of an electronically injection controlled spark ignition (SI) methanol engine during cold start were investigated experimentally based on a single cycle fuel injection with cycle-by-cycle control strategy. The critical firing and misfiring boundary was restricted by all parameters. For ambient temperatures below 16 °C, methanol engines must use auxiliary start-aids during cold start. Optimal control of the methanol injection and ignition timing can realize ideal next cycle firing combustion after injection. Resistance wire and glow plug preheating can provide critical firing down to ambient temperatures of 5 °C and 0 °C, respectively. Using an additional LPG injection into the intake manifold can provide critical firing down to an ambient temperature of −13 °C during cold start. As the ambient temperature decreases, the optimal angle difference between methanol injection timing and LPG injection timing for critical firing of a methanol engine increases rapidly during cold start. - Highlights: • A single cycle fuel injection and cycle-by-cycle control strategy are used to study. • In-cylinder pressure and instantaneous speed were used to determine firing boundary. • For the ambient temperatures below 16 °C, an auxiliary start-aids must be used. • A preheating and additional LPG were used to expand critical firing boundary. • Additional LPG can result in critical firing down to ambient temperature of −13 °C

  2. The acceptability of three vaccine injections given to infants during a single clinic visit in South Africa

    Directory of Open Access Journals (Sweden)

    Hanani Tabana

    2016-08-01

    Full Text Available Abstract Background The Expanded Programme on Immunisation (EPI has increased the number of antigens and injections administered at one visit. There are concerns that more injections at a single immunisation visit could decrease vaccination coverage. We assessed the acceptability and acceptance of three vaccine injections at a single immunisation visit by caregivers and vaccinators in South Africa. Methods A mixed methods exploratory study of caregivers and vaccinators at clinics in two provinces of South Africa was conducted. Quantitative and qualitative data were collected using questionnaires as well as observations of the administration of three-injection vaccination sessions. Results The sample comprised 229 caregivers and 98 vaccinators. Caregivers were satisfied with the vaccinators’ care (97 % and their infants receiving immunisation injections (93 %. However, many caregivers, (86 % also felt that three or more injections were excessive at one visit. Caregivers had limited knowledge of actual vaccines provided, and reasons for three injections. Although vaccinators recognised the importance of informing caregivers about vaccination, they only did this sometimes. Overall, acceptance of three injections was high, with 97 % of caregivers expressing willingness to bring their infant for three injections again in future visits despite concerns about the pain and discomfort that the infant experienced. Many (55 % vaccinators expressed concern about giving three injections in one immunisation visit. However, in 122 (95 % observed three-injection vaccination sessions, the vaccinators administered all required vaccinations for that visit. The remaining seven vaccinations were not completed because of vaccine stock-outs. Conclusions We found high acceptance by caregivers and vaccinators of three injections. Caregivers’ poor understanding of reasons for three injections resulted from limited information sharing by vaccinators for

  3. Highly efficient subcloning of rodent malaria parasites by injection of single merosomes or detached cells.

    Science.gov (United States)

    Stanway, Rebecca R; Graewe, Stefanie; Rennenberg, Annika; Helm, Susanne; Heussler, Volker T

    2009-01-01

    This protocol describes a method for obtaining rodent Plasmodium parasite clones with high efficiency, which takes advantage of the normal course of Plasmodium in vitro exoerythrocytic development. At the completion of development, detached cells/merosomes form, which contain hundreds to thousands of merozoites. As all parasites within a single detached cell/merosome derive from the same sporozoite, we predicted them to be genetically identical. To prove this, hepatoma cells were infected simultaneously with a mixture of Plasmodium berghei sporozoites expressing either GFP or mCherry. Subsequently, individual detached cells/merosomes from this mixed population were selected and injected into mice, resulting in clonal blood stage parasite infections. Importantly, as a large majority of mice become successfully infected using this protocol, significantly less mice are necessary than for the widely used technique of limiting dilution cloning. To produce a clonal P. berghei blood stage infection from a non-clonal infection using this procedure requires between 4 and 5 weeks.

  4. Single injection techniques in determining age-related changes in porcine renal function

    International Nuclear Information System (INIS)

    Robbins, M.E.C.

    1984-01-01

    Glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) were determined in 32 anaesthetised female Large White pigs, aged 4-24 months, from the plasma disappearance curves of [sup(99m)Tc]DTPA and [ 131 I]hippuran respectively. Clearance was also monitored by external counting over the heart. GFR and ERPF increased markedly with age in pigs up to 12 months old, reaching mean values of 242.06 +- 5.89 and 919.39 +- 79.01 mL/min. In pigs aged 12-24 months ERPF increased slightly but renal function remained essentially unchanged after 1 yr of age. These results for renal function were similar to previous estimates, using continuous infusion techniques inferring that GFR and ERPF could be accurately monitored using single injection procedures. (author)

  5. Baseline performance and emissions data for a single-cylinder, direct-injected diesel engine

    Science.gov (United States)

    Dezelick, R. A.; Mcfadden, J. J.; Ream, L. W.; Barrows, R. F.

    1983-01-01

    Comprehensive fuel consumption, mean effective cylinder pressure, and emission test results for a supercharged, single-cylinder, direct-injected, four-stroke-cycle, diesel test engine are documented. Inlet air-to-exhaust pressure ratios were varied from 1.25 to 3.35 in order to establish the potential effects of turbocharging techniques on engine performance. Inlet air temperatures and pressures were adjusted from 34 to 107 C and from 193 to 414 kPa to determine the effects on engine performance and emissions. Engine output ranged from 300 to 2100 kPa (brake mean effective pressure) in the speed range of 1000 to 3000 rpm. Gaseous and particulate emission rates were measured. Real-time values of engine friction and pumping loop losses were measured independently and compared with motored engine values.

  6. Influence of heat exchange of reservoir with rocks on hot gas injection via a single well

    Science.gov (United States)

    Nikolaev, Vladimir E.; Ivanov, Gavril I.

    2017-11-01

    In the computational experiment the influence of heat exchange through top and bottom of the gas-bearing reservoir on the dynamics of temperature and pressure fields during hot gas injection via a single well is investigated. The experiment was carried out within the framework of modified mathematical model of non-isothermal real gas filtration, obtained from the energy and mass conservation laws and the Darcy law. The physical and caloric equations of state together with the Newton-Riemann law of heat exchange of gas reservoir with surrounding rocks, are used as closing relations. It is shown that the influence of the heat exchange with environment on temperature field of the gas-bearing reservoir is localized in a narrow zone near its top and bottom, though the size of this zone is increased with time.

  7. [Fluoroprophylaxis by the parenteral route].

    Science.gov (United States)

    Bergese, F

    1990-05-01

    The author sustains the value parenteral fluoroprophylaxis; this method of administering fluoride is the most appropriate during the period of formation of the enamel and in the pre-eruptive stage of the tooth, and is thus an essential procedure in a fluoroprophylaxis programme, which should be used above all in the case of public health measures.

  8. Interpretation of injection-withdrawal tracer experiments conducted between two wells in a large single fracture.

    Science.gov (United States)

    Novakowski, K S; Bickerton, G; Lapcevic, P

    2004-09-01

    Tracer experiments conducted using a flow field established by injecting water into one borehole and withdrawing water from another are often used to establish connections and investigate dispersion in fractured rock. As a result of uncertainty in the uniqueness of existing models used for interpretation, this method has not been widely used to investigate more general transport processes including matrix diffusion or advective solute exchange between mobile and immobile zones of fluid. To explore the utility of the injection-withdrawal method as a general investigative tool and with the intent to resolve the transport processes in a discrete fracture, two tracer experiments were conducted using the injection-withdrawal configuration. The experiments were conducted in a fracture which has a large aperture (>500 microm) and horizontally pervades a dolostone formation. One experiment was conducted in the direction of the hydraulic gradient and the other in the direction opposite to the natural gradient. Two tracers having significantly different values of the free-water diffusion coefficient were used. To interpret the experiments, a hybrid numerical-analytical model was developed which accounts for the arcuate shape of the flow field, advection-dispersion in the fracture, diffusion into the matrix adjacent to the fracture, and the presence of natural flow in the fracture. The model was verified by comparison to a fully analytical solution and to a well-known finite-element model. Interpretation of the tracer experiments showed that when only one tracer, advection-dispersion, and matrix diffusion are considered, non-unique results were obtained. However, by using multiple tracers and by accounting for the presence of natural flow in the fracture, unique interpretations were obtained in which a single value of matrix porosity was estimated from the results of both experiments. The estimate of porosity agrees well with independent measurements of porosity obtained from

  9. Singles transmission scans performed post-injection for quantitative whole body FDG-PET

    Energy Technology Data Exchange (ETDEWEB)

    Smith, R.J.; Benard, F.; Karp, J.S. [Univ. of Pennsylvania, Philadelphia, PA (United States)] [and others

    1996-12-31

    Post-injection singles transmission scanning has been implemented in the septumless PENN PET 240H scanner (prototype of the GE QUEST). The method uses a 6 mCi point transmission source of {sup 137}Cs at the axial center and 37 cm of transaxial center of the camera field of view. Singles transmission scans of 1.8 minutes per bed axial position provide similar scan count densities to 15 minute coincidence transmission scans with 0.5 mCi {sup 68}Ge rod transmission source. Scatter and emission contamination suppression are achieved by applying a narrow 662 keV transmission photopeak energy window. The residual 511 keV emission contamination constitutes a background of uniform spatial distribution. Accurate and low noise attenuation correction is achieved by segmenting the singles transmission images into lung and soft tissue volumes. Established 511 keV gamma ray attenuation coefficients are then applied and these images are forward projected for attenuation correction. Expectation maximisation or OS-EM reconstruction of the transmission and emission images is used to improve image quality. Both the segmentation and OS-EM reconstruction maintain quantitative accuracy in the fully corrected emission images compared to measured coincidence transmission correction. Thus, a clinical protocol involving 40 minutes of emission scans followed by 20 minutes of singles transmission scans allow the 60 cm of the human torso to be fully scanned within 60 minutes. These quantitative whole body FDG PET images may then be used for tumor grading and assessment of tumor response to treatment.

  10. Magnetic resonance imaging of single co-labeled mesenchymal stromal cells after intracardial injection in mice

    Energy Technology Data Exchange (ETDEWEB)

    Salamon, J.; Adam, G.; Peldschus, K. [University Medical Center Hamburg-Eppendorf, Hamburg (Germany). Dept. of Diagnostic and Interventional Radiology; Wicklein, D.; Schumacher, U. [University Medical Center Hamburg-Eppendorf, Hamburg (Germany). Inst. of Anatomy II: Experimental Morphology; Didie, M. [Goettingen Univ. (Germany). Inst. of Pharmacology; Lange, C. [University Medical Center Hamburg-Eppendorf, Hamburg (Germany). Dept. of Bone Marrow Transplantation

    2014-04-15

    Purpose: The aim of this study was to establish co-labeling of mesenchymal stromal cells (MSC) for the detection of single MSC in-vivo by MRI and histological validation. Materials and Methods: Mouse MSC were co-labeled with fluorescent iron oxide micro-particles and carboxyfluorescein succinimidyl ester (CFSE). The cellular iron content was determined by atomic absorption spectrometry. Cell proliferation and expression of characteristic surface markers were determined by flow cytometry. The chondrogenic differentiation capacity was assessed. Different amounts of cells (n1 = 5000, n2 = 15 000, n3 = 50 000) were injected into the left heart ventricle of 12 mice. The animals underwent sequential MRI on a clinical 3.0T scanner (Intera, Philips Medical Systems, Best, The Netherlands). For histological validation cryosections were examined by fluorescent microscopy. Results: Magnetic and fluorescent labeling of MSC was established (mean cellular iron content 23.6 ± 3 pg). Flow cytometry showed similar cell proliferation and receptor expression of labeled and unlabeled MSC. Chondrogenic differentiation of labeled MSC was verified. After cell injection MRI revealed multiple signal voids in the brain and fewer signal voids in the kidneys. In the brain, an average of 4.6 ± 1.2 (n1), 9.0 ± 3.6 (n2) and 25.0 ± 1.0 (n3) signal voids were detected per MRI slice. An average of 8.7 ± 3.1 (n1), 22.0 ± 6.1 (n2) and 89.8 ± 6.5 (n3) labeled cells per corresponding stack of adjacent cryosections could be detected in the brain. Statistical correlation of the numbers of MRI signal voids in the brain and single MSC found by histology revealed a correlation coefficient of r = 0.91. Conclusion: The study demonstrates efficient magnetic and fluorescent co-labeling of MSC and their detection on a single cell level in mice by in-vivo MRI and histology. The described techniques may broaden the methods for in-vivo tracking of MSC. (orig.)

  11. Single well injection withdrawal tests (SWIW) in fractured rock. Some aspects on interpretation

    Energy Technology Data Exchange (ETDEWEB)

    Neretnieks, Ivars [Dept. of Chemical Engineering and Technology, Royal Inst. of Technology, Stockholm (Sweden)

    2007-08-15

    Single-Well-Injection-Withdrawal, SWIW, tests are used to try to extract information on fracture apertures, sorption and diffusion properties and dispersion information in individual fractures. It is done by injecting a given amount of traced water into an isolated fracture. After a waiting period water is withdrawn from the fracture and the tracer concentration is measured. The concentration time curve is fitted to a model and the parameter values quantifying the different interaction mechanisms are determined. A number of different mechanisms influence the recovery of the tracer. One or more of the following mechanisms are considered. They include: dispersion due to velocity differences, sorption on fracture surface and on infill, diffusion in rock fragments in the fracture, diffusion between 'streamlines', diffusion into rock matrix and other stagnant water volumes, sorption kinetics and slow drift of the plume caused by the natural gradient. Many of the interaction mechanisms can influence the recovery curve in a similar way. For example, diffusion into rock matrix water and into stagnant water in the fracture adjacent to the flowing channels cannot be distinguished if only one tracer is used. Tracers with different properties can in principle be used but they will encounter different parts of the fracture, the sorbing tracer will move out less from the injection point than a nonsorbing tracer will. Diffusion and sorption in small particles in the flowpath can influence the recovery curve in a similar way as rock matrix diffusion does. Dispersion caused by diffusion between 'streamlines', Taylor dispersion, can give very different results in channels of different shapes. Such dispersion effects can be difficult to distinguish from matrix diffusion effects. Dispersion coefficients obtained in a SWIW test may have little relation to dispersion of a tracer moving from A to B. This is partly due to the different mechanisms and partly due to

  12. Single well injection withdrawal tests (SWIW) in fractured rock. Some aspects on interpretation

    International Nuclear Information System (INIS)

    Neretnieks, Ivars

    2007-08-01

    Single-Well-Injection-Withdrawal, SWIW, tests are used to try to extract information on fracture apertures, sorption and diffusion properties and dispersion information in individual fractures. It is done by injecting a given amount of traced water into an isolated fracture. After a waiting period water is withdrawn from the fracture and the tracer concentration is measured. The concentration time curve is fitted to a model and the parameter values quantifying the different interaction mechanisms are determined. A number of different mechanisms influence the recovery of the tracer. One or more of the following mechanisms are considered. They include: dispersion due to velocity differences, sorption on fracture surface and on infill, diffusion in rock fragments in the fracture, diffusion between 'streamlines', diffusion into rock matrix and other stagnant water volumes, sorption kinetics and slow drift of the plume caused by the natural gradient. Many of the interaction mechanisms can influence the recovery curve in a similar way. For example, diffusion into rock matrix water and into stagnant water in the fracture adjacent to the flowing channels cannot be distinguished if only one tracer is used. Tracers with different properties can in principle be used but they will encounter different parts of the fracture, the sorbing tracer will move out less from the injection point than a nonsorbing tracer will. Diffusion and sorption in small particles in the flowpath can influence the recovery curve in a similar way as rock matrix diffusion does. Dispersion caused by diffusion between 'streamlines', Taylor dispersion, can give very different results in channels of different shapes. Such dispersion effects can be difficult to distinguish from matrix diffusion effects. Dispersion coefficients obtained in a SWIW test may have little relation to dispersion of a tracer moving from A to B. This is partly due to the different mechanisms and partly due to different time scales

  13. Numerical simulations of single and multi-staged injection of H2 in a supersonic scramjet combustor

    Directory of Open Access Journals (Sweden)

    L. Abu-Farah

    2014-12-01

    Full Text Available Computational fluid dynamics (CFD simulations of a single staged injection of H2 through a central wedge shaped strut and a multi-staged injection through wall injectors are carried out by using Ansys CFX-12 code. Unstructured tetrahedral grids for narrow channel and quarter geometries of the combustor are generated by using ICEM CFD. Steady three-dimensional (3D Reynolds-averaged Navier-stokes (RANS simulations are carried out in the case of no H2 injection and compared with the simulations of single staged pilot and/or main H2 injections and multistage injection. Shear stress transport (SST based on k-ω turbulent model is adopted. Flow field visualization (complex shock waves interactions and static pressure distribution along the wall of the combustor are predicted and compared with the experimental schlieren images and measured wall static pressures for validation. A good agreement is found between the CFD predicted results and the measured data. The narrow and quarter geometries of the combustor give similar results with very small differences. Multi-staged injections of H2 enhance the turbulent H2/air mixing by forming vortices and additional shock waves (bow shocks.

  14. A prospective, randomized comparison between single- and multiple-injection techniques for ultrasound-guided subgluteal sciatic nerve block.

    Science.gov (United States)

    Yamamoto, Hiroto; Sakura, Shinichi; Wada, Minori; Shido, Akemi

    2014-12-01

    It is believed that local anesthetic injected to obtain circumferential spread around nerves produces a more rapid onset and successful blockade after some ultrasound-guided peripheral nerve blocks. However, evidence demonstrating this point is limited only to the popliteal sciatic nerve block, which is relatively easy to perform by via a high-frequency linear transducer. In the present study, we tested the hypothesis that multiple injections of local anesthetic to make circumferential spread would improve the rate of sensory and motor blocks compared with a single-injection technique for ultrasound-guided subgluteal sciatic nerve block, which is considered a relatively difficult block conducted with a low-frequency, curved-array transducer. Ninety patients undergoing knee surgery were divided randomly into 2 groups to receive the ultrasound-guided subgluteal approach to sciatic nerve block with 20 mL of 1.5% mepivacaine with epinephrine. For group M (the multiple-injection technique), the local anesthetic was injected to create circumferential spread around the sciatic nerve without limitation on the number of needle passes. For group S (the single-injection technique), the number of needle passes was limited to 1, and the local anesthetic was injected to create spread along the dorsal surface of the sciatic nerve, during which no adjustment of the needle tip was made. Sensory and motor blockade were assessed in double-blind fashion for 30 minutes after completion of the block. The primary outcome was sensory blockade of all sciatic components tested, including tibial, superficial peroneal, and sural nerves at 30 minutes after injection. Data from 86 patients (43 in each group) were analyzed. Block execution took more time for group M than group S. The proportion of patients with complete sensory blockade of all sciatic components at 30 minutes after injection was significantly larger for group M than group S (41.9% vs 16.3%, P = 0.018). Complete motor blockade of

  15. Single-dose methotrexate injection for treatment of ectopic pregnancy in women with relatively low levels of human chorionic gonadotropin.

    Science.gov (United States)

    Krissi, Haim; Peled, Yoav; Eitan, Ram; Bishara, Amani; Goldchmit, Chen; Ben-Haroush, Avi

    2013-05-01

    To evaluate potential risk factors at admission for failed single-dose methotrexate injection in women with ectopic pregnancy. File review of a tertiary medical center in Israel yielded 102 consecutive patients with ectopic pregnancy initially treated with single-dose methotrexate. Overall successful treatment was defined as normalization of human chorionic gonadotropin (hCG) levels after the first or second injection. The mean pretreatment hCG level for the whole cohort was 2350 ± 2955 mIU/mL (median, 1187 mIU/mL; 90th percentile, 5000 mIU/mL). Resolution of ectopic pregnancy was achieved after a single injection in 76/102 (74.5%) women and after a second dose in 16/21 (76.2%) women. The remaining 10 (9.8%) patients were treated surgically after the first (5/76) or the second (5/26) dose. The overall success rate for methotrexate treatment was 90.2%. On multivariate stepwise logistic analysis, fetal cardiac activity was an independent predictor of a failed first methotrexate injection, and presence of a yolk sac and mass size were independent predictors of overall methotrexate failure and need for secondary surgery. In patients with ectopic pregnancy and relatively low levels of serum hCG, the most important predictors of overall failure of methotrexate injection were the presence of a yolk sac and mass size. Copyright © 2013 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  16. A new glass option for parenteral packaging.

    Science.gov (United States)

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

    2014-01-01

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

  17. Effects of a single glucocorticoid injection on propylene glycol-treated cows with clinical ketosis.

    Science.gov (United States)

    van der Drift, Saskia G A; Houweling, Martin; Bouman, Marina; Koets, Ad P; Tielens, Aloysius G M; Nielen, Mirjam; Jorritsma, Ruurd

    2015-05-01

    This study investigated the metabolic effects of glucocorticoids when administered to propylene glycol-treated cows with clinical ketosis. Clinical ketosis was defined by depressed feed intake and milk production, and a maximal score for acetoacetate in urine. All cows received 250 mL oral propylene glycol twice daily for 3 days and were randomly assigned to a single intramuscular injection with sterile isotonic saline solution (n = 14) or dexamethasone-21-isonicotinate (n = 17). Metabolic blood variables were monitored for 6 days and adipose tissue variables for 3 days. β-Hydroxybutyrate (BHBA) concentrations in blood decreased in all cows during treatment, but were lower in glucocorticoid-treated cows. Cows treated with glucocorticoids had higher plasma glucose and insulin concentrations, whereas concentrations of non-esterified fatty acids, 3-methylhistidine and growth hormone were unaffected. mRNA expression of hormone-sensitive lipase, BHBA receptor and peroxisome proliferator-activated receptor type γ in adipose tissue was not affected. This shows that lipolytic effects do not appear to be important in ketotic cows when glucocorticoids are combined with PG. Plasma 3-methyl histidine concentrations were similar in both groups, suggesting that glucocorticoids did not increase muscle breakdown and that the greater rise in plasma glucose in glucocorticoid-treated cows may not be due to increased supply of glucogenic amino acids from muscle. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. Administration of follitropin alfa and lutropin alfa combined in a single injection: a feasibility assessment

    Directory of Open Access Journals (Sweden)

    Agostinetto Rita

    2009-05-01

    Full Text Available Abstract Background Gonadotrophins are routinely administered in assisted reproductive technology (ART treatment protocols. Recombinant human follicle-stimulating hormone (r-hFSH; follitropin alfa and recombinant human luteinizing hormone (r-hLH; lutropin alfa can be administered individually or in a fixed combination. The ability to vary the FSH to LH dose ratio in a single injection without compromising the bioactivity of either gonadotrophin or generating losses of active principle is important for physicians and patients alike. Methods This study investigated whether follitropin alfa (GONAL-f (R, as lyophilized powder for reconstitution or solution from the GONAL-f (R (filled-by-mass [FbM] Prefilled Pen, could be used to reconstitute Pergoveris TM (follitropin alfa/lutropin alfa 150 IU/75 IU lyophilized powder. In Ratio Groups 1 and 2, the r-hFSH:r-hLH ratio was 3:1; in Ratio Groups 3 and 4, the ratios of r-hFSH:r-hLH were 5:1 and 8:1, respectively. The protein content and bioactivity of each mixed solution were evaluated. The r-hFSH and r-hLH content was determined using reverse-phase high performance liquid chromatography. The biological activity of r-hFSH and r-hLH was assessed using the Steelman-Pohley and Van Hell in vivo bioassays in rats, respectively. Results Follitropin alfa/lutropin alfa 150 IU/75 IU lyophilized powder could be successfully mixed with follitropin alfa 75 IU FbM solution that was either reconstituted from lyophilized powder or injected directly from the prefilled pen to create solutions with ratios of r-hFSH and r-hLH from 3:1 to 8:1. The measured content of r-hFSH and r-hLH corresponded favourably with the target protein content in Ratio Groups 1–4. The in vivo target and measured bioactivity of r-hFSH and r-hLH were also closely matched in all Ratio Groups. Conclusion Follitropin alfa lyophilized powder or solution can be accurately mixed with follitropin alfa/lutropin alfa 150 IU/75 IU lyophilized powder to

  19. ESPEN Guidelines on Parenteral Nutrition: gastroenterology

    DEFF Research Database (Denmark)

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

    2009-01-01

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

  20. Knee Viscosupplementation: Cost-Effectiveness Analysis between Stabilized Hyaluronic Acid in a Single Injection versus Five Injections of Standard Hyaluronic Acid

    Directory of Open Access Journals (Sweden)

    Francisco J. Estades-Rubio

    2017-03-01

    Full Text Available Given the wide difference in price per vial between various presentations of hyaluronic acid, this study seeks to compare the effectiveness and treatment cost of stabilized hyaluronic acid (NASHA in a single injection with standard preparations of hyaluronic acid (HA in five injections in osteoarthritis (OA of the knee. Fifty-four patients with knee osteoarthritis (Kellgren–Lawrence Grade II and III and the Western Ontario and McMaster Universities Arthritis Index (WOMAC pain score greater than 7, with a homogeneous distribution of age, sex, BMI, and duration of disease, were included in this study. Patients were randomized into two groups: Group I was treated with NASHA (Durolane® and Group II with HA (Go-ON®. Patient’s evolution was followed up at the 1st, 2nd, 4th, 8th, 12th, and 26th week after treatment. A statistically significant improvement in WOMAC score was observed for patients treated with NASHA versus those who received HA at Week 26. In addition, the need for analgesia was significantly reduced at Week 26 in the NASHA-treated group. Finally, the economic analysis showed an increased cost of overall treatment with HA injections. Our data support the use of the NASHA class of products in the treatment of knee OA.

  1. Knee Viscosupplementation: Cost-Effectiveness Analysis between Stabilized Hyaluronic Acid in a Single Injection versus Five Injections of Standard Hyaluronic Acid.

    Science.gov (United States)

    Estades-Rubio, Francisco J; Reyes-Martín, Alvaro; Morales-Marcos, Victor; García-Piriz, Mercedes; García-Vera, Juan J; Perán, Macarena; Marchal, Juan A; Montañez-Heredia, Elvira

    2017-03-17

    Given the wide difference in price per vial between various presentations of hyaluronic acid, this study seeks to compare the effectiveness and treatment cost of stabilized hyaluronic acid (NASHA) in a single injection with standard preparations of hyaluronic acid (HA) in five injections in osteoarthritis (OA) of the knee. Fifty-four patients with knee osteoarthritis (Kellgren-Lawrence Grade II and III) and the Western Ontario and McMaster Universities Arthritis Index (WOMAC) pain score greater than 7, with a homogeneous distribution of age, sex, BMI, and duration of disease, were included in this study. Patients were randomized into two groups: Group I was treated with NASHA (Durolane ® ) and Group II with HA (Go-ON ® ). Patient's evolution was followed up at the 1st, 2nd, 4th, 8th, 12th, and 26th week after treatment. A statistically significant improvement in WOMAC score was observed for patients treated with NASHA versus those who received HA at Week 26. In addition, the need for analgesia was significantly reduced at Week 26 in the NASHA-treated group. Finally, the economic analysis showed an increased cost of overall treatment with HA injections. Our data support the use of the NASHA class of products in the treatment of knee OA.

  2. The comparison of knee osteoarthritis treatment with single-dose bone marrow-derived mononuclear cells vs. hyaluronic acid injections.

    Science.gov (United States)

    Goncars, Valdis; Jakobsons, Eriks; Blums, Kristaps; Briede, Ieva; Patetko, Liene; Erglis, Kristaps; Erglis, Martins; Kalnberzs, Konstantins; Muiznieks, Indrikis; Erglis, Andrejs

    2017-01-01

    The aim of this study was to compare treatment methods of the knee joint degenerative osteoarthritis, using autologous bone marrow-derived mononuclear cells and hyaluronic acid injections and observe prevalence of adverse effects in both groups. A prospective randomized controlled clinical trial was carried out. The analysis of pain and changes in osteoarthritis symptoms after a single intra-articular bone marrow-derived mononuclear cell injection into the knee joint in the Kellgren-Lawrence stage II-III osteoarthritis during the 12-month period were performed. The results were compared with the control group treated routinely by hyaluronic acid injections therapy. A therapy group of patients (n=28) received single bone marrow-derived mononuclear cell intra-articular injections. A control group of patients (n=28) was treated with a total of three sodium hyaluronate intra-articular injections each one performed a week apart. The clinical results were obtained using the Knee Osteoarthritis Outcome Score (KOOS) and the Knee Society Score (KSS) before and 3, 6, and 12 months after injection. A statistically significant improvement was observed in the mononuclear cell group over the starting point in all scores. At the endpoint at month 12, the KOOS score improved significantly (Phyaluronic acid versus the bone marrow-derived mononuclear cells group at time points 6 and 12 months demonstrated a statistically significant (Phyaluronic acid group. In both groups serious adverse effects were not observed. The intra-articular injection of bone marrow-derived mononuclear cells is a safe manipulation with no side effects during the 12-month period. This treatment provides statistically significant clinical improvement between the starting point and 1, 3, 6, and 12 months after. When compared to hyaluronic acid treatment, better pain relief in the long-term period of mononuclear cell group was observed. Copyright © 2017 The Lithuanian University of Health Sciences. Production

  3. Effect of injection pressure on performance, emission, and combustion characteristics of diesel-acetylene-fuelled single cylinder stationary CI engine.

    Science.gov (United States)

    Srivastava, Anmesh Kumar; Soni, Shyam Lal; Sharma, Dilip; Jain, Narayan Lal

    2018-03-01

    In this paper, the effect of injection pressure on the performance, emission, and combustion characteristics of a diesel-acetylene fuelled single cylinder, four-stroke, direct injection (DI) diesel engine with a rated power of 3.5 kW at a rated speed of 1500 rpm was studied. Experiments were performed in dual-fuel mode at four different injection pressures of 180, 190, 200, and 210 bar with a flow rate of 120 LPH of acetylene and results were compared with that of baseline diesel operation. Experimental results showed that highest brake thermal efficiency of 27.57% was achieved at injection pressure of 200 bar for diesel-acetylene dual-fuel mode which was much higher than 23.32% obtained for baseline diesel. Carbon monoxide, hydrocarbon, and smoke emissions were also measured and found to be lower, while the NO x emissions were higher at 200 bar in dual fuel mode as compared to those in other injection pressures in dual fuel mode and also for baseline diesel mode. Peak cylinder pressure, net heat release rate, and rate of pressure rise were also calculated and were higher at 200 bar injection pressure in dual fuel mode.

  4. Injection-locked single-mode VCSEL for orthogonal multiplexing and amplitude noise suppression

    DEFF Research Database (Denmark)

    Chipouline, Arkadi; Lyubopytov, Vladimir S.; Malekizandi, Mohammadreza

    2017-01-01

    an injection-locked 1550 nm VCSEL as a slave laser providing separation of amplitude and phase modulations, carrying independent information flows. To validate the possibility of phase modulation extraction by an injection-locked VCSEL, an experimental setup shown in Fig. 1 has been built....

  5. Engine with hydraulic fuel injection and ABS circuit using a single high pressure pump

    Science.gov (United States)

    Bartley, Bradley E.; Blass, James R.; Gibson, Dennis H.

    2001-01-01

    An engine system comprises a hydraulically actuated fuel injection system and an ABS circuit connected via a fluid flow passage that provides hydraulic fluid to both the fuel injection system and to the ABS circuit. The hydraulically actuated system includes a high pressure pump. The fluid control passage is in fluid communication with an outlet from the high pressure pump.

  6. Current approaches for in vitro drug release study of long acting parenteral formulations.

    Science.gov (United States)

    Dadhaniya, Tejas M; Sharma, Om Prakash; Gohel, Mukesh C; Mehta, Priti J

    2015-01-01

    Long acting parenteral formulations are preferred over conventional formulations for the treatment of chronic diseases. Prevalence of such diseases provoked the interest of researchers and pharmaceutical industries in the development of long acting parenteral formulations. The regulatory guidelines and pharmacopoeia have remained silent on dissolution methods for long acting parenteral formulations due to their diverse nature. The lack of compendial method for dissolution testing increases the duration of approval process for long acting parenteral formulations. This article reviews various dissolution methods used to study in vitro drug release profile of long acting parenteral formulations. Compendial as well as noncompendial methods, such as- rotating dialysis cell, dialysis tube, rotating bottle, shaking flask, single drop, inverted cup and incubation, are used by researchers for drug release profile of long acting parenteral formulations. This review article also highlights the advantages and disadvantages of reported dissolution methods along with the suitability of these methods for particular type of long acting formulation. The compiled work will help the researchers in designing the biorelevant dissolution method and expedite the development of long acting parenteral formulations.

  7. Cadmium-induced anemia in growing pigs: protective effect of oral or parenteral iron

    Energy Technology Data Exchange (ETDEWEB)

    Pond, W.G.; Walker, E.F. Jr.; Kirtland, D.

    1973-01-01

    Forty-two weanling Yorkshire pigs were used in two experiments to determine the effect of oral or injected Fe on the anemia and growth depression induced by dietary Cd. In both experiments 154 ppm Cd (as CdCl/sub 2/) added to a corn-soybean meal diet significantly (P < .01) depressed hemoglobin; in experiment 2, daily weight gain and feed consumption were significantly (P < .01) depressed by Cd. The depression in hemoglobin induced by Cd was prevented by oral (400 ppm Fe as FeSO/sub 4/ 7H/sub 2/O) or intramuscular (800 mg Fe as iron dextrin) Fe (experiment 1) or by intramuscular (1000 mg Fe as iron dextrin) Fe (experiment 2). Daily weight gain of pigs fed the basal diet was not significantly different from that of pigs fed Cd when Fe was injected (experiment 2). Oral Fe was incorporated into the feed throughout the experiment; parenteral Fe was administered as a single intramuscular injection on day 1 of each experiment. The protective effect of Fe on Cd-induced anemia observed previously in the rat is apparently operative in the pig as well.

  8. Single mode operation of a tea CO2 laser by a CW CO2 laser radiation injection

    International Nuclear Information System (INIS)

    Silakhori, K.; Soltanmoradi, F.; Behjat, A.; Montazerghaem, M.; Sadr, R.

    2005-01-01

    In this research work, single mode operation based on injection of a CW laser beam into TEA CO 2 laser cavity has been demonstrated. The technique has vast applications in research programs for laser spectroscopy and optical pumping. The observed smooth pulse shapes indicated that the system is operating in a single mode of operation, where no additional PZT mounted elements or other cavity stabilizing devices have been used. In addition, it have been observed that the output energy has not been reduced when the laser was operating in a single mode of operation, compared with the case when the laser is operating in the multi-mode regime

  9. The biological effects of 224Ra injected into dogs

    International Nuclear Information System (INIS)

    Muggenburg, B.A.; Lloyd, R.D.; Hahn, F.F.; Griffith, W.C.; Boecker, B.B.

    1994-01-01

    The purpose of this study was to investigate the toxicity of injected 224 Ra in the dog. Radium-224 is a short-lived isotope of radium with a half-life of 3.62 d. When administered parenterally, it deposits on bone surfaces; because of its short half-life, most of its energy is deposited on bone surfaces, in a manner similar to plutonium. The experimental design included a comparison to the exposed human population. Instead of using a single injection of 224 Ra, groups were included in which dogs were injected once, 10 times, or 50 times. This design provided groups that could be compared to the multiple injections often used in people for the treatment of ankylosing spondylitis

  10. Experimental investigation of gasoline fumigation in a single cylinder direct injection (DI) diesel engine

    International Nuclear Information System (INIS)

    Sahin, Z.; Durgun, O.; Bayram, C.

    2008-01-01

    In the presented study, the effects of gasoline fumigation have been investigated experimentally in a single cylinder direct injection (DI) diesel engine. Gasoline has been introduced into the inlet air flow using an elementary carburetor and no other modification on the engine has been done. The effects of 2%, 4%, 6%, 8% and 10% (by vol.) gasoline fumigation have been investigated experimentally at the speeds of (900-1600) (rpm) and at the selected compression ratios of (18-23). From the experimental results it is determined that by application of gasoline fumigation effective power output increases at the levels of 4-9%, effective efficiency increases by approximately 1.5-4% and specific fuel consumption decreases by approximately 1.5-4%. It is also determined that 4-6% fumigation ratio range is the most favorable percentage interval of gasoline at the selected compression ratios for this engine. Because cost of gasoline is higher than diesel fuel in Turkey as well as in many of the other countries and the decrease ratio of specific fuel consumption is low, gasoline fumigation is not economic for this engine. In the presented study, heat balance tests have also been performed for 18 and 21 compression ratios. The heat balance has been investigated experimentally in respect of effective power, heat rejected to the cooling water, heat lost through exhaust, and other losses (unaccounted-for losses). Heat lost through exhaust decreases until 4-6% gasoline fumigation ratios and after these fumigation ratios it starts to increase because of increasing exhaust gas temperature. Heat rejected to the cooling water decreases at low fumigation ratios, but at high fumigation ratios it increases. Other losses generally exhibit an increasing tendency at low fumigation ratios

  11. Shower emboli and digital necrosis after a single corticosteroid injection for trigger thumb: case report.

    Science.gov (United States)

    Park, Jonathan; Dumanian, Gregory A

    2009-02-01

    Local corticosteroid injection into the hand is the preferred initial step in the management of trigger finger owing to its safety and efficacy. We report the case of a patient with shower emboli and digital necrosis after a local corticosteroid injection for the treatment of trigger thumb. Given the patient's subsequent negative hypercoagulability workup, we suspect that the patient's symptoms resulted from the injection of steroids into the princeps pollicis artery, with subsequent retrograde flow into multiple other arteries of the hand. The patient was managed conservatively and ultimately her symptoms resolved. No new areas of digital necrosis have appeared in 8 years of follow-up.

  12. Rapid induction of dopamine sensitization in the nucleus accumbens shell induced by a single injection of cocaine.

    Science.gov (United States)

    Singer, Bryan F; Bryan, Myranda A; Popov, Pavlo; Robinson, Terry E; Aragona, Brandon J

    2017-05-01

    Repeated intermittent exposure to cocaine results in the neurochemical sensitization of dopamine (DA) transmission within the nucleus accumbens (NAc). Indeed, the excitability of DA neurons in the ventral tegmental area (VTA) is enhanced within hours of initial psychostimulant exposure. However, it is not known if this is accompanied by a comparably rapid change in the ability of cocaine to increase extracellular DA concentrations in the ventral striatum. To address this question we used fast-scan cyclic voltammetry (FSCV) in awake-behaving rats to measure DA responses in the NAc shell following an initial intravenous cocaine injection, and then again 2-h later. Both injections quickly elevated DA levels in the NAc shell, but the second cocaine infusion produced a greater effect than the first, indicating sensitization. This suggests that a single injection of cocaine induces sensitization-related plasticity very rapidly within the mesolimbic DA system. Copyright © 2017 Elsevier B.V. All rights reserved.

  13. Zinc Deficiency With Dermatitis in a Parenteral Nutrition-Dependent Patient Due to National Shortage of Trace Minerals.

    Science.gov (United States)

    Sant, Vivek R; Arnell, Tracey D; Seres, David S

    2016-05-01

    The shortages of intravenous drugs remains critical, with sterile injectables accounting for 80% of the approximately 300 shortages. The impact is being felt in patients dependent on parenteral nutrition (PN), and severe deficiencies are becoming more commonplace. We report here a man who developed severe zinc deficiency, manifesting as a painful desquamative rash, due to an inability to obtain multi-trace element additives for his PN. © 2015 American Society for Parenteral and Enteral Nutrition.

  14. Perfil de los usuarios de drogas por vía parenteral que mantienen conductas de riesgo relacionadas con la inyección en Cataluña Characteristics of intravenous drug users who share injection equipment in Catalonia (Spain

    Directory of Open Access Journals (Sweden)

    Cinta Folch

    2012-02-01

    Full Text Available Objetivos: Estimar la prevalencia de las prácticas de riesgo directas e indirectas relacionadas con la inyección de drogas e identificar los factores asociados en los usuarios de drogas por vía parenteral (UDVP en centros de reducción de daños en Cataluña. Métodos: Estudio transversal realizado entre 2008 y 2009 en centros de reducción de daños. La información conductual se recogió mediante un cuestionario anónimo administrado por entrevistadores previamente formados. Resultados: De los 748 entrevistados, el 31,5% compartió jeringas usadas en los últimos 6 meses y el 55,2% compartió la cuchara, el agua o el filtro, o realizó el front/backloading con jeringas usadas. Los UDVP que se inyectan diariamente (odds ratio [OR]=1,5, se inyectan cocaína (OR=1,6, obtienen menos jeringas gratuitas (OR=2,5 menos de la mitad a ninguna, tienen una pareja sexual UDVP (OR=1,8 y comparten indirectamente (OR=4,1 presentaron una mayor probabilidad de haber compartido jeringas. Por otro lado, tener una fuente de ingresos ilegal (OR=1,5, inyectarse diariamente (OR=1, 5, inyectarse cocaína (OR=1,4, haber compartido jeringas (OR=3,9 y haber tenido alguna sobredosis en la vida (OR=1,5 fueron factores asociados a compartir de forma indirecta. Conclusiones: A pesar de la generalización de los programas de reducción de daños, en Cataluña se mantiene un porcentaje de UDVP que realizan conductas de riesgo relacionadas con la inyección. Sería necesario mejorar el acceso a todo el material estéril de inyección, en especial entre los que se inyectan cocaína y los que se inyectan con mayor frecuencia, e incluir también a las parejas sexuales UDVP en estas intervenciones preventivas.Objectives: To estimate the prevalence of direct and indirect syringe sharing among intravenous drug users (IDUs attending a harm reduction center in Catalonia (Spain and to identify factors associated with risk behaviors. Methods: A cross-sectional study was conducted

  15. Improved estimation of receptor density and binding rate constants using a single tracer injection and displacement

    International Nuclear Information System (INIS)

    Syrota, A.; Delforge, J.; Mazoyer, B.M.

    1988-01-01

    The possibility of improving receptor model parameter estimation using a displacement experiment in which an excess of an unlabeled ligand (J) is injected after a delay (t D ) following injection of trace amounts of the β + - labeled ligand (J*) is investigated. The effects of varying t D and J/J* on parameter uncertainties are studied in the case of 11 C-MQNB binding to myocardial acetycholine receptor using parameters identified in a dog experiment

  16. Single-shot measurements of low emittance beams from laser-plasma accelerators comparing two triggered injection methods

    Science.gov (United States)

    van Tilborg, Jeroen

    2017-10-01

    The success of laser plasma accelerator (LPA) based applications, such as a compact x-ray free electron laser (FEL), relies on the ability to produce electron beams with excellent 6D brightness, where brightness is defined as the ratio of charge to the product of the three normalized emittances. As such, parametric studies of the emittance of LPA generated electron beams are essential. Profiting from a stable and tunable LPA setup, combined with a carefully designed single-shot energy-dispersed emittance diagnostic, we present a direct comparison of charge dependent emittance measurements of electron beams generated by two different injection mechanisms: ionization injection and shock-induced density down-ramp injection. Both injection mechanisms have gained in popularity in recent years due to their demonstrated stable LPA performance. For the down-ramp injection configuration, normalized emittances a factor of two lower were recorded: less than 1 micron at spectral charge densities up to 2 pC/MeV. For both injection mechanisms, a contributing correlation of space charge to the emittance was identified. This measurement technique in general, and these results specifically, are critical to the evaluation of LPA injection methods and development of high-quality LPA beam lines worldwide. This work is supported by the U.S. DOE under Contract No. DE-AC02-05CH11231, by the U.S. DOE NNSA, DNN R&D (NA22), by the National Science Foundation under Grant No. PHY-1415596, and by the Gordon and Betty Moore Foundation under Grant ID GBMF4898.

  17. Parenteral iron administration in suckling piglets – a review

    Directory of Open Access Journals (Sweden)

    Martin Svoboda

    2017-01-01

    Full Text Available Parenteral iron administration has been a common practice for the prevention of iron deficiency in newborn piglets. The efficacy and safety of this method require reexamination due to the introduction of new genetic lines and management changes in swine production. The aim of this article was to review current knowledge on this method of anaemia prevention in piglets. Iron requirements, iron sources, and the mode of action, dosage, and negative effects of iron dextran injection are discussed. The paper also reviews methods for evaluating the efficacy of iron administration in piglets.

  18. Compatibility considerations in parenteral nutrient solutions.

    Science.gov (United States)

    Niemiec, P W; Vanderveen, T W

    1984-05-01

    Information on compatibility of nutrients and drugs with parenteral nutrient (PN) solutions is reviewed and evaluated. Precipitation of calcium phosphate when calcium and phosphate salts are added can be affected by pH, amino acid concentration, amino acid product, temperature, sequence of additives, specific salt used, and time since admixture; precipitate formation can occur gradually over 24 hours. Insulin is chemically stable in PN solutions, but adsorption to the infusion system can cause decreased availability. Poor delivery of vitamin A via PN solutions has been reported. The sodium bisulfite content of amino acid injections may cause degradation of thiamine, but studies simulating clinical use are needed. Folic acid stability in PN solutions has been demonstrated, and phytonadione appears to be stable. Drug administration via PN solutions may be advantageous when fluid intake is restricted or peripheral vein access is limited and in home PN therapy. Summarized are results of studies involving heparin, cimetidine hydrochloride, aminophylline, amphotericin B, iron dextran, hydrochloric acid, corticosteroids, narcotics, metoclopramide, digoxin, and fluorouracil. Many antibiotics are probably stable, especially when administered by co-infusion rather than by direct mixture in the PN solution container. When lipids are mixed in the same container with amino acid-dextrose solutions, compatibility and stability of electrolytes, vitamins, and trace elements must be reassessed. Practical research is needed, and availability of additives should be studied in specific patient populations and for specific PN formulations. Valid conclusions are dependent on careful study design.

  19. Numerical Simulations of Two-Phase Reacting Flow in a Single-Element Lean Direct Injection (LDI) Combustor Using NCC

    Science.gov (United States)

    Liu, Nan-Suey; Shih, Tsan-Hsing; Wey, C. Thomas

    2011-01-01

    A series of numerical simulations of Jet-A spray reacting flow in a single-element lean direct injection (LDI) combustor have been conducted by using the National Combustion Code (NCC). The simulations have been carried out using the time filtered Navier-Stokes (TFNS) approach ranging from the steady Reynolds-averaged Navier-Stokes (RANS), unsteady RANS (URANS), to the dynamic flow structure simulation (DFS). The sub-grid model employed for turbulent mixing and combustion includes the well-mixed model, the linear eddy mixing (LEM) model, and the filtered mass density function (FDF/PDF) model. The starting condition of the injected liquid spray is specified via empirical droplet size correlation, and a five-species single-step global reduced mechanism is employed for fuel chemistry. All the calculations use the same grid whose resolution is of the RANS type. Comparisons of results from various models are presented.

  20. Optimizing CT angiography in patients with Fontan physiology: single-center experience of dual-site power injection

    International Nuclear Information System (INIS)

    Sandler, K.L.; Markham, L.W.; Mah, M.L.; Byrum, E.P.; Williams, J.R.

    2014-01-01

    Aim: To identify adult patients with single-ventricle congenital heart disease and Fontan procedure palliation who have been misdiagnosed with or incompletely evaluated for pulmonary embolism. Additionally, this study was designed to demonstrate that simultaneous, dual-injection of contrast medium into an upper and lower extremity vein is superior to single-injection protocols for CT angiography (CTA) of the chest in this population. Materials and methods: Patients included in the study were retrospectively selected from the Adult Congenital Heart Disease (ACHD) database. Search criteria included history of Fontan palliation and available chest CT examination. Patients were evaluated for (1) type of congenital heart disease and prior operations;(2) indication for initial CT evaluation;(3) route of contrast medium administration for the initial CT examination and resulting diagnosis;(4) whether or not anticoagulation therapy was initiated; and (5) final diagnosis and treatment plan. Results: The query of the ACHD database resulted in 28 individuals or patients with Fontan palliation (superior and inferior venae cavae anastomosed to the pulmonary arteries). Of these, 19 patients with Fontan physiology underwent CTA of the pulmonary circulation, and 17 had suboptimal imaging studies. Unfortunately, seven of these 17 patients (41%) were started on anticoagulation therapy due to a diagnosis of pulmonary embolism that was later excluded. Conclusion: Patients with single-ventricle/Fontan physiology are at risk of thromboembolic disease. Therefore, studies evaluating their complex anatomy must be performed with the optimal imaging protocol to ensure diagnostic accuracy, which is best achieved with dual-injection of an upper and lower extremity central vein. - Highlights: • The adult congenital heart disease population is growing. • Many of these patients have single ventricle/Fontan physiology. • Patients with Fontan physiology are at increased risk for

  1. Injection molded polymer chip for electrochemical and electrophysiological recordings from single cells

    DEFF Research Database (Denmark)

    Tanzi, Simone; Larsen, Simon Tylsgaard; Taboryski, Rafael J.

    We present a novel method to fabricate an all in polymer injection molded chip for electrochemical cell recordings and lateral cell trapping. The complete device is molded in thermoplastic polymer and it results from assembling two halves. We tested spin-coated conductive polymer poly(3...

  2. Histopathological Alterations after Single Epidural Injection of Ropivacaine, Methylprednizolone Acetate, or Contrast Material in Swine

    International Nuclear Information System (INIS)

    Kitsou, Maria-Chrysanthi; Kostopanagiotou, Georgia; Kalimeris, Konstantinos; Vlachodimitropoulos, Demetrios; Soultanis, Konstantinos; Batistaki, Chrysanthi; Kelekis, Alexis

    2011-01-01

    Purpose: The consequences from the injection of different types of drugs in the epidural space remains unknown. Increasing evidence suggests that localized inflammation, fibrosis, and arachnoiditis can complicate sequential epidural blockades, or even epidural contrast injection. We investigate the in vivo effect of epidural injections in the epidural space in an animal model. Materials and Methods: A group of ten male adult pigs, five punctures to each at distinct vertebral interspaces under general anesthesia, were examined, testing different drugs, used regularly in the epidural space (iopamidol, methylprednisolone acetate, ropivacaine). Each site was marked with a percutaneous hook wire marker. Histological analysis of the epidural space, the meninges, and the underlying spinal cord of the punctured sites along with staining for caspase-3 followed 20 days later. Results: The epidural space did not manifest adhesions or any other pathology, and the outer surface of the dura was not impaired in any specimen. The group that had the contrast media injection showed a higher inflammation response compared to the other groups (P = 0.001). Positive staining for caspase-3 was limited to <5% of neurons with all substances used. Conclusion: No proof of arachnoiditis and/or fibrosis was noted in the epidural space with the use of the above-described drugs. A higher inflammation rate was noted with the use of contrast media.

  3. 229 nm UV LEDs on aluminum nitride single crystal substrates using p-type silicon for increased hole injection

    Science.gov (United States)

    Liu, Dong; Cho, Sang June; Park, Jeongpil; Seo, Jung-Hun; Dalmau, Rafael; Zhao, Deyin; Kim, Kwangeun; Gong, Jiarui; Kim, Munho; Lee, In-Kyu; Albrecht, John D.; Zhou, Weidong; Moody, Baxter; Ma, Zhenqiang

    2018-02-01

    AlGaN based 229 nm light emitting diodes (LEDs), employing p-type Si to significantly increase hole injection, were fabricated on single crystal bulk aluminum nitride (AlN) substrates. Nitride heterostructures were epitaxially deposited by organometallic vapor phase epitaxy and inherit the low dislocation density of the native substrate. Following epitaxy, a p-Si layer is bonded to the heterostructure. LEDs were characterized both electrically and optically. Owing to the low defect density films, large concentration of holes from p-Si, and efficient hole injection, no efficiency droop was observed up to a current density of 76 A/cm2 under continuous wave operation and without external thermal management. An optical output power of 160 μW was obtained with the corresponding external quantum efficiency of 0.03%. This study demonstrates that by adopting p-type Si nanomembrane contacts as a hole injector, practical levels of hole injection can be realized in UV light-emitting diodes with very high Al composition AlGaN quantum wells, enabling emission wavelengths and power levels that were previously inaccessible using traditional p-i-n structures with poor hole injection efficiency.

  4. Rapid dual-injection single-scan 13N-ammonia PET for quantification of rest and stress myocardial blood flows

    International Nuclear Information System (INIS)

    Rust, T C; DiBella, E V R; McGann, C J; Christian, P E; Hoffman, J M; Kadrmas, D J

    2006-01-01

    Quantification of myocardial blood flows at rest and stress using 13 N-ammonia PET is an established method; however, current techniques require a waiting period of about 1 h between scans. The objective of this study was to test a rapid dual-injection single-scan approach, where 13 N-ammonia injections are administered 10 min apart during rest and adenosine stress. Dynamic PET data were acquired in six human subjects using imaging protocols that provided separate single-injection scans as gold standards. Rest and stress data were combined to emulate rapid dual-injection data so that the underlying activity from each injection was known exactly. Regional blood flow estimates were computed from the dual-injection data using two methods: background subtraction and combined modelling. The rapid dual-injection approach provided blood flow estimates very similar to the conventional single-injection standards. Rest blood flow estimates were affected very little by the dual-injection approach, and stress estimates correlated strongly with separate single-injection values (r = 0.998, mean absolute difference = 0.06 ml min -1 g -1 ). An actual rapid dual-injection scan was successfully acquired in one subject and further demonstrates feasibility of the method. This study with a limited dataset demonstrates that blood flow quantification can be obtained in only 20 min by the rapid dual-injection approach with accuracy similar to that of conventional separate rest and stress scans. The rapid dual-injection approach merits further development and additional evaluation for potential clinical use

  5. Forecast of thermal-hydrological conditions and air injection test results of the single heater test at Yucca Mountain

    International Nuclear Information System (INIS)

    Birkholzer, J.T.; Tsang, Y.W.

    1996-12-01

    The heater in the Single Heater Test (SHT) in alcove 5 of the Exploratory Studies Facility (ESF) was turned on August 26, 1996. A large number of sensors are installed in the various instrumented boreholes to monitor the coupled thermal-hydrological-mechanical-chemical responses of the rock mass to the heat generated in the single heater. In this report the authors present the results of the modeling of both the heating and cooling phases of the Single Heater Test (SHT), with focus on the thermal-hydrological aspect of the coupled processes. Also in this report, the authors present simulations of air injection tests will be performed at different stages of the heating and cooling phase of the SHT

  6. An Optical Method for Measuring Injection Timing in Diesel Engines, Using a Single Port

    Science.gov (United States)

    2014-09-01

    5 and NATO F-76, the current fleet standards. However, the use of seawater compensated shipboard storage tanks, legacy engine technology , high flash...76 is 46 [4, 5]. SPK, produced using the Fischer-Tropsch process, was originally derived in Germany in the 1920s and 1930s in response to fuel...noise. Sugiyama et al. [18] tested a hydrotreated vegetable oil (HVO) in a direct injection, turbocharged, automotive diesel and found both decreased

  7. Chemical castration by a single bilateral intra-testicular injection of ...

    African Journals Online (AJOL)

    Six apparently healthy Borno white bucks weighing 15± 1.6 kg and aged 1.3± 0.3 years were used for this study. Two and half (2.5) ml Purit® (chlorhexidine gluconate 0.3% B.P W/V and cetrimide 3.0% B.P W/V CAPL Lagos) were injected bilaterally into the caudae of each epididymis following sedation with xylazine ...

  8. Methodological study on determining endogenous amino acid excretion of broiler chickens by single intravenous injection of 3H-leucine

    International Nuclear Information System (INIS)

    Yao Junhu; Wang Kangning; Yang Feng; Zhou Anguo; Cai Xuelin; Duanmu Dao

    1999-01-01

    Forty broiler chickens (1.5 kg of body weight, BW) were randomly divided into 20 groups. Every fifth group was force-fed a nitrogen-free diet (NFD) or a NFd + 3.20% enzyme hydrolysed casein (EHC) diet or diets with 5% and 20% crude protein (CP) in which soybean meal (sol.) was the sole nitrogen source. 30μCi 3 H-leucine/kg BW was intravenously injected into all birds just after the force-feeding. Venous blood samples were taken at 5 min, 4h, 24h, 36h and 48h after the injection, and the amount of excreta for the whole period of 48h was collected. The amino acids excreted after force-feeding NFD + 3.20% EHC of CP5% diet were theoretically endogenous. The ratios of specific radioactivity (SR) in excreta and the value of definite integral in free plasma from 0 to 48 h after injection of labelled leucine were not different (P > 0.05) when NFD, NFD + 3.20% EHC or CP5% diet was fed. From these results and theoretical analysis, it was suggested that for the birds with CP20% diet, the ratio of SR in endogenous leucine and value of definite integral in free plasma from 0 to 48 h after injection of labelled leucine would be the same as that of the birds with NFD diet, and thus endogenous losses of leucine and other amino acids, by the endogenous amino acid pattern measured with NFD diet, could be estimated for CP20% diet. The endogenous amino acid losses measured by this new technique was 120.50% of those measured by NFD method. It was suggested that single intravenous injection of 3 H-leucine first proposed would be more valuable for determining endogenous amino acid losses, especially when practical nitrogen-containing diet was fed

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

    Science.gov (United States)

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

    2012-06-01

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

  10. Pulmonary nodules secondary to total parenteral alimentation

    International Nuclear Information System (INIS)

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

    1989-01-01

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

  11. American Society for Parenteral & Enteral Nutrition

    Science.gov (United States)

    ... Journals and Publications Donate Today! Support Nutrition Research Twitter Tweets by ASPENWEB Advertisement Events Webinar: Parenteral Nutrition ... Staff Find a Clinician Press Room Career Center Advertising and Sponsorship Related Websites BPS NBNSC NBPNS Connect ...

  12. Pulmonary nodules secondary to total parenteral alimentation

    Energy Technology Data Exchange (ETDEWEB)

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

    1989-07-01

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

  13. Inhibition of Neuropathic Pain by a Single Intraperitoneal Injection of Diazepam in the Rat: Possible Role of Neurosteroids.

    Science.gov (United States)

    Chen, Shu-Ling; Zang, Ying; Zheng, Wen-Hui; Wei, Xu-Hong; Liu, Xian-Guo

    2016-02-29

    Diazepam binds with the same high affinity to the central benzodiazepine receptor (CBR) and the peripheral benzodiazepine receptor, which has been renamed translocator protein (TSPO). Both receptors could promote neurosteroid synthesis. In the present study, we investigated whether a single dose of diazepam could inhibit neuropathic pain induced by L5 spinal nerve ligation (L5 SNL), and whether CBR and TSPO mediated this effect. We found that a single intraperitoneal injection of diazepam 9 d after L5 SNL significantly depressed the established mechanical allodynia and thermal hyperalgesia, which persisted until the end of the experiments. Furthermore, the effects were mimicked by a single intraperitoneal injection of Ro5-4864, a specific TSPO agonist and pregnenolone, a neurosteroid precursor. In addition, we found that the inhibitory effect of diazepam was also completely blocked by pretreatment with a specific CBR antagonist, flumazenil. The effects of diazepam or Ro5-4864 on neuropathic pain were completely blocked by pretreatment with a neurosteroid synthesis inhibitor, aminoglutethimide (AMG). Finally, any one of the three drugs, diazepam, Ro5-4864 and pregnenolone, could reduce the activation of astrocytes and the production of interleukin-1beta (IL-1β) in the L5 spinal dorsal horn 14 d after L5 SNL. These results suggest that in addition to exerting effects on CBR, diazepam may inhibit neuropathic pain via TSPO, which promotes neurosteroid formation, subsequently reducing the activation of astrocytes and production of cytokines.

  14. Manganese in long term paediatric parenteral nutrition.

    OpenAIRE

    Reynolds, A P; Kiely, E; Meadows, N

    1994-01-01

    The current practice of providing manganese supplementation to neonates on long term parenteral nutrition is leading to a high incidence of hypermanganesaemia. Magnetic resonance imaging (MRI) studies in adults on long term manganese parenteral nutrition have shown changes in TI weighted MRI images and similar findings in a neonate receiving trace element supplementation are reported here. Whole blood manganese concentration in the infant was 1740 nmol/l (or 8.3 times upper reference limit). ...

  15. Effectiveness of a single platelet-rich plasma injection to promote recovery in rugby players with ankle syndesmosis injury.

    Science.gov (United States)

    Samra, David J; Sman, Amy D; Rae, Katherine; Linklater, James; Refshauge, Kathryn M; Hiller, Claire E

    2015-01-01

    To determine whether a single ultrasound-guided platelet-rich plasma (PRP) injection into the anterior inferior tibiofibular ligament (AITFL) reduces the time for rugby athletes to return to function and match play following MRI confirmed ankle syndesmosis injury. Cohort controlled pilot study. 10 Rugby Union players were recruited during the 2014 season, and consented to receive a single autologous PRP injection into the AITFL within 14 days of MRI confirmed ankle syndesmosis injury. A historical control group included 11 comparable Rugby Union players between 2011 and 2013 who were treated conservatively with the same inclusion criteria and rehabilitation protocol as the intervention group. Participants followed a standardised rehabilitation protocol involving simple milestones for progression. Early functional tests were performed 2 weeks after the removal of the CAM (controlled ankle motion) boot. Time to return to play was recorded. Repeat functional testing occurred within 1 week of return to play. Groups were comparable in anthropometrics, playing position and MRI injury severity. Time to return to play was significantly less in the intervention group (p=0.048). Following return to play, athletes in the intervention group showed higher agility (p=0.002) and vertical jump (p=0.001). There was a lower level of fear avoidance associated with rugby in the intervention group (p=0.014). This pilot study shows that, following ankle syndesmosis injury, a single autologous PRP injection may accelerate safe and successful return to Rugby Union, with improved functional capacity and reduced fear avoidance. It demonstrates the feasibility of a randomised controlled trial to further assess this therapy. ANZCTRN12614000055606.

  16. Foamed surfactant solution as a template for self-setting injectable hydroxyapatite scaffolds for bone regeneration.

    Science.gov (United States)

    Montufar, E B; Traykova, T; Gil, C; Harr, I; Almirall, A; Aguirre, A; Engel, E; Planell, J A; Ginebra, M P

    2010-03-01

    The application of minimally invasive surgical techniques in the field of orthopaedic surgery has created a growing need for new injectable synthetic materials that can be used for bone grafting. In this work a novel fully synthetic injectable calcium phosphate foam was developed by mixing alpha-tricalcium phosphate (alpha-TCP) powder with a foamed polysorbate 80 solution. Polysorbate 80 is a non-ionic surfactant approved for parenteral applications. The foam was able to retain the porous structure after injection provided that the foamed paste was injected shortly after mixing (typically 2.5 min), and set through the hydrolysis of alpha-TCP to a calcium-deficient hydroxyapatite, thus producing a hydroxyapatite solid foam in situ. The effect of different processing parameters on the porosity, microstructure, injectability and mechanical properties of the hydroxyapatite foams was analysed, and the ability of the pre-set foam to support osteoblastic-like cell proliferation and differentiation was assessed. Interestingly, the concentration of surfactant needed to obtain the foams was lower than that considered safe in drug formulations for parenteral administration. The possibility of combining bioactivity, injectability, macroporosity and self-setting ability in a single fully synthetic material represents a step forward in the design of new materials for bone regeneration compatible with minimally invasive surgical techniques. Copyright 2009 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

  17. Estimation of effective renal plasma flow in children by use of a single plasma sample after injection of orthoiodohippurate

    International Nuclear Information System (INIS)

    Tauxe, W.N.; Hagge, W.; Stickler, G.B.

    1975-01-01

    Estimates of effective renal plasma flow (ERPF) in adults have been greatly simplified by the use of recently developed regression equations based on a single plasma concentration of radioiodinated orthoiodohippurate (OIH) obtained 44 min after a single intravenous injection of the material. The paper reports similar equations for the prediction of ERPF in children. Studies were made in 30 children of both sexes, aged 4 to 16 years, with a wide variety of renal diseases. A single intravenous injection of labelled OIH was made and plasma was sampled at 10, 15, 20, 25, 30, 40, 50 and 60 min after injection. Plasma concentration curves were analysed by the conventional two-compartment analysis technique (Sapirstein, Matthews) and ERPF was computed from them. In addition to ERPF calculations, sizes of the two volumes of distribution (V 1 and V 2 ), intercompartmental flow rates and fractional rate constants were also calculated. Surface area (SA) was calculated from the DuBois height-weight regression formula. Reciprocals of the OIH plasma concentration in terms of per cent injected dose per litre were calculated at each sampling time; this reciprocal is designated x. These values at each sampling time were plotted against ERPF and regression equations and residual error (Sy.x) were calculated. The optimal sampling time was found to occur at 53 min and the corresponding linear regression equation was 19.33 + 3.87x with a Sy.x value of 36 ml. This compares with an optimal sampling time in adults of 44 min. The mean initial volume of distribution (V 1 ) was found to be 5.3 litres and the mean V 2 was found to be 6.8 litres. In contrast to findings in the previous study in adults these volumes were found to correlate well with SA. A mean intercompartmental flow rate of 276 ml/min was found. No correlation between this value and clinical diagnosis was found. The relationship of the concentration reciprocal and plasma flow was a linear one instead of the polynomial one

  18. A single injection technique for subtraction of blood background in 131I-hippuran renograms

    International Nuclear Information System (INIS)

    Rutland, M.D.

    1979-01-01

    A method of subtracting blood background during probe-renography is presented which does not require a prior injection of RIHSA and which produces results approximately 11% higher than the RIHSA method. The new method treats the renogram up to two-and-a-half minutes as a combination of a fraction of the blood curve and a fraction of the integral of the blood curve. Analysis of the data, using either a computer or a programmed calculator, enables these two fractions to be calculated, hence producing the 'background subtraction factor' and the 'uptake constant'. (author)

  19. Single well push-pull CO2 injection experiment for evaluating in-situ residual trapping at Heletz, Israel

    Science.gov (United States)

    Niemi, Auli; Bensabat, Jacob; Fagerlund, Fritjof; Ronen, Rona; Goren, Yoni; Perez, Lily; Tsarfis, Igal; Joodaki, Saba; Yang, Zhibing; Liang, Tian; Sauter, Martin; Hassan, Jawad; Gouze, Philippe; Rasmusson, Kristina

    2017-04-01

    The Heletz sands is a depleted oil reservoir at 1.6 km depth with saline water at its edges. In the saline part of the reservoir a CO2 injection experiment site has been developed for the purpose of scientifically motivated injection experiments, especially in the context of EU FP7 projects MUSTANG and TRUST. This presentation describes the single-well CO2 injection experiment carried out in September 2016, with the objective of determining field scale values of key CO2 trapping mechanisms, the residual and dissolution trapping. The sequence consisted in creating a residually trapped CO2 zone as well as reference hydraulic and heater tests prior and after the establishment of the zone, in order to determine the in-situ residual trapping. Monitoring included down-hole pressure and temperature measurement, distributed temperature sensing along the well via an optical fiber (DTS), U-tube sampling and tracers. We here present the experimental sequence, the monitoring and sampling system, the key results as well as the first interpretations.

  20. Parenteral Nutrition and Intestinal Failure.

    Science.gov (United States)

    Bielawska, Barbara; Allard, Johane P

    2017-05-06

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

  1. Direct current injection and thermocapillary flow for purification of aligned arrays of single-walled carbon nanotubes

    Energy Technology Data Exchange (ETDEWEB)

    Xie, Xu; Islam, Ahmad E.; Seabron, Eric; Dunham, Simon N.; Du, Frank; Lin, Jonathan; Wilson, William L.; Rogers, John A., E-mail: jrogers@illinois.edu [Department of Materials Science and Engineering, Frederick Seitz Materials Research Laboratory, University of Illinois at Urbana-Champaign, Urbana, Illinois 61801 (United States); Wahab, Muhammad A.; Alam, Muhammad A. [School of Electrical and Computer Engineering, Purdue University, West Lafayette, Indiana 47907 (United States); Li, Yuhang [Institute of Solid Mechanics, Beihang University, Beijing 100191 (China); Tomic, Bojan [Department of Electrical Engineering, University of Illinois at Urbana-Champaign, Urbana, Illinois 61801 (United States); Huang, Jiyuan [Department of Physics, University of Illinois at Urbana-Champaign, Urbana, Illinois 61801 (United States); Burns, Branden [Department of Physics, Purdue University, West Lafayette, Indiana 47907 (United States); Song, Jizhou [Department of Engineering Mechanics and Soft Matter Research Center, Zhejiang University, Hangzhou 310027 (China); Huang, Yonggang [Department of Civil and Environmental Engineering, Department of Mechanical Engineering, Center for Engineering and Health, and Skin Disease Research Center, Northwestern University, Evanston, Illinois 60208 (United States)

    2015-04-07

    Aligned arrays of semiconducting single-walled carbon nanotubes (s-SWNTs) represent ideal configurations for use of this class of material in high performance electronics. Development of means for removing the metallic SWNTs (m-SWNTs) in as-grown arrays represents an essential challenge. Here, we introduce a simple scheme that achieves this type of purification using direct, selective current injection through interdigitated electrodes into the m-SWNTs, to allow their complete removal using processes of thermocapillarity and dry etching. Experiments and numerical simulations establish the fundamental aspects that lead to selectivity in this process, thereby setting design rules for optimization. Single-step purification of arrays that include thousands of SWNTs demonstrates the effectiveness and simplicity of the procedures. The result is a practical route to large-area aligned arrays of purely s-SWNTs with low-cost experimental setups.

  2. Direct current injection and thermocapillary flow for purification of aligned arrays of single-walled carbon nanotubes

    International Nuclear Information System (INIS)

    Xie, Xu; Islam, Ahmad E.; Seabron, Eric; Dunham, Simon N.; Du, Frank; Lin, Jonathan; Wilson, William L.; Rogers, John A.; Wahab, Muhammad A.; Alam, Muhammad A.; Li, Yuhang; Tomic, Bojan; Huang, Jiyuan; Burns, Branden; Song, Jizhou; Huang, Yonggang

    2015-01-01

    Aligned arrays of semiconducting single-walled carbon nanotubes (s-SWNTs) represent ideal configurations for use of this class of material in high performance electronics. Development of means for removing the metallic SWNTs (m-SWNTs) in as-grown arrays represents an essential challenge. Here, we introduce a simple scheme that achieves this type of purification using direct, selective current injection through interdigitated electrodes into the m-SWNTs, to allow their complete removal using processes of thermocapillarity and dry etching. Experiments and numerical simulations establish the fundamental aspects that lead to selectivity in this process, thereby setting design rules for optimization. Single-step purification of arrays that include thousands of SWNTs demonstrates the effectiveness and simplicity of the procedures. The result is a practical route to large-area aligned arrays of purely s-SWNTs with low-cost experimental setups

  3. Tunable single-longitudinal-mode operation of an injection-locked TEA CO2 laser. [ozone absorption spectroscopy

    Science.gov (United States)

    Megie, G.; Menzies, R. T.

    1979-01-01

    The tunable single-longitudinal-mode operation of a TEA CO2 laser by an injection technique using a CW waveguide laser as the master oscillator is reported. With the experimental arrangement described, in which the waveguide laser frequency is tuned to correspond to one of the oscillating longitudinal modes of the TEA laser, single-longitudinal-mode operation was achieved with no apparent reduction in the TEA output energy, on various CO2 lines with frequency offsets from the line center as large as 300 MHz. The capability of this technique for high-resolution spectroscopy or atmospheric lidar studies is demonstrated by the recording of the absorption spectrum of a strong ozone line.

  4. Geometry-induced injection dispersion in single-cell protein electrophoresis.

    Science.gov (United States)

    Pan, Qiong; Herr, Amy E

    2018-02-13

    Arrays of microwells are widely used to isolate individual cells, facilitate high throughput cytometry assays, and ensure compatibility of those assays with whole-cell imaging. Microwell geometries have recently been utilized for handling and preparation of single-cell lysate, prior to single-cell protein electrophoresis. It is in the context of single-cell electrophoresis that we investigate the interplay of microwell geometry (circular, rectangular, triangular) and transport (diffusion, electromigration) on the subsequent performance of single-cell polyacrylamide gel electrophoresis (PAGE) for protein targets. We define and measure injector-induced dispersion during PAGE, and develop a numerical model of band broadening sources, experimentally validate the numerical model, and then identify operating conditions (characterized through the Peclet number, Pe) that lead to microwell-geometry induced losses in separation performance. With analysis of mammalian cells as a case study, we sought to understand at what Pe is the PAGE separation performance adversely sensitized to the microwell geometry. In developing design rules, we find that for the microwell geometries that are the most suitable for isolation of mammalian cells and moderate mass protein targets, the Pe is usually small enough (Pe geometry on protein PAGE of single-cell lysate. In extreme cases where the largest mammalian cells are analyzed (Pe > ∼20), consideration of Pe suggests using a rectangular - and not the widely used circular - microwell geometry to maximize protein PAGE separation performance. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Effect of intake swirl on the performance of single cylinder direct injection diesel engine

    Science.gov (United States)

    Sharma, Vinod Kumar; Mohan, Man; Mouli, Chandra

    2017-11-01

    In the present work, the effect of inlet manifold geometry and swirl intensity on the direct injection (DI) diesel engine performance was investigated experimentally. Modifications in inlet manifold geometry have been suggested to achieve optimized swirl for the better mixing of fuel with air. The intake swirl intensities of modified cylinder head were measured in swirl test rig at different valve lifts. Later, the overall performance of 435 CC DI diesel engine was measured using modified cylinder head. In addition, the performance of engine was compared for both modified and old cylinder head. For same operating conditions, the brake power and brake specific fuel consumption was improved by 6% and 7% respectively with modified cylinder head compared to old cylinder head. The maximum brake power of 9 HP was achieved for modified cylinder head. The results revealed that the intake swirl has great influence on engine performance.

  6. Symptomatic hepatic cyst in a child: treatment with single-shot injection of tetracycline hydrochloride

    International Nuclear Information System (INIS)

    Fabrizzi, Giancarlo; Lanza, Cecilia; Bolli, Valeria; Pieroni, Giovanni

    2009-01-01

    The prevalence of hepatic cysts is 0.1% to 0.5% based on autopsy studies, and 2.5% based on US examinations. Percutaneous therapies are a new alternative to surgery. They include simple percutaneous aspiration, catheter drainage alone, and catheter drainage with sclerotherapy. We present an 11-year-old boy admitted to hospital because of abdominal pain. A diagnosis of simple hepatic cyst was made, which was treated with aspiration and tetracycline hydrochloride solution (5%) injection into the cystic cavity. Complete regression was seen on US and MRI examination at 3 months, with total collapse and deflation of the cyst. The cyst regressed totally, leaving a hyperechoic linear scar on US examination at 1 year. On the basis of the clinical and imaging results obtained, percutaneous sclerotherapy of hepatic cysts can be recommended as the treatment of choice and as a valid alternative to laparoscopy in children. (orig.)

  7. Symptomatic hepatic cyst in a child: treatment with single-shot injection of tetracycline hydrochloride

    Energy Technology Data Exchange (ETDEWEB)

    Fabrizzi, Giancarlo; Lanza, Cecilia; Bolli, Valeria; Pieroni, Giovanni [Azienda Ospedaliero-Universitaria Ospedali Riuniti, Servizio di Radiologia Generale e Pediatrica, Ancona (Italy)

    2009-10-15

    The prevalence of hepatic cysts is 0.1% to 0.5% based on autopsy studies, and 2.5% based on US examinations. Percutaneous therapies are a new alternative to surgery. They include simple percutaneous aspiration, catheter drainage alone, and catheter drainage with sclerotherapy. We present an 11-year-old boy admitted to hospital because of abdominal pain. A diagnosis of simple hepatic cyst was made, which was treated with aspiration and tetracycline hydrochloride solution (5%) injection into the cystic cavity. Complete regression was seen on US and MRI examination at 3 months, with total collapse and deflation of the cyst. The cyst regressed totally, leaving a hyperechoic linear scar on US examination at 1 year. On the basis of the clinical and imaging results obtained, percutaneous sclerotherapy of hepatic cysts can be recommended as the treatment of choice and as a valid alternative to laparoscopy in children. (orig.)

  8. Observing Exoplanets with High-dispersion Coronagraphy. II. Demonstration of an Active Single-mode Fiber Injection Unit

    Energy Technology Data Exchange (ETDEWEB)

    Mawet, D.; Ruane, G.; Xuan, W.; Echeverri, D.; Klimovich, N.; Randolph, M.; Fucik, J.; Wang, J.; Dekany, R.; Delorme, J.-R. [Department of Astronomy, California Institute of Technology, 1200 East California Boulevard, MC 249-17, Pasadena, CA 91125 (United States); Wallace, J. K.; Vasisht, G.; Mennesson, B.; Choquet, E.; Serabyn, E., E-mail: dmawet@astro.caltech.edu [Jet Propulsion Laboratory, California Institute of Technology, 4800 Oak Grove Drive, Pasadena, CA 91109 (United States)

    2017-04-01

    High-dispersion coronagraphy (HDC) optimally combines high-contrast imaging techniques such as adaptive optics/wavefront control plus coronagraphy to high spectral resolution spectroscopy. HDC is a critical pathway toward fully characterizing exoplanet atmospheres across a broad range of masses from giant gaseous planets down to Earth-like planets. In addition to determining the molecular composition of exoplanet atmospheres, HDC also enables Doppler mapping of atmosphere inhomogeneities (temperature, clouds, wind), as well as precise measurements of exoplanet rotational velocities. Here, we demonstrate an innovative concept for injecting the directly imaged planet light into a single-mode fiber, linking a high-contrast adaptively corrected coronagraph to a high-resolution spectrograph (diffraction-limited or not). Our laboratory demonstration includes three key milestones: close-to-theoretical injection efficiency, accurate pointing and tracking, and on-fiber coherent modulation and speckle nulling of spurious starlight signal coupling into the fiber. Using the extreme modal selectivity of single-mode fibers, we also demonstrated speckle suppression gains that outperform conventional image-based speckle nulling by at least two orders of magnitude.

  9. Single injection of the β2-adrenergic receptor agonist, clenbuterol, into newly hatched chicks alters abdominal fat pad mass in growing birds.

    Science.gov (United States)

    Ishimaru, Yoshitaka; Ijiri, Daichi; Shimamoto, Saki; Ishitani, Kanae; Nojima, Tsutomu; Ohtsuka, Akira

    2015-01-15

    Excessive energy is stored in white adipose tissue as triacylglycerols in birds as well as in mammals. Although β2-adrenergic receptor agonists reduce adipose tissue mass in birds, the underlying mechanism remains unclear. The aim of the current study was to examine the effects of a single intraperitoneal injection of the β2-adrenergic receptor agonist, clenbuterol, on the abdominal fat pad tissue development. Thirty-three chicks at 1-day-old were given a single intraperitoneal injection of clenbuterol (0.1mg/kg body weight) or phosphate-buffered saline. At 2 weeks post-dose, the weight of the abdominal fat tissue was decreased in the clenbuterol-injected chicks, and small adipocyte-like cells were observed in the abdominal fat pad tissue of the clenbuterol-injected chicks. Then, the expression of mRNAs encoding genes related to avian adipogenesis was examined in the abdominal fat pat tissue. The expression of mRNAs encoding Krüppel-like zinc finger transcription factor 5 (KLF-5), KLF-15, and zinc finger protein 423 in the abdominal fat pad tissue of the clenbuterol-injected chicks was significantly lower (Pclenbuterol-injected chicks, while clenbuterol injection did not affect FAS activity in liver. These results suggested that a single injection with clenbuterol into newly hatched chicks reduces their abdominal fat pad mass possibly via disrupting adipocyte development during later growth stages. Copyright © 2014 Elsevier Inc. All rights reserved.

  10. Direct observation of spin-injection in tyrosinate-functionalized single-wall carbon nanotubes

    NARCIS (Netherlands)

    Tsoufis, Theodoros; Ampoumogli, Asem; Gournis, Dimitrios; Georgakilas, Vasilios; Jankovic, Lubos; Christoforidis, Konstantinos C.; Deligiannakis, Yiannis; Mavrandonakis, Andreas; Froudakis, George E.; Maccallini, Enrico; Rudolf, Petra; Mateo-Alonso, Aurelio; Prato, Maurizio

    In this work, we report on the interaction of a tyrosinate radical with single wall carbon nanotubes (CNT). The tyrosinate radical was formed from tyrosine (ester) by Fenton's reagent and, reacted in situ with carbon nanotubes resulting in novel tyrosinated carbon nanotube derivatives. The covalent

  11. Controlled tunnel-coupled ferromagnetic electrodes for spin injection in organic single-crystal transistors

    NARCIS (Netherlands)

    Naber, W.J.M.; Craciun, M.F.; Lemmens, J.H.J.; Arkenbout, A.H.; Palstra, T.T.M.; Morpurgo, A.F.; van der Wiel, Wilfred Gerard

    2010-01-01

    We report on single-crystal rubrene field-effect transistors (FETs) with ferromagnetic Co electrodes, tunnel-coupled to the conduction channel via an Al2O3 tunnel barrier. Magnetic and electronic characterization shows that the Al2O3 film not only protects the Co from undesired oxidation, but also

  12. Controlled tunnel-coupled ferromagnetic electrodes for spin injection in organic single-crystal transistors

    NARCIS (Netherlands)

    Naber, W. J. M.; Craciun, M. F.; Lemmens, J. H. J.; Arkenbout, A. H.; Palstra, T. T. M.; Morpurgo, A. F.; van der Wiel, W. G.

    We report on single-crystal rubrene. eld-effect transistors (FETs) with ferromagnetic Co electrodes, tunnel-coupled to the conduction channel via an Al(2)O(3) tunnel barrier. Magnetic and electronic characterization shows that the Al(2)O(3) film not only protects the Co from undesired oxidation, but

  13. Administering Multiple Injectable Vaccines During a Single Visit-Summary of Findings From the Accelerated Introduction of Inactivated Polio Vaccine Globally.

    Science.gov (United States)

    Dolan, Samantha B; Patel, Manish; Hampton, Lee M; Burnett, Eleanor; Ehlman, Daniel C; Garon, Julie; Cloessner, Emily; Chmielewski, Elizabeth; Hyde, Terri B; Mantel, Carsten; Wallace, Aaron S

    2017-07-01

    In 2013, the World Health Organization's (WHO's) Strategic Advisory Group of Experts (SAGE) recommended that all 126 countries using only oral polio vaccine (OPV) introduce at least 1 dose of inactivated polio vaccine (IPV) into their routine immunization schedules by the end of 2015. In many countries, the addition of IPV would necessitate delivery of multiple injectable vaccines (hereafter, "multiple injections") during a single visit, with infants receiving IPV alongside pentavalent vaccine (which covers diphtheria, tetanus, and whole-cell pertussis; hepatitis B; and Haemophilus influenzae type b) and pneumococcal vaccine. Unanticipated concerns emerged from countries over acceptability of multiple injections, sites of administration, and safety. We contextualized the issues surrounding multiple injections by documenting concerns associated with administration of ≥3 injections, existing evidence in the published literature, and findings of a systematic review on administration practices and techniques. Concerns associated with multiple-injection visits were documented from meetings and personal communications with immunization program managers. Published literature on the acceptability of multiple injections by providers and caregivers was summarized, and a systematic review of the literature on administration practices was completed on the following topics: spacing between injection sites (ie, vaccine spacing), site of injection, route of injection, and procedural preparedness. WHO and United Nations Children's Fund data from 2013-2015 were used to assess multiple-injection visits included in national immunization schedules. Healthcare provider and caregiver attitudes and practices indicated concerns about infant pain, potential adverse effects, and uncertainty about vaccine effectiveness with multiple-injection visits. Published literature reinforced the record of safety and acceptance of the recommended schedule of IPV by the SAGE, but the evidence was

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

    DEFF Research Database (Denmark)

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

    2017-01-01

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

  15. [Parenteral alimentation in the early postoperative period].

    Science.gov (United States)

    Brisky, T

    1981-01-01

    Parenteral diet is a rather important problem for all of medical science, but especially for intensive care units. During the last few decades, a significant advancement has been made in this field, and there are indications that parenteral diet will be still more adequate, quantitatively and qualitatively, in the future. According to many published papers, patients can now be maintained exclusively on a parenteral diet, as our ward has done in the treatment of a variety of illnesses and diseases. This paper describes all the ingredients necessary for a parenteral diet. Briefly described are the effects on the organism, caloric values, and the ways in which the cells and organs utilize the food (as energy sources). All the preparations that we have used as well as those used by other institutions both foreign and domestic are listed. A full list of the ingredients of the preparations would consume too much space: however, there is a wealth of available literature and brochures for the reader who would like more detailed information. Based on the experience of a great many authors and that of our own institution, guidelines to be followed daily are provided. For such a program to be effectively applied, each member of the team should constantly monitor the parenteral diet, and there should be a frequent exchange of information and experiences. By so doing, still more could be contributed to overcoming this important problem.

  16. Parenteral feeding of cats and dogs

    Directory of Open Access Journals (Sweden)

    Jovanović Milan S.

    2008-01-01

    Full Text Available Inadequate diet combined with disease, injury or stress increases the metaobolic activity of patients to above the normal activity at rest. Sick or injured patients that are incapable of the intake of food and use nutritive matter through the digestive tract are indicated for parenteral feeding. Prior to the application of parenteral nutrition itself, it is necessary to carry out a series of clinical and laboratory analyses in order to determine which patients should actually be treated in this way. In order to determine the parenteral nutritive requirements, the veterinarian must assess the nutritive requirements of the patient, and on these grounds determine the type of solution that will be applied. It is very difficult to determine the precise requirements, so that certain relations are used in practice between the individual nutritive components that are based on the average requirements of these animal species. For parenteral nutrition, solutions are applied that are based on dextrose or glucose, amino acids, lipids, vitamins, micro and macro elements. In the course of the application of parenteral feeding, constant monitoring of the patient is necessary in the form of clinical examinations and laboratory tests.

  17. Alteraciones hepáticas inducidas por la nutrición parenteral

    OpenAIRE

    J Salas Salvado; A Recaséns Garica

    1993-01-01

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

  18. Heat transfer characteristics around a single heated rod immersed in sodium pool with gas jet injection

    International Nuclear Information System (INIS)

    Hideto Niikura; Kazuo Soga; Ken-ichiro Sugiyama; Akira Yamaguchi

    2005-01-01

    In a steam generator using liquid sodium, water intensely reacts with sodium when it leaks out from a heat transfer tube. It is important to evaluate the influence of sodium-water reaction to surrounding tubes and the shell. Hence, it has been desired to develop the simulation code for the evaluation of sodium-water reaction. From this viewpoint, the Japan Nuclear Cycle is now developing the SERAPHIM code. We reported a preliminary study to establish an experimental method for a single heated rod immersed in sodium pool with steam jet impingement planned in the near future as well as to obtain a preliminary data to verify the adequacy of SERAPHIM code. We first measured local and mean heat transfer coefficients around a horizontal single heated rod immersed in a water pool and a sodium pool with a limited volume in the experimental apparatus. It was confirmed that the mean heat transfer coefficients fairly agreed with the existing data for natural convection in water and sodium. Secondary we measured local and mean heat transfer coefficients around a horizontal single heated rod with Ar gas jet impingement immersed in the limited water pool and in the limited sodium pool. It was clearly observed that the local heat transfer coefficients in the sodium pool keep almost the same values in every angle regardless of increase in Ar gas jet velocity varied from about 8.7m/s to about 78m/s. On the other hand, it was confirmed in the water pool that local heat transfer coefficients on the forward stagnation side exposed in the Ar gas jet impingement increase with increasing the jet velocity while the local heat transfer coefficients on the opposite surface keep almost same values regardless of increase in the velocity. (authors)

  19. Stability of dobutamine hydrochloride in selected large-volume parenterals.

    Science.gov (United States)

    Kirschenbaum, H L; Aronoff, W; Perentesis, G P; Piltz, G W; Goldberg, R J; Cutie, A J

    1982-11-01

    Stability of dobutamine hydrochloride when mixed with large-volume parenteral solutions was assessed. Dobutamine hydrochloride was added to large-volume solutions of 5% dextrose injection, 0.9% sodium chloride injection, lactated Ringer's injection, and 5% dextrose and 0.45% sodium chloride injection, in both glass and polyvinyl chloride containers; the initial concentration was 1 mg/ml. After 0.25, 1, 3, 8, 24, and 48 hours, the concentration of dobutamine hydrochloride was determined by high-pressure liquid chromatography assay, and each solution was visually examined for evidence of haze, precipitation, color change, or evolution of gas. Concentration of dobutamine hydrochloride in the samples did not exhibit any appreciable change over the 48-hour period, and no HPLC peaks indicating degradation products were noted. Color changes were observed in some of the solutions, but no other visual changes occurred. There were no apparent differences in stability between the admixtures packaged in glass and those in polyvinyl chloride bags. At the concentration studied, dobutamine hydrochloride is stable in the admixtures tested for a minimum of 48 hours.

  20. Low-pressure, single-point grout injection for tank heel sludge mixing and in-situ immobilization

    International Nuclear Information System (INIS)

    Whyatt, G.A.; Hymas, C.R.

    1998-09-01

    This report describes tests conducted in an approximately 9-ft diameter test tank situated outside the 336 building in Hanford's 300 area. The tests were performed to measure the ability of jets of grout slurry to mobilize and mix simulated tank sludge. The technique is intended for in situ immobilization of tank waste heels. The current approach uses a single, rotated, larger-diameter nozzle driven at lower pressure. Due to the larger diameter, the potential for plugging is reduced and the effective radius around an injection point over which the jet is effective in mobilizing sludge from the tank bottom can be made larger. A total of three grout injection tests were conducted in a 9-ft diameter tank. In each case, a 2-in. layer of kaolin clay paste was placed on a dry tank floor to simulate a sludge heel. The clay was covered with 4 inches of water. The grout slurry, consisting of Portland cement, class F fly ash, and eater, was prepared and delivered by an offsite vendor. In the third test, the sludge in half of the tank was replaced by a layer of 20x50 mesh zeolite, and bentonite clay was added to the grout formulation. After injection, the grout was allowed to set and then the entire grout monolith was manually broken up and excavated using a jack hammer. Intact pieces of clay were visually apparent due to a sharp color contrast between the grout and clay. Remaining clay deposits were collected and weighed and suspended clay pieces within the monolith were photographed. The mobilization performance of the grout jets exceeded expectations

  1. Improved healing of transected rabbit Achilles tendon after a single injection of cartilage-derived morphogenetic protein-2.

    Science.gov (United States)

    Forslund, Carina; Aspenberg, Per

    2003-01-01

    Achilles tendon ruptures in humans might be treated more efficiently with the help of a growth factor. Cartilage-derived morphogenetic protein-2 has been shown to induce formation of tendon-like tissue. Cartilage-derived morphogenetic protein-2 has a positive effect on mechanical parameters for tendon healing in a rabbit model with Achilles tendon transection. Controlled laboratory study. The right Achilles tendon of 40 rabbits was transected without tendon suture. Cartilage-derived morphogenetic protein-2 (10 micro g) or vehicle control (acetate buffer) was injected locally 2 hours postoperatively. All tendons were tested biomechanically at 8 and 14 days, and treated tendons were histologically and radiographically evaluated at 56 days. At 14 days, both failure load and stiffness of treated tendons were increased by 35%. The treated tendons had significantly larger callus size at 8 and 14 days. Histologic and radiographic examination showed no signs of ossification in the treated tendons after 56 days. A single injection of cartilage-derived morphogenetic protein-2 led to a stronger and stiffer tendon callus than that in the controls without inducing bone formation. Similar results from a larger animal model would suggest a possible future use of cartilage-derived morphogenetic protein-2 in the treatment of human Achilles tendon ruptures.

  2. Performance and combustion analysis of Mahua biodiesel on a single cylinder compression ignition engine using electronic fuel injection system

    Directory of Open Access Journals (Sweden)

    Gunasekaran Anandkumar

    2016-01-01

    Full Text Available In this investigation, experiment is carried out on a 1500 rpm constant speed single cylinder Diesel engine. The test is carried out with Neat diesel, neat biodiesel, and blend B20. The engine considered was run with electronic fuel injection system supported by common rail direct injection to obtain high atomization and effective air utilization inside the combustion chamber. The performance of the engine in terms of break thermal efficiency and brake specific energy consumption was found and compared. The B20 blend shows 1.11% decrease in break thermal efficiency and 3.35% increase in brake specific energy consumption than diesel. The combustion characteristics found are in-cylinder pressure, rate of pressure rise, and heat release rate and compared for peak pressure load to understand the nature of combustion process. For each fuel test run, the maximum peak pressure is observed at part load condition. The rate of change of pressure and heat release rate of diesel is high compared to pure biodiesel and B20 blend. The diffusion combustion is observed to be predominant in case of B100 than B20 and Neat diesel.

  3. Future trends in parenteral nutrition.

    Science.gov (United States)

    Wretlind, A

    1975-01-01

    alimentation. The future trend in parenteral nutrition will also be to use this method for exact nutrition balances. In this way it will be possible to determine the endogenous loss via feces, as well as to study the requirements of nutrients in different conditions.

  4. Alanine turnover in the postabsorptive state and during parenteral hyperalimentation before and after surgery

    NARCIS (Netherlands)

    Sauerwein, H. P.; Michels, R. P.; Cejka, V.

    1981-01-01

    Influence of total parenteral nutrition and operation on alanine turnover and venous alanine concentration was determined in 5 patients with stomach carcinoma using single technique of U-14C alanine. Every patient served at his own control. In the postabsorptive state alanine turnover was 1.63 +/-

  5. Total parenteral nutrition - Problems in compatibility and stability

    DEFF Research Database (Denmark)

    Schroder, A.M.

    2008-01-01

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

  6. Curcumin protects dopaminergic neurons against inflammation-mediated damage and improves motor dysfunction induced by single intranigral lipopolysaccharide injection.

    Science.gov (United States)

    Sharma, Neha; Sharma, Sheetal; Nehru, Bimla

    2017-06-01

    Various studies have indicated a lower incidence and prevalence of neurological conditions in people consuming curcumin. The ability of curcumin to target multiple cascades, simultaneously, could be held responsible for its neuroprotective effects. The present study was designed to investigate the potential of curcumin in minimizing microglia-mediated damage in lipopolysaccharide (LPS) induced model of PD. Altered microglial functions and increased inflammatory profile of the CNS have severe behavioral consequences. In the current investigation, a single injection of LPS (5 ug/5 µl PBS) was injected into the substantia nigra (SN) of rats, and curcumin [40 mg/kg b.wt (i.p.)] was administered daily for a period of 21 days. LPS triggered an inflammatory response characterized by glial activation [Iba-1 and glial fibrillary acidic protein (GFAP)] and pro-inflammatory cytokine production (TNF-α and IL-1β) leading to extensive dopaminergic loss and behavioral abnormality in rats. The behavioral observations, biochemical markers, quantification of dopamine and its metabolites (DOPAC and HVA) using HPLC followed by IHC of tyrosine hydroxylase (TH) were evaluated after 21 days of LPS injection. Curcumin supplementation prevented dopaminergic degeneration in LPS-treated animals by normalizing the altered levels of biomarkers. Also, a significant improvement in TH levels as well as behavioral parameters (actophotometer, rotarod, beam walking and grid walking tests) were seen in LPS injected rats. Curcumin shielded the dopaminergic neurons against LPS-induced inflammatory response, which was associated with suppression of glial activation (microglia and astrocytes) and transcription factor NF-κB as depicted from RT-PCR and EMSA assay. Curcumin also suppressed microglial NADPH oxidase activation as observed from NADPH oxidase activity. The results suggested that one of the important mechanisms by which curcumin mediates its protective effects in the LPS-induced PD

  7. [Incidence rate of adverse reaction/event by Qingkailing injection: a Meta-analysis of single rate].

    Science.gov (United States)

    Ai, Chun-ling; Xie, Yan-ming; Li, Ming-quan; Wang, Lian-xin; Liao, Xing

    2015-12-01

    To systematically review the incidence rate of adverse drug reaction/event by Qingkailing injection. Such databases as the PubMed, EMbase, the Cochrane library, CNKI, VIP WanFang data and CBM were searched by computer from foundation to July 30, 2015. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data and cross check data. Then, Meta-analysis was performed by using the R 3.2.0 software, subgroup sensitivity analysis was performed based on age, mode of medicine, observation time and research quality. Sixty-three studies involving 9,793 patients with Qingkailing injection were included, 367 cases of adverse reactions/events were reported in total. The incidence rate of adverse reaction in skin and mucosa group was 2% [95% CI (0.02; 0.03)]; the digestive system adverse reaction was 6% [95% CI(0.05; 0.07); the injection site adverse reaction was 4% [95% CI (0.02; 0.07)]. In the digestive system as the main types of adverse reactions/events, incidence of children and adults were 4.6% [0.021 1; 0.097 7] and 6.9% [0.053 5; 0.089 8], respectively. Adverse reactions to skin and mucous membrane damage as the main performance/event type, the observation time > 7 days and ≤ 7 days incidence of 3% [0.012 9; 0.068 3] and 1.9% [0.007 8; 0.046 1], respectively. Subgroup analysis showed that different types of adverse reactions, combination in the incidence of adverse reactions/events were higher than that of single drug, the difference was statistically significant (P reactions occur, and clinical rational drug use, such as combination, age and other fators, and the influence factors vary in different populations. Therefore, clinical doctors for children and the elderly use special care was required for a clear and open spirit injection, the implementation of individualized medication.

  8. POSSIBLE PARENTERAL METHOTREXATE APPLICATION IN THE TREATMENT OF JUVENILE IDIOPATHIC ARTHRITIS

    Directory of Open Access Journals (Sweden)

    Yu. М. Spivakovsky

    2014-01-01

    Full Text Available The article describes a case of using methotrexate for subcutaneous injection in a rated dose of 12.5 mg / m2 of body surface per week when treating a child with juvenile idiopathic arthritis. When switching to the parenteral route of administration, methotrexate ensured the development of joint syndrome remission, normalization of laboratory indices of disease activity, and improvement of joint functions. After 6 months the inactive disease stage was detected, and after 12 months — remission.

  9. Not single but periodic injections of synovial mesenchymal stem cells maintain viable cells in knees and inhibit osteoarthritis progression in rats.

    Science.gov (United States)

    Ozeki, N; Muneta, T; Koga, H; Nakagawa, Y; Mizuno, M; Tsuji, K; Mabuchi, Y; Akazawa, C; Kobayashi, E; Matsumoto, K; Futamura, K; Saito, T; Sekiya, I

    2016-06-01

    We investigated the effects of single or repetitive intra-articular injections of synovial mesenchymal stem cells (MSCs) on a rat osteoarthritis (OA) model, and elucidated the behaviors and underlying mechanisms of the stem cells after the injection. One week after the transection of the anterior cruciate ligament (ACL) of wild type Lewis rats, one million synovial MSCs were injected into the knee joint every week. Cartilage degeneration was evaluated with safranin-o staining after the first injection. To analyze cell kinetics or MSC properties, luciferase, LacZ, and GFP expressing synovial MSCs were used. To confirm the role of MSCs, species-specific microarray and PCR analyses were performed using human synovial MSCs. Histological analysis for femoral and tibial cartilage showed that a single injection was ineffective but weekly injections had significant chondroprotective effects for 12 weeks. Histological and flow-cytometric analyses of LacZ and GFP expressing synovial MSCs revealed that injected MSCs migrated mainly into the synovium and most of them retained their undifferentiated MSC properties though the migrated cells rapidly decreased. In vivo imaging analysis revealed that MSCs maintained in knees while weekly injection. Species-specific microarray and PCR analyses showed that the human mRNAs on day 1 for 21 genes increased over 50-fold, and increased the expressions of PRG-4, BMP-2, and BMP-6 genes encoding chondroprotective proteins, and TSG-6 encoding an anti-inflammatory one. Not single but periodic injections of synovial MSCs maintained viable cells without losing their MSC properties in knees and inhibited osteoarthritis (OA) progression by secretion of trophic factors. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  10. Will a single periarticular lidocaine-corticosteroid injection improve the clinical efficacy of intraarticular hyaluronic acid treatment of symptomatic knee osteoarthritis?

    Science.gov (United States)

    Ertürk, Cemil; Altay, Mehmet Akif; Altay, Nuray; Kalender, Ali Murat; Öztürk, İbrahim Avşin

    2016-11-01

    A local injection of corticosteroid-lidocaine into the periarticular soft tissue structures is used commonly for rapid pain relief. It is hypothesized that knee pain associated with knee osteoarthritis would be relieved quickly and effectively in patients receiving intraarticular hyaluronic acid combined with a periarticular lidocaine-corticosteroid injection. To test this hypothesis, the clinical effect of the combined treatment with hyaluronic acid injection alone in patients with symptomatic knee osteoarthritis as compared in this prospective single-blinded randomized trial. This study included 70 patients. Group 1 (n = 35) received intraarticular hyaluronic acid injections only, whereas group 2 (n = 35) received intraarticular hyaluronic acid injections combined with a single local injection of corticosteroid-lidocaine. Injections were administered to the most painful areas of the anterior or posterior medial condyle of the femur or tibia. The outcome was measured by independent assessors (blinded to treatment) using a linear VAS pain scale and WOMAC and HSS knee scores. Assessments were performed at baseline and at 1, 3, 6, 12, 26, and 52 weeks. During the first 3 weeks, group 2 patients showed significantly better all scores than did group 1 patients (p hyaluronic acid alone in patients with knee osteoarthritis and can be considered a useful adjunctive treatment modality. This combined method may provide early return to patient's daily activity. Therapeutic study, Level I.

  11. Prolonged parenteral nutrition after neonatal gastrointestinal surgery

    DEFF Research Database (Denmark)

    Estmann, Anne; Qvist, Niels; Husby, Steffen

    2002-01-01

    INTRODUCTION: Long-term treatment with parenteral nutrition (PN) may be essential for survival in infants after neonatal gastrointestinal surgery. It seemed well indicated in a population-based study to estimate the need for long-term PN and to characterize the infants that received TPN with regard...

  12. Parenteral lipids: safety aspects and toxicity

    NARCIS (Netherlands)

    Wanten, G.J.A.

    2015-01-01

    Lipid emulsions (LEs) used in modern parenteral nutrition formulations are indispensable sources of calories and (essential) fatty acids ((E)FAs). Several generations of LEs based on various FA sources have been developed, and issues related to their safe use deserve attention. The relevant issues

  13. Solid lipid nanoparticles for parenteral drug delivery

    NARCIS (Netherlands)

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

    2004-01-01

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

  14. The effects of a single intravenous injection of novel activin A/BMP-2 (AB204) on toxicity and the respiratory and central nervous systems.

    Science.gov (United States)

    Yoon, Byung-Hak; Lee, Jae Hyup; Na, Kyuheum; Ahn, Chihoon; Cho, Jongho; Ahn, Hyun Chan; Choi, Jungyoun; Oh, Hyosun; Kim, Byong Moon; Choe, Senyon

    2016-01-01

    The purpose of this study was to determine the effects of a single intravenous injection of a novel osteoinductive material, activin A/BMP-2 (AB204), to rodents on toxicity and their respiratory functions and central nervous system (CNS). A single intravenous injection of AB204 was given to Sprague-Dawley (SD) rats in doses of 0, 0.625, 2.5 and 10 mg/kg to observe the mortality rate, the general symptoms for 14 days. The experimental groups were also given 0.2, 0.4 and 0.8 mg/kg of AB204, respectively, and the respiration rate, the tidal volume and the minute volume were measured for 240 min. The experimental groups of imprinting control region (ICR) mice were given a single intravenous injection of 0.2, 0.4 and 0.8 mg/kg of AB204, respectively. Their body temperature was taken and general behaviors were observed to evaluate the effect of AB204 on the CNS for 240 min. The study on toxicity of a single intravenous injection found no death or abnormal symptoms, abnormal findings from autopsy, or abnormal body weight gain or loss in all the experimental groups. No abnormal variation associated with the test substance was observed in the respiration rate, the tidal volume, the minute volume, body temperature or the general behaviors. On the basis of these results, the approximate lethal dose of AB204 for a single intravenous injection exceeds 10 mg/kg for SD rats and a single intravenous injection of ≤0.8 mg/kg AB204 has no effect on their respiratory system for SD rat and no effect on their CNS for ICR mice.

  15. Efficient injection from large telescopes into single-mode fibres: Enabling the era of ultra-precision astronomy

    Science.gov (United States)

    Jovanovic, N.; Schwab, C.; Guyon, O.; Lozi, J.; Cvetojevic, N.; Martinache, F.; Leon-Saval, S.; Norris, B.; Gross, S.; Doughty, D.; Currie, T.; Takato, N.

    2017-08-01

    Photonic technologies offer numerous advantages for astronomical instruments such as spectrographs and interferometers owing to their small footprints and diverse range of functionalities. Operating at the diffraction-limit, it is notoriously difficult to efficiently couple such devices directly with large telescopes. We demonstrate that with careful control of both the non-ideal pupil geometry of a telescope and residual wavefront errors, efficient coupling with single-mode devices can indeed be realised. A fibre injection was built within the Subaru Coronagraphic Extreme Adaptive Optics (SCExAO) instrument. Light was coupled into a single-mode fibre operating in the near-IR (J - H bands) which was downstream of the extreme adaptive optics system and the pupil apodising optics. A coupling efficiency of 86% of the theoretical maximum limit was achieved at 1550 nm for a diffraction-limited beam in the laboratory, and was linearly correlated with Strehl ratio. The coupling efficiency was constant to within 40% for 84% of the time and >50% for 41% of the time. The laboratory results allow us to forecast that extreme adaptive optics levels of correction (Strehl ratio >90% in H-band) would allow coupling of >67% (of the order of coupling to multimode fibres currently) while standard levels of wavefront correction (Strehl ratio >20% in H-band) would allow coupling of >18%. For Strehl ratios <20%, few-port photonic lanterns become a superior choice but the signal-to-noise, and pixel availability must be considered. These results illustrate a clear path to efficient on-sky coupling into a single-mode fibre, which could be used to realise modal-noise-free radial velocity machines, very-long-baseline optical/near-IR interferometers and/or simply exploit photonic technologies in future instrument design.

  16. Reduction of waveform distortion in grid-injection current from single-phase utility interactive PV-inverter

    International Nuclear Information System (INIS)

    Hamid, Muhammad Imran; Jusoh, Awang

    2014-01-01

    Highlights: • A reduction scheme for harmonics from utility interactive PV-inverter is proposed. • Single-phase conditioner with 3-phase expandability structure is used. • The single-phase conditioner in 3-phase structure work independently. • The scheme works effectively within overall operation range of the PV-inverter. • Conditioner in the scheme also improves the PV-inverter and plant’s utility factor. - Abstract: As the natural behavior of energy source and design characteristic, the current generated by a grid-interactive PV-inverter may contain harmonics. This distortion component will be carried on from the PV-inverter during injection power into the grid. Excessive harmonics in a grid will lead to a variety of power quality problems. This paper presents a distortion reduction scheme, utilizing a fed forward single-phase, generation-side power conditioner with a structure that can be expanded for use in a three-phase system and can work independently under imbalanced condition. Conditioner is placed in parallel with the photovoltaic plant and it functions to compensate the plant’s output current distortion, so that the total current flow to the grid is sinusoidal. This method also includes the implementation of a simpler control system for the conditioner, which consists of a combination of distortion current extraction, synchronization and a current control system, and realized through a TMS320F28335: a 150 MHz floating point DSP controller. Testing of the conditioner prototype, which was conducted on a real operation of a PV plant, showed that the scheme worked effectively within the overall operation range of the PV plant. This paper also discusses the potential of utility factor improvement of the PV-inverter and plant due to implementation of conditioner in the scheme

  17. A prospective, randomized, single - blind study comparing intraplaque injection of thiocolchicine and verapamil in Peyronie's Disease: a pilot study

    Directory of Open Access Journals (Sweden)

    I. L. Toscano Jr.

    Full Text Available ABSTRACT Objectives: To compare the response to tiocolchicine and verapamil injection in the plaque of patients with Peyronie's disease. Materials and Methods: Prospective, single-blind, randomized study, selecting patients who have presented Peyronie's disease for less than 18 months. Thiocolchicine 4mg or verapamil 5mg were given in 7 injections (once a week. Patients who had received any treatment for Peyronie's disease in the past three months were excluded. The parameters used were the International Index of Erectile Function (IIEF-5 score, analysis of the curvature on pharmaco-induced erections and size of the plaque by ultrasonography. Results: Twenty-five patients were randomized, 13 received thiocolchicine and 12 were treated with verapamil. Both groups were statistically similar. The mean curvature was 46.7° and 36.2° before and after thiocolchicine, respectively (p=0.019 and 50.4° and 42.08° before and after verapamil, respectively (p=0.012. The curvature improved in 69% of patients treated with thiocolchicine and in 66% of those who received verapamil. Regarding sexual function, there was an increase in the IIEF-5 from 16.69 to 20.85 (p=0.23 in the thiocolchicine group. In the verapamil group the IIEF-5 score dropped from 17.50 to 16.25 (p=0.58. In the thiocolchicine group, the plaque was reduced in 61% of patients. In the verapamil group, 8% presented decreased plaque size. No adverse event was associated to thiocolchicine. Conclusion: The use of thiocolchicine in Peyronie's disease demonstrated improvement on penile curvature and reduction in plaque size. Thiocolchicine presented similar results to verapamil in curvature assessment. No significant side effects were observed with the use of tiocolchicine.

  18. Optimization of single injection liver arterial phase gadolinium enhanced MRI using bolus track real-time imaging.

    Science.gov (United States)

    Sharma, Puneet; Kalb, Bobby; Kitajima, Hiroumi D; Salman, Khalil N; Burrow, Bobbie; Ray, Gaye L; Martin, Diego R

    2011-01-01

    To measure contrast agent enhancement kinetics in the liver and to further evaluate and develop an optimized gadolinium enhanced MRI using a single injection real-time bolus-tracking method for reproducible imaging of the transient arterial-phase. A total of 18 subjects with hypervascular liver lesions were imaged with four dimensional (4D) perfusion scans to measure time-to-peak (TTP) delays of arterial (aorta-celiac axis), liver parenchyma, liver lesion, portal, and hepatic veins. Time delays were calculated from the TTP-aorta signal, and then related to the gradient echo (GRE) k-space acquisition design, to determine optimized timing for real-time bolus-track triggering methodology. As another measure of significance, 200 clinical patients were imaged with 3D-GRE using either a fixed time-interval or by individualized arterial bolus real-time triggering. Bolus TTP-aorta was calculated and arterial-phase acquisitions were compared for accuracy and reproducibility using specific vascular enhancement indicators. The mean bolus transit-time to peak-lesion contrast was 8.1 ± 2.7 seconds following arterial detection, compared to 32.1 ± 5.4 seconds from contrast injection, representing a 62.1% reduction in the time-variability among subjects (N = 18). The real-time bolus-triggered technique more consistently captured the targeted arterial phase (94%), compared to the fixed timing technique (73%), representing an expected improvement of timing accuracy in 28% of patients (P = 0.0001389). Our results show detailed timing window analysis required for optimized arterial real-time bolus-triggering acquisition of transient arterial phase features of liver lesions, with optimized arterial triggering expected to improve reproducibility in a significant number of patients. Copyright © 2010 Wiley-Liss, Inc.

  19. Comparison of a single- or double-injection technique for ultrasound-guided supraclavicular block: a prospective, randomized, blinded controlled study.

    Science.gov (United States)

    Roy, Mélanie; Nadeau, Marie-Josée; Côté, Dany; Levesque, Simon; Dion, Nicolas; Nicole, Pierre C; Turgeon, Alexis F

    2012-01-01

    Despite good success rates reported with ultrasound-guided supraclavicular block using 1 or multiple injections, no consensus exists on the best technique to use. We designed this study to test the hypothesis that a double-injection technique would hasten the onset of sensory block. Adult patients undergoing hand, wrist, or elbow surgery were enrolled in this prospective double-blind randomized study. Blocks were performed under ultrasound guidance. In group S (single injection), 30 mL of mepivacaine 1.5% was injected at the junction of the subclavian artery and the first rib. In group D (double injection), 15 mL of the same solution was injected at the site described above, then 15 mL was injected in the most superficial portion of the lateral aspect of the cluster formed by the brachial plexus trunks and divisions. The primary end point was the rate of complete sensory block at 15 mins. Secondary end points were the rates of sensory, motor, and surgical blocks and procedure time. Fifty-one patients were randomized to each group. The rate of complete sensory block was similar at 15 mins (group S: 49% [95% confidence interval, 36%-62%], group D: 53% [95% confidence interval, 40%-66%]; P = 0.80) and at each time interval. The rates of complete motor block and surgical block success were similar between groups. The procedure time was shorter in group S (179 ± 104 vs 275 ± 137 secs; P block.

  20. Stepwise injection potentiometric determination of caffeine in saliva using single-drop microextraction combined with solvent exchange.

    Science.gov (United States)

    Timofeeva, I; Medinskaia, K; Nikolaeva, L; Kirsanov, D; Bulatov, A

    2016-04-01

    A flow potentiometric method for determination of caffeine in saliva is suggested. This task is important for non-invasive assessment of drug metabolizing system activity in hepatocytes. In the current study, stepwise injection analysis (SWIA) was successfully combined with single-drop liquid microextraction (SDLME) and solvent exchange procedure. The method is based on the caffeine SDLME with subsequent solvent evaporation and dissolution of analyte in sulfuric acid followed by potentiometric detection using poly(vinyl chloride) membrane electrode containing potassium tetrakis[3,5-bis(trifluoromethyl)phenyl]borate as electroactive component. SDLME was employed for elimination of interfering matrix effects of saliva and caffeine metabolites such as theophylline, theobromine and paraxanthine. A linear range of 10(-5)-10(-2)M was established for caffeine with detection limit at 6 × 10(-6)M. The sample throughput was 6 samples h(-1). The proposed method was successfully applied to the determination of caffeine in saliva and the analytical results agreed well with the results obtained with reference HPLC method. Copyright © 2016 Elsevier B.V. All rights reserved.

  1. Durable recovery of the macular architecture and functionality of a diagnosed age-related macular degeneration 1 year after a single intravitreal injection of dobesilate

    Science.gov (United States)

    Cuevas, P; Outeiriño, L A; Azanza, C; Giménez-Gallego, G

    2013-01-01

    Among the age-related diseases that affect vision, age-related macular degeneration is the most frequent cause of blindness in patients older than 60 years. In this communication, we report the full anatomical and functional recovery of a patient diagnosed with wet age-related macular degeneration 1 year after a single intravitreal injection of dobesilate. PMID:24225910

  2. [Application of a bacterial endotoxin test for parenteral drugs].

    Science.gov (United States)

    Ogawa, Y

    1994-01-01

    The Limulus test, which has been adopted as the Test for Bacterial Endotoxins in the JP XII, can detect or quantitate endotoxins of Gram-negative bacterial origin using blood corpuscle extracts (Limulus amebocyte lysate, LAL) of horseshoe crabs (Limulus polyphemus, Tachypleus tridentatus, etc.). It may be conducted by the gel-clot or spectrophotometric (turbidimetric and colorimetric) techniques, the former being based on gel formation due to the activation of LAL by endotoxins. The turbidimetric technique is based on the LAL turbidity change during the gel formation and the colorimetric technique on activation of peptide hydrolytic enzymes in LAL. The Limulus test has been unofficially utilized as a simple and highly sensitive method for the determination of endotoxins in parenteral drugs in lieu of the in vivo Pyrogen Test using rabbits. For the Bacterial Endotoxins Test of the JP XII, the gel-clot technique alone was adopted, the technique being only allowed for Injection. Although most parenteral drugs show inhibition or enhancement in practice, this test can be most easily conducted by eliminating interfering effects through dilution of specimens by a factor not exceeding the maximum valid dilution (MVD) with water. Since MVD is dependent on the sensitivity of applied methodology, the turbidimetric and colorimetric techniques, which are more sensitive than the gel-clot technique, have a distinct advantage. The JP, as the leading Pharmacopoeia for the international harmonization of Bacterial Endotoxins Testing, has presented a "Draft towards International Harmonization of Bacterial Endotoxins Test", whose main purpose is the introduction of supplementary turbidimetric and colorimetric techniques. Under these circumstances the following subjects are discussed: (1) the proposal that, with a view towards international harmonization of the technical requirements of Pharmacopoeias, both the turbidimetric and colorimetic techniques should be included together with

  3. MRI in children receiving total parenteral nutrition

    International Nuclear Information System (INIS)

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

    1996-01-01

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

  4. Total parenteral alimentation in childhood general considerations.

    Science.gov (United States)

    Shmerling, D H

    1975-02-01

    The paper presents a discussion of the definition, the indications and some of the difficulties and complications of total long-term parenteral alimentation in infants and children. The problems of protein quality, the inadequacy of the E/T ratio, the quantities and quality of carbohydrates and the metabolic complications due to inappropriate electrolyte and mineral salts composition are reviewed. It is pointed out that the optimal amounts of some of the components used are still under investigation, that there seems to be no imperative reason not to use glucose as the sole carbohydrate in this age group and that most of the possible long-term sequelae and complications of total long-term parenteral alimentation will have to be looked for by prospective studies of the children treated.

  5. Experimental study of unsteady heat release in an unstable single element Lean Direct Injection (LDI) gas turbine combustor

    Science.gov (United States)

    Lakshmanan, Varun S.

    In an effort to curb emissions from gas turbine engines, many low emission engine concepts have been developed. Among the most promising of these is the LDI (Lean Direct Injection). These systems operate at relatively low equivalence ratios close to blowout and are prone to instabilities. Combustion instabilities can reduce the life of the combustor by causing large pressure fluctuations and enhanced heat release to the walls of the combustor and reduce the efficiency of the engines. The understanding of combustion instabilities is vital to the implementation of such systems. Combustion instabilities are studied in an self-excited single element gas turbine combustor that uses an LDI element for fuel injection at elevetaed chamber pressures. The LDI combustor uses a swirler to ensure mixing of the air and the fuel and expansion of the swirl through a pressure swirl venturi to create a swirl stabilized flame. This project aims to study the heat release modes that occur in the combustor through measurement of light emissions from the flame using photodiodes that are sensitive to wavelengths of light produced by the flame. These are used along with high frequency pressure transducers. The focus is on the flame behavior in the diverging section of the venturi where the swirl is expanded and the flame starts since optic access cannot be obtained in this section. The use of photodiodes also facilitates the study of hydrodynamic modes that occur in the combustor alongside the thermoacoustics. A section which could accommodate the photodiodes was designed and installed on the LDI test rig in the Gas Turbine Cell at Maurice J Zucrow Propulsion Labs at Purdue University. The combustor was tested with this section and dynamic data was obtained from the pressure transducers and the photodiodes for a range of inlet air temperatures and range of equivalence ratios for each inlet air temperature. The dominant instability modes in both sets of data were analyzed and are presented

  6. Recent advances in polymeric microspheres for parenteral drug delivery--part 1.

    Science.gov (United States)

    Mao, Shirui; Guo, Chunqiang; Shi, Yi; Li, Luk Chiu

    2012-09-01

    Polymeric microspheres have been established as a valuable parenteral drug delivery system for sustained release of therapeutic agents via subcutaneous or intramuscular injection. Biodegradable polymers which are either synthetic or from natural sources are reviewed with respect to recent advances in exploring their applications for microsphere fabrications. New information on the impact of formulation variables on the properties of microspheres formed by an emulsion method was also presented. The characterization of microspheres using advanced physical analytical techniques was also reviewed and the utilization of the information in assessing in vivo performance of the product was also highlighted. The broad clinical use of microspheres for delivery of therapeutic agents in particular biologics such as proteins has not been realized commercially. The limited availability of biodegradable polymers with a long history of regulatory approval and the challenges in gaining regulatory approval of a new polymer have hindered the development of microspheres for parenteral drug delivery.

  7. Steroidal Compounds in Commercial Parenteral Lipid Emulsions

    Directory of Open Access Journals (Sweden)

    Rafat A. Siddiqui

    2012-08-01

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

  8. Steroidal Compounds in Commercial Parenteral Lipid Emulsions

    Science.gov (United States)

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

    2012-01-01

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

  9. Plasma trace metals during total parenteral alimentation.

    Science.gov (United States)

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

    1976-06-01

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

  10. [Partial parenteral nutrition in severe virus hepatitis].

    Science.gov (United States)

    Kleinberger, G; Schneeweiss, B; Druml, W; Laggner, A; Lenz, K

    1984-03-01

    Patients with severe virus hepatitis and a prothrombin concentration below 25% have a bad prognosis. This is due to direct consequences of hepatic failure and to the rather frequent complications of this disease. The clinical course of such patients is essentially dependent upon the degree of liver regeneration, which again is dependent upon the mass of hepatocytes which are able to regenerate and upon the so called hepatotrophic factors. Patients with severe hepatitis suffer during the first weeks rather frequently from nausea and loss of appetite and for that reason their nutrition is insufficient. In the study recorded here 9 cases were investigated (7 patients with hepatitis B, 2 patients with hepatitis non A non B). The question was asked, if partial parenteral nutrition in addition to a liver diet not containing meat would improve liver function. It could be shown that the prothrombin concentration, which could not be improved by vitamine K1 supplements, was increased during a 7 day parenteral nutrition period from 19,3 +/- 2,9% to 41,5 +/- 8,1% (p less than 0,05), serum albumine and cholinesterase activity improved as well. During the first day of treatment there was a significant fall of ammoniac from 115 +/- 10 mumol to 73 +/- 10 mumol/l (p less than 0,05), at the same time production of urea did not increase. All patients survived. The results show, that parenteral nutrition can improve liver function and decrease the catabolic status of metabolism.

  11. The mechanism of the transient depression of the erythropoietic rate induced in the rat by a single injection of uranyl nitrate

    International Nuclear Information System (INIS)

    Giglio, M.J.; Brandan, N.; Leal, T.L.; Bozzini, C.E.

    1989-01-01

    With the purpose of assessing the effect of uranyl nitrate (UN) on the rate of erythropoiesis, 1 mg/kg of the compound was injected iv to adult female Wistar rats. The dosing vehicle was injected into control animals. A single injection of UN induced a transient depression of the rate of red cell volume 59 Fe uptake, which reached its lowest value (68% depression) by the seventh postinjection day. By 14 days, 59 Fe incorporation had returned to normal. The amount of iron going to erythroid tissue per hour, reticulocyte count, and immunoreactive erythropoietin concentration in both plasma and kidney extracts were also significantly depressed in UN-treated rats in relation to these values in vehicle-injected rats by the seventh postinjection day. Dose-response curves for exogenous erythropoietin (Epo) performed in polycythemic intact and UN-treated rats 7 days after drug injection revealed a significant depression of the response in UN-injected animals. Moreover, bone marrow cells obtained from rats pretreated with UN formed a reduced number of erythroid colonies in vitro in response to Epo. Therefore, possible mechanisms for the observed transient depression in the rate of erythropoiesis associated with acute UN treatment include decreased Epo production and direct or indirect damage of erythroid progenitor cells

  12. The effects of bacterial endotoxin on lipide metabolism. I. The responses of the serum lipides of rabbits to single and repeated injections of Shear's polysaccharide.

    Science.gov (United States)

    LEQUIRE, V S; HUTCHERSON, J D; HAMILTON, R L; GRAY, M E

    1959-08-01

    Single intravenous injections of Shear's polysaccharide in varying dosages invariably produced an elevation in the levels of the total serum lipides 24 hours after injection of endotoxin. The total serum cholesterol and lipide phosphorus were also affected, although they did not change with smaller doses of endotoxin and were rarely elevated to the same degree as were the total serum lipides. The degree of elevation of the serum lipides was apparently related to the amount of endotoxin injected up to a certain point, beyond which there was no further increase. There were two types of response to endotoxin by the serum lipides, a moderate increase and an uncontrolled increase. Higher dosages of endotoxin and fasting apparently increased the incidence of the latter response. No direct correlation could be made between serum lipide responses and histologic evidence typical of the generalized Shwartzman reaction following this regimen of endotoxin injection. The Shwartzman reaction did occur with greater frequency and with lower dosages of endotoxin in fasted animals. Animals given repeated injections of endotoxin showed an initial increase in serum lipides followed by a progressive decrease to normal levels as tolerance to the febrile action of endotoxin appeared. The febrile tolerance as well as the unresponsiveness of the serum lipides to endotoxin was abolished by thorium dioxide (thorotrast) in these animals. In similar experiments a "breakthrough" of lipide unresponsiveness to endotoxin was obtained by increasing the amount of endotoxin injected. Some of the implications of these results for the metabolic alterations produced by bacterial endotoxins are discussed.

  13. Assessment of the efficacy and safety of single platelet-rich plasma injection on different types and grades of facial wrinkles.

    Science.gov (United States)

    Elnehrawy, Naema Y; Ibrahim, Zeinab A; Eltoukhy, Azza M; Nagy, Hala M

    2017-03-01

    Platelet-rich plasma (PRP) is considered as a growing modality for tissue regeneration and a developing research area for clinicians and researchers. PRP injection treatment provides supraphysiological concentrations of growth factors that may help in accelerated tissue remodeling and regeneration. To evaluate the efficacy and safety of single autologous PRP intradermal injection for treatment of facial wrinkles and for facial rejuvenation. A total of 20 subjects with different types of facial wrinkles were included in this study. All subjects received single PRP intradermal injection and were clinically assessed before and after treatment for a period of 8 weeks using Wrinkle Severity Rating Scale (WSRS), Skin Homogeneity and Texture (SHnT) Scale, Physician Assessment Scale, and Subject Satisfaction Scale. The mean value of WSRS reduced from 2.90 ± 0.91 before treatment to 2.10 ± 0.79 after 8 weeks of treatment. The most significant results were with younger subjects that have mild and moderate wrinkles of the nasolabial folds (NLFs). Fourteen of seventeen subjects with NLFs showed more than 25% improvement in their appearance. Side effects of PRP treatment were minimal to mild and with excellent tolerability. Single PRP intradermal injection is well tolerated and capable of rejuvenating the face and producing a significant correction of wrinkles especially the NLFs. © 2016 Wiley Periodicals, Inc.

  14. Treatment of autonomously functioning thyroid nodules at a single institution. Radioiodine therapy, surgery, and ethanol injection therapy

    International Nuclear Information System (INIS)

    Yano, Yukiko; Sugino, Kiminori; Akaishi, Junko

    2011-01-01

    The purpose of this study was to clarify the efficacy of radioiodine (RI) therapy in Japanese patients with autonomously functioning thyroid nodules (AFTNs). We performed a retrospective analysis to assess the management of AFTN patients. Thyroid lobectomy was performed to treat toxic adenoma (TA) patients, and total thyroidectomy to treat toxic multinodular goiter (TMNG) patients. RI therapy was administered in the form of a single dose (500 MBq) of isotope in the outpatient clinic. Percutaneous ethanol injection therapy (PEIT) was performed under ultrasound guidance. Of the total 205 patients, consisting of 159 TA and 46 TMNG patients, 99 underwent surgery, 50 received RI therapy, and 56 received PEIT. Remission of thyrotoxicosis was achieved in all of the patients who were treated surgically. Hypothyroidism was documented in six of the 72 patients who were treated surgically other than by total thyroidectomy. Remission of thyrotoxicosis was observed in 43 of the 50 patients who were treated by RI therapy. Nine TA patients developed hypothyroidism during the follow-up period after RI therapy. Several PEIT sessions were required to achieve a remission of thyrotoxicosis. Remission of thyrotoxicosis was achieved in 29 of the 56 patients treated by PEIT, and thyrotoxicosis recurred in 17 these 56 patients. Surgery is the treatment of choice for large nodules and nodules that are resistant to other treatments, because it allows prompt control of thyrotoxicosis. RI therapy is a safe and effective means of controlling thyrotoxicosis in AFTN patients. We conclude that RI therapy is the treatment of choice for definitive treatment of AFTN patients who do not have local compression symptoms. (author)

  15. Pharmacokinetics of tulathromycin in plasma and milk samples after a single subcutaneous injection in lactating goats (Capra hircus).

    Science.gov (United States)

    Grismer, B; Rowe, J D; Carlson, J; Wetzlich, S E; Tell, L A

    2014-04-01

    Eight adult female dairy goats received one subcutaneous administration of tulathromycin at a dosage of 2.5 mg/kg body weight. Blood and milk samples were assayed for tulathromycin and the common fragment of tulathromycin, respectively, using liquid chromatography/mass spectrometry. Pharmacokinetic disposition of tulathromycin was analyzed by a noncompartmental approach. Mean plasma pharmacokinetic parameters (±SD) following single-dose administration of tulathromycin were as follows: C(max) (121.54 ± 19.01 ng/mL); T(max) (12 ± 12-24 h); area under the curve AUC(0→∞) (8324.54 ± 1706.56 ng·h/mL); terminal-phase rate constant λz (0.01 ± 0.002 h⁻¹); and terminal-phase rate constant half-life t1/2λz (67.20 h; harmonic). Mean milk pharmacokinetic parameters (±SD) following 45 days of sampling were as follows: Cmax (1594 ± 379.23 ng/mL); Tmax (12 ± 12-36 h); AUC(0→∞) (72,250.51 ± 18,909.57 ng·h/mL); λz (0.005 ± 0.001 h⁻¹); and t(1/2λz) (155.28 h; harmonic). All goats had injection-site reactions that diminished in size over time. The conclusions from this study were that tulathromycin residues are detectable in milk samples from adult goats for at least 45 days following subcutaneous administration, this therapeutic option should be reserved for cases where other treatment options have failed, and goat milk should be withheld from the human food chain for at least 45 days following tulathromycin administration. © 2013 John Wiley & Sons Ltd.

  16. 3D pulmonary perfusion MRI and MR angiography of pulmonary embolism in pigs after a single injection of a blood pool MR contrast agent

    Energy Technology Data Exchange (ETDEWEB)

    Fink, Christian; Ley, Sebastian; Puderbach, Michael; Plathow, Christian; Kauczor, Hans-Ulrich [Department of Radiology, Innovative Cancer Diagnostic and Therapy, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg (Germany); Bock, Michael [Department of Medical Physics in Radiology, Innovative Cancer Diagnostic and Therapy, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg (Germany)

    2004-07-01

    The purpose of this study was to assess the feasibility of contrast-enhanced 3D perfusion MRI and MR angiography (MRA) of pulmonary embolism (PE) in pigs using a single injection of the blood pool contrast Gadomer. PE was induced in five domestic pigs by injection of autologous blood thrombi. Contrast-enhanced first-pass 3D perfusion MRI (TE/TR/FA: 1.0 ms/2.2 ms/40 ; voxel size: 1.3 x 2.5 x 4.0 mm{sup 3}; TA: 1.8 s per data set) and high-resolution 3D MRA (TE/TR/FA: 1.4 ms/3.4 ms/40 ; voxel size: 0.8 x 1.0 x 1.6 mm{sup 3}) was performed during and after a single injection of 0.1 mmol/kg body weight of Gadomer. Image data were compared to pre-embolism Gd-DTPA-enhanced MRI and post-embolism thin-section multislice CT (n=2). SNR measurements were performed in the pulmonary arteries and lung. One animal died after induction of PE. In all other animals, perfusion MRI and MRA could be acquired after a single injection of Gadomer. At perfusion MRI, PE could be detected by typical wedge-shaped perfusion defects. While the visualization of central PE at MRA correlated well with the CT, peripheral PE were only visualized by CT. Gadomer achieved a higher peak SNR of the lungs compared to Gd-DTPA (21{+-}8 vs. 13{+-}3). Contrast-enhanced 3D perfusion MRI and MRA of PE can be combined using a single injection of the blood pool contrast agent Gadomer. (orig.)

  17. Stability and compatibility of lidocaine hydrochloride with selected large-volume parenterals and drug additives.

    Science.gov (United States)

    Kirschenbaum, H L; Aronoff, W; Perentesis, G P; Plitz, G W; Cutie, A J

    1982-06-01

    The stability of lidocaine hydrochloride in six commonly used large-volume parenterals when stored for 14 days and the visual compatibility of lidocaine hydrochloride in admixtures with eight frequently used drugs were studied. Lidocaine hydrochloride admixtures of 2 mg/ml were prepared in both glass and plastic containers of 5% dextrose injection, 0.9% sodium chloride injection, lactated Ringer's injection, 5% dextrose and lactated Ringer's injection, 0.45% sodium chloride injection (plastic container only), and 0.45% sodium chloride and 5% dextrose injection. The admixtures were examined visually and stored for 14 days at 25 +/- 0.5 degrees C under fluorescent light. Lidocaine hydrochloride concentrations were determined spectrophotometrically at times 0, 0.25, 1, 3, 8, and 24 hours, and at 24-hour intervals thereafter. Spectrophotometric assays were confirmed with high-pressure liquid chromatography. Admixtures of lidocaine hydrochloride were prepared with aminophylline, bretylium tosylate, calcium gluconate, digoxin, dopamine hydrochloride, regular insulin, phenytoin sodium, and procainamide hydrochloride in 5% dextrose injection, 0.9% sodium chloride injection, and lactated Ringer's injection. The admixtures were examined visually for 24 hours. Admixtures of lidocaine hydrochloride were stable for 14 days. All admixtures of lidocaine hydrochloride with other drugs were visually compatible except those containing phenytoin sodium. It is concluded that lidocaine hydrochloride is stable in the solutions studied for 14 days at 25 degrees C and visually compatible for 24 hours in admixtures containing all drugs studied except phenytoin sodium.

  18. Safety and Potential Effect of a Single Intracavernous Injection of Autologous Adipose-Derived Regenerative Cells in Patients with Erectile Dysfunction Following Radical Prostatectomy

    DEFF Research Database (Denmark)

    Haahr, Martha Kirstine; Jensen, Charlotte Harken; Toyserkani, Navid Mohamadpour

    2016-01-01

    is registered with ClinicalTrials.gov, NCT02240823. FINDINGS: Intracavernous injection of ADRCs was well-tolerated and only minor events related to the liposuction and cell injections were reported at the one-month evaluation, but none at later time points. Overall during the study period, 8 of 17 men recovered...... to a mean difference of 0.57 (0.38-0.85; p = 0.0069), versus inclusion. In contrast, incontinent men did not regain erectile function (median IIEF1/3/6 months = 5 (95% CI 5-6); mean difference 1 (95% CI 0.85-1.18), p > 0.9999). INTERPRETATION: In this phase I trial a single intracavernosal injection...

  19. Single-dose Intramuscular-injection Toxicology Test of Water-soluble Carthami-flos and Cervi cornu parvum Pharmacopuncture in a Rat Model

    Directory of Open Access Journals (Sweden)

    Sunju Park

    2015-09-01

    Full Text Available Objectives: The aim of the study is to investigate both the single-dose intramuscular injection toxicity and the approximate lethal dose of water-soluble Carthami-flos and Cervi cornu parvum pharmacopuncture (WCFC in male and female Sprague-Dawley (SD rats. Methods: The study was conducted at Biotoxtech Co. according to the Good Laboratory Practice (GLP regulation and the toxicity test guidelines of the Ministry of Food and Drug Safety (MFDS after approval of the Institutional Animal Care and Use Committee. Dosages for the control, high dose, middle dose and low dose groups were 0.5 mL/animal of saline and 0.5, 0.25 and 0.125 mL/animal of WCFC, respectively. WCFC was injected into the muscle of the left femoral region by using a disposable syringe (1 mL, 26 gauge. The general symptoms and mortality were observed 30 minutes, 1, 2, 4, and 6 hours after the first injection and then daily for 14 days after the injection. The body weights of the SD rats were measured on the day of the injection (before injection and on the third, seventh, and fourteenth days after the injection. Serum biochemical and hematologic tests, necropsy examinations, and histopathologic examinations at the injection site were performed after the observation period. Results: No deaths, abnormal clinical symptoms, or significant weight changes were observed in either male or female SD rats in the control or the test (0.125, 0.25, and 0.5 mL/animal groups during the observation period. No significant differences in hematology and serum biochemistry and no macroscopic abnormalities at necropsy were found. No abnormal reactions at injection sites were noted on the topical tolerance tests. Conclusion: The results of this single-dose toxicity study show that WCFC is safe, its lethal doses in male and female SD rats being estimated to be higher than 0.5 mL/animal.

  20. Determination of the optional time for taking blood samples by single intravenous injection of 3H-leucine

    International Nuclear Information System (INIS)

    Meng Delian; Yao Junhu; Lu Jinyin; Wu Xiaobin; Liu Jun

    2003-01-01

    Twenty four young hens (1.5 kg of body weight, BW) were randomly divided into 4 groups. Every group was diet free (FAS) or force-fed a nitrogen-free diet (NFD) or the diet with 20% crude protein in which soybean meal or cotton seed meal was the sole nitrogen source (30 g DM/kg BW). 30 μCi 3 H-Leu/kg BW was intravenously injected into all birds just after force-fed or on fasting. Venous blood samples were taken at 5, 30 min, 4,24,36 and 48h after injection. The excreta during the whole period of 48h after injection was collected. Special radioactivities of nonprotein plasma at every time point and excreta were measured. The optional time of taking blood samples was 20-24 hours after injected 3 H-Leu

  1. Effect of steam injection on nox emissions and performance of a single cylinder diesel engine fuelled with soy methyl ester

    Directory of Open Access Journals (Sweden)

    Manickam Madhavan V.

    2017-01-01

    Full Text Available Biodiesel attracts most of the researchers and automotive industries in recent years as an alternative fuel for diesel engines, because of its better lubricity property, higher cetane number, and less greenhouse gas emissions. The use of bio diesel leads to reduction in hydro carbons, carbon monoxide, and particulate matter, but increase in NOx emissions. Increase in biodiesel blends in standard diesel leads to increase in NOx emission. In this study, an attempt is made to reduce the NOx emis-sions of a diesel engine fueled with pure soy methyl ester (B100 with low pressure steam injection. Experiments were carried out and studied for both standard diesel and pure biodiesel of soy methyl ester with steam injection ratio of 5, 10, and 15% on mass ratio basis of air in the inlet manifold. The present study has shown that around 30% reduction in NOx can be achieved for the steam injection rate of 10% and considerable reduction for all other steam injection rates when compared to standard diesel and B100. It is also observed that steam injection having signifi-cant impact on reduction of other emissions such as HC, CO, and CO2. The study also noted marginal improvement in the engine brake power, brake thermal effi-ciency and reduction in specific fuel consumption at part loads and minor increase during peak load operation for the low pressure steam injection on B100.

  2. The 15N-leucine single-injection method allows for determining endogenous losses and true digestibility of amino acids in cecectomized roosters.

    Directory of Open Access Journals (Sweden)

    Rujiu Hu

    Full Text Available This study was conducted to assess the influence of dietary protein content in poultry when using the 15N-leucine single-injection method to determine endogenous amino acid losses (EAALs in poultry. Forty-eight cecectomized roosters (2.39 ± 0.23 kg were randomly allocated to eight dietary treatments containing protein levels of 0, 3%, 6%, 9%, 12%, 15%, 18% and 21%. Each bird was precisely fed an experimental diet of 25 g/kg of body weight. After feeding, all roosters were subcutaneously injected with a 15N-leucine solution at a dose of 20 mg/kg of body weight. Blood was sampled 23 h after the injection, and excreta samples were continuously collected during the course of the 48-h experiment. The ratio of 15N-enrichment of leucine in crude mucin to free leucine in plasma ranged from 0.664 to 0.763 and remained relatively consistent (P > 0.05 across all treatments. The amino acid (AA profiles of total endogenous AAs, except isoleucine, alanine, aspartic acid, cysteine, proline and serine, were not influenced (P > 0.05 by dietary protein contents. The predominant endogenous AAs in the excreta were glutamic acid, aspartic acid, threonine, serine and proline. The order of the relative proportions of these predominant AAs also remained relatively constant (P > 0.05. The endogenous losses of total AAs determined with the 15N-leucine single-injection method increased curvilinearly with the dietary protein contents. The true digestibility of most AAs and total AAs was independent of their respective dietary protein levels. Collectively, the 15N-leucine single-injection method is appropriate for determining EAALs and the true digestibility of AAs in poultry fed varying levels of protein-containing ingredients.

  3. Endoscopic treatment of vesicoureteral reflux in children with subureteral dextranomer/hyaluronic acid injection: a single-centre, 7-year experience

    Science.gov (United States)

    Biočíc, Mihovil; Todoríc, Jakov; Budimir, Dražen; Roíc, Andrea Cvitkovíc; Pogorelíc, Zenon; Juríc, Ivo; Šušnjar, Tomislav

    2012-01-01

    Background The goals of medical intervention in patients with vesicoureteral reflux are to allow normal renal growth, prevent infections and pyelonephritis, and prevent renal failure. We present our experience with endoscopic treatment of vesicoureteral reflux in children by subureteral dextranomer/hyaluronic acid copolymer injection. Methods Under cystoscopic guidance, dextranomer/hyaluronic acid copolymer underneath the intravesical portion of the ureter in a subureteral or submucosal location was injected in patients undergoing endoscopic correction of vesicoureteral reflux. Results A total of 282 patients (120 boys and 162 girls) underwent the procedure. There were 396 refluxed ureters altogether. The mean age of patients was 4.9 years. The mean overall follow-up period was 44 months. Among the 396 ureters treated, 76% were cured with a single injection. A second and third injection raised the cure rate to 93% and 94%, respectively. Twenty-two (6%) ureters failed all 3 injections, and were converted to open surgery. Conclusion Endoscopic treatment of vesicoureteral reflux can be recommended as a first-line therapy for most cases of vesicoureteral reflux, because of the short hospital stay, absence of complications and the high success rate. PMID:22854114

  4. Australasian Society for Parenteral and Enteral Nutrition guidelines for supplementation of trace elements during parenteral nutrition.

    Science.gov (United States)

    Osland, Emma J; Ali, Azmat; Isenring, Elizabeth; Ball, Patrick; Davis, Melvyn; Gillanders, Lyn

    2014-01-01

    This work represents the first part of a progressive review of AuSPEN's 1999 Guidelines for Provision of Micronutrient Supplementation in Adult Patients receiving Parenteral Nutrition, in recognition of the developments in the literature on this topic since that time. A systematic literature review was undertaken and recommendations were made based on the available evidence and with consideration to specific elements of the Australian and New Zealand practice environment. The strength of evidence underpinning each recommendation was assessed. External reviewers provided feedback on the guidelines using the AGREE II tool. Reduced doses of manganese, copper, chromium and molybdenum, and an increased dose of selenium are recommended when compared with the 1999 guidelines. Currently the composition of available multi-trace element formulations is recognised as an obstacle to aligning these guidelines with practice. A paucity of available literature and limitations with currently available methods of monitoring trace element status are acknowledged. The currently unknown clinical impact of changes to trace element contamination of parenteral solutions with contemporary practices highlights need for research and clinical vigilance in this area of nutrition support practice. Trace elements are essential and should be provided daily to patients receiving parenteral nutrition. Monitoring is generally only required in longer term parenteral nutrition, however should be determined on an individual basis. Industry is encouraged to modify existing multi-trace element solutions available in Australia and New Zealand to reflect changes in the literature outlined in these guidelines. Areas requiring research are highlighted.

  5. Pharmacokinetics of meloxicam in red-eared slider turtles (Trachemys scripta elegans) after single intravenous and intramuscular injections.

    Science.gov (United States)

    Uney, Kamil; Altan, Feray; Aboubakr, Mohammed; Cetin, Gul; Dik, Burak

    2016-05-01

    OBJECTIVE To determine the pharmacokinetics of meloxicam after single IV and IM injections in red-eared slider turtles (Trachemys scripta elegans). ANIMALS 8 healthy red-eared slider turtles. PROCEDURES Turtles received 1 dose of meloxicam (0.2 mg/kg) IV or IM (4 turtles/route), a 30-day washout period was provided, and then turtles received the same dose by the opposite route. Blood samples were collected at predetermined times for measurement of plasma meloxicam concentration. Pharmacokinetic values for each administration route were determined with a 2-compartment open model approach. RESULTS For IV administration, mean ± SD values of major pharmacokinetic variables were 1.02 ± 0.41 hours for distribution half-life, 9.78 ± 2.23 hours for elimination half-life, 215 ± 32 mL/kg for volume of distribution at steady state, 11.27 ± 1.44 μg•h/mL for area under the plasma concentration versus time curve, and 18.00 ± 2.32 mL/h/kg for total body clearance. For IM administration, mean values were 0.35 ± 0.06 hours for absorption half-life, 0.72 ± 0.06 μg/mL for peak plasma concentration, 1.5 ± 0.0 hours for time to peak concentration, 3.73 ± 2.41 hours for distribution half-life, 13.53 ± 1.95 hours for elimination half-life, 11.33 ± 0.92 μg•h/mL for area under the plasma concentration versus time curve, and 101 ± 6% for bioavailability. No adverse reactions were detected. CONCLUSIONS AND CLINICAL RELEVANCE Long half-life, high bioavailability, and lack of immediate adverse reactions of meloxicam administered IM at 0.2 mg/kg suggested the possibility of safe and effective clinical use in turtles. Additional studies are needed to establish appropriate administration frequency and clinical efficacy.

  6. 10 mJ single-frequency, injection-seeded Q-switched Er:YAG laser pumped by a 1470 nm fiber-coupled LD

    Science.gov (United States)

    Gao, C. Q.; Shi, Y.; Ye, Q.; Wang, S.; Na, Q. X.; Wang, Q.; Gao, M. W.

    2018-02-01

    A 1645 nm injection-seeded Q-switched Er:YAG laser resonantly pumped by a 1470 nm fiber-coupled laser diode is demonstrated with a non-planar ring oscillator as a seed laser to realize the single-frequency operation. The maximum output pulse energy of the laser is 10.1 mJ, corresponding to a pulse width of 205 ns at a repetition rate of 200 Hz. The half-width of the pulse spectrum is 2.44 MHz measured by a heterodyne technique. The fluctuation of the center frequency of the pulsed laser is 1.43 MHz (RMS) in 1 h. To the best of our knowledge, this is highest energy obtained from a single-frequency, injection-seeded Er:YAG laser pumped by a laser diode.

  7. Long-term correction of obesity and diabetes in genetically obese mice by a single intramuscular injection of recombinant adeno-associated virus encoding mouse leptin.

    Science.gov (United States)

    Murphy, J E; Zhou, S; Giese, K; Williams, L T; Escobedo, J A; Dwarki, V J

    1997-12-09

    The ob/ob mouse is genetically deficient in leptin and exhibits a phenotype that includes obesity and non-insulin-dependent diabetes mellitus. This phenotype closely resembles the morbid obesity seen in humans. In this study, we demonstrate that a single intramuscular injection of a recombinant adeno-associated virus (AAV) vector encoding mouse leptin (rAAV-leptin) in ob/ob mice leads to prevention of obesity and diabetes. The treated animals show normalization of metabolic abnormalities including hyperglycemia, insulin resistance, impaired glucose tolerance, and lethargy. The effects of a single injection have lasted through the 6-month course of the study. At all time points measured the circulating levels of leptin in the serum were similar to age-matched control C57 mice. These results demonstrate that maintenance of normal levels of leptin (2-5 ng/ml) in the circulation can prevent both the onset of obesity and associated non-insulin-dependent diabetes. Thus a single injection of a rAAV vector expressing a therapeutic gene can lead to complete and long-term correction of a genetic disorder. Our study demonstrates the long-term correction of a disease caused by a genetic defect and proves the feasibility of using rAAV-based vectors for the treatment of chronic disorders like obesity.

  8. Long-term correction of obesity and diabetes in genetically obese mice by a single intramuscular injection of recombinant adeno-associated virus encoding mouse leptin

    Science.gov (United States)

    Murphy, John E.; Zhou, Shangzhen; Giese, Klaus; Williams, Lewis T.; Escobedo, Jaime A.; Dwarki, Varavani J.

    1997-01-01

    The ob/ob mouse is genetically deficient in leptin and exhibits a phenotype that includes obesity and non-insulin-dependent diabetes melitus. This phenotype closely resembles the morbid obesity seen in humans. In this study, we demonstrate that a single intramuscular injection of a recombinant adeno-associated virus (AAV) vector encoding mouse leptin (rAAV-leptin) in ob/ob mice leads to prevention of obesity and diabetes. The treated animals show normalization of metabolic abnormalities including hyperglycemia, insulin resistance, impaired glucose tolerance, and lethargy. The effects of a single injection have lasted through the 6-month course of the study. At all time points measured the circulating levels of leptin in the serum were similar to age-matched control C57 mice. These results demonstrate that maintenance of normal levels of leptin (2–5 ng/ml) in the circulation can prevent both the onset of obesity and associated non-insulin-dependent diabetes. Thus a single injection of a rAAV vector expressing a therapeutic gene can lead to complete and long-term correction of a genetic disorder. Our study demonstrates the long-term correction of a disease caused by a genetic defect and proves the feasibility of using rAAV-based vectors for the treatment of chronic disorders like obesity. PMID:9391128

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

    Science.gov (United States)

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

    2016-12-01

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

  10. ESPEN Guidelines on Parenteral Nutrition: geriatrics.

    Science.gov (United States)

    Sobotka, L; Schneider, S M; Berner, Y N; Cederholm, T; Krznaric, Z; Shenkin, A; Stanga, Z; Toigo, G; Vandewoude, M; Volkert, D

    2009-08-01

    Older subjects are at increased risk of partial or complete loss of independence due to acute and/or chronic disease and often of concomitant protein caloric malnutrition. Nutritional care and support should be an indispensable part of their management. Enteral nutrition is always the first choice for nutrition support. However, when patients cannot meet their nutritional requirements adequately via the enteral route, parenteral nutrition (PN) is indicated. PN is a safe and effective therapeutic procedure and age per se is not a reason to exclude patients from this treatment. The use of PN should always be balanced against a realistic chance of improvement in the general condition of the patient. Lower glucose tolerance, electrolyte and micronutrient deficiencies and lower fluid tolerance should be assumed in older patients treated by PN. Parenteral nutrition can be administered either via peripheral or central veins. Subcutaneous administration is also a possible solution for basic hydration of moderately dehydrated subjects. In the terminal, demented or dying patient the use of PN or hydration should only be given in accordance with other palliative treatments.

  11. Reliability Analysis of Single-Phase PV Inverters with Reactive Power Injection at Night Considering Mission Profiles

    DEFF Research Database (Denmark)

    Anurag, Anup; Yang, Yongheng; Blaabjerg, Frede

    2015-01-01

    , especially at night when there is no solar irradiance. This serves as a motivation for utilizing the PV inverters at night for reactive power compensation. Thus, an analysis on the impact of reactive power injection by PV inverters outside feed-in operation on the thermal performance and the reliability has...... at night, the impact of PV sites on the economic value of the inverter is assessed. This analysis can be useful in choosing between conventional reactive power compensation devices or PV inverters for injecting reactive power to the grid....

  12. Alterations in pentobarbital pharmacokinetics in response to parenteral and enteral alimentation in the rat.

    Science.gov (United States)

    Knodell, R G; Spector, M H; Brooks, D A; Keller, F X; Kyner, W T

    1980-12-01

    Recent in vitro observations suggest that the intestine, in addition to the liver, may be an important organ of first-pass drug metabolism. While a variety of changes in intestinal morphology and function in response to continuous parenteral and enteral nutrition have been documented, the effect of different routes of alimentation on intestinal drug metabolism has not been previously investigated. Objectives of this study were to assess the contribution of intestinal pentobarbital metabolism to overall in vivo pentobarbital pharmacokinetics in the rat and to determine if differences in pentobarbital pharmacokinetics were seen between parenterally and enterally nourished animals. After 7 days of continuous infusion of amino acid-glucose mixture via a gastric or jugular vein catheter, pharmacokinetic parameters were determined after 40 mg/kg of pentobarbital was given orally or into the portal or femoral vein. Reduced systemic availability of pentobarbital after oral administration as compared to portal vein injection was seen in both alimentation groups indicating that significant intestinal metabolism of pentobarbital occurred in vivo. Total area under the pentobarbital plasma concentration-time curve was significantly greater in parenterally nourished animals as compared with enterally alimented animals after oral, portal vein and systemic vein drug administration. Differences in pentobarbital, pharmacokinetics between the two alimentation groups appeared to be primarly due to effects on hepatic pentobarbital metabolism. While the mechanism producing these changes has not been defined, differences in gut hormones release and/or pancreatic secretion in response to the two routes of alimentation may be contributory. The widespread use of enteral and parenteral alimentation in clinical medicine suggests that studies to determine if nutrition route of administration similarly influences drug metabolism in humans may be indicated.

  13. Watt-level widely tunable single-mode emission by injection-locking of a multimode Fabry-Perot quantum cascade laser

    Science.gov (United States)

    Chevalier, Paul; Piccardo, Marco; Anand, Sajant; Mejia, Enrique A.; Wang, Yongrui; Mansuripur, Tobias S.; Xie, Feng; Lascola, Kevin; Belyanin, Alexey; Capasso, Federico

    2018-02-01

    Free-running Fabry-Perot lasers normally operate in a single-mode regime until the pumping current is increased beyond the single-mode instability threshold, above which they evolve into a multimode state. As a result of this instability, the single-mode operation of these lasers is typically constrained to few percents of their output power range, this being an undesired limitation in spectroscopy applications. In order to expand the span of single-mode operation, we use an optical injection seed generated by an external-cavity single-mode laser source to force the Fabry-Perot quantum cascade laser into a single-mode state in the high current range, where it would otherwise operate in a multimode regime. Utilizing this approach, we achieve single-mode emission at room temperature with a tuning range of 36 cm-1 and stable continuous-wave output power exceeding 1 W at 4.5 μm. Far-field measurements show that a single transverse mode is emitted up to the highest optical power, indicating that the beam properties of the seeded Fabry-Perot laser remain unchanged as compared to free-running operation.

  14. 21 CFR 201.323 - Aluminum in large and small volume parenterals used in total parenteral nutrition.

    Science.gov (United States)

    2010-04-01

    ... accumulate aluminum at levels associated with central nervous system and bone toxicity. Tissue loading may... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Aluminum in large and small volume parenterals... for Specific Drug Products § 201.323 Aluminum in large and small volume parenterals used in total...

  15. Randomised trial of single and repeated fibrin glue compared with injection of polidocanol in treatment of bleeding peptic ulcer

    NARCIS (Netherlands)

    Rutgeerts, P.; Rauws, E.; Wara, P.; Swain, P.; Hoos, A.; Solleder, E.; Halttunen, J.; Dobrilla, G.; Richter, G.; Prassler, R.

    1997-01-01

    Although injection treatments for ulcer haemostasis seem to be effective, recurrent bleeding remains a serious problem. Large randomised clinical trials are required to show differences between treatment modalities for gastrointestinal bleeding. The aim of this study was to compare the safety and

  16. Single well field injection test of humate to enhance attenuation of uranium and other radionuclides in an acidic plume

    Energy Technology Data Exchange (ETDEWEB)

    Denham, M. [Savannah River Site (SRS), Aiken, SC (United States)

    2014-09-30

    This report documents the impact of the injected humate on targeted contaminants over a period of 4 months and suggests it is a viable attenuation-based remedy for uranium, potentially for I-129, but not for Sr-90. Future activities will focus on issues pertinent to scaling the technology to full deployment.

  17. Clinical Evaluation of Non-surgical Sterilization of Male Cats with Single Intra-testicular Injection of Calcium Chloride

    Directory of Open Access Journals (Sweden)

    Samanta Prabhat K

    2011-07-01

    Full Text Available Abstract Background Calcium chloride solution is an established injectable sterilant in dogs and other mammals. With cat populations a continuing problem, we sought to explore its first use in cats. Six cats per group were injected with 5%, 10% or 20% calcium chloride dihydrate in saline solution with lignocaine hydrochloride, a local anaesthetic. Results At the 60th day post-injection, cat testes were collected and showed complete testicular necrosis and replacement by fibrous tissue; very low sperm counts; and reduction of serum testosterone by at least 70% in 20% dose. Androgenic enzyme activities and their expressions were also reduced in all the treated groups along with intra-testicular testosterone concentration was also low. Increased testicular lipid peroxidation, with reduced antioxidants and mitochondrial membrane potential, were evident following calcium chloride treatments. However, there were no apparent changes in serum concentrations of cortisol, fasting blood sugar level, blood urea nitrogen, packed cell volume, or total serum protein following calcium chloride injection, suggesting that this method of sterilization is not associated with any general stress response. Conclusion Calcium chloride solution demonstrates potential for androgenesis-eliminating nonsurgical sterilization of male cats in addition to its proven efficacy in dogs and other mammals.

  18. Tratamento da anemia ferropriva com ferro por via parenteral Iron deficiency anemia treatment with parenteral iron

    Directory of Open Access Journals (Sweden)

    Rodolfo D. Cançado

    2010-06-01

    Full Text Available Embora o ferro por via oral seja considerado a primeira opção de tratamento da deficiência de ferro, em algumas situações específicas, a administração de ferro por via parenteral é uma opção terapêutica que deve ser considerada. Diferentemente do ferro dextran de alto peso molecular utilizado na década de 80 e lembrado como um composto associado ao alto risco de reação anafilática e morte, o desenvolvimento e comercialização de novos compostos com ferro para uso parenteral, sobretudo por via endovenosa - como o ferro sacarato, ferro gluconato e, mais recentemente, a carboximaltose férrica - , tem se tornado cada vez mais uma alternativa terapêutica segura e efetiva, e tem possibilitado ampliar o leque de indicações desta modalidade de tratamento além da nefrologia, como obstetrícia e ginecologia, cirurgia, pediatria, gastroenterologia, hematologia e hemoterapia. Os autores revisam as principais indicações do tratamento com ferro por via parenteral, analisam as principais drogas disponíveis para a correção da anemia ferropriva por via endovenosa e propõem uma estratégia de investigação diagnóstica, tratamento e seguimento laboratorial dos pacientes com indicação desta opção terapêutica.Although oral iron is generally considered the first choice in the treatment of iron deficiency, in some specific situations, parenteral iron administration is a therapeutic option that should be considered. Different to the high-molecular-weight iron dextran utilized in the eighties and remembered as a compound associated with a high risk of anaphylaxis and death, the development and marketing of newer preparations for parenteral, in particular endovenous, administration, such as iron sucrose, ferric gluconate and more recently ferric carboxymaltose, are becoming a more effective and safe therapeutic alternative, that have extended the range of indications beyond nephrology to obstetrics and gynecology, surgery, pediatrics

  19. Safety and effectiveness of a single and repeat intramuscular injection of a GnRH vaccine (GonaCon™) in adult female domestic cats.

    Science.gov (United States)

    Vansandt, L M; Kutzler, M A; Fischer, A E; Morris, K N; Swanson, W F

    2017-04-01

    Sterilization is a key strategy to reduce the number of domestic cats entering and killed in shelters each year. However, surgical sterilization is expensive and labour-intensive and cannot fully address the 70 million free-roaming cats estimated to exist in the United States. GonaCon™ is a gonadotropin-releasing hormone vaccine originally developed for use as a wildlife immunocontraceptive. An earlier formulation was tested in domestic cats and found to be safe and effective for long-term contraception. However, the current Environmental Protection Agency (EPA)-registered formulation consists of a different antigen-carrier protein and increased antigen concentration and has never been tested in cats. A pilot study was undertaken to evaluate the short-term safety of a single GonaCon immunization, assess the consequences of vaccinated cats receiving an accidental second GonaCon injection and determine the humoral immune response to immunization. During Phase 1, cats in Group A (n = 3) received a single intramuscular injection of GonaCon and Group B (n = 3) received a single intramuscular injection of saline. During Phase 2, Group A received a second GonaCon injection and Group B received their initial GonaCon injection. All cats developed GnRH antibodies within 30 days of vaccine administration. The endpoint titre (1:1,024,000) was similar among all cats, and levels remained high throughout the duration of the study. Four cats developed a sterile, painless, self-limiting mass at the site of injection. The mean number of days to mass development was 110.3 (range, 18-249 days). In conclusion, this preliminary study suggests that the EPA-registered GonaCon formulation is safe for continued testing in domestic cats, an accidental revaccination should not increase the risk of a vaccine reaction and the EPA-registered formulation effectively elicits a strong humoral immune response. © 2016 Blackwell Verlag GmbH.

  20. Dynamics of 1.55 μm Wavelength Single-Mode Vertical-Cavity Surface-Emitting Laser Output under External Optical Injection

    Directory of Open Access Journals (Sweden)

    Kyong Hon Kim

    2012-01-01

    Full Text Available We review the temporal dynamics of the laser output spectrum and polarization state of 1.55 μm wavelength single-mode (SM vertical-cavity surface-emitting lasers (VCSELs induced by external optical beam injection. Injection of an external continuous-wave laser beam to a gain-switched SM VCSEL near the resonance wavelength corresponding to its main polarization-mode output was critical for improvement of its laser pulse generation characteristics, such as pulse timing-jitter reduction, linewidth narrowing, pulse amplitude enhancement, and pulse width shortening. Pulse injection of pulse width shorter than the cavity photon lifetime into the SM VCSEL in the orthogonal polarization direction with respect to its main polarization mode caused temporal delay of the polarization recovery after polarization switching (PS, and its delay was found to be the minimum at an optimized bias current. Polarization-mode bistability was observed even in the laser output of an SM VCSEL of a standard circularly cylindrical shape and used for all-optical flip-flop operations with set and reset injection pulses of very low pulse energy of order of the 3.5~4.5 fJ.

  1. Elimination of Mange Mites Sarcoptes scabiei var. suis from Two Naturally Infested Danish Sow Herds Using a Single Injection Regime with Doramectin

    Science.gov (United States)

    Jensen, JCE; Nielsen, LH; Arnason, T; Cracknell, V

    2002-01-01

    Attempts to eliminate Sarcoptes scabiei var. suis were made in 2 naturally infested sow herds, by intramuscular (IM) injection of doramectin (Dectomax®, Pfizer, New York, USA). A single injection strategy was used. In one of the herds, the environment was treated with an acaricide following dry cleaning of floors, walls and equipment. In the second herd, no environmental treatment was performed. Results were measured by skin lesion scoring, ear scrapings to show Sarcoptes scabiei var. suis, and calculating rubbing index throughout the observation period of 20 months following treatment. Skin lesion scores decreased and stayed low following treatment for the entire observation period. Live Sarcoptes scabiei var. suis mites were isolated prior to treatment from both herds, but not following treatment. Rubbing index decreased following treatment, but was occasionally at or above 0.4. The results of these studies indicate that elimination of Sarcoptes scabiei var. suis from 2 naturally infested herds was successful, using doramectin in a single injection strategy. Precautions must be taken to ensure adequate dosing of every pig, and to avoid reinfestation due to poor biosecurity. PMID:12173505

  2. Elimination of Mange Mites Sarcoptes scabiei var. suis from Two Naturally Infested Danish Sow Herds Using a Single Injection Regime with Doramectin

    Directory of Open Access Journals (Sweden)

    Arnason T

    2002-06-01

    Full Text Available Attempts to eliminate Sarcoptes scabiei var. suis were made in 2 naturally infested sow herds, by intramuscular (IM injection of doramectin (Dectomax®, Pfizer, New York, USA. A single injection strategy was used. In one of the herds, the environment was treated with an acaricide following dry cleaning of floors, walls and equipment. In the second herd, no environmental treatment was performed. Results were measured by skin lesion scoring, ear scrapings to show Sarcoptes scabiei var. suis, and calculating rubbing index throughout the observation period of 20 months following treatment. Skin lesion scores decreased and stayed low following treatment for the entire observation period. Live Sarcoptes scabiei var. suis mites were isolated prior to treatment from both herds, but not following treatment. Rubbing index decreased following treatment, but was occasionally at or above 0.4. The results of these studies indicate that elimination of Sarcoptes scabiei var. suis from 2 naturally infested herds was successful, using doramectin in a single injection strategy. Precautions must be taken to ensure adequate dosing of every pig, and to avoid reinfestation due to poor biosecurity.

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

    Science.gov (United States)

    Ramreddy, Srividya; Kandadi, Prabhakar; Veerabrahma, Kishan

    2012-01-01

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

  4. Evaluation of repeated exposure systemic toxicity test of PVC with new plasticizer on rats via dual parenteral routes.

    Science.gov (United States)

    Hou, Li; Fan, Chunguang; Liu, Chenghu; Qu, Qiujin; Wang, Chunren; Shi, Yanping

    2018-02-01

    Systemic toxicity caused by repeated exposure to both polar and nonpolar leachables of di(2-ethylhexyl)-1,2-cyclohexane plasticized polyvinyl chloride (PVC) was evaluated with dual routes of parenteral administration method on rats in the study. Experimental group and control group were designed by researchers. Tail intravenous injection with 0.9% sodium chloride injection extracts and intraperitoneal injection with corn oil extracts were conducted to the experimental rats while tail intravenous injection with 0.9% sodium chloride Injection and intraperitoneal injection with corn oil were conducted to the control rats. After 14 days, blood specimens were collected for clinical pathology (hematology and clinical chemistry) analysis. Selected organs were weighed and a histopathological examination was conducted. As a result, compared with the control animals, there were no toxicity-related changes on the parameters above. The results show that the rats do not show obvious systemic toxicity reaction caused by repeated exposure with dual routes of parenteral administration method on rats after administration with both polar and nonpolar exacts of di(2-ethylhexyl)-1,2-cyclohexane plasticized PVC simultaneously up for 14 days.

  5. Micronutrientes en nutrición parenteral Micronutrients in parenteral nutrition

    OpenAIRE

    A. García de Lorenzo; J. Álvarez; T. Bermejo; P. Gomis; G. Piñeiro

    2009-01-01

    En un debate multidisciplinar, y tras revisar la evidencia disponible así como la experiencia de los expertos, la IV Mesa de Trabajo Baxter-SENPE establece las indicaciones y pautas de manejo de los micronutrientes (vitaminas hidrosolubles y liposolubles y oligoelementos o elementos traza) en la Nutrición Parenteral. Se concluye en la conveniencia del aporte diario de micronutrientes contemplándose diferentes posibilidades en lo que respecta a dosis por exceso y defecto, sistemas de administr...

  6. Rapid Quantitative Analysis of Multiple Explosive-Compound Classes on a Single Instrument via Flow-Injection Analysis Tandem Mass Spectrometry

    Science.gov (United States)

    2017-03-20

    on a Single In‐ strument via Flow‐Injection Analysis Tandem Mass  Spectrometry   Alla Ostrinskaya, Roderick R. Kunz, Michelle Clark, Rich P...alla.ostrinskaya@ll.mit.edu    ABSTRACT: A flow injection analysis (FIA) tandem mass spectrometry (MSMS) method was developed for rapid quantita- tive analysis of...and has redundant detection channels for reduced  error   rates necessary  for probative use,  (b)  is more  rapid  than existing methods to allow for

  7. The comparison of knee osteoarthritis treatment with single-dose bone marrow-derived mononuclear cells vs. hyaluronic acid injections

    Directory of Open Access Journals (Sweden)

    Valdis Goncars

    2017-01-01

    Conclusions: The intra-articular injection of bone marrow-derived mononuclear cells is a safe manipulation with no side effects during the 12-month period. This treatment provides statistically significant clinical improvement between the starting point and 1, 3, 6, and 12 months after. When compared to hyaluronic acid treatment, better pain relief in the long-term period of mononuclear cell group was observed.

  8. Bee venom acupuncture point injection for central post stroke pain: a preliminary single-blind randomized controlled trial.

    Science.gov (United States)

    Cho, Seung-Yeon; Park, Joo-Young; Jung, Woo-Sang; Moon, Sang-Kwan; Park, Jung-Mi; Ko, Chang-Nam; Park, Seong-Uk

    2013-06-01

    We investigated apipuncture, or acupuncture point injection with diluted bee venom, as a promising new treatment for central post stroke pain (CPSP). Bee venom, diluted to 0.005% in normal saline, was administered to the treatment group, and normal saline given to control group as twice-weekly injections for three weeks. The points were LI15, GB21, LI11, GB31, ST36 and GB39 of the affected side and the amount of injection was 0.05 ml at each point. Eight patients in each group were included in the analysis. After three weeks there were significant decreases in visual analogue pain scores compared with baseline in both groups and the treatment group improved more significantly than the control group (p = 0.009). Apipuncture significantly improved CPSP in this pilot trial. Further studies of its mechanisms and a larger and long-term follow-up trial will be needed to determine more definitely the efficacy of apipuncture and to elucidate duration of improvement. Copyright © 2013 Elsevier Ltd. All rights reserved.

  9. High-power actively Q-switched single-mode 1342 nm Nd:YVO4 ring laser, injection-locked by a cw single-frequency microchip laser.

    Science.gov (United States)

    Koch, Peter; Bartschke, Juergen; L'huillier, Johannes A

    2015-11-30

    In this paper we report on the realization of a single-mode Q-switched Nd:YVO4 ring laser at 1342 nm. Unidirectional and single-mode operation of the ring laser is achieved by injection-locking with a continuous wave Nd:YVO4 microchip laser, emitting a single-frequency power of up to 40 mW. The ring laser provides a single-mode power of 13.9 W at 10 kHz pulse repetition frequency with a pulse duration of 18.2 ns and an excellent beam quality (M2 laser, a power of 8.7 W at 671 nm with a pulse duration of 14.8 ns and a beam propagation factor of M2 < 1.1 is obtained. The 671 nm radiation features a long-term spectral width of 75 MHz.

  10. Evaluation of Plasma Creatine Phosphokinase (CPK Level Following a Single Injection of Methotrexate as a Predicator of Treatment Success in Ectopic Pregnancy.

    Directory of Open Access Journals (Sweden)

    Leila Safdarian

    2013-12-01

    Full Text Available To evaluate the plasma creatine phosphokinase (CPK level after a single injection of methotrexate (MTX as a predictor of treatment success in ectopic pregnancy (EP.In this prospective study, seventy nine women older than 18 years treated with methotrexate for ectopic pregnancy were evaluated for CPK and β-subunit of human chorionic gonadotropin (βhCG levels, while they received intramuscular MTX at a dose of 50 mg/m2. The day of injection was considered as day 1 (D1. CPK level on D1 was compared between the group 1(as treatment success group, treated by a single MTX injection, and the group 2, treated by two or three MTX injections or by surgery.The success rate of MTX treatment was 58 (73.3%. The mean of CPK was higher in treatment success group (group1 than failure group (group 2 (71.98 ± 15.711 vs. 64.43 ± 15.898, but the difference was not significant (p=0.06. The mean of βhCG was significantly lower in treatment success group (group 1 than failure group (group 2 (1187.52±631.45 vs. 1663.87±1096.845; p=0.01. Ultrasonographic findings of EP were seen in 63 patients, while the means of βHCG and CPK were higher in these patients than those with normal ultrasonography, but difference was not significant (p=0.37 and p=0.24, respectively.The sample was not large enough to indicate a significant difference in the CPK level, which can be considered as an indicator for differentiating between the successful and unsuccessful treatment groups. Moreover, the present study did not show any relation between initial β-hCG and CPK serum levels, so our findings indicate that they are not possibly considered as two independent biomarkers in ectopic pregnancy.

  11. Neonatal parenteral nutrition: Review of the pharmacist role as a prescriber.

    Science.gov (United States)

    Ragab, Mohamed H; Al-Hindi, Mohammed Y; Alrayees, Meshari M

    2016-07-01

    In the context of the continuous quest to improve the care of the neonates especially the critically ill premature infants, the extended role of pharmacists in the process of parenteral nutrition order writing and effective participation in decision-making especially in the neonatal population is increasingly important. This review aims to present results from the literature review of available evidence on the pharmacist role in neonatal parenteral nutrition therapy. Key medical, clinical, and review databases were searched; relevant articles were retrieved and evaluated. A total of 19 papers out of 7127 searched papers met the criteria for inclusion, discussing the review topic. The main focus of the selected papers was on parenteral nutrition practice as related to the pharmacy practice. The overall quality of studies was mixed. Overall, the review presents the up-to-date status of the most recent analysis being undertaken on the topic of pharmacist involvement in the parenteral nutrition order writing practices and more specific in the neonatal population over the period from 1979 to 2013. The overall impression is that the practice of pharmacist writing neonatal parenteral nutrition orders already exists, but still limited if compared with the practice of pharmacist writing adult parenteral nutrition orders which is much more established in many countries. There was no single clinical study evaluating this practice, as we were able to retrieve only two surveys, which make it difficult to evaluate the pharmacist role in this area. Nevertheless, despite the wide variation in literature types, characteristics and quality, there are consistent patterns across all the reviewed literatures that competencies of the pharmacist in this field are well represented, which make it very important to carry out good quality clinical studies in this field. Finally, we are currently conducting a prospective clinical study to evaluate the impact of clinical pharmacist as a

  12. 21 CFR 310.509 - Parenteral drug products in plastic containers.

    Science.gov (United States)

    2010-04-01

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

  13. Identification and weighting factors influencing the establishment of a single minute exchange of dies in plastic injection industry using VIKOR and Shannon Entropy

    Directory of Open Access Journals (Sweden)

    Gholam Reza Hashemzadeh

    2014-05-01

    Full Text Available Single minute exchange of dies (SMED is one of the most important tools to achieve lean production system. The main idea of this system is to provide methods and to use creative and innovative solutions for continuous improvement. Due to the importance of this issue and its effect on reducing waste during the production process, this study presents a method to identify and to weight factors in the establishment of a single minute exchange of dies in 14 plastic injection factories. In this study, fourteen factories in injection industry were chosen and the factors influencing the implementation of single minute exchange of dies were identified. Following data collection, decision matrix was formed and the weight of each factor was determined by using Shannon Entropy. Then, in order to determine the readiness of factories, VIKOR method was used to rank companies. The results indicate priorities of the following factors in establishing SMED that include: Senior management support, technical capabilities, technical knowledge of staff and consultants, knowledge of mold design, manufacturing infrastructure, team work, combination of the project team work, benchmarking, training, clear understanding of project objectives, rewards and motivation, proper management expectation, project management, teamwork and organizational culture. Practical implications: Due to the factors, Top manager can make the best decision for implementing of SMED technique. This study develops factors influencing on SMED implementation based on Shannon and VIKOR methods for ranking parameters and plants.

  14. Single-injection method for evaluation of renal function with 14C-inulin and 3H-tetraethylammonium bromide in dogs and cats

    International Nuclear Information System (INIS)

    Fettman, M.J.; Allen, T.A.; Wilke, W.L.; Radin, M.J.; Eubank, M.C.

    1985-01-01

    A double-isotope single-injection method without urine collection for the estimation of glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) in dogs and cats was evaluated. The GFR was determined, using 14 C-inulin and ERPF was determined, using [ 3 H]tetraethylammonium bromide. Using a modified single exponential, 1-compartment mathematical model, the renal clearance of these solutes was estimated with a plasma radioactivity disappearance curve constructed from samples collected over a 150-minute time period. In 25 dogs, GFR, ERPF, and filtration fraction were 3.55 +/- 0.14 ml/kg/min, 10.51 +/- 0.72 ml/kg/min, and 0.34 +/- 0.02, respectively. In 25 cats, GFR, ERPF, and filtration fraction were 3.24 +/- 0.14 ml/kg/min, 8.14 +/- 0.53 ml/kg/min, and 0.39 +/- 0.02, respectively. This time-efficient and reliable method, using beta-emitting isotopes, yielded renal functional values well within the normal ranges reported by a variety of other isotopic and nonisotopic procedures. The advantages of the present procedure over previous double-isotope single-injection methods include the use of less costly, lower energy-using, and less penetrating beta emittors, as well as a shortened blood sampling schedule

  15. Pharmacokinetics of a single intramuscular injection of ceftiofur crystalline-free acid in red-tailed hawks (Buteo jamaicensis).

    Science.gov (United States)

    Sadar, Miranda J; Hawkins, Michelle G; Byrne, Barbara A; Cartoceti, Andrew N; Keel, Kevin; Drazenovich, Tracy L; Tell, Lisa A

    2015-12-01

    To determine the pharmacokinetics and adverse effects at the injection site of ceftiofur crystalline-free acid (CCFA) following IM administration of 1 dose to red-tailed hawks (Buteo jamaicensis). 7 adult nonreleasable healthy red-tailed hawks. In a randomized crossover study, CCFA (10 or 20 mg/kg) was administered IM to each hawk and blood samples were obtained. After a 2-month washout period, administration was repeated with the opposite dose. Muscle biopsy specimens were collected from the injection site 10 days after each sample collection period. Pharmacokinetic data were calculated. Minimum inhibitory concentrations of ceftiofur for various bacterial isolates were assessed. Mean peak plasma concentrations of ceftiofur-free acid equivalent were 6.8 and 15.1 μg/mL for the 10 and 20 mg/kg doses, respectively. Mean times to maximum plasma concentration were 6.4 and 6.7 hours, and mean terminal half-lives were 29 and 50 hours, respectively. Little to no muscle inflammation was identified. On the basis of a target MIC of 1 μg/mL and target plasma ceftiofur concentration of 4 μg/mL, dose administration frequencies for infections with gram-negative and gram-positive organisms were estimated as every 36 and 45 hours for the 10 mg/kg dose and every 96 and 120 hours for the 20 mg/kg dose, respectively. Study results suggested that CCFA could be administered IM to red-tailed hawks at 10 or 20 mg/kg to treat infections with ceftiofur-susceptible bacteria. Administration resulted in little to no inflammation at the injection site. Additional studies are needed to evaluate effects of repeated CCFA administration.

  16. Development of etoposide-loaded bovine serum albumin nanosuspensions for parenteral delivery.

    Science.gov (United States)

    Wang, Zhonglan; Li, Zhongwen; Zhang, Dong; Miao, Lei; Huang, Guihua

    2015-01-01

    Nanosuspensions emerge as a promising strategy for delivery of poorly water-soluble drugs. Albumin is a versatile protein carrier for drug delivery and targeting. The purpose of this study was to develop a formulation of etoposide-loaded bovine serum albumin (BSA) nanosuspensions, to study in vitro characterization, and to estimate the in vivo safety and tissue distribution of etoposide-loaded BSA nanosuspensions for parenteral delivery. Etoposide-loaded BSA nanosuspensions were prepared by high-pressure homogenization-solvent precipitation method. The particle size, zeta potential, drug entrapment efficiency, and drug loading of the lyophilized formulation were 182.3 nm, -22.18 mV, 86.44%, and 8.49% respectively. In vitro release files of the formulation presented sustained release properties. Preliminary safety study was conducted to evaluate the delivery system, and results indicated that myelosuppression effect of the etoposide-loaded BSA nanosuspensions group was significantly lower than the Injection® group. Furthermore, results of tissue distribution studies showed that the concentration and AUC of etoposide were increased significantly in lung, liver, spleen while reduced in heart, kidney compared with the etoposide injection® group after i.v. administration of etoposide-loaded BSA nanosuspensions. The formulation played a role in targeting delivery to lung, reduce toxicity, and side effects of etoposide. In conclusion, etoposide-loaded BSA nanosuspensions were promising for parenteral delivery of etoposide.

  17. Effect of Pilot Injection Timings on the Combustion Temperature Distribution in a Single-Cylinder CI Engine Fueled with DME and ULSD

    Directory of Open Access Journals (Sweden)

    Jeon Joonho

    2016-01-01

    Full Text Available Many studies of DiMethyl Ether (DME as an alternative fuel in Compression-Ignition (CI engines have been performed. Although diverse DME engine research has been conducted, the investigation of combustion behavior and temperature distribution in the combustion engine has not progressed due to the fact that there is no sooting flame in DME combustion. In order to investigate the combustion characteristics in this study, the KIVA-3 V code was implemented to research various pilot injection strategies on a single-cylinder CI engines with DME and Ultra-Low-Sulfur Diesel (ULSD fuels. The combustion distribution results obtained from the numerical investigation were validated when compared with the measurement of flame temperature behaviors in the experimental approach. This study showed that long intervals between two injection timings enhanced pilot combustion by increasing the ambient pressure and temperature before the start of the main combustion. Different atomization properties between DME and ULSD fuels contributed to the formation of a fuel-air mixture at the nozzle tip and piston lip regions, separately, which strongly affected the temperature distribution of the two fuels. In addition, the pilot injection timing played a vital role in regard to ignition delay and peak combustion temperatures. Exhaust emissions, such as NOx and soot, are related to the local equivalence ratio and temperature in the combustion chamber, also illustrated by the contrary result on a Φ (equivalence ratio – T (temperature map.

  18. Tritium retention in the femoral bone marrow and spleens of mice receiving single intravenous injections of tritiated water and tritiated thymidine

    International Nuclear Information System (INIS)

    Joshima, Hisamasa; Matsushita, Satoru; Fukutsu, Kumiko; Kashima, Masatoshi

    1987-01-01

    To derive parameters necessary for evaluating the possible hazards of tritium, retention of tritium in total and TCA-insoluble fractions of the femoral marrow and spleen of mice were observed after single intravenous injections of tritiated water and tritiated thymidine. Retention curves of tritium in TCA-insoluble fractions of the femoral marrow and spleen were resolved fairly well into two exponential components. After injecting tritiated thymidine, most of the activity was detected in the TCA-insoluble fraction. Tritium in this fraction decreased with half-times of 2.2 days in the femoral marrow and 3.6 days in the spleen as the first component, and 23.9 days and 30.5 days, respectively, as the second component. After tritiated water injections, the tritium incorporated into the TCA-insoluble fraction was quite small. Most of the activity was considered to be in the TCA-soluble fraction. Tritium in this fraction was estimated to decrease with half-times of 2.6 days in the femoral marrow and 2.3 days in the spleen as the first component, and 8.0 days and 8.2 days, respectively, as the second component. It is concluded that the retention curves of tritium in the bone marrow are similar to those in the spleen for tritiated water, but not for tritiated thymidine. (author)

  19. Short-term parenteral and peroral testosterone administration in men with alcoholic cirrhosis

    DEFF Research Database (Denmark)

    Gluud, C; Bennett, Patrick; Dietrichson, O

    1981-01-01

    Serum concentrations of testosterone were measured in 24 male patients with alcoholic cirrhosis during testosterone administration. The purpose was to compare serum concentrations of testosterone during peroral with those during parenteral testosterone administration in these patients. Patients who...... were injected intramuscularly with a combination of short- and long-acting testosterone (Triolandren, 348 mg testosterone) had median peak values of serum testosterone of about 40 ng/ml, which fell to basal levels after a fortnight. During testosterone propionate injections (84 mg testosterone) every...... other day, rather constant serum concentrations with median values of about 30 ng/ml were reached after 4 days. Peroral testosterone administration (800 mg micronized free testosterone) each day also resulted in fairly constant serum concentrations after 4 days, and the median values were about 50 ng...

  20. Parenteral midazolam is superior to diazepam for treatment of prehospital seizures.

    Science.gov (United States)

    Clemency, Brian M; Ott, Jamie A; Tanski, Christopher T; Bart, Joseph A; Lindstrom, Heather A

    2015-01-01

    Diazepam and midazolam are commonly used by paramedics to treat seizures. A period of drug scarcity was used as an opportunity to compare their effectiveness in treating prehospital seizures. A retrospective chart review of a single, large, commercial agency during a 29-month period was performed. The period included alternating shortages of both medications. Ambulances were stocked with either diazepam or midazolam based on availability of the drugs. Adult patients who received at least 1 parenteral dose of diazepam or midazolam for treatment of seizures were included. The regional prehospital protocol recommended 5 mg intravenous (IV) diazepam, 5 mg intramuscular (IM) diazepam, 5 mg IM midazolam, or 2.5 mg IV midazolam. Medication effectiveness was compared with respect to the primary end point: cessation of seizure without repeat seizure during the prehospital encounter. A total of 440 study subjects received 577 administrations of diazepam or midazolam and met the study criteria. The subjects were 52% male, with a mean age of 48 (range 18-94) years. A total of 237 subjects received 329 doses of diazepam, 64 (27%) were treated with first-dose IM. A total of 203 subjects received 248 doses of midazolam; 71 (35%) were treated with first-dose IM. Seizure stopped and did not recur in 49% of subjects after parenteral diazepam and 65% of subjects after parenteral midazolam (p = 0.002). Diazepam and midazolam exhibited similar first dose success for IV administration (58 vs. 62%; p = 0.294). Age, gender, seizure history, hypoglycemia, the presence of trauma, time to first administration, prehospital contact time, and frequency of IM administration were similar between groups. For parenteral administration, midazolam demonstrated superior first-dose seizure suppression. This study demonstrates how periods of drug scarcity can be utilized to study prehospital medication effectiveness.

  1. A single intracoronary injection of midkine reduces ischemia/reperfusion injury in swine hearts: a novel therapeutic approach for acute coronary syndrome

    Directory of Open Access Journals (Sweden)

    Hisaaki eIshiguro

    2011-06-01

    Full Text Available Several growth factors are effective for salvaging myocardium and limiting infarct size in experimental studies with small animals. Their benefit in large animals and feasibility in clinical practice remains to be elucidated. We investigate the cardioprotective effect of midkine (MK in swine subjected to ischemia/reperfusion (I/R. I/R was created in swine by left anterior descending coronary artery occlusion for 45 min using a percutaneous over-the-wire balloon catheter. MK protein was injected as a bolus through the catheter at the initiation of reperfusion (midkine injected group; MKT. Saline was injected in controls (CONT. Survival rate 24h after I/R was significantly higher in MKT than in CONT, whereas infarct size/area at risk was almost 5 times smaller. Echocardiography in MKT revealed a significantly higher percent wall thickening of the interventricular septum, a higher % fractional shortening and a lower E/e’ compared with CONT. LV catheterization in MKT showed a lower LVEDP, and a higher dP/dtmax compared with CONT. TUNEL-positive myocytes and CD45-positive cell infiltration in the peri-infarct area were significantly less in MKT than in CONT. Here, we showed that a single intracoronary injection of MK protein in swine hearts at the onset of reperfusion dramatically reduces infarct size and mortality and ameliorates systolic/diastolic LV function. This beneficial effect is associated with a reduction of apoptotic and inflammatory reactions. MK application during percutaneous coronary intervention may become a promising adjunctive therapy in acute coronary syndromes.

  2. Parenteral administration medicines: recommendations of preparation, administration and stability

    OpenAIRE

    M. Gaspar Carreño; F. Torrico Martín; L. Novajarque Sala; M. Batista Cruz; P. Ribeiro Gonçalves; B. Porta Oltra; J. C. Sánchez Santos

    2014-01-01

    Objective: To develop recommendations for the preparation of parenteral drugs (MAP), to assess the transferability of their preparation, from nursing units in the hospital ward to the pharmacy service (SF). Method: A table of stabilities of parenteral drugs included in the pharmacotherapeutic guideline was developed using the american and spanish guidelines. Information about MAP was collected (method of preparation, support, maintenance, validity, administration specifications and packaging...

  3. A randomised non-inferiority controlled trial of a single versus a four intradermal sterile water injection technique for relief of continuous lower back pain during labour

    Directory of Open Access Journals (Sweden)

    Webster Joan

    2011-03-01

    Full Text Available Abstract Background Almost one third of women suffer continuous lower back pain during labour. Evidence from three systematic reviews demonstrates that sterile water injections (SWI provide statistically and clinically significant pain relief in women experiencing continuous lower back pain during labour. The most effective technique to administer SWI is yet to be determined. Therefore, the aim of this study is to determine if the single injection SWI technique is no less effective than the routinely used four injection SWI method in reducing continuous lower back pain during labour. Methods/design The trial protocol was developed in consultation with an interdisciplinary team of clinical researchers. We aim to recruit 319 women presenting at term, seeking analgesia for continuous severe lower back pain during labour. Participants will be recruited from two major maternity hospitals in Australia. Randomised participants are allocated to receive a four or single intradermal needle SWI technique. The primary outcome is the change in self-reported pain measured by visual analogue scale at baseline and thirty minutes post intervention. Secondary outcomes include VAS change scores at 10, 60, 90 and 120 min, analgesia use, mode of birth and maternal satisfaction. Statistical analysis Sample size was calculated to achieve 90% power at an alpha of 0.025 to detect a non-inferiority margin of ≤ 1 cm on the VAS, using a one-sided, two-sample t-test. Baseline demographic and clinical characteristics will be analysed for comparability between groups. Differences in primary (VAS pain score and secondary outcomes between groups will be analysed by intention to treat and per protocol analysis using Student's t-test and ANOVA. Conclusion This study will determine if a single intradermal SWI technique is no less effective than the routinely used four injection technique for lower back pain during labour. The findings will allow midwives to offer women

  4. Quantitative analysis of fragrance in selectable one dimensional or two dimensional gas chromatography-mass spectrometry with simultaneous detection of multiple detectors in single injection.

    Science.gov (United States)

    Tan, Hui Peng; Wan, Tow Shi; Min, Christina Liew Shu; Osborne, Murray; Ng, Khim Hui

    2014-03-14

    A selectable one-dimensional ((1)D) or two-dimensional ((2)D) gas chromatography-mass spectrometry (GC-MS) system coupled with flame ionization detector (FID) and olfactory detection port (ODP) was employed in this study to analyze perfume oil and fragrance in shower gel. A split/splitless (SSL) injector and a programmable temperature vaporization (PTV) injector are connected via a 2-way splitter of capillary flow technology (CFT) in this selectable (1)D/(2)D GC-MS/FID/ODP system to facilitate liquid sample injections and thermal desorption (TD) for stir bar sorptive extraction (SBSE) technique, respectively. The dual-linked injectors set-up enable the use of two different injector ports (one at a time) in single sequence run without having to relocate the (1)D capillary column from one inlet to another. Target analytes were separated in (1)D GC-MS/FID/ODP and followed by further separation of co-elution mixture from (1)D in (2)D GC-MS/FID/ODP in single injection without any instrumental reconfiguration. A (1)D/(2)D quantitative analysis method was developed and validated for its repeatability - tR; calculated linear retention indices (LRI); response ratio in both MS and FID signal, limit of detection (LOD), limit of quantitation (LOQ), as well as linearity over a concentration range. The method was successfully applied in quantitative analysis of perfume solution at different concentration level (RSD≤0.01%, n=5) and shower gel spiked with perfume at different dosages (RSD≤0.04%, n=5) with good recovery (96-103% for SSL injection; 94-107% for stir bar sorptive extraction-thermal desorption (SBSE-TD). Copyright © 2014 Elsevier B.V. All rights reserved.

  5. Effects of parenteral phosphorus dose restriction in preterm infants.

    Science.gov (United States)

    McNelis, K; Viswanathan, S

    2016-06-22

    In response to a national shortage of parenteral phosphorus solutions (2013), a hospital-wide phosphorus dose restriction strategies was implemented which included judicious use of phosphorus in preterm infants birth weight and no parenteral phosphorus in preterm infants >1250 g birth weight unless they have a critically low phosphorus level. To study the effect of parenteral phosphorus dose restriction in preterm infants admitted to the neonatal intensive care unit. Preterm infants (≤35 weeks birth gestation and ≤2500 g birth weight) who received parenteral nutrition, survived >1 week and had no major congenital anomalies were studied. Clinical and laboratory data in the first 4 weeks of life of infants admitted during the parenteral phosphorus shortage (cases) were compared to infants who were admitted 6 months prior to the shortage (controls). Twenty consecutive cases were compared to 40 consecutive controls. Cases had lower serum phosphorus levels, higher serum alkaline phosphatase levels, and need for greater inotropic support compared to controls. These differences were significant only in preterm infants with birth weight >1250 g, the group who received more parenteral phosphorus dose restriction while they were similar in preterm infants with birth weight <1250 g. The modest effects of phosphorus dose restriction may become more clinically important if shortage is prolonged or severe or if it involves extreme preterm infants.

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

    Science.gov (United States)

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

    2004-03-01

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

  7. A single-dose, open-label, parallel, randomized, dose-proportionality study of paliperidone after intramuscular injections of paliperidone palmitate in the deltoid or gluteal muscle in patients with schizophrenia.

    Science.gov (United States)

    Cleton, Adriaan; Rossenu, Stefaan; Crauwels, Herta; Berwaerts, Joris; Hough, David; Gopal, Srihari; Eerdekens, Marielle; Vandebosch, An; Remmerie, Bart; De Meulder, Marc; Rosso, Clara M

    2014-09-01

    Paliperidone palmitate (PP) is a long-acting injectable (LAI) antipsychotic, developed for monthly intramuscular (i.m.) administration into deltoid/gluteal muscle, approved for the treatment of schizophrenia in many countries. To assess the options for i.m. injection sites, dose-proportionality of PP was investigated after injection of a single dose (25-150 mg eq.) of PP in either gluteal (n = 106) or deltoid (n = 95) muscle of schizophrenic patients. Overall, mean (geometric) area under plasma concentration-time curve from time zero to infinity (AUC∞ ) of paliperidone increased proportionally with increasing PP doses, regardless of injection site. Mean maximum plasma concentration (Cmax ) was slightly less than dose-proportional for both injection sites at PP doses >50 mg eq. Mean Cmax was higher after injection in the deltoid compared with the gluteal muscle, except for the 100 mg eq. dose, while AUC∞ for both injection sites was comparable at all doses. Median time to reach Cmax (tmax ) ranged from 13-14 days after deltoid and 13-17 days after gluteal injection across all doses. Single PP injections in deltoid and gluteal muscles in the dose range of 25-150 mg eq. were generally tolerable both locally and systemically. © 2014, The American College of Clinical Pharmacology.

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

    Directory of Open Access Journals (Sweden)

    José Geraldo Speciali

    1971-09-01

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

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

    DEFF Research Database (Denmark)

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

    2009-01-01

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

  10. O papel da enfermagem na administração do ferro por via parenteral The role of nurses in parenteral iron administration

    Directory of Open Access Journals (Sweden)

    Ana Elizabeth P. L. Figueiredo

    2010-06-01

    Full Text Available Este artigo tem como objetivo descrever os cuidados de enfermagem na administração de ferro parenteral intramuscular e endovenoso. A escolha da apresentação de ferro a ser usada depende da tolerabilidade do paciente. A administração de um medicamento por via intramuscular ou endovenosa envolve mais do que a injeção de uma solução no interior da massa muscular ou veia, mas também uma avaliação sobre a melhor região e músculo a ser selecionado. Tal procedimento deve ser realizado por pessoas que possuam conhecimentos sobre os aspectos fundamentais de sua execução, ou seja, a equipe de enfermagem. Isso requer conhecimentos de farmacologia relacionados ao tipo da droga, mecanismos de ação, excreção, atuação nos sistemas orgânicos, além de conhecimentos de semiologia e semiotécnica, e avaliação clínica do estado de saúde do paciente.This article aims at describing nursing care with the intramuscular and intravenous administration of parenteral iron. The choice of the type of iron to be used depends on the tolerability of the patient. The intramuscular or intravenous administration of a medicine involves more than just the injection of a solution inside the muscle mass or vein, an evaluation of the best site for the injection must also be considered. This procedure must be carried out by a professional with knowledge on the basic aspects of administration, that is, the nursing team. It requires knowledge of the pharmacology of the drug type, mechanisms of action, excretion and performance in organic systems, as well as knowledge of the clinical evaluation of the patient's state of health.

  11. Should pediatric parenteral nutrition be individualized?

    Directory of Open Access Journals (Sweden)

    Renata Germano Borges de Oliveira Nascimento Freitas

    2014-12-01

    Full Text Available INTRODUCTION: Parenteral nutrition (PN formulations are commonly individualized, since their standardization appears inadequate for the pediatric population. This study aimed to evaluate the nutritional state and the reasons for PN individualization in pediatric patients using PN, hospitalized in a tertiary hospital in Campinas, São Paulo.METHODS: This longitudinal study comprised patients using PN followed by up to 67 days. Nutritional status was classified according to the criteria established by the World Health Organization (WHO (2006 and WHO (2007. The levels of the following elements in blood were analyzed: sodium, potassium, ionized calcium, chloride, magnesium, inorganic phosphorus, and triglycerides (TGL. Among the criteria for individualization, the following were considered undeniable: significant reduction in blood levels of potassium (<3mEq/L, sodium (<125mEq/L, magnesium (<1mEq/L, phosphorus (<1.5mEq/L, ionic calcium (<1mmol, and chloride (<90mEq/L, or any value above the references.RESULTS: Twelve pediatric patients aged 1 month to 15 years were studied (49 individualizations. Most patients were classified as malnourished. It was observed that 74/254 (29.2% of examinations demanded individualized PN for indubitable reasons.CONCLUSION: The nutritional state of patients was considered critical in most cases. Thus, the individualization performed in the beginning of PN for energy protein adequacy was indispensable. In addition, the individualized PN was indispensable in at least 29.2% of PN for correction of alterations found in biochemical parameters.

  12. Future considerations for pharmacologic adjuvants in single-injection peripheral nerve blocks for patients with diabetes mellitus.

    Science.gov (United States)

    Williams, Brian A; Murinson, Beth B; Grable, Benjamin R; Orebaugh, Steven L

    2009-01-01

    As the epidemics of obesity and diabetes expand, there are more patients with these disorders requiring elective surgery. For surgery on the extremities, peripheral nerve blocks have become a highly favorable anesthetic option when compared with general anesthesia. Peripheral blocks reduce respiratory and cardiac stresses, while potentially mitigating untreated peripheral pain that can foster physiologic conditions that increase risks for general health complications. However, local anesthetics are generally accepted to be a rare but possible cause of nerve damage, and there are no evidence-based recommendations for dosing local anesthetic nerve blocks in patients with diabetes. This is important because anesthesiologists do not want to potentially accelerate peripheral nerve dysfunction in diabetic patients at risk. This translational vignette (i) examines laboratory models of diabetes, (ii) summarizes the pharmacology of perineural adjuvants (epinephrine, clonidine, buprenorphine, midazolam, tramadol, and dexamethasone), and (iii) identifies areas that warrant further research to determine viability of monotherapy or combination therapy for peripheral nerve analgesia in diabetic patients. Conceivably, future translational research regarding peripheral nerve blocks in diabetic patients may logically include study of nontoxic injectable analgesic adjuvants, in combination, to provide desired analgesia, while possibly avoiding peripheral nerve toxicity that diabetic animal models have exhibited when exposed to traditional local anesthetics.

  13. Double injection/single detection asymmetric flow injection manifold for spectrophotometric determination of ascorbic acid and uric acid: Selection the optimal conditions by MCDM approach based on different criteria weighting methods

    Science.gov (United States)

    Boroumand, Samira; Chamjangali, Mansour Arab; Bagherian, Ghadamali

    2017-03-01

    A simple and sensitive double injection/single detector flow injection analysis (FIA) method is proposed for the simultaneous kinetic determination of ascorbic acid (AA) and uric acid (UA). This method is based upon the difference between the rates of the AA and UA reactions with Fe3 + in the presence of 1, 10-phenanthroline (phen). The absorbance of Fe2 +/1, 10-phenanthroline (Fe-phen) complex obtained as the product was measured spectrophotometrically at 510 nm. To reach a good accuracy in the differential kinetic determination via the mathematical manipulations of the transient signals, different criteria were considered in the selection of the optimum conditions. The multi criteria decision making (MCDM) approach was applied for the selection of the optimum conditions. The importance weights of the evaluation criteria were determined using the analytic hierarchy process, entropy method, and compromised weighting (CW). The experimental conditions (alternatives) were ranked by the technique for order preference by similarity to an ideal solution. Under the selected optimum conditions, the obtained analytical signals were linear in the ranges of 0.50-5.00 and 0.50-4.00 mg L- 1 for AA and UA, respectively. The 3σ detection limits were 0.07 mg L- 1 for AA and 0.12 mg L- 1 for UA. The relative standard deviations for four replicate determinations of AA and UA were 2.03% and 3.30% respectively. The method was also applied for the analysis of analytes in the blood serum, Vitamine C tablets, and tap water with satisfactory results.

  14. Intra-Articular, Single-Shot Hylan G-F 20 Hyaluronic Acid Injection Compared with Corticosteroid in Knee Osteoarthritis: A Double-Blind, Randomized Controlled Trial.

    Science.gov (United States)

    Tammachote, Nattapol; Kanitnate, Supakit; Yakumpor, Thanasak; Panichkul, Phonthakorn

    2016-06-01

    The treatment of knee osteoarthritis with hyaluronic acid or corticosteroid injection has been widely used. The purpose of this study was to compare the efficacy of hyaluronic acid (hylan G-F 20) with triamcinolone acetonide as a single intra-articular injection for knee osteoarthritis. This study was a prospective, randomized, double-blind clinical trial. Participants with symptomatic knee osteoarthritis were recruited. They were randomized to receive a single-shot, intra-articular injection of either 6 mL of hylan G-F 20 or 6 mL of a solution comprising 1 mL of 40-mg triamcinolone acetonide and 5 mL of 1% lidocaine with epinephrine. The primary outcomes were knee pain severity, knee function, and range of motion at 6 months. Ninety-nine patients were assessed before injection and underwent a 6-month follow-up. Patients and evaluators were blinded. Multilevel regression models were used to estimate differences between the groups. At the 6-month follow-up, compared with patients who took hylan G-F 20, patients who took triamcinolone acetonide had similar improvement in knee pain, knee function, and range of motion. The difference in mean outcome scores between groups was, with regard to knee pain, a visual analog scale (VAS) score of 3 points (95% confidence interval [95% CI], -6 to 11 points); with regard to knee function, a modified Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score of 0 points (95% CI, -8 to 6 points); and, with regard to range of motion, flexion of -1° (95% CI, -5° to 2°) and extension of 0° (95% CI, -0.5° to 0.5°). However, patients who took triamcinolone acetonide had better pain improvement from 24 hours until 1 week after injection; the mean difference between groups with regard to the VAS score was 12 points (95% CI, 5 to 20 points; p = 0.002) at 24 hours and 9 points (95% CI, 1 to 15 points; p = 0.018) at 1 week. At 2 weeks after injection, patients who took triamcinolone acetonide also had better knee

  15. Spray and atomization of diesel fuel and its alternatives from a single-hole injector using a common rail fuel injection system

    KAUST Repository

    Chen, PinChia

    2013-01-01

    Fuel spray and atomization characteristics play an important role in the performance of internal combustion engines. As the reserves of petroleum fuel are expected to be depleted within a few decades, finding alternative fuels that are economically viable and sustainable to replace the petroleum fuel has attracted much research attention. In this work, the spray and atomization characteristics were investigated for commercial No. 2 diesel fuel, biodiesel (FAME) derived from waste cooking oil (B100), 20% biodiesel blended diesel fuel (B20), renewable diesel fuel produced in house, and civil aircraft jet fuel (Jet-A). Droplet diameters and particle size distributions were measured by a laser diffraction particle analyzing system and the spray tip penetrations and cone angles were acquired using a high speed imaging technique. All experiments were conducted by employing a common-rail high-pressure fuel injection system with a single-hole nozzle under room temperature and pressure. The experimental results showed that biodiesel and jet fuel had different features compared with diesel. Longer spray tip penetration and larger droplet diameters were observed for B100. The smaller droplet size of the Jet-A were believed to be caused by its relatively lower viscosity and surface tension. B20 showed similar characteristics to diesel but with slightly larger droplet sizes and shorter tip penetration. Renewable diesel fuel showed closer droplet size and spray penetration to Jet-A with both smaller than diesel. As a result, optimizing the trade-off between spray volume and droplet size for different fuels remains a great challenge. However, high-pressure injection helps to optimize the trade-off of spray volume and droplet sizes. Furthermore, it was observed that the smallest droplets were within a region near the injector nozzle tip and grew larger along the axial and radial direction. The variation of droplet diameters became smaller with increasing injection pressure.

  16. Cell turnover in the odontogenic organ of the rat incisor as visualized by graphic reconstructions following a single injection of 3H-thymidine.

    Science.gov (United States)

    Smith, C E

    1980-07-01

    Turnover of cells within the odontogenic organ was studied in three dimensions by preparing serial sections of incisors from young male rats killed at various times following a single intraperitoneal injection of 1 muCi/g body weight of 3H-thymidine. Radioautographs showed that at 1 hour after injection labeled cells were present in all cell layers throughout the entire depth of the odontogenic organ. They were encountered frequently within the inner dental epithelium and stratum intermedium but appeared less abundant within the stellate reticulum and outer dental epithelium. With time, the frequency of labeled cells in each layer declined progressively, and more rapidly at the anterior and labial side of the odontogenic organ than toward its posterior and lingual side. Hence labeled cells were observed over the longest time interval in regions where cell layers were in closest proximity to the opening of the apical foramen, that is, near the apical and cervical loops. By 32 days after injection, numerous labeled cells could still be identified within the outer dental epithelium and stellate reticulum near the apical loop (bulbous part of the odontogenic organ) and the outer dental epithelium near the cervical loops ("U"-shaped part of the odontogenic organ). These findings support the hypothesis that cells originate within the bulbous part of the odontogenic organ and migrate anteriorly through the "U"-shaped and root sheath parts of the odontogenic organ during renewal of the incisor. It appears that individual stem cell compartments may be maintained for surface (outer/inner dental epithelium) and intermediate layers (stellate reticulum/stratum intermedium) in the odontogenic epithelium.

  17. Detection of active alveolar bone destruction in human periodontal disease by analysis of radiopharmaceutical uptake after a single injection of 99m-Tc-methylene diphosphonate

    International Nuclear Information System (INIS)

    Jeffcoat, M.K.; Williams, R.C.; Holman, B.L.; English, R.; Goldhaber, P.

    1986-01-01

    Previous studies have shown that, following a single injection of 99m-Tc-MDP, measurement of bone-seeking radiopharmaceutical uptake can detect ''active'' alveolar bone loss due to periodontal disease in beagle dogs, as determined by radiographs taken at the time of, and several months after, the nuclear medicine procedure. The efficacy of this diagnostic test, however, had not been assessed in human periodontal disease. The ability of a single boneseeking radiopharmaceutical uptake examination to detect ''active'' alveolar bone loss due to periodontal disease in human patients was assessed by comparing a single uptake measurement to the rate of bone loss determined from serial radiographs taken over a 6-month period. Uptake was expressed as a ratio of the cpm from the alveolar bone divided by the cpm from the non-tooth supporting bone of the nuchal crest. High uptake ratios were associated with ''active'' loss and low uptake ratios were associated with little if any change in alveolar bone height (p<0.001). The nuclear medicine examination was an accurate detector of periodontal disease activity in nearly 80% of the individual teeth studied. These data indicate that high bone-seeking radiopharmaceutical uptake ratios may be pathognomonic of active bone loss in human periodontal disease. (author)

  18. CT-guided single high-dose percutaneous acetic acid injection for small hepatocellular carcinoma: A long-term follow-up study

    International Nuclear Information System (INIS)

    Ma Heng; Liu Jing; Liu Fengli

    2012-01-01

    Objective: To evaluate the long-term outcome of CT-guided single high-dose percutaneous acetic acid injection (PAI) for the treatment of small hepatocellular carcinoma (SHCC). Materials and methods: Sixty-eight consecutive patients (37 men and 31 women; age 52 ± 16 years) with SHCC have undergone CT-guided single high-dose PAI therapy since December 2000. Complications of high-dose PAI were recorded. Tumour survival and recurrence rates were assessed. Results: All PAI therapies were successful and no severe complications developed. The average follow-up period was 46 ± 18 months. The overall survival rates at 1, 2, 3, 4 and 5 years were 93%, 82%, 68%, 59% and 51%, respectively. The cumulative local recurrence rates for the main tumour at 1, 2, 3, 4 and 5 years were 18%, 22%, 25%, 28% and 28%, respectively. The cumulative new tumour recurrence rates at 1, 2, 3, 4 and 5 years were 24%, 40%, 43%, 60% and 62%, respectively. Conclusion: CT-guided single high-dose PAI is safe and effective for the treatment of SHCC after long-term follow-up.

  19. Development of on-line single-drop micro-extraction sequential injection system for electrothermal atomic absorption spectrometric determination of trace metals

    International Nuclear Information System (INIS)

    Anthemidis, Aristidis N.; Adam, Ibrahim S.I.

    2009-01-01

    A novel automatic sequential injection (SI) single-drop micro-extraction (SDME) system is proposed as versatile approach for on-line metal preconcentration and/or separation. Coupled to electrothermal atomic absorption spectrometry (ETAAS) the potentials of this SI scheme are demonstrated for trace cadmium determination in water samples. A non-charged complex of cadmium with ammonium diethyldithiophosphate (DDPA) was produced and extracted on-line into a 60 μL micro-drop of di-isobutyl ketone (DIBK). The extraction procedure was performed into a newly designed flow-through extraction cell coupled on a sequential injection manifold. As the complex Cd(II)-DDPA flowed continuously around the micro-droplet, the analyte was extracting into the solvent micro-drop. All the critical parameters were optimized and offered good performance characteristics and high preconcentration ratios. For 600 s micro-extraction time, the enhancement factor was 10 and the sampling frequency was 6 h -1 . The detection limit was 0.01 μg L -1 and the precision (RSD at 0.1 μg L -1 of cadmium) was 3.9%. The proposed method was evaluated by analyzing certified reference material

  20. Cyano-substituted oligo(p-phenylene vinylene) single-crystal with balanced hole and electron injection and transport for ambipolar field-effect transistors.

    Science.gov (United States)

    Deng, Jian; Tang, Jia; Xu, Yuanxiang; Liu, Liqun; Wang, Yan; Xie, Zengqi; Ma, Yuguang

    2015-02-07

    High and balanced hole and electron mobilities were achieved in OFETs based on the high photoluminescence of a 1,4-bis(2-cyano-2-phenylethenyl)benzene single-crystal with symmetric electrodes. For electron and hole, the operation voltage in the OFETs based on symmetric gold electrodes was 30 and -20 V, respectively. The accumulation threshold voltage is low enough for the OFETs to operate in an ambipolar model with the source/drain voltage (Vds) around 50 V despite the high injection barrier. The highest electron and hole mobility was 0.745 cm(2) V(-1) s(-1) and 0.239 cm(2) V(-1) s(-1), and the current density reached 90.7 and 27.4 A cm(-2), respectively with an assumed 10 nm accumulation layer. The high mobility comes from the strong π-π interactions. In addition, the highly ordered hydrogen bonding matrix may create an efficient route to pump the charge to the inner layer which can improve the injection ability.

  1. Immersed single-drop microextraction interfaced with sequential injection analysis for determination of Cr(VI) in natural waters by electrothermal-atomic absorption spectrometry

    International Nuclear Information System (INIS)

    Pena, Francisco; Lavilla, Isela; Bendicho, Carlos

    2008-01-01

    Single-drop microextraction (SDME) and sequential injection analysis have been hyphenated for ultratrace metal determination by Electrothermal-Atomic Absorption Spectrometry (ETAAS). The novel method was targeted on extraction of the Cr(VI)-APDC chelate and encompasses the potential of SDME as a miniaturized and virtually solvent-free preconcentration technique, the ability of sequential injection analysis to handle samples and the versatility of furnace autosamplers for introducing microliter samples in ETAAS. The variables influencing the microextraction of Cr(VI) onto an organic solvent drop, i.e., type of organic solvent, microextraction time, stirring rate of the sample solution, drop volume, immersion depth of the drop, salting-out effect, temperature of the sample, concentration of the complexing agent and pH of the sample solution were fully investigated. For a 5 and 20 min microextraction time, the preconcentration factors were 20 and 70, respectively. The detection limit was 0.02 μg/L of Cr(VI) and the repeatability expressed as relative standard deviation was 7%. The SDME-SIA-ETAAS technique was validated against BCR CRM 544 (lyophilized solution) and applied to ultrasensitive determination of Cr(VI) in natural waters

  2. Effects of local microwave diathermy on shoulder pain and function in patients with rotator cuff tendinopathy in comparison to subacromial corticosteroid injections: a single-blind randomized trial.

    Science.gov (United States)

    Rabini, Alessia; Piazzini, Diana B; Bertolini, Carlo; Deriu, Laura; Saccomanno, Maristella F; Santagada, Domenico A; Sgadari, Antonio; Bernabei, Roberto; Fabbriciani, Carlo; Marzetti, Emanuele; Milano, Giuseppe

    2012-04-01

    Single-blind randomized clinical trial, with a follow-up of 24 weeks. To determine the effects of hyperthermia via localized microwave diathermy on pain and disability in comparison to subacromial corticosteroid injections in patients with rotator cuff tendinopathy. Hyperthermia improves symptoms and function in several painful musculoskeletal disorders. However, the effects of microwave diathermy in rotator cuff tendinopathy have not yet been established. Ninety-two patients with rotator cuff tendinopathy and pain lasting for at least 3 months were recruited from the outpatient clinic of the Department of Orthopaedics and Traumatology, University Hospital, Rome, Italy. Participants were randomly allocated to either local microwave diathermy or subacromial corticosteroids. The primary outcome measure was the short form of the Disabilities of the Arm, Shoulder and Hand Questionnaire (QuickDASH). Secondary outcome measures were the Constant-Murley shoulder outcome score and a visual analog scale for pain assessment. At the end of treatment and at follow-up, both treatment groups experienced improvements in all outcome measures relative to baseline values. Changes over time in QuickDASH, Constant-Murley, and visual analog scale scores were not different between treatment arms. In patients with rotator cuff tendinopathy, the effects of localized microwave diathermy on disability, shoulder function, and pain are equivalent to those elicited by subacromial corticosteroid injections.

  3. Concentration-dependent optical properties of TGA stabilized CdTe Quantum dots synthesized via the single injection hydrothermal method in the ambient environment

    Science.gov (United States)

    Jai Kumar, B.; Mahesh, H. M.

    2017-04-01

    Thioglycolic acid (TGA) stabilized aqueous CdTe Quantum dots (QDs) were synthesized using a facile, cost efficient Single Injection Hydrothermal (SIH) method. The complete preparation of precursors and growth of QDs was carried out in the ambient environment without inter gas protection. The Cadmium and Tellurium precursors were prepared from cadmium nitrate and elemental tellurium powder with sodium borohydride as reducing agent respectively. A systematic investigation was carried out in order to study the effect of 0.04M and 0.08M TGA concentration on ease synthesis, stability and size-tunable optical absorbance, bandgap, photoluminescence (PL) and Quantum yield (QY) of CdTe QDs. The Structure of QDs was verified by XRD and optical properties by absorbance and PL spectra. Experimental results revealed that the 0.08M TGA QDs possess good chemical and optical stability with high luminescence and decent QY, ready to use in optoelectronics, photovoltaic and biological application.

  4. Assessment of infection control practices for interventional techniques: a best evidence synthesis of safe injection practices and use of single-dose medication vials.

    Science.gov (United States)

    Manchikanti, Laxmaiah; Falco, Frank J E; Benyamin, Ramsin M; Caraway, David L; Helm Ii, Standiford; Wargo, Bradley W; Hansen, Hans; Parr, Allan T; Singh, Vijay; Hirsch, Joshua A

    2012-01-01

    It is universally accepted that transmission of bloodborne pathogens during health care procedures continues to occur because of the use of unsafe and improper injection, infusion, and medication administration practices by health care professionals in various clinical settings. This resulted in development of multiple guidelines based on case reports; however, these case reports are confounded by multiple factors without causal relationship to a single factor. Even then, single-dose vials used for multiple patients have been singled out and became the focus of infection control policies resulting in inordinate expenses for practices without improving patient safety. The cost of implementation of single dose vial policy in interventional pain management for drugs alone may cost $750 million, whereas with single use radional gloves may exceed $1 billion per year. Best evidence synthesis. To critically appraise and synthesize the literature on infection control practices for interventional techniques, including safe injection and medication vial utilization. The available literature on infection control practices was reviewed. Due to the nature of the studies involved, with the majority being case reports, and a few prospective evaluations, quality assessment and clinical relevance criteria were not applied. Data sources included relevant literature identified through searches of PubMed and EMBASE from 1966 through June 2012, literature from the Centers for Disease Control and Prevention (CDC), the U.S. Food and Drug Administration (FDA), and manual searches of the bibliographies of known primary and review articles. The primary outcome measure was correlating infection to a breach of standards in infection control practices. The secondary objective was to assess the contribution of single-dose vials independently for infection. A total of 60 reports met inclusion criteria, with 16 reports related to pain management and other procedures, of which 9 reports were

  5. An Experimental Investigation of Self-Excited Combustion Dynamics in a Single Element Lean Direct Injection (LDI) Combustor

    Science.gov (United States)

    Gejji, Rohan M.

    The management of combustion dynamics in gas turbine combustors has become more challenging as strict NOx/CO emission standards have led to engine operation in a narrow, lean regime. While premixed or partially premixed combustor configurations such as the Lean Premixed Pre-vaporized (LPP), Rich Quench Lean burn (RQL), and Lean Direct Injection (LDI) have shown a potential for reduced NOx emissions, they promote a coupling between acoustics, hydrodynamics and combustion that can lead to combustion instabilities. These couplings can be quite complex, and their detailed understanding is a pre-requisite to any engine development program and for the development of predictive capability for combustion instabilities through high-fidelity models. The overarching goal of this project is to assess the capability of high-fidelity simulation to predict combustion dynamics in low-emissions gas turbine combustors. A prototypical lean-direct-inject combustor was designed in a modular configuration so that a suitable geometry could be found by test. The combustor comprised a variable length air plenum and combustion chamber, air swirler, and fuel nozzle located inside a subsonic venturi. The venturi cross section and the fuel nozzle were consistent with previous studies. Test pressure was 1 MPa and variables included geometry and acoustic resonance, inlet temperatures, equivalence ratio, and type of liquid fuel. High-frequency pressure measurements in a well-instrumented metal chamber yielded frequencies and mode shapes as a function of inlet air temperature, equivalence ratio, fuel nozzle placement, and combustor acoustic resonances. The parametric survey was a significant effort, with over 105 tests on eight geometric configurations. A good dataset was obtained that could be used for both operating-point-dependent quantitative comparisons, and testing the ability of the simulation to predict more global trends. Results showed a very strong dependence of instability amplitude on

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

    Science.gov (United States)

    Zaloga, Gary P

    2015-09-01

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

  7. A single intraperitoneal injection of bovine fetuin-A attenuates bone resorption in a murine calvarial model of particle-induced osteolysis.

    Science.gov (United States)

    Jablonski, Heidrun; Polan, Christina; Wedemeyer, Christian; Hilken, Gero; Schlepper, Rüdiger; Bachmann, Hagen Sjard; Grabellus, Florian; Dudda, Marcel; Jäger, Marcus; Kauther, Max Daniel

    2017-12-01

    Particle-induced osteolysis, which by definition is an aseptic inflammatory reaction to implant-derived wear debris eventually leading to local bone destruction, remains the major reason for long-term failure of orthopedic endoprostheses. Fetuin-A, a 66kDa glycoprotein with diverse functions, is found to be enriched in bone. Besides being an important inhibitor of ectopic calcification, it has been described to influence the production of mediators of inflammation. Furthermore, a regulatory role in bone metabolism has been assigned. In the present study, the influence of a single dose of bovine fetuin-A, intraperitoneally injected in mice subjected to particle-induced osteolysis of the calvaria, was analyzed. Twenty-eight male C57BL/6 mice, twelve weeks of age, were randomly divided into four groups. Groups 2 and 4 were subjected to ultra-high molecular weight polyethylene (UHMWPE) particles placed on their calvariae while groups 1 and 3 were sham-operated. Furthermore, groups 3 and 4 received a single intraperitoneal injection of 20mg bovine fetuin-A while groups 1 and 2 were treated with physiologic saline. After 14days calvarial bone was qualitatively and quantitatively assessed using microcomputed tomography (μCT) and histomorphometrical approaches. Application of fetuin-A led to a reduction of particle-induced osteolysis in terms of visible osteolytic lesions and eroded bone surface. The reduction of bone thickness and bone volume, as elicited by UHMWPE, was alleviated by fetuin-A. In conclusion, fetuin-A was found to exert an anti-resorptive effect on particle-induced osteolysis in-vivo. Thus, fetuin-A could play a potentially osteoprotective role in the treatment of bone metabolic disorders. Copyright © 2017 Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

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

    2017-12-01

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

  9. Experiences with Lean Six Sigma as improvement strategy to reduce parenteral medication administration errors and associated potential risk of harm.

    Science.gov (United States)

    van de Plas, Afke; Slikkerveer, Mariëlle; Hoen, Saskia; Schrijnemakers, Rick; Driessen, Johanna; de Vries, Frank; van den Bemt, Patricia

    2017-01-01

    In this controlled before-after study the effect of improvements, derived from Lean Six Sigma strategy, on parenteral medication administration errors and the potential risk of harm was determined. During baseline measurement, on control versus intervention ward, at least one administration error occurred in 14 (74%) and 6 (46%) administrations with potential risk of harm in 6 (32%) and 1 (8%) administrations. Most administration errors with high potential risk of harm occurred in bolus injections: 8 (57%) versus 2 (67%) bolus injections were injected too fast with a potential risk of harm in 6 (43%) and 1 (33%) bolus injections on control and intervention ward. Implemented improvement strategies, based on major causes of too fast administration of bolus injections, were: Substitution of bolus injections by infusions, education, availability of administration information and drug round tabards. Post intervention, on the control ward in 76 (76%) administrations at least one error was made (RR 1.03; CI95:0.77-1.38), with a potential risk of harm in 14 (14%) administrations (RR 0.45; CI95:0.20-1.02). In 40 (68%) administrations on the intervention ward at least one error occurred (RR 1.47; CI95:0.80-2.71) but no administrations were associated with a potential risk of harm. A shift in wrong duration administration errors from bolus injections to infusions, with a reduction of potential risk of harm, seems to have occurred on the intervention ward. Although data are insufficient to prove an effect, Lean Six Sigma was experienced as a suitable strategy to select tailored improvements. Further studies are required to prove the effect of the strategy on parenteral medication administration errors.

  10. Testosterone Injection

    Science.gov (United States)

    ... typical male characteristics. Testosterone injection works by supplying synthetic testosterone to replace the testosterone that is normally ... as a pellet to be injected under the skin.Testosterone injection may control your symptoms but will ...

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

    International Nuclear Information System (INIS)

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

    2010-01-01

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

  12. Parenteral glutamine dipeptide supplementation does not ameliorate chemotherapy-induced toxicity

    NARCIS (Netherlands)

    van Zaanen, H. C.; van der Lelie, H.; Timmer, J. G.; Fürst, P.; Sauerwein, H. P.

    1994-01-01

    Glutamine-supplemented total parenteral nutrition (TPN) improved the nitrogen balance in catabolic situations. In animal studies, parenteral glutamine supplementation appeared to maintain gut integrity. This study was performed to evaluate the possible positive effects of glutamine supplementation

  13. Sterilization of solutions for parenterals products. Problem analysis

    Directory of Open Access Journals (Sweden)

    Yanelys Montes-González

    2017-09-01

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

  14. Therapy of the experimental infection by Strongyloides venezuelensis in rats with injectable ivermectin or levamizole

    Directory of Open Access Journals (Sweden)

    Rubens Campos

    1989-02-01

    Full Text Available For the therapy of human strongyloidiasis, are necessary effective drugs to eliminate both larvae and adult worm parasitism, which may also be used by parenteral route, to obviate the particular conditions presented by many patients. A study based on the experimental infection by Strongyloides venezuelensis in rats was done, administering injectable ivermectin or levamizole. Both drugs were shown to be active, when used in single doses of 0.2 to 0.5 mg/kg of ivermectin, or 26 mg/kg for levamizole. Ivermectin was slightly more effective as far as larval stage of the infection is concerned, and the same happened for levamisole for the adult worm stage. Promising perspectives are visualized to improve the therapy of patients with serious disseminated infection by Strongyloides stercoralis.

  15. Comparison of clinical applications of single-dose intravenous injection of mivacurium and cisatracurium in adults’ vocalcordpolyps resection under self-retaining laryngoscope

    Directory of Open Access Journals (Sweden)

    Han Fanglei

    2017-01-01

    Full Text Available Objective: Through comparing the clinical observation of mivacurium and cisatracurium in vocal polyp extraction, to study the advantage of mivacurium in vocal polyp extraction. Methods: Forty American Society of Anesthesiologists(ASA physical status I~II patients for vocal polyp extraction, aged 18~60 years old, were randomly divided into two groups as Mivacurium injection group(Group M and Cis-atracurium injection group(Group C, each group includes 20 subjects. None of the patients are allergic, has serious diseases of cardiovascular system, liver or kidney.None of them has asthma, airway high response, difficult airway or neuromuscular diseases.Those patients who use beta-blockers or calcium channel blockers for a long time were excluded .All the subjects had the same premedication, fasting and fluid fobidden time. All the subjects who get into the operating room get the routine monitoring of electrocardiogram(EEG, blood pressure(BP, heart rate(HR, pulse oxygen saturation(SpO2 and the TOF WATCH SX. Each group gives the same medicine other than the muscle relaxant during induction of general anesthesia to do the vocal polyp extraction by the same experienced operator. Two groups were recorded in each index of anesthesia induction and tracheal intubation conditions, operation conditions, anesthesia, muscle relaxation monitoring. Results: There are no statistically significant in Cormack-Lehane grading system,Cooper’s grading system and operation satifaction(p>0.05. 2. Group A have shorter intubation time than Group B(p0.05. Conclusion: 1. A single intubating dose of mivacurium can provide similar intubation and surgeon satisfaction for the vocal polyp extraction. 2. Compared with cis-atracurium, mivacurium can shorten the intubation time and the recovery time of anesthesia. The adverse reactions of mivacurium is mild, and it has less Residual muscle relaxation. Therefore mivacurium is more suitable for the vocal polyp extraction than cis-atracurium.

  16. A single intraperitoneal injection of endotoxin in rats induces long-lasting modifications in behavior and brain protein levels of TNF-α and IL-18

    Directory of Open Access Journals (Sweden)

    Bossù Paola

    2012-05-01

    Full Text Available Abstract Background Systemic inflammation might cause neuronal damage and sustain neurodegenerative diseases and behavior impairment, with the participation of pro-inflammatory cytokines, like tumor necrosis factor (TNF-α and interleukin (IL-18. However, the potential contribution of these cytokines to behavioral impairment in the long-term period has not been fully investigated. Methods Wistar rats were treated with a single intraperitoneal injection of LPS (5 mg/kg or vehicle. After 7 days and 10 months, the animal behavior was evaluated by testing specific cognitive functions, as mnesic, discriminative, and attentional functions, as well as anxiety levels. Contextually, TNF-α and IL-18 protein levels were measured by ELISA in defined brain regions (that is, frontal cortex, hippocampus, striatum, cerebellum, and hypothalamus. Results Behavioral testing demonstrated a specific and persistent cognitive impairment characterized by marked deficits in reacting to environment modifications, possibly linked to reduced motivational or attentional deficits. Concomitantly, LPS induced a TNF-α increase in the hippocampus and frontal cortex (from 7 days onward and cerebellum (only at 10 months. Interestingly, LPS treatment enhanced IL-18 expression in these same areas only at 10 months after injection. Conclusions Overall, these results indicate that the chronic neuroinflammatory network elicited by systemic inflammation involves a persistent participation of TNF-α accompanied by a differently regulated contribution of IL-18. This leads to speculation that, though with still unclear mechanisms, both cytokines might take part in long-lasting modifications of brain functions, including behavioral alteration.

  17. Influence of parenteral application of beta-carotene on fertility in cows

    Directory of Open Access Journals (Sweden)

    Veličković Miljan

    2008-01-01

    Full Text Available Thirty Holstein breed cows from the breeding stock of high yielding dairy cattle were selected for testing. The cows were selected during their high gravidity and fell into two groups. The i.m beta-carotene, Carofertin, of 20 ml (200 mg of beta-carotene was applied to the experimental group (n=15 two weeks before the expected parturition date. Another injection of the beta-carotene preparation was applied to the experimental group two weeks after parturition. Simultaneously, a physiological solution of 20 ml was injected i.m to the experimental group (n=15. The blood samples for testing of the beta-carotene and vitamin A concentration were taken during high gravidity and in the early puerperium two days after the beta-carotene application and on the day of parturition. Two-of parenteral application of beta-carotene before parturition does not have an impact significantly on the frequency of the occurrence of retained placenta in experimental cows comparing to the cows of the control group (x=33.3 % and x=20.0 % and length of the service period (x =97.20±31.64 and x=98.8±35.8 days. Based on the results obtained during this research, it can be concluded that the parenteral application of the beta-carotene (Carofertin as 200 mg per cow, which is meant for protection of the reproductive disorders of cows, does not affect the level of carotinemia when its concentration in the blood serum is within the physiological limits. Therefore, no significant discrepancy in values of the reproduction figures between the cows of the experimental and control group was found. All in all, its usage is advisable only during scarce feeding.

  18. Single Event Analysis and Fault Injection Techniques Targeting Complex Designs Implemented in Xilinx-Virtex Family Field Programmable Gate Array (FPGA) Devices

    Science.gov (United States)

    Berg, Melanie D.; LaBel, Kenneth; Kim, Hak

    2014-01-01

    An informative session regarding SRAM FPGA basics. Presenting a framework for fault injection techniques applied to Xilinx Field Programmable Gate Arrays (FPGAs). Introduce an overlooked time component that illustrates fault injection is impractical for most real designs as a stand-alone characterization tool. Demonstrate procedures that benefit from fault injection error analysis.

  19. Glass particle contamination of parenteral preparations of ...

    African Journals Online (AJOL)

    This was a prospective, randomised, single-blinded comparative study to assess the amount of glass particle contamination in single-use drug ampoules, and to compare the differences between the filter straw (B Braun Filter Straw® 5 micron), 23G hypodermic needles and 18G drawing-up needles in reducing ...

  20. Pharmacokinetic properties and safety profile of histamine dihydrochloride injection in Chinese healthy volunteers: a phase I, single-center, open-label, randomized study.

    Science.gov (United States)

    Li, Jiapeng; Huang, Xiaojun; Wang, Qian; Jing, Shan; Jiang, Hao; Wei, Zhongna; Zang, Yannan; Liu, Yang; Zhao, Libo; Fang, Yi; Feng, Wanyu

    2015-10-01

    Histamine dihydrochloride (HDC) injection has been approved in Europe for the treatment of adults with acute myeloid leukemia, used in combination therapy with the T-cell-derived cytokine interleukin-2. Despite years of clinical applications of HDC in Europe, no data are available on its tolerability and pharmacokinetic properties in Chinese patients. The objective of this study was to determine the safety profile and pharmacokinetic properties of HDC in Chinese healthy volunteers (HVs). In this Phase I, single-center, open-label, randomized study, 20 Chinese HVs were randomized to receive a single dose of 0.5 or 1.0 mg HDC via a 10-minute subcutaneous injection. Whole-blood and urine samples were collected at designated time points after dosing. Plasma and urine concentrations of histamine and metabolite N-methyl histamine were measured using a validated HPLC-MS/MS method. Pharmacokinetic parameters were estimated through noncompartmental procedures based on concentration-time data. Adverse events and evaluation of clinical laboratory tests were used to assess the safety profile. The pharmacokinetic profile for a single-dose of 1.0 mg HDC in Chinese HVs was compared with that in Western HVs. No severe adverse events occurred in this study, and the severity of all adverse events was grade I according to the Common Terminology Criteria for Adverse Events, version 4.0. For the pharmacokinetic parameters of histamine at the 0.5-mg and 1.0-mg dose levels, t½ was 0.50 and 1.02 hours; Tmax was 0.15 and 0.14 hours; mean Cmax was 26.59 and 71.01 nmol/L; AUC0-t was 8.35 and 20.43 nmol/h/L; AUC0-∞ was 9.61 and 22.69 nmol/h/L; accumulated amount excreted in urine within 24 hours was 125.93 and 145.52 nmol; and maximum urine excretion rates were 21.85 and 38.94 nmol/h, respectively. For N-methyl histamine at the 0.5-mg and 1.0-mg dose levels, t½ was 0.58 and 0.66 hours; Tmax was 0.28 and 0.26 hours; mean Cmax was 17.01 and 23.54 nmol/L; AUC0-t was 7.72 and 17.08 nmol

  1. Home parenteral nutrition increases fat free mass in patients with incurable gastrointestinal cancer. Results of a randomized controlled trial

    DEFF Research Database (Denmark)

    Obling, Sine Roelsgaard; Wilson, Benedicte Vibjerg; Pfeiffer, Per

    2018-01-01

    Objective: Preventing loss of muscle mass and function is an enduring challenge in malnourished patients with incurable cancer. The benefit of supplemental home parenteral nutrition has not been firmly established. Our aim was to evaluate the effects of supplemental home parenteral nutrition......, the primary endpoint being fat free mass (FFM) and secondary: muscle function, quality of life and overall survival. Design and methods: In a single centre open-label randomised controlled trial, patients with incurable gastrointestinal cancer, nutritionally at risk, were randomly assigned to either; a) best.......8-35.7) and (91%) were receiving palliative chemotherapy. Median FFM and fat free mass index increased in the sHPN group. At 12 weeks a significant difference (p

  2. High-Voltage Leak Detection of a Parenteral Proteinaceous Solution Product Packaged in Form-Fill-Seal Plastic Laminate Bags. Part 3. Chemical Stability and Visual Appearance of a Protein-Based Aqueous Solution for Injection as a Function of HVLD Exposure.

    Science.gov (United States)

    Rasmussen, Mats; Damgaard, Rasmus; Buus, Peter; Guazzo, Dana Morton

    2013-01-01

    This Part 3 of this three-part research series reports the impact of high-voltage leak detection (HVLD) exposure on the physico-chemical stability of the packaged product. The product, intended for human administration by injection, is an aqueous solution formulation of the rapid acting insulin analogue, insulin aspart (NovoRapid®/NovoLog®) by Novo Nordisk A/S, Bagsværd, Denmark. The package is a small-volume form-fill-seal plastic laminate bag. Product-packages exposed to HVLD were compared to unexposed product after storage for 9 months at recommended storage conditions of 5 ± 3 °C. No differences in active ingredient or degradation products assays were noted. No changes in any other stability indicating parameter results were observed. This report concludes this three-part series. Part 1 documented HVLD method development and validation work. Part 2 explored the impact of various package material, package temperature, and package storage conditions on HVLD test results. Detection of leaks in the bag seal area was investigated. In conclusion, HVLD is reported to be a validatable leak test method suitable for rapid, nondestructive container-closure integrity evaluation of the subject product-package. In Part 1 of this three-part series, a leak test method based on electrical conductivity and capacitance, also called high-voltage leak detection (HVLD), was proven to find hole leaks in small plastic bags filled with a solution of insulin aspart intended for human injection (NovoRapid®/NovoLog® by Novo Nordisk A/S, Bagsværd, Denmark). In Part 2, the ability of the HVLD method to find other types of package leaks was tested, and the impact of package material and product storage temperature on HVLD results was explored. This final Part 3 checked how well the packaged protein drug solution maintained its potency after HVLD exposure over 9 months of storage under long-term stability conditions. Results showed that HVLD caused no harm to the product.

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

    African Journals Online (AJOL)

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

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

    African Journals Online (AJOL)

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

  5. Tocopherol isoforms in parenteral lipid emulsions and neutrophil activation.

    NARCIS (Netherlands)

    Wanten, G.J.A.; Beunk, J.; Naber, A.H.J.; Swinkels, D.W.

    2002-01-01

    BACKGROUND AND AIMS: Tocopherol is a lipid-soluble anti-oxidant that exists in several isoforms. Patients on total parenteral nutrition depend on lipid emulsions for their tocopherol intake. In the present study, we analysed the content of tocopherol isoforms in various lipid emulsions. We also

  6. Oral or Parenteral Paracetamol as a Substitute for Banned Dipyrone ...

    African Journals Online (AJOL)

    In October 2004 there were 103 prescriptions which included Analgin IM (5), ibuprofen (6), oral paracetamol (102). In April 2005, there were 218 prescriptions for antipyretics and non-steroidal anti-inflammatory drugs (NSAIDs) which included piroxicam (11), ibuprofen (9), oral paracetamol (176), parenteral paracetamol (4).

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

    Science.gov (United States)

    Nelson, R.

    1974-01-01

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

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

    African Journals Online (AJOL)

    2014-11-01

    Nov 1, 2014 ... and infectious complications; and metabolic complications relating to PN, including hepatobiliary complications, i.e. cholestasis. Insulin therapy in patients receiving PN may prevent cholestasis.9. ESPEN suggests the early start of supplementary PN on day 2-3, while the American Society for Parenteral and ...

  9. Total parenteral nutrition in patients with short bowel syndrome.

    Science.gov (United States)

    Ekema, G; Milianti, S; Boroni, G

    2009-06-01

    Nowadays short bowel syndrome (SBS) is quite frequent, because of more aggressive surgical and medical approaches to the management of neonatal intra-addominal catastrophes. Intestinal rehabilitation can be reached in case of SBS with a strategy that merges nutritional, pharmacologic and surgical approaches to achieve the ultimate goal of enteral nutrition. Long-term clinical nutrition which combines total parenteral nutrition (TPN) and enteral nutrition is required for the adaptation process. Long-term TPN can, however, be associated with mechanical, septic and metabolic complications, most of which have been consistently reduced by a better understanding of the prerequisites for its application and by improvements in parenteral solutions. Parenteral nutrition associated cholestasis (PNAC) and liver disease (PNALD) remain indeed the most worrisome complications and bear with them a high mortality rate. Their prevention will further improve the role of TPN in patients with SBS. The etiology of PNAC and PNALD, although elusive, is thought to be multifactorial and proposed theories also include problems arising from lipid emulsions. Parenteral nutrition, that includes n-3 fatty acids, appear to diminish the extent of the inflammatory response thought to be responsible for PNAC and PNALD. This article will attempt to review the role of TPN in the rehabilitation process and discuss energy and macronutrients requirements.

  10. Micronutrients in Parenteral Nutrition: Boron, Silicon, and Fluoride

    Science.gov (United States)

    Long-term parenteral nutrition (providing nutrients intravenously) is a life-saving treatment for patients with severe malabsorption of nutrients caused by intestinal failure, intestinal trauma (for example, gunshot or stab wounds), and intestinal removal. Metabolic bone disease characterized by min...

  11. New developments in parenteral anticoagulation for arterial and venous thromboembolism

    NARCIS (Netherlands)

    van Es, Nick; Bleker, Suzanne M.; Büller, Harry R.; Coppens, Michiel

    2013-01-01

    The efficacy and safety of heparin and low-molecular-weight heparins (LMWHs) are well documented in venous and arterial thromboembolism. Several drawbacks of heparins have inspired the development of newer parenteral anticoagulants for specific indications, including heparin-induced thrombocytopenia

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

    DEFF Research Database (Denmark)

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

    2018-01-01

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

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

    African Journals Online (AJOL)

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

  14. Gluconeogenesis continues in premature infants receiving total parenteral nutrition

    Science.gov (United States)

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

  15. Assessment of the effects of parenteral quinine on testicular ...

    African Journals Online (AJOL)

    Assessment of the effects of parenteral quinine on testicular histology and sperm parameters in wistar rats. JE Ataman, D Baxter-Grillo, AAA Osinubi. Abstract. Twenty-four week duration experiment was conducted with twenty-one male Wistar rats (200 - 250 g) to investigate the effects of quinine on the testis. The rats were ...

  16. THE CELLULAR TRANSFORMATION OF INJECTED COLLOIDAL IRON COMPLEXES INTO FERRITIN AND HEMOSIDERIN IN EXPERIMENTAL ANIMALS

    Science.gov (United States)

    Richter, Goetz W.

    1959-01-01

    As revealed by electron microscopy and electron diffraction, the physical state of ferric hydroxide micelles contained in iron-dextran, saccharated iron oxide, and hydrous ferric oxide ("ferric hydroxide") differs notably from the state of the ferric hydroxide in ferritin or hemosiderin. By virtue of this difference one can trace the intracellular transformation of colloidal iron, administered parenterally, into ferritin and hemosiderin. One hour after intraperitoneal injection of iron-dextran or saccharated iron oxide into mice, characteristic deposits were present in splenic macrophages, in sinusoidal endothelial cells of spleen and liver, and in vascular endothelial cells of various renal capillaries. Four hours after injection, small numbers of ferritin molecules were identifiable about intracellular aggregates of injected iron compounds; and by the 6th day, ferritin was abundant in close proximity to deposits of injected iron compounds. The latter were frequently situated in cytoplasmic vesicles delimited by single membranes. These vesicles were most frequently found in tissue obtained during the first 6 days after injection; and in certain of the vesicles ferritin molecules surrounded closely packed aggregates of injected material. Much unchanged ferric hydroxide was still present in macrophages and vascular endothelial cells 3 to 4 weeks after injection. While electron microscopy left no doubt about the identity of injected ferric hydroxide on the one hand, and of ferritin or hemosiderin on the other, histochemical tests for iron failed in this respect. Precipitation of ferric hydroxide (hydrous ferric oxide) from stabilized colloidal dispersions of iron-dextran was brought about in vitro by incubation with minced mouse tissue (e.g. liver), but not by incubation with mouse serum or blood. Subcutaneous injections of hydrous gel of ferric oxide into mice initially produced localized extracellular precipitates. Most of the material was still extracellular 16

  17. IODINE CONTENT OF ENTERAL AND PARENTERAL NUTRITION SOLUTIONS.

    Science.gov (United States)

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

    2017-07-01

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

  18. A single exposure to cocaine during development elicits regionally-selective changes in basal basic Fibroblast Growth Factor (FGF-2) gene expression and alters the trophic response to a second injection.

    Science.gov (United States)

    Giannotti, Giuseppe; Caffino, Lucia; Malpighi, Chiara; Melfi, Simona; Racagni, Giorgio; Fumagalli, Fabio

    2015-02-01

    During adolescence, the brain is maturing and more sensitive to drugs of abuse that can influence its developmental trajectory. Recently, attention has been focused on basic fibroblast growth factor (FGF-2) given that its administration early in life enhances the acquisition of cocaine self-administration and sensitization at adulthood (Turner et al. (Pharmacol Biochem Behav 92:100-4, 2009), Clinton et al. (Pharmacol Biochem Behav103:6-17, 2012)). Additionally, we found that abstinence from adolescent cocaine exposure long lastingly dysregulates FGF-2 transcription (Giannotti et al. (Psychopharmacology (Berl) 225:553-60, 2013 ). The objectives of the study are to evaluate if (1) a single injection of cocaine (20 mg/kg) at postnatal day 35 alters FGF-2 messenger RNA (mRNA) levels and (2) the first injection influences the trophic response to a second injection (10 mg/kg) provided 24 h or 7 days later. We found regional differences in the FGF-2 expression pattern as either the first or the second injection of cocaine by themselves upregulated FGF-2 mRNA in the medial prefrontal cortex and nucleus accumbens while downregulating it in the hippocampus. The first injection influences the trophic response of the second. Of note, 24 h after the first injection, accumbal and hippocampal FGF-2 changes produced by cocaine in saline-pretreated rats were prevented in cocaine-pretreated rats. Conversely, in the medial prefrontal cortex and hippocampus 7 days after the first injection, the cocaine-induced FGF-2 changes were modified by the subsequent exposure to the psychostimulant. These findings show that a single cocaine injection is sufficient to produce enduring changes in the adolescent brain and indicate that early cocaine priming alters the mechanisms regulating the trophic response in a brain region-specific fashion.

  19. A model of reaction field in gas-injected arc-in-water method to synthesize single-walled carbon nanohorns: Influence of water temperature

    International Nuclear Information System (INIS)

    Poonjarernsilp, Chantamanee; Sano, Noriaki; Tamon, Hajime; Charinpanitkul, Tawatchai

    2009-01-01

    The method to synthesize single-walled carbon nanohorns (SWCNHs) using gas-injected arc in water (GI-AIW) has been experimentally studied. GI-AIW is known as one of the cost-effective methods to obtain SWCNHs. It was revealed that the yield of SWCNHs significantly decreases with the increase in water temperature although the purity of SWCNHs is not dependent on the temperature change. Then the model of relevant reactions in the GI-AIW system was proposed by accounting the emission of carbon vapor, formation of SWCNHs, and diffusion of water vapor in three zones inside the cathode hole (arc plasma zone, quenching zone, and downstream zone). The side reaction between H 2 O and C produces H 2 gas and consumes a certain amount of carbon vapor, resulting in the hindered SWCNH formation. Moreover the observation of the optical spectra emitting from the arc plasma zone strongly supported that the H 2 generating reaction does not occur at arc plasma zone since N 2 flow can purge H 2 O out. The model proposed in this study can precisely explain the correlation between H 2 gas production and water temperature.

  20. Combined magnetic resonance imaging of deep venous thrombosis and pulmonary arteries after a single injection of a blood pool contrast agent

    Energy Technology Data Exchange (ETDEWEB)

    Hansch, Andreas; Neumann, Steffi; Baltzer, Pascal; Waginger, Matthias; Kaiser, Werner A.; Mentzel, Hans-Joachim [Friedrich-Schiller-University Jena, Institute of Diagnostic and Interventional Radiology, Jena (Germany); Betge, Stefan; Poehlmann, Gunther [Friedrich-Schiller-University Jena, Department of Internal Medicine I, Jena (Germany); Pfeil, Alexander; Wolf, Gunter [Friedrich-Schiller-University Jena, Department of Internal Medicine III, Jena (Germany); Boettcher, Joachim [SRH Klinikum Gera, Institute of Diagnostic and Interventional Radiology, Gera (Germany)

    2011-02-15

    Agreement rate between magnetic resonance imaging (MRI) and Doppler ultrasound (DUS) for the detection of deep vein thrombosis (DVT) in the lower extremities was attempted by using the intravascular MRI contrast agent gadofosveset trisodium. The potential of this method to detect pulmonary embolism (PE) was also evaluated. Forty-three consecutive inpatients with ultrasound-confirmed DVT but no clinical signs of PE were prospectively enrolled in this feasibility study. MRI was performed after a single injection of gadofosveset trisodium. The pulmonary arteries were imaged using a 3D Fast Low Angle Shot (FLASH) gradient recalled echo sequence. Additionally, pulmonary arteries, abdominal veins, pelvic and leg veins were imaged using a fat-suppressed 3D gradient echo Volume Interpolated Breath-hold Examination (VIBE FS). Gadofosveset trisodium-enhanced MRI detected more thrombi in the pelvic region, upper leg and lower leg than the initial DUS. In addition, PE was detected in 16 of the 43 DVT patients (37%). This study shows the feasibility of a combined protocol for the MRI diagnosis of DVT and PE using gadofosveset trisodium. This procedure is not only more sensitive in detecting DVT compared to standard DUS, but is also able to detect PE in asymptomatic patients. (orig.)

  1. Attenuation values of the intracranial arterial and venous vessels by bolus injection of various contrast agents. A study with a single-detector helical CT scanner

    International Nuclear Information System (INIS)

    Nagahata, Morio; Abe, Yoshinao; Ono, Shuichi; Yamaguchi, Hikaru; Miura, Hiroyuki; Ohata, Takashi; Tsushima, Fumiyasu; Morimoto, Kohei; Seino, Hiroko

    2007-01-01

    We evaluated the arteriovenous contrast on the source images of intracranial three-dimensional computed tomography (CT) angiography (3D-CTA) using a high-concentration (370 mgI/ml) contrast agent in comparison with intermediate-concentration (300 mgI/ml) contrast. With a fixed intravenous injection rate and scanning delay, 3D-CTA was performed using a single-detector helical CT scanner in 30 consecutive patients. We used 100 ml of iohexol 300 for 10 patients, 100 ml of iopamidol 300 for 10 patients, and 80 ml of iopamidol 370 for 10 patients. Attenuation values of the bilateral internal carotid arteries, bilateral middle cerebral arteries, basilar artery trunk, bilateral cavernous sinuses, bilateral basal veins, and Galenic vein were measured quantitatively on the axial CT angiographic source images. High-concentration contrast significantly increased the attenuation values of the intracranial arterial system without increasing the attenuation of the venous system. High-concentration contrast is helpful for obtaining valuable arteriovenous contrast on source images with intracranial 3D-CTA. (author)

  2. Pharmacokinetic/pharmacodynamic evaluation of marbofloxacin as a single injection for Pasteurellaceae respiratory infections in cattle using population pharmacokinetics and Monte Carlo simulations.

    Science.gov (United States)

    Paulin, A; Schneider, M; Dron, F; Woehrle, F

    2018-02-01

    Population pharmacokinetic of marbofloxacin was investigated with 52 plasma concentration-time profiles obtained after intramuscular administration of Forcyl® in cattle. Animal's status, pre-ruminant, ruminant, or dairy cow, was retained as a relevant covariate for clearance. Monte Carlo simulations were performed using a stratification by status, and 1000 virtual disposition curves were generated in each bovine subpopulation for the recommended dosage regimen of 10 mg/kg as a single injection. The probability of target attainment (PTA) of pharmacokinetic/pharmacodynamic (PK/PD) ratios associated with clinical efficacy and prevention of resistance was determined in each simulated subpopulation. The cumulative fraction of response (CFR) of animals achieving a PK/PD ratio predictive of positive clinical outcome was then calculated for the simulated dosage regimen, taking into account the minimum inhibitory concentration (MIC) distribution of Pasteurella multocida, Mannheimia haemolytica, and Histophilus somni. When considering a ratio of AUC 0-24 hr /MIC (area under the curve/minimum inhibitory concentration) greater than 125 hr, CFRs ranging from 85% to 100% against the three Pasteurellaceae in each bovine subpopulation were achieved. The PTA of the PK/PD threshold reflecting the prevention of resistances was greater than 90% up to MPC (mutant prevention concentration) values of 1 μg/ml in pre-ruminants and ruminants and 0.5 μg/ml in dairy cows. © 2017 The Authors. Journal of Veterinary Pharmacology and Therapeutics Published by John Wiley & Sons Ltd.

  3. Psoriasis responds to intralesional injections of alefacept and may predict systemic response to intramuscular alefacept: interim results of a single-arm, open-label study.

    Science.gov (United States)

    Gattu, Shilpa; Busse, Kristine; Bhutani, Tina; Chiang, Charles; Nguyen, Thao; Becker, Emily; Koo, John Y M

    2012-04-01

    Alefacept is a remittive treatment for generalized psoriasis but is rarely used due to its erratic efficacy. To determine if psoriasis plaques will respond to intralesional alefacept and if this predicts a systemic response to intramuscular (IM) alefacept. We describe a 25-week, single-center, open-label study. Patients received weekly intralesional alefacept of increasing concentrations into target plaques for 3 weeks followed by IM injections for 12 weeks and concluded with an observation period of 9 weeks. The psoriasis area and severity index (PASI) was used to assess the efficacy of IM alefacept. Interim results are reported for the first seven patients enrolled. Two patients responded intralesionally to the most dilute 1:100 concentration of alefacept to sterile water and achieved a 59% and 100% improvement in PASI. Five patients did not respond intralesionally to the most dilute form of alefacept and none achieved PASI 75. Two of these five patients did not respond to any concentration and achieved a 26% and 38% improvement in PASI. Limitations to this study include a small sample size and being non-placebo-controlled. Alefacept is effective intralesionally and may predict a systemic response - challenging the concept that biologics must work systemically.

  4. The efficiency enhancement of single-layer solution-processed blue phosphorescent organic light emitting diodes by hole injection layer modification

    International Nuclear Information System (INIS)

    Yeoh, K H; Talik, N A; Whitcher, T J; Ng, C Y B; Woon, K L

    2014-01-01

    Poly(3,4-ethylenedioxythiophene): poly(styrenesulfonate) PEDOT : PSS is extensively used as a hole injection layer (HIL) in solution-processed organic light emitting diodes (OLEDs). The high work function of a HIL is crucial in improving OLED efficiency. The work function of PEDOT : PSS is usually around 5.1–5.3 eV. By adding perfluorinated ionomer (PFI), the work function of PEDOT : PSS has been reported to reach as high as 5.95 eV. We investigated the effects of PFI-modified PEDOT : PSS in a single-layer solution-processed blue phosphorescent OLED (PHOLED). We observed that high concentrations of a PFI in PEDOT : PSS has detrimental effects on the device efficiency due to the low conductivity of the PFI. Using this approach, blue PHOLEDs with efficiencies of 9.4 lm W −1 (18.2 cd A −1 ) and 7.9 lm W −1 (20.4 cd A −1 ) at 100 cd m −2 and 1000 cd m −2 , respectively, were demonstrated. (paper)

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

    Directory of Open Access Journals (Sweden)

    Bischoff, S. C.

    2009-11-01

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

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

    Science.gov (United States)

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

    2009-11-18

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

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

    Science.gov (United States)

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

    2009-11-18

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

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

    Directory of Open Access Journals (Sweden)

    Rothaermel, S.

    2009-11-01

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

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

    Directory of Open Access Journals (Sweden)

    Druml, W.

    2009-11-01

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

  10. Stability and visual compatibility of bretylium tosylate with selected large-volume parenterals and additives.

    Science.gov (United States)

    Perentesis, G P; Piltz, G W; Kirshcenbaum, H L; Navalakha, P; Aronoff, W; Cutie, A J

    1983-06-01

    The stability of bretylium tosylate when mixed with large-volume parenteral (LVP) solutions was assessed over a four-week period, and the compatibility of bretylium tosylate when mixed with eight frequently used drugs was evaluated. Bretylium tosylate admixtures of approximately 1 mg/ml were prepared in both polyvinyl chloride (PVC) bags and glass bottles of 5% dextrose injection, 0.9% sodium chloride injection, and lactated Ringer's injection. The admixtures were examined visually and stored for four weeks at 25 +/- 0.5 degree C under fluorescent light. The concentrations of bretylium tosylate were determined spectrophotometrically at times 0.25, 0.5, 1, 3, 8, 24, and 48 hours and twice weekly thereafter for four weeks. Spectrophotometric assays were confirmed with high-pressure liquid chromatography. Admixtures of bretylium tosylate were prepared with aminophylline, calcium gluconate, digoxin, regular insulin, lidocaine hydrochloride, phenytoin sodium, procainamide hydrochloride, and quinidine gluconate in 5% dextrose injection and 0.9% sodium chloride injection. The admixtures were examined visually for 48 hours. The concentration of bretylium tosylate did not change appreciably during the four-week study period. There were no signs of haze, precipitation, color change, or evolution of gas. There were no apparent differences in stability when comparing the glass with the PVC containers. Bretylium tosylate was also found to be compatible with all the additives tested except phenytoin sodium; a precipitate formed immediately when the latter drug was added to the bretylium tosylate solution. Bretylium tosylate was stable for four weeks in the LVP solutions studied in both glass and PVC containers. The admixtures of bretylium sodium with the other drugs were all visually compatible except those containing phenytoin sodium.

  11. Cefoxitin Injection

    Science.gov (United States)

    ... injection is used to treat infections caused by bacteria including pneumonia and other lower respiratory tract (lung) infections; and urinary tract, abdominal (stomach area), female reproductive organs, blood, ... by killing bacteria.Antibiotics such as cefoxitin injection will not work ...

  12. Golimumab Injection

    Science.gov (United States)

    ... damaged, and do not use an auto-injection device if the security seal is broken. Look through the viewing window on the prefilled syringe or auto-injection device. The liquid inside should be clear and colorless ...

  13. Doxycycline Injection

    Science.gov (United States)

    ... may have been exposed to anthrax in the air. Doxycycline injection is in a class of medications ... decrease the effectiveness of hormonal contraceptives (birth control pills, patches, rings, or injections). Talk to your doctor ...

  14. Abaloparatide Injection

    Science.gov (United States)

    ... injection may cause osteosarcoma (bone cancer) in laboratory rats. It is not known whether abaloparatide injection increases ... too have too much calcium in the blood, hyperparathyroidism (condition in which the body produces too much ...

  15. Paliperidone Injection

    Science.gov (United States)

    Paliperidone extended-release injections (Invega Sustenna, Invega Trinza) are used to treat schizophrenia (a mental illness that ... interest in life, and strong or inappropriate emotions). Paliperidone extended-release injection (Invega Sustenna) is also used ...

  16. Doripenem Injection

    Science.gov (United States)

    ... injection is in a class of medications called carbapenem antibiotics. It works by killing bacteria.Antibiotics such ... if you are allergic to doripenem injection; other carbapenem antibiotics such as imipenem/cilastatin (Primaxin) or meropenem ( ...

  17. Ceftriaxone Injection

    Science.gov (United States)

    Ceftriaxone injection is used to treat certain infections caused by bacteria such as gonorrhea (a sexually transmitted ... skin, urinary tract, blood, bones, joints, and abdomen. Ceftriaxone injection is also sometimes given before certain types ...

  18. Nalbuphine Injection

    Science.gov (United States)

    ... injection is in a class of medications called opioid agonist-antagonists. It works by changing the way ... suddenly stop using nalbuphine injection, you may experience withdrawal symptoms including restlessness; teary eyes; runny nose; yawning; ...

  19. Naltrexone Injection

    Science.gov (United States)

    ... Videos & Tools Español You Are Here: Home → Drugs, Herbs and Supplements → Naltrexone Injection URL of this page: ... become depressed and sometimes try to harm or kill themselves. Receiving naltrexone injection does not decrease the ...

  20. Comprehensive low-dose imaging of carotid and coronary arteries with a single-injection dual-source CT angiography protocol

    International Nuclear Information System (INIS)

    Tognolini, A.; Arellano, C.S.; Marfori, W.; Heidari, G.; Sayre, J.W.; Krishnam, M.S.; Ruehm, S.G.

    2014-01-01

    Aim: To assess the feasibility of a fast single-bolus combined carotid and coronary computed tomography angiography (CTA) protocol in asymptomatic patients. Materials and methods: Thirty-three consecutive patients (18 women and 15 men) with a median age of 61 ± 14 years old (range 37–87 years) with known or suspected atherosclerotic disease were enrolled in this prospective study. A single breath-hold, single biphasic injection protocol (50 ml at 3 ml/s, 50 ml at 5 ml/s, 50 ml saline flush at 5 ml/s) was used for combined CTA imaging of the supra-aortic (SAA) and coronary arteries (CA) on a 64-slice dual-source CT (DSCT) machine. Helical CTA acquisition of the SAA was followed by prospective electrocardiography (ECG)-triggered coronary CTA. Subjective (four-point scale) image quality and objective signal-to-noise (SNR) and contrast-to-noise (CNR) measurements were performed. Vascular disease was graded on a four-point scale (grade 1: absent; grade 2: mild, grade 3: moderate; grade 4: severe). The radiation dose was recorded for each patient. Results: The average enhancement and subjective quality score of SAA and CA segments were 396 HU/358 HU and 1.2 ± 0.3/1.72 ± 0.4, respectively. The SNR was 27.1 ± 1.7 in the SAA and 21.6 ± 1.6 in the CA (p < 0.0001). The CNR was 18.1 ± 1.2 and 15.9 ± 1.8, respectively (p = 0.4). Four percent of SAA and 14% of CA segments (mostly due to peri-venous streak artefacts and small calibre, respectively) produced non-diagnostic images. SAA findings were as follows: 26/33 (79%) patients showed no disease and 6/33 (18%) had grade 2 and 1/33 (3%) had grade 3 disease. CA findings were as follows: 25/33 (76%) showed no disease and 6/33 (18%) patients had grade 2 and 2/33 (6%) had grade 3 disease. Five patients had disease in both districts. The average radiation dose for the combined CTA angiogram was 4.3 ± 0.6 mSv. Conclusion: A fast, low-dose combined DSCT angiography protocol appears technically feasible for imaging carotid and

  1. Comprehensive low-dose imaging of carotid and coronary arteries with a single-injection dual-source CT angiography protocol.

    Science.gov (United States)

    Tognolini, A; Arellano, C S; Marfori, W; Heidari, G; Sayre, J W; Krishnam, M S; Ruehm, S G

    2014-03-01

    To assess the feasibility of a fast single-bolus combined carotid and coronary computed tomography angiography (CTA) protocol in asymptomatic patients. Thirty-three consecutive patients (18 women and 15 men) with a median age of 61 ± 14 years old (range 37-87 years) with known or suspected atherosclerotic disease were enrolled in this prospective study. A single breath-hold, single biphasic injection protocol (50 ml at 3 ml/s, 50 ml at 5 ml/s, 50 ml saline flush at 5 ml/s) was used for combined CTA imaging of the supra-aortic (SAA) and coronary arteries (CA) on a 64-slice dual-source CT (DSCT) machine. Helical CTA acquisition of the SAA was followed by prospective electrocardiography (ECG)-triggered coronary CTA. Subjective (four-point scale) image quality and objective signal-to-noise (SNR) and contrast-to-noise (CNR) measurements were performed. Vascular disease was graded on a four-point scale (grade 1: absent; grade 2: mild, grade 3: moderate; grade 4: severe). The radiation dose was recorded for each patient. The average enhancement and subjective quality score of SAA and CA segments were 396 HU/358 HU and 1.2 ± 0.3/1.72 ± 0.4, respectively. The SNR was 27.1 ± 1.7 in the SAA and 21.6 ± 1.6 in the CA (p grade 2 and 1/33 (3%) had grade 3 disease. CA findings were as follows: 25/33 (76%) showed no disease and 6/33 (18%) patients had grade 2 and 2/33 (6%) had grade 3 disease. Five patients had disease in both districts. The average radiation dose for the combined CTA angiogram was 4.3 ± 0.6 mSv. A fast, low-dose combined DSCT angiography protocol appears technically feasible for imaging carotid and coronary atherosclerotic disease. Copyright © 2013 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  2. Myocardial blood flow rate and capillary permeability for 99mTc-DTPA in patients with angiographically normal coronary arteries. Evaluation of the single-injection, residue detection method with intracoronary indicator bolus injection and the use of a mobile gamma camera

    DEFF Research Database (Denmark)

    Svendsen, Jesper Hastrup; Kelbaek, H; Efsen, F

    1994-01-01

    The aims of the present study were to quantitate myocardial perfusion and capillary permeability in the human heart by means of the single-injection, residue detection method using a mobile gamma camera. With this method, the intravascular mean transit time and the capillary extraction fraction (...

  3. A Three-arm Randomized Clinical Trial Comparing Continuous Femoral Plus Single-injection Sciatic Peripheral Nerve Blocks versus Periarticular Injection with Ropivacaine or Liposomal Bupivacaine for Patients Undergoing Total Knee Arthroplasty.

    Science.gov (United States)

    Amundson, Adam W; Johnson, Rebecca L; Abdel, Matthew P; Mantilla, Carlos B; Panchamia, Jason K; Taunton, Michael J; Kralovec, Michael E; Hebl, James R; Schroeder, Darrell R; Pagnano, Mark W; Kopp, Sandra L

    2017-06-01

    Multimodal analgesia is standard practice for total knee arthroplasty; however, the role of regional techniques in improved perioperative outcomes remains unknown. The authors hypothesized that peripheral nerve blockade would result in lower pain scores and opioid consumption than two competing periarticular injection solutions. This three-arm, nonblinded trial randomized 165 adults undergoing unilateral primary total knee arthroplasty to receive (1) femoral catheter plus sciatic nerve blocks, (2) ropivacaine-based periarticular injection, or (3) liposomal bupivacaine-based periarticular injection. Primary outcome was maximal pain during postoperative day 1 (0 to 10, numerical pain rating scale) in intention-to-treat analysis. Additional outcomes included pain scores and opioid consumption for postoperative days 0 to 2 and 3 months. One hundred fifty-seven study patients received peripheral nerve block (n = 50), ropivacaine (n = 55), or liposomal bupivacaine (n = 52) and reported median maximal pain scores on postoperative day 1 of 3, 4, and 4.5 and on postoperative day 0 of 1, 4, and 5, respectively (average pain scores for postoperative day 0: 0.6, 1.7, and 2.4 and postoperative day 1: 2.5, 3.5, and 3.7). Postoperative day 1 median maximal pain scores were significantly lower for peripheral nerve blockade compared to liposomal bupivacaine-based periarticular injection (P = 0.016; Hodges-Lehmann median difference [95% CI] = -1 [-2 to 0]). After postanesthesia care unit discharge, postoperative day 0 median maximal and average pain scores were significantly lower for peripheral nerve block compared to both periarticular injections (ropivacaine: maximal -2 [-3 to -1]; P bupivacaine: maximal -3 [-4 to -2]; P bupivacaine over ropivacaine in periarticular injections for total knee arthroplasty.

  4. Synthesis of chemically-modified single-walled carbon nanotubes by counter-current ammonia gas injection into the induction thermal plasma process

    Science.gov (United States)

    Shahverdi, Ali

    Pristine single-walled carbon nanotubes (SWCNTs) are poorly dispersible and insoluble in many solvents and need to be chemically modified prior to their use in many applications. This work is focused on the investigation of the synthesis of chemically modified SWCNTs material through an in situ approach. The main objectives of the presented research are: 1) to explore the in situ chemical process during the synthesis of SWCNT and 2) to closely examine the effect of a reactive environment on SWCNTs. Effects of the catalyst type and content on the SWCNTs final product, synthesized by induction thermal plasma (ITP), were studied to replace toxic cobalt (Co) in the feedstock. In this regard, three different catalyst mixtures (i.e. Ni-Y2O3, Ni-Co-Y2O3, and Ni-Mo-Y2O3) were used. Experimental results showed that the catalyst type affects the quality of the SWCNT final product. Similar quality SWCNTs can be produced when the same amount of Co was replaced by Ni. Moreover, the results observed in this experimental work were further explained by thermodynamic calculation results. Thermogravimetry (TG) was used throughout the work to characterize the SWCNTs product. TG was firstly standardized by studying the effects of three main instrumental parameters (temperature ramp, TR, initial mass of the sample, IM, and gas flow rate, FR) on the Tonset and full-width half maximum (FWHM) obtained from TG and derivative TG graphs of carbon black, respectively. Therefore, a two-level factorial statistical design was performed. The statistical analysis showed that the effect of TR, IM, and to a lower extent, FR, is significant on FWHM and insignificant on Tonset. A methodology was then developed based upon the SWCNTs synthesis using the ITP system, through an in situ chemistry approach. Ammonia (NH3) was selected and counter-currently injected into the ITP reactor at three different flow rates and by four different nozzle designs. Numerical simulation indicated a better mixing of NH3 in

  5. Dose-dependent effect of a single GnRHa injection on the spawning of meagre (Argyrosomus regius broodstock reared in captivity

    Directory of Open Access Journals (Sweden)

    Hipolito Fernandez-Palacios

    2014-10-01

    Full Text Available The present study aimed to determine the spawning efficacy, egg quality and quantity of captive breed meagre induced with a single gonadotrophin‐releasing hormone agonist (GnRHa injection of 0, 1, 5, 10, 15, 20, 25, 30, 40 or 50 µg kg-1 to determine a recommended optimum dose to induce spawning. The doses 10, 15 and 20 μg kg-1 gave eggs with the highest quality (measured as: percentage of viability, floating, fertilisation and hatch and quantity (measured as: total number of eggs, number of viable eggs, number of floating eggs, number of hatched larvae and number of larvae that reabsorbed the yolk sac. All egg quantity parameters were described by Gaussian regression analysis with R2=0.89 or R2=0.88. The Gaussian regression analysis identified that the optimal dose used was 15 μg kg-1. The regression analysis highlighted that this comprehensive study examined doses that ranged from low doses insufficient to stimulate a high spawning response (significantly lower egg quantities, p<0.05 compared to 15 μg kg-1 through to high doses that stimulated the spawning of significantly lower egg quantities and eggs with significantly lower quality (egg viability. In addition, the latency period (time from hormone application to spawning decreased with increasing doses to give a regression (R2=0.93 which suggests that higher doses accelerated oocyte development that in turn reduced egg quality and quantity. The identification of an optimal dose for the spawning of meagre, which has high aquaculture potential, represents an important advance for the Mediterranean aquaculture industry.

  6. Nutrición parenteral precoz en el neonato grave

    Directory of Open Access Journals (Sweden)

    Alina González Mustelier

    2004-06-01

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

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

    Directory of Open Access Journals (Sweden)

    Jauch, K. W.

    2009-11-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

  9. Malassezia Pneumonia: A Rare Complication of Parenteral Nutrition Therapy.

    Science.gov (United States)

    Baker, Richelle M; Stegink, Ryan J; Manaloor, John J; Schmitt, Bryan H; Stevens, John C; Christenson, John C

    2016-11-01

    Malassezia species (formerly known as Pityrosporum) are part of normal human skin flora and have been associated with benign dermatologic conditions, such as seborrheic dermatitis and tinea versicolor. In rare cases, however, Malassezia has been associated with systemic disease in immunocompromised patients and infants in the neonatal intensive care unit. Malassezia species require long-chain fatty acids for growth and therefore have a known predilection for individuals receiving lipid containing intravenous parenteral nutrition (PN). Systemic infections are characterized by prolonged fevers and illness but can include nonspecific signs and symptoms. We present the diagnosis and management of a rare case of an immunocompetent, nonneonatal, PN-dependent child with Malassezia furfur pneumonia. © 2015 American Society for Parenteral and Enteral Nutrition.

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

    Science.gov (United States)

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

    1977-01-01

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

  11. Innovative Parenteral and Enteral Nutrition Therapy for Intestinal Failure

    OpenAIRE

    Le, Hau D.; Fallon, Erica M.; de Meijer, Vincent E.; Malkan, Alpin D.; Puder, Mark; Gura, Kathleen M.

    2010-01-01

    Children with intestinal failure suffer from insufficient intestinal length or function, making them dependent on parenteral nutrition (PN) for growth and survival. PN and its components are associated with many complications ranging from simple electrolyte abnormalities to life-threatening PN-associated liver disease, which is also called intestinal failure-associated liver disease (ILALD). From a nutrition perspective, the ultimate goal is to provide adequate caloric requirements and make t...

  12. Growth factor-based therapies provide additional benefit beyond physical therapy in resistant elbow tendinopathy: a prospective, single-blind, randomised trial of autologous blood injections versus platelet-rich plasma injections.

    Science.gov (United States)

    Creaney, Leon; Wallace, Andrew; Curtis, Mark; Connell, David

    2011-09-01

    Growth factor technologies are increasingly used to enhance healing in musculoskeletal injuries, particularly in sports medicine. Two such products; platelet-rich plasma (PRP) and autologous blood, have a growing body of supporting evidence. No previous trial has directly compared the efficacy of these two methods. Growth factor administration improves tissue regeneration in patients who have failed to respond to conservative therapy. A prospective, double-blind, randomised trial. Elbow tendinopathy patients who had failed conservative physical therapy were divided into two patient groups: PRP injection (N=80) and autologous blood injection (ABI) (N=70). Each patient received two injections at 0 and 1 month. Patient-related tennis elbow evaluation (PRTEE) was recorded by a blinded investigator at 0, 1, 3 and 6 months. The main outcome measure was PRTEE, a validated composite outcome for pain, activities of daily living and physical function, utilising a 0-100 scale. At 6 months the authors observed a 66% success rate in the PRP group versus 72% in the ABI group, p=NS. There was a higher rate of conversion to surgery in the ABI group (20%) versus the PRP group (10%). In patients who are resistant to first-line physical therapy such as eccentric loading, ABI or PRP injections are useful second-line therapies to improve clinical outcomes. In this study, up to seven out of 10 additional patients in this difficult to treat cohort benefit from a surgery-sparing intervention.

  13. Indications for the use of parenteral H2-receptor antagonists.

    Science.gov (United States)

    Thompson, J C; Walker, J P

    1984-11-19

    Development of acute mucosal ulceration is a complex series of catabolic interactions. Hospitalized patients with duodenal or gastric ulcer, pathologic gastric hypersecretory states (such as Zollinger-Ellison syndrome), gastric outlet obstruction, esophagitis, severe gastritis or duodenitis, sepsis, trauma (particularly head injury or burns), and some patients receiving high-dose corticosteroids are at risk of developing acute stress ulcers. Treatment should be initiated as soon as the patient is identified as being at risk, because measures designed to prevent bleeding or perforation are more effective than those designed to stop bleeding once it supervenes and the cascade of multiple organ failure commences. The presence of acid will trigger the onset of this condition; however, ulceration will not occur if the intraluminal pH can be maintained above 5 by periodic antacid treatment or by H2-receptor blockade. The dosing regimen of antacid or of H2-receptor antagonist should not be fixed, but should be sufficient to keep the gastric pH higher than 5. Antagonists administered via a nasogastric tube are the first line of defense, but 30 to 50 percent of the most ill patients will also be treated parenterally with H2-receptor antagonists. Parenteral H2-receptor blockade therapy is indicated in these patients when the risk of acute or continued ulceration of esophageal, gastric, or duodenal mucosa is high and the oral administration of medication is either not possible or the response to such therapy is unreliable. Parenteral H2-receptor antagonists are rarely administered alone.

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

    Science.gov (United States)

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

    1982-01-01

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

  15. Parenteral administration medicines: recommendations of preparation, administration and stability

    Directory of Open Access Journals (Sweden)

    M. Gaspar Carreño

    2014-11-01

    Full Text Available Objective: To develop recommendations for the preparation of parenteral drugs (MAP, to assess the transferability of their preparation, from nursing units in the hospital ward to the pharmacy service (SF. Method: A table of stabilities of parenteral drugs included in the pharmacotherapeutic guideline was developed using the american and spanish guidelines. Information about MAP was collected (method of preparation, support, maintenance, validity, administration specifications and packaging by consulting product technical sheets, pharmaceutical industries, literature review and databases. Results: After reviewing 209 drugs, a list of recommendations was developed. According to the data, MAP will be prepared as follows: 89 drugs will be prepared from SF, 62 drugs at nursing units because of its immediate administration requirement and 58 are already packed for its administration by the industry. Of these 62 drugs prepared a nursing units, 14 of them will be prepared in the following doses by the SF. Therefore, 48 drugs will be prepared at nursing units from the 209 parenteral drugs reviewed. Conclusions: A standardized method of preparation, storage, administration and validity of MAP was established by the SF. The preparation of MAP in the SF extends its shelf life, by considering physicochemical stability, level of risk and product vulnerability to microbiological contamination. The information provided will contribute to a reduction of errors associated with the preparation and administration of MAP.

  16. [Parenteral administration medicines: recommendations of preparation, administration and stability].

    Science.gov (United States)

    Gaspar Carreño, M; Torrico Martín, F; Novajarque Sala, L; Batista Cruz, M; Ribeiro Gonçalves, P; Porta Oltra, B; Sánchez Santos, J C

    2014-11-03

    To develop recommendations for the preparation of parenteral drugs (MAP), to assess the transferability of their preparation, from nursing units in the hospital ward to the pharmacy service (SF). A table of stabilities of parenteral drugs included in the pharmacotherapeutic guideline was developed using the american and spanish guidelines. Information about MAP was collected (method of preparation, support, maintenance, validity, administration specifications and packaging) by consulting product technical sheets, pharmaceutical industries, literature review and databases. After reviewing 209 drugs, a list of recommendations was developed. According to the data, MAP will be prepared as follows: 89 drugs will be prepared from SF, 62 drugs at nursing units because of its immediate administration requirement and 58 are already packed for its administration by the industry. Of these 62 drugs prepared a nursing units, 14 of them will be prepared in the following doses by the SF. Therefore, 48 drugs will be prepared at nursing units from the 209 parenteral drugs reviewed. A standardized method of preparation, storage, administration and validity of MAP was established by the SF. The preparation of MAP in the SF extends its shelf life, by considering physicochemical stability, level of risk and product vulnerability to microbiological contamination. The information provided will contribute to a reduction of errors associated with the preparation and administration of MAP. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  17. Current uses and abuses of total parenteral nutrition.

    Science.gov (United States)

    Archer, S B; Burnett, R J; Fischer, J E

    1996-01-01

    Total parenteral nutrition remains a vital medical intervention, and in our institution it is considered as basic as intravenous fluids, antibiotics, and blood transfusions. As is true of most treatments, there are specific indications as well as associated risks and costs which mandate justification of its use. It is clear that the indications for TPN are diminishing as basic science and clinical studies continue to find increased benefits associated with enteral feeding, and as techniques for initiating enteral nutrition improve. Because of unproven benefits and/or increased complication rates, TPN has lost favor in the treatment of conditions that were previously thought to require parenteral alimentation, such as acute pancreatitis, pediatric and adult burns, critical care, and preoperative use in patients with mild or moderate malnutrition. Despite diminishing indications, TPN continues to generate excitement in some areas as its immunological effects become better defined. The use of TPN in patients with cancer before certain therapies, as well as in the transplant population, remains hopeful. New uses of TPN will result from a better understanding of the cellular and molecular effects of parenteral feeding. In the future, TPN may well be used as a pharmacologic agent rather than as nutritional intervention.

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

    Science.gov (United States)

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

    2009-11-18

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

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

    Directory of Open Access Journals (Sweden)

    Holland-Cunz, S.

    2009-11-01

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

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

    Directory of Open Access Journals (Sweden)

    Kreymann, G.

    2009-11-01

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

  1. Gamma irradiated micro system for long-term parenteral contraception: An alternative to synthetic polymers.

    Science.gov (United States)

    Puthli, S; Vavia, P

    2008-11-15

    An injectable system of levonorgestrel (LNG) was developed using biodegradable polymer of natural origin. The parenteral system was optimized for particle size and higher drug loading. The microparticulate system was characterised by scanning electron microscopy, encapsulation efficiency, moisture content, IR, DSC, XRD, residual solvent content, sterility testing, test of abnormal toxicity and test for pyrogens. The microparticles were sterilised by gamma irradiation (2.5Mrad). The system was injected intramuscularly in rabbits and the blood levels of LNG were determined using radioimmunoassay technique. An optimized drug to polymer ratio of 0.3-1.0 (w/w ratio) gave improved drug loading of about 52%. In vivo studies in rabbits showed that the drug was released in a sustained manner for a period of 1 month. The AUC(0-t) was found to be 9363.6+/-2340pg/mLday(-1) with MRT calculated to be about 16 days and Kel of 0.01day(-1). LNG levels were maintained between 200 and 400pg/mL. In vivo release exhibited an initial burst effect which was not observed in the in vitro dissolution. This promising "Progestin-only" long-term contraceptive with improved user compliance is an alternative to the synthetic expensive polymeric carriers.

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

    Directory of Open Access Journals (Sweden)

    Geraldo Duarte

    2005-08-01

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

  3. Physical compatibility of various drugs with neonatal total parenteral nutrient solution during simulated Y-site administration.

    Science.gov (United States)

    Fox, Laura M; Wilder, Alyson G; Foushee, Jaime A

    2013-03-15

    The physical compatibility of various drugs with neonatal total parenteral nutrient (TPN) solution during simulated Y-site administration was evaluated. Study drugs were selected based on the lack of compatibility data with them and neonatal TPN solution and the frequency of use in a local neonatal unit. These drugs included amiodarone, caffeine citrate, clindamycin, enalaprilat, epinephrine, fluconazole, fosphenytoin sodium, hydrocortisone, metoclopramide, midazolam, pentobarbital, phenobarbital, and rifampin. Equal volumes of neonatal TPN solution or sterile water for injection were combined with study drugs or sterile water for injection at concentrations used clinically in neonates. Each test was performed in triplicate. The samples were examined via turbidimetric analysis and visually against light and dark backgrounds immediately after mixing and at 0.25, 0.5, 1, 2, and 3 hours after mixing. Analysis of variance was used to determine statistically significant differences between the test and control solutions. Many of the drugs studied exhibited no visual or turbidimetric evidence of incompatibility when combined with neonatal TPN solution for up to three hours in a simulated Y-site injection. Pentobarbital, phenobarbital, and rifampin formed visible precipitation immediately after mixing with the neonatal TPN solution. Caffeine citrate, clindamycin, enalaprilat, epinephrine, fluconazole, fosphenytoin sodium, hydrocortisone, metoclopramide, and midazolam exhibited no visual or turbidimetric evidence of incompatibility when combined with a neonatal TPN solution for up to three hours in a simulated Y-site injection. Amiodarone, pentobarbital, phenobarbital, and rifampin were not compatible with the neonatal TPN solution and should not be coadministered via Y-site injection.

  4. Thermal Performance and Reliability Analysis of Single-Phase PV Inverters with Reactive Power Injection Outside Feed-In Operating Hours

    DEFF Research Database (Denmark)

    Anurag, Anup; Yang, Yongheng; Blaabjerg, Frede

    2015-01-01

    there is no solar irradiance. However, reactive power injection causes additional power losses in the switching components leading to a temperature rise in the devices. Thus, this paper analyses the impact of reactive power injection by PV inverters outside feed-in operation on the thermal performance...... of their power switching components. A thermal analysis based on the mission profile (i.e., solar irradiance and ambient temperature) has been incorporated, so as to determine the additional temperature rise in the components induced by the operation outside feed-in hours. An analytical lifetime model has been...... used. The damage produced on the transistors has been quantified using Palmgren Miner rule. A reliability analysis has been carried out on a PV inverter with and without the injection of reactive power into the utility grid at nights. Economic impacts of injecting reactive power from PV inverters...

  5. Effects of single injection of local anesthetic agents on intervertebral disc degeneration: ex vivo and long-term in vivo experimental study.

    Directory of Open Access Journals (Sweden)

    Koji Iwasaki

    Full Text Available Analgesic discography (discoblock can be used to diagnose or treat discogenic low back pain by injecting a small amount of local anesthetics. However, recent in vitro studies have revealed cytotoxic effects of local anesthetics on intervertebral disc (IVD cells. Here we aimed to investigate the deteriorative effects of lidocaine and bupivacaine on rabbit IVDs using an organotypic culture model and an in vivo long-term follow-up model.For the organotypic culture model, rabbit IVDs were harvested and cultured for 3 or 7 days after intradiscal injection of local anesthetics (1% lidocaine or 0.5% bupivacaine. Nucleus pulposus (NP cell death was measured using confocal microscopy. Histological and TUNEL assays were performed. For in vivo study, each local anesthetic was injected into rabbit lumbar IVDs under a fluoroscope. Six or 12 months after the injection, each IVD was prepared for magnetic resonance imaging (MRI and histological analysis.In the organotypic culture model, both anesthetic agents induced time-dependent NP cell death; when compared with injected saline solution, significant effects were detected within 7 days. Compared with the saline group, TUNEL-positive NP cells were significantly increased in the bupivacaine group. In the in vivo study, MRI analysis did not show any significant difference. Histological analysis revealed that IVD degeneration occurred to a significantly level in the saline- and local anesthetics-injected groups compared with the untreated control or puncture-only groups. However, there was no significant difference between the saline and anesthetic agents groups.In the in vivo model using healthy IVDs, there was no strong evidence to suggest that discoblock with local anesthetics has the potential of inducing IVD degeneration other than the initial mechanical damage of the pressurized injection. Further studies should be performed to investigate the deteriorative effects of the local injection of analgesic agents

  6. Hospitalization and Survival in Patients Using Epoprostenol for Injection in the PROSPECT Observational Study

    Science.gov (United States)

    Frantz, Robert P.; Schilz, Robert J.; Chakinala, Murali M.; Badesch, David B.; Frost, Adaani E.; McLaughlin, Vallerie V.; Barst, Robyn J.; Rosenberg, Daniel M.; Miller, Dave P.; Hartline, Brian K.; Benton, Wade W.

    2015-01-01

    BACKGROUND: Few studies have prospectively reported outcomes in patients with pulmonary arterial hypertension (PAH) treated with epoprostenol in the modern-day era of oral therapy and combination treatments. The Registry to Prospectively Describe Use of Epoprostenol for Injection (Veletri, prolonged room temperature stable-epoprostenol [RTS-Epo]) in Patients with Pulmonary Arterial Hypertension (PROSPECT) was established to prospectively describe the course of PAH in patients prescribed RTS-Epo. METHODS: PROSPECT is a multicenter, US-based drug registry of primarily group 1 patients with PAH treated with RTS-Epo who were parenteral-naive or parenteral-transitioned at enrollment. Patients were followed until discontinuation of RTS-Epo, withdrawal, loss to follow-up, death, or end of study (maximum 1 year). One-year freedom from hospitalization (FH) and survival estimates were summarized by prostacyclin history (parenteral-naive or parenteral-transitioned), sex, and chronic renal insufficiency (CRI). RESULTS: A total of 336 patients were included. The overall 1-year FH estimate was 51.0% ± 2.8% and was lower in parenteral-naive patients than parenteral-transitioned patients (42.8% ± 4.3% vs 57.1% ± 3.7%, respectively; P = .002). FH estimates were lower in male patients than female patients (38.3% ± 5.9% vs 54.6% ± 3.2%, respectively; P < .015) and in patients with CRI than patients without CRI (17.0% ± 8.4% vs 53.7% ± 2.9%, respectively; P < .001). The overall 1-year survival estimate was 84.0% ± 2.1%. Survival was poorer in parenteral-naive patients, male patients, and patients with CRI. CONCLUSIONS: Risk of hospitalization and mortality remain high in patients with PAH. In particular, patients who are parenteral-naive at initiation of RTS-Epo therapy, male patients, and patients with CRI require close monitoring and aggressive clinical management. PMID:25320967

  7. A Single-blind, Split-face, Randomized, Pilot Study Comparing the Effects of Intradermal and Intramuscular Injection of Two Commercially Available Botulinum Toxin A Formulas to Reduce Signs of Facial Aging

    Science.gov (United States)

    Sapra, Priya; Sapra, Sheetal; Khanna, Julie; Mraud, Kelli; Bonadonna, Jennifer

    2017-01-01

    Objective: To examine the effectiveness of intradermal botulinum toxin type A injection in improving skin texture and midface lift while reducing pore size and sebum production, as well as investigate the differences in effectiveness between onabotulinumtoxinA and abobotulinumtoxinA using intradermal and intramuscular injection methods. Design: A 16-week, single-blind, split-face, randomized study. Each patient served as their own control, receiving onabotulinumtoxinA and abobotulinumtoxinA randomized to either the left or right side of the face. Patients received intradermal botulinum toxin type A injections at Week 0 and intramuscular botulinum toxin type A injections at Week 2. Participants: Ten women aged 35 to 65 years who exhibited static rhytids in the glabellar and periorbital area. Measurements: The primary endpoint was efficacy of split-face treatment of intradermal and intramuscular onabotulinumtoxinA and abobotulinumtoxinA as assessed by a blinded evaluator using baseline and post-treatment photographs. The secondary endpoints included safety as assessed by adverse events and patient satisfaction measured by questionnaires completed at baseline and post-treatment. Results: Intradermal injection of botulinum toxin type A led to a statistically significant improvement in skin texture (p=0.004) while also resulting in mild midface lift (p=0.024), but did not provide a significant reduction of pore size and sebum production. There was no statistically significant difference between onabotulinumtoxinA and abobotulinumtoxinA when injected intradermally or intramuscularly. Conclusion: Intradermal injection of botulinum toxin type A appears to be a safe and effective therapy that provides an improvement in facial skin texture and midface lift. Registry: clinicaltrials.gov (ID#: NCT02907268). PMID:28367260

  8. Clinical and instrumental evaluation of a cross-linked hyaluronic acid filler dermal injection: effects on nasolabial folds skin biophysical parameters and augmentation from a single-dose, monocentric, open-label trial.

    Science.gov (United States)

    Cameli, Norma; Mariano, Maria; Serio, Mirko; Berardesca, Enzo

    2016-10-01

    When a hyaluronic acid dermal device to fill soft tissues is chosen, efficacy, safety and durability are key concerns. This is an open-label prospective study to instrumentally evaluate the effects of HA filler dermal injection on nasolabial folds skin biophysical parameters and augmentation. A single Italian site treated female subjects aged 40-55, for nasolabial folds, with a single standardized injection. The outcome was evaluated with objective quantitative measurements after 90 (T1) and 180 days (T2) from the injection comparing to baseline (T0) by means of Corneometer (skin hydration measurement), Cutometer (skin elasticity measurement), and Visioface devices for digital and UV computerized image analysis. Secondary endpoints were safety assessment, subject investigator satisfaction with the intervention. Assessment of aesthetic results included photographic documentation. The computerized image analysis confirmed the clinical assessment showing statistically significant reduction in nasolabial folds both at T1 and T2. Visioface® indexes showed a marked and statistical significant response. An excellent profile of satisfaction of the product at T2 from investigators and patients was recorded. Skin hydration and elasticity did not show significant changes. In our study, a standardized HA filler dermal injection on nasolabial folds did not influence skin biophysical parameters such as skin hydration and elasticity. Nasolabial folds showed a persistent and significative response at T2 confirmed by instrumental evaluation. The tolerability and safety profile of the product was excellent.

  9. Periodontal ligament injection versus routine local infiltration for nonsurgical single posterior maxillary permanent tooth extraction: comparative double-blinded randomized clinical study

    Directory of Open Access Journals (Sweden)

    Al-Shayyab MH

    2017-10-01

    Full Text Available Mohammad H Al-Shayyab Department of Oral and Maxillofacial Surgery, Oral Medicine and Periodontology, School of Dentistry, University of Jordan, Amman, Jordan Aim: The aim of this study was to evaluate the efficacy of, and patients’ subjective responses to, periodontal ligament (PDL anesthetic injection compared to traditional local-anesthetic infiltration injection for the nonsurgical extraction of one posterior maxillary permanent tooth. Materials and methods: All patients scheduled for nonsurgical symmetrical maxillary posterior permanent tooth extraction in the Department of Oral and Maxillofacial Surgery at the University of Jordan Hospital, Amman, Jordan over a 7-month period were invited to participate in this prospective randomized double-blinded split-mouth study. Every patient received the recommended volume of 2% lidocaine with 1:100,000 epinephrine for PDL injection on the experimental side and for local infiltration on the control side. A visual analog scale (VAS and verbal rating scale (VRS were used to describe pain felt during injection and extraction, respectively. Statistical significance was based on probability values <0.05 and measured using Χ2 and Student t-tests and nonparametric Mann–Whitney and Kruskal–Wallis tests. Results: Of the 73 patients eligible for this study, 55 met the inclusion criteria: 32 males and 23 females, with a mean age of 34.87±14.93 years. Differences in VAS scores and VRS data between the two techniques were statistically significant (P<0.001 and in favor of the infiltration injection. Conclusion: The PDL injection may not be the alternative anesthetic technique of choice to routine local infiltration for the nonsurgical extraction of one posterior maxillary permanent tooth. Keywords: PDL injection, infiltration, anesthesia, extraction

  10. Intraoperative Injection of Technetium-99m Sulfur Colloid for Sentinel Lymph Node Biopsy in Breast Cancer Patients: A Single Institution Experience

    Directory of Open Access Journals (Sweden)

    Julian Berrocal

    2017-01-01

    Full Text Available Background. Most institutions require a patient undergoing sentinel lymph node biopsy to go through nuclear medicine prior to surgery to be injected with radioisotope. This study describes the long-term results using intraoperative injection of radioisotope. Methods. Since late 2002, all patients undergoing a sentinel lymph node biopsy at the Yale-New Haven Breast Center underwent intraoperative injection of technetium-99m sulfur colloid. Endpoints included number of sentinel and nonsentinel lymph nodes obtained and number of positive sentinel and nonsentinel lymph nodes. Results. At least one sentinel lymph node was obtained in 2,333 out of 2,338 cases of sentinel node biopsy for an identification rate of 99.8%. The median number of sentinel nodes found was 2 and the mean was 2.33 (range: 1–15. There were 512 cases (21.9% in which a sentinel node was positive for metastatic carcinoma. Of the patients with a positive sentinel lymph node who underwent axillary dissection, there were 242 cases (54.2% with no additional positive nonsentinel lymph nodes. Advantages of intraoperative injection included increased comfort for the patient and simplification of scheduling. There were no radiation related complications. Conclusion. Intraoperative injection of technetium-99m sulfur colloid is convenient, effective, safe, and comfortable for the patient.

  11. Fenoldopam: novo antihipertensivo parenteral; alternativa ao nitroprussiato Fenoldopam: nuevo antihipertensivo parenteral; alternativa al nitroprusiato Fenoldopan: a new parenteral anti-hypertensive; an alternative to nitroprusside

    Directory of Open Access Journals (Sweden)

    Daniel Sousa César

    2001-12-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: O fenoldopam é um agonista dopaminérgico seletivo para os receptores dopaminérgicos tipo 1 (DA-1 que causa vasodilatação periférica e o objetivo deste artigo é reunir as informações clínicas sobre este fármaco. CONTEÚDO: Neste artigo foram revisadas as experiências em urgências e emergências hipertensivas, mostrando que o fenoldopam apresenta vantagens sobre o nitroprussiato de sódio (NPS no tratamento das mesmas. Ao contrário do NPS, o fenoldopam causa vasodilatação periférica, ao mesmo tempo que induz diurese e natriurese em pacientes com hipertensão grave sem causar os efeitos deletérios pelo tiocianato. CONCLUSÕES: O fenoldopam parenteral, pelos seus efeitos renais e menor impacto de efeitos colaterais, pode ser considerado uma boa alternativa ao nitroprussiato de sódio no tratamento de emergências hipertensivas.JUSTIFICATIVA Y OBJETIVOS: El fenoldopam es un agonista dopaminérgico selectivo para los receptores dopaminérgicos tipo 1 (DA-1 que causa vasodilatación periférica y el objetivo de este artículo es reunir las informaciones clínicas sobre este fármaco. CONTENIDO: En este articulo fueron revisadas las experiencias en urgencias y emergencias hipertensivas, mostrando que el fenoldopam presenta ventajas sobre el nitroprusiato de sodio (NPS en el tratamiento de las mismas. Al contrario del NPS, el fenoldopam causa vasodilatación periférica, al mismo tiempo que induce diuresis y natriuresis en pacientes con hipertensión grave sin causar los efectos deletérios por el tiocianato. CONCLUSIONES: El fenoldopam parenteral, por sus efectos renales y menor impacto de efectos colaterales, pode ser considerado una buena alternativa al nitroprusiato de sodio en tratamiento de emergencias hipertensivas.Background and Objectives: Fenoldopan is a selective dopaminergic agonist for dopaminergic receptors type 1 (DA-1, which induces peripheral vasodilation. This review aimed at collecting

  12. Growth responses following a single intra-muscular hGH plasmid administration compared to daily injections of hGH in dwarf mice.

    Science.gov (United States)

    Higuti, Eliza; Cecchi, Claudia R; Oliveira, Nelio A J; Vieira, Daniel P; Jensen, Thomas G; Jorge, Alexander A L; Bartolini, Paolo; Peroni, Cibele N

    2012-12-01

    In previous work, sustained levels of circulating human growth hormone (hGH) and a highly significant weight increase were observed after electrotransfer of naked plasmid DNA (hGH-DNA) into the muscle of immunodeficient dwarf mice (lit/scid). In the present study, the efficacy of this in vivo gene therapy strategy is compared to daily injections (5 μg/twice a day) of recombinant hGH (r-hGH) protein, as assessed on the basis of several growth parameters. The slopes of the two growth curves were found to be similar (P > 0.05): 0.095 g/mouse/d for protein and 0.094 g/mouse/d for DNA injection. In contrast, the weight increases averaged 35.5% (P hGH-DNA administration thus appears to be comparable to repeated hormone injections for promoting growth and may represent a feasible alternative for the treatment of growth hormone deficiency.

  13. Efficacy and safety of cross-linked hyaluronic acid single injection on osteoarthritis of the knee: a post-marketing phase IV study

    Directory of Open Access Journals (Sweden)

    Bashaireh K

    2015-04-01

    Full Text Available Khaldoon Bashaireh,1 Ziad Naser,2 Khaled Al Hawadya,2 Sorour Sorour,2 Rami Nabeel Al-Khateeb3 1Department of Orthopedics Surgery, King Abdullah University Hospital, Jordan University of Science and Technology, Irbid, Jordan; 2Private Clinic, 3Elaf Medical Supplies Company, Amman, Jordan Purpose: The primary objective of this study was to evaluate the efficacy, safety, and duration of action of viscosupplementation with Crespine® Gel over a 9-month period.Materials and methods: The study was a post-marketing phase IV study. A total of 109 participants with osteoarthritis of the knee (grades 1–4 in the tibio–femoral compartment were recruited in Jordan. Data were collected from each participant during the baseline visit. Each participant received Crespine® Gel injection, and follow-up visits took place at 3 months, 6 months, and 9 months post-injection.Main outcome measure(s: An assessment of participants by phone was conducted at 1 month, 2 months, 4 months, 5 months, 7 months, and 8 months post-injection. Western Ontario and McMaster Universities Arthritis Index questionnaires were completed during each visit. A 72-hour visit questionnaire was used to assess the safety of the injection. Statistical analysis included a two-sided 95% confidence interval for the difference between pain scores across visits, and the percent change from baseline was calculated.Main results: The full analysis included 84 participants who gave their informed consent and finished the necessary baseline and follow-up visits needed to assess efficacy and safety. Peak improvement was noted at 5 months post-injection, when pain and physical performance scores had decreased to 2.60 and 9.90, respectively, and the stiffness score was 0.33. The peak improvement in stiffness was noted at 8 months post-injection, when the stiffness score had decreased to 0.32. Significant improvements were still apparent at 9 months post-injection, when the pain score was 3

  14. [Postoperative nutritional support in liver surgery. Effects of specialized parenteral nutrition enriched with branched-chain amino acids following liver resections for colorectal carcinoma metastases].

    Science.gov (United States)

    Vyhnánek, F; Duchác, V; Vyhnánková, I; Skála, P

    2008-01-01

    Perioperative nutritional support in liver surgery remains specific regarding the role of the liver in the metabolism regulation. The loss of functional liver tissue following resection procedures may result in significant metabolic disorders, particularly in patients with preoperative liver impairment in chronic conditions. Perioperative nutritional support is indicated in patients suffering from malnutrition, chronic liver disorders and also following liver resections with limiting residual parenchyma. The retrospective study assessed the effect of complete parenteral nutrition enriched with branched chain amino acids on liver function and the rate of postoperative complications following liver resections (of at least two segments) for colorectal carcinoma metastases. 142 subjects following liver resections for colorectal carcinoma metastases were included in the study. In 42 subjects with anatomical resections of at least two segments, complete parenteral nutrition enriched with branched chain amino acids (3.8 g) was administered postoperatively from Day 1. The parenteral nutrition was maintained for 5 to 7 days, from Day 3, additional oral diet regime was indicated. In 100 subjects with a single segment resections or wedge resections, a combination of glucose 10% and crystalloid solutions was administered from Day 1, and early oral diet was added from Day2. Liver tests were performed during the first postoperative week and protein electrophoresis 14 days postoperatively. During the first postoperative week, the liver test values reached normal values in patients with specialized complete parenteral nutrition. In subjects, where the specialized parenteral nutrition was not administered, increased alcaline phosphatase levels and gamma glutamyl transpherase levels were recorded through the postoperative Day 7. No significant differences were detected in protein electrophoresis values and in rates of postoperative complications (14% in both patient groups). Liver

  15. Phase I, first-in-human study of BMS747158, a novel 18F-labeled tracer for myocardial perfusion PET: dosimetry, biodistribution, safety, and imaging characteristics after a single injection at rest.

    Science.gov (United States)

    Maddahi, Jamshid; Czernin, Johannes; Lazewatsky, Joel; Huang, Sung-Cheng; Dahlbom, Magnus; Schelbert, Heinrich; Sparks, Richard; Ehlgen, Alexander; Crane, Paul; Zhu, Qi; Devine, Marybeth; Phelps, Michael

    2011-09-01

    (18)F-labeled BMS747158 is a novel myocardial perfusion imaging tracer that targets mitochondrial complex 1. The objectives of this phase I study were to evaluate radiation dosimetry, biodistribution, human safety, tolerability, and early elimination of (18)F activity in urine after injection of a single dose of the tracer at rest in healthy subjects. Thirteen healthy subjects were injected with 170-244 MBq (4.6-6.6 mCi) of BMS747158 intravenously. Dynamic PET was obtained over the heart for 10 min, followed by sequential whole-body imaging for 5 h. Blood samples and urinary excretion were collected for up to 8 h. Heart rate, electrocardiogram, and blood pressure were monitored before and during imaging. The residence times were determined from multiexponential regression of organ region-of-interest data normalized by injected dose. Absorbed dose estimates for all target organs were determined using MIRD schema with OLINDA/EXM software. The organ receiving the largest mean absorbed dose was the kidneys at 0.066 mSv/MBq (0.24 rem/mCi), followed by the heart wall at 0.048 mSv/MBq (0.18 rem/mCi). The mean effective dose was 0.019 mSv/MBq (0.072 rem/mCi). The heart exhibited high and sustained retention of BMS747158 from the earliest images through approximately 5 h after injection. There were no drug-related adverse events, and the tracer was well tolerated in all subjects. Mean urinary excretion was 4.83 percentage injected dose (range, 0.64-12.41 percentage injected dose). These preliminary data suggest that (18)F-labeled BMS747158 appears to be well tolerated and has a unique potential for myocardial perfusion PET.

  16. Conjugated hyperbilirubinemia in infancy associated with parenteral alimentation.

    Science.gov (United States)

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

    1977-03-01

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

  17. Cefazolin Injection

    Science.gov (United States)

    ... is used to treat certain infections caused by bacteria including skin, bone, joint, genital, blood, heart valve, respiratory tract (including pneumonia), biliary tract, and urinary tract infections. Cefazolin injection ...

  18. Atezolizumab Injection

    Science.gov (United States)

    ... is in a class of medications called monoclonal antibodies. It works by blocking the action of a ... infection breath that smells fruity slowed, fast or irregular heartbeat Atezolizumab injection may cause other side effects. ...

  19. Cidofovir Injection

    Science.gov (United States)

    Cidofovir injection is used along with another medication (probenecid) to treat cytomegaloviral retinitis (CMV retinitis) in people ... body's response to the medication.You must take probenecid tablets by mouth with each dose of cidofovir. ...

  20. Acyclovir Injection

    Science.gov (United States)

    ... It is also used to treat first-time genital herpes outbreaks (a herpes virus infection that causes sores ... in the body. Acyclovir injection will not cure genital herpes and may not stop the spread of genital ...

  1. Alirocumab Injection

    Science.gov (United States)

    ... further decrease the amount of low-density lipoprotein (LDL) cholesterol ('bad cholesterol') in the blood. Alirocumab injection is ... antibodies. It works by blocking the production of LDL cholesterol in the body to decrease the amount of ...

  2. Pegloticase Injection

    Science.gov (United States)

    ... doctor if you have glucose-6-phosphate dehydrogenase (G6PD) deficiency (an inherited blood disease). Your doctor may test you for G6PD deficiency before you start to receive pegloticase injection. If ...

  3. Risperidone Injection

    Science.gov (United States)

    ... of interest in life, and strong or inappropriate emotions). Risperidone extended-release injection is used alone or ... during your treatment: extreme thirst, frequent urination, extreme hunger, blurred vision, or weakness. It is very important ...

  4. Olanzapine Injection

    Science.gov (United States)

    ... of interest in life, and strong or inappropriate emotions). Olanzapine injection is used to treat episodes of ... during your treatment: extreme thirst, frequent urination, extreme hunger, blurred vision, or weakness. It is very important ...

  5. Tacrolimus Injection

    Science.gov (United States)

    ... in people who have received kidney, liver, or heart transplants. Tacrolimus injection should only be used by people ... or nurse will watch you closely during the first 30 minutes of your treatment and then will ...

  6. Omalizumab Injection

    Science.gov (United States)

    ... injection is used to decrease the number of asthma attacks (sudden episodes of wheezing, shortness of breath, and ... about how to treat symptoms of a sudden asthma attack. If your asthma symptoms get worse or if ...

  7. Daclizumab Injection

    Science.gov (United States)

    ... neck, armpits, or groin; diarrhea; bloody stools; stomach pain; or any new, unexplained symptom affecting any part of your body.Because of the risks with this medication, daclizumab injection is available only through a special ...

  8. Temozolomide Injection

    Science.gov (United States)

    ... balance or coordination fainting dizziness hair loss insomnia memory problems pain, itching, swelling, or redness in the place where the medication was injected changes in vision Some side effects can be serious. If you ...

  9. Moxifloxacin Injection

    Science.gov (United States)

    ... tendon area, or inability to move or to bear weight on an affected area.Using moxifloxacin injection ... muscle weakness) and cause severe difficulty breathing or death. Tell your doctor if you have myasthenia gravis. ...

  10. Delafloxacin Injection

    Science.gov (United States)

    ... a tendon area, or inability to move or bear weight on an affected area.Using delafloxacin injection ... muscle weakness) and cause severe difficulty breathing or death. Tell your doctor if you have myasthenia gravis. ...

  11. Levofloxacin Injection

    Science.gov (United States)

    ... tendon area, or inability to move or to bear weight on an affected area.Using levofloxacin injection ... muscle weakness) and cause severe difficulty breathing or death. Tell your doctor if you have myasthenia gravis. ...

  12. Ciprofloxacin Injection

    Science.gov (United States)

    ... a tendon area, or inability to move or bear weight on an affected area.Using ciprofloxacin injection ... muscle weakness) and cause severe difficulty breathing or death. Tell your doctor if you have myasthenia gravis. ...

  13. Butorphanol Injection

    Science.gov (United States)

    ... Butorphanol is in a class of medications called opioid agonist-antagonists. It works by changing the way ... suddenly stop using butorphanol injection, you may experience withdrawal symptoms such as nervousness, agitation, shakiness, diarrhea, chills, ...

  14. Haloperidol Injection

    Science.gov (United States)

    ... of interest in life, and strong or inappropriate emotions). Haloperidol injection is also used to control motor ... and the laboratory. Your doctor may order certain lab tests to check your body's response to haloperidol ...

  15. Ketorolac Injection

    Science.gov (United States)

    ... of ketorolac by intravenous (into a vein) or intramuscular (into a muscle) injection in a hospital or ... You can also visit the Food and Drug Administration (FDA) website (http://www.fda.gov/Drugs/DrugSafety/ ...

  16. Efficacy and safety of cross-linked hyaluronic acid single injection on osteoarthritis of the knee: a post-marketing Phase IV study.

    Science.gov (United States)

    Bashaireh, Khaldoon; Naser, Ziad; Hawadya, Khaled Al; Sorour, Sorour; Al-Khateeb, Rami Nabeel

    2015-01-01

    The primary objective of this study was to evaluate the efficacy, safety, and duration of action of viscosupplementation with Crespine® Gel over a 9-month period. The study was a post-marketing Phase IV study. A total of 109 participants with osteoarthritis of the knee (grades 1-4) in the tibio-femoral compartment were recruited in Jordan. Data were collected from each participant during the baseline visit. Each participant received Crespine® Gel injection, and follow-up visits took place at 3 months, 6 months, and 9 months post-injection. An assessment of participants by phone was conducted at 1 month, 2 months, 4 months, 5 months, 7 months, and 8 months post-injection. Western Ontario and McMaster Universities Arthritis Index questionnaires were completed during each visit. A 72-hour visit questionnaire was used to assess the safety of the injection. Statistical analysis included a two-sided 95% confidence interval for the difference between pain scores across visits, and the percent change from baseline was calculated. The full analysis included 84 participants who gave their informed consent and finished the necessary baseline and follow-up visits needed to assess efficacy and safety. Peak improvement was noted at 5 months post-injection, when pain and physical performance scores had decreased to 2.60 and 9.90, respectively, and the stiffness score was 0.33. The peak improvement in stiffness was noted at 8 months post-injection, when the stiffness score had decreased to 0.32. Significant improvements were still apparent at 9 months post-injection, when the pain score was 3.36, the stiffness score was 0.42, and the physical performance score was 11.5. All side effects were local and transient, and included pain, swelling, and redness of the knee. Most side effects were treated. Hyaluronan should be encouraged as an alternative or adjunct treatment to oral analgesics to reduce their required doses, and delay potential future surgical intervention.

  17. Collagenase injections for the treatment of single cords in cases of Dupuytren’s contracture – a prospective intervention study of long-term experience with Xiapex

    Directory of Open Access Journals (Sweden)

    Fischer, Lisa Maria

    2017-04-01

    Full Text Available Introduction: The gold standard in the treatment of Dupuytren’s contracture is surgical therapy. Alternatives are percutaneous needle fasciotomy and radiation in exceptional cases. Injection treatments with Xiapex (Pfizer are a new therapy option. This collagenase, extracted from clostridium histolyticum, is used to break down the affected tissue cords. The objective of this study is to examine the effect and long-term success of treatment with Xiapex.Methods: In this study, Xiapex treatment was conducted on a sample group of 19 patients with Dupuytren’s contracture. The injection was placed either on the cord at the level of the metacarpophalangeal (MCP joint (n=17 or of the proximal interphalangeal (PIP joint (n=7. Break-up of the cord occurred 24 hours after the injection. The neutral zero method was used to assess the extent of movement. The Michigan Hand Outcomes Questionnaire (MHQ was selected for evaluation of the general hand function in 16 patients. The WHO-5 and the EQ-5D VAS Score were used as a measure of the patients’ satisfaction and their state of health. All values were collected both pre-injection as well as 1 year post-injection.Results: Out of 19 patients in our sample group, 16 patients (≈84% benefitted in terms of improvement in mobility. Overall, the range of movement increased by Ø 26° in the affected finger. A separate assessment demonstrated that:The range of movement increased by 77% in the MCP joint. The extent of movement pre-injection was Ø (0-28-78 and post-injection it was Ø (0-9-81 with an improvement of Ø 22°. In the PIP joint, only slight improvement was observed (Ø pre (0-27-93; post (0-24-95.The MHQ increased from Ø 76% (R: 32–97% to 81% (R: 39–100%.The painfulness decreased from Ø 19% (R: 0–55% to Ø11% (R: 0–55%, corresponding to Ø 43%. Satisfaction increased in 72% of patients by Ø 21%.According to WHO-5, patient satisfaction pre-injection was Ø 20 (R: 11–25, and 1 year after

  18. Efficacy and Safety of Single Botulinum Toxin Type A (Botox®) Injection for Relief of Upper Trapezius Myofascial Trigger Point: A Randomized, Double-Blind, Placebo-Controlled Study.

    Science.gov (United States)

    Kwanchuay, Photsawee; Petchnumsin, Thavatchai; Yiemsiri, Pichet; Pasuk, Nakkamol; Srikanok, Wannarat; Hathaiareerug, Chanasak

    2015-12-01

    Botulinum toxin injection has been applied for pain relief in various chronic pain syndromes. Recently, systematic review studies reported inconclusive effects of Botulinum toxin in myofascial pain management. The present study aimed to demonstrate the efficacy and safety of Botulinum toxin type A (BTxA) (Botox®) injection for pain reduction in myofascial trigger point (MTrP) of the upper trapezius muscle. Thirty-three patients with 48 MTrP on the upper trapezius muscles over three months with moderate to severe pain intensity diagnosed at physical medicine and rehabilitation outpatient department were recruited between December 2011 and March 2012. Eligible patients were blinded and randomly injected with single 0.2 ml (20 IU) of BTxA for 24 MTrP and 0.2 ml of 0.9% NaCl solution for 24 MTrP at the most tender trigger point on the upper trapezius muscle. All patients were advised for stretching exercise and ergonomic adaptation throughout the study. At 3- and 6-week after injections, visual analogue scale (VAS), the pressure pain threshold (PPT), and reported adverse effects were measured. Both BTxA and control groups demonstrated statistically significant differences in VAS reduction and increased PPT after 3 weeks and 6 weeks compared with before treatment. There were no statistically significant differences in VAS reduction from baseline between the two groups at 3- and 6-week after treatment. A statistically significant difference in improvement of PPT from baseline and 6-week after BTxA injection compared with 0.9% NaCl group was shown (1.0 ± 0.9 and 0.5 ± 0.7, p = 0.036). There was mild degree side-effects that spontaneous resolved within one week in both groups without significant difference in percentage. No severe adverse effects were reported during the study. The efficacy in VAS reduction of a single 20 IU of Botulinum toxin type A (Botox®) injection was not different from 0.9% NaCl for myofascial trigger point at the upper trapezius muscle. However

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

    NARCIS (Netherlands)

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

    2013-01-01

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

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

    NARCIS (Netherlands)

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

    2011-01-01

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

  1. New generation lipid emulsions prevent PNALD in chronic parenterally fed preterm pigs

    NARCIS (Netherlands)

    Vlaardingerbroek, Hester; Ng, Kenneth; Stoll, Barbara; Benight, Nancy; Chacko, Shaji; Kluijtmans, Leo A. J.; Kulik, Wim; Squires, E. James; Olutoye, Oluyinka; Schady, Deborah; Finegold, Milton L.; van Goudoever, Johannes B.; Burrin, Douglas G.

    2014-01-01

    Total parenteral nutrition (TPN) is associated with the development of parenteral nutrition-associated liver disease (PNALD) in infants. Fish oil-based lipid emulsions can reverse PNALD, yet it is unknown if they can prevent PNALD. We studied preterm pigs administered TPN for 14 days with either

  2. Efficacy of opioid rotation to continuous parenteral hydromorphone in advanced cancer patients failing on other opioids

    NARCIS (Netherlands)

    W.H. Oldenmenger (Wendy); P.J. Lieverse (P. J.); P.J.J.M. Janssen (Paul); W. Taal (Walter); C.C.D. van der Rijt (Carin); A. Jager (Agnes)

    2012-01-01

    textabstractPurpose: The effectiveness of an opioid rotation to parenteral hydromorphone in advanced cancer patients has never been investigated. Therefore, the purpose of this study was to investigate the analgesic efficacy and side effects of parenteral hydromorphone on serious cancer-related

  3. 76 FR 50741 - 2011 Parenteral Drug Association/Food and Drug Administration Joint Public Conference; Quality...

    Science.gov (United States)

    2011-08-16

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

  4. A single injection of the anabolic bone agent, parathyroid hormone-collagen binding domain (PTH-CBD), results in sustained increases in bone mineral density for up to 12 months in normal female mice.

    Science.gov (United States)

    Ponnapakkam, Tulasi; Katikaneni, Ranjitha; Suda, Hirofumi; Miyata, Shigeru; Matsushita, Osamu; Sakon, Joshua; Gensure, Robert C

    2012-09-01

    Parathyroid hormone (PTH) is the most effective osteoporosis treatment, but it is only effective if administered by daily injections. We fused PTH(1-33) to a collagen binding domain (PTH-CBD) to extend its activity, and have shown an anabolic bone effect with monthly dosing. We tested the duration of action of this compound with different routes of administration. Normal young C57BL/6J mice received a single intraperitoneal injection of PTH-CBD (320 μg/kg). PTH-CBD treated mice showed a 22.2 % increase in bone mineral density (BMD) at 6 months and 12.8 % increase at 12 months. When administered by subcutaneous injection, PTH-CBD again caused increases in BMD, 15.2 % at 6 months and 14.3 % at 12 months. Radiolabeled PTH-CBD was concentrated in bone and skin after either route of administration. We further investigated skin effects of PTH-CBD, and histological analysis revealed an apparent increase in anagen VI hair follicles. A single dose of PTH-CBD caused sustained increases in BMD by >10 % for 1 year in normal mice, regardless of the route of administration, thus showing promise as a potential osteoporosis therapy.

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

    Science.gov (United States)

    Friedman, B; Kanter, G; Titus, D

    1994-04-01

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

  6. Validation of cold chain during distribution of parenteral nutrition

    Directory of Open Access Journals (Sweden)

    Federico Tuan

    2015-09-01

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

  7. Hepatology – Guidelines on Parenteral Nutrition, Chapter 16

    Directory of Open Access Journals (Sweden)

    Plauth, M.

    2009-11-01

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

  8. 5.7  W cw single-frequency laser at 671  nm by single-pass second harmonic generation of a 17.2  W injection-locked 1342  nm Nd : YVO4 ring laser using periodically poled MgO : LiNbO3.

    Science.gov (United States)

    Koch, Peter; Ruebel, Felix; Bartschke, Juergen; L'huillier, Johannes A

    2015-11-20

    We demonstrate a continuous wave single-frequency laser at 671.1 nm based on a high-power 888 nm pumped Nd:YVO4 ring laser at 1342.2 nm. Unidirectional operation of the fundamental ring laser is achieved with the injection-locking technique. A Nd:YVO4 microchip laser serves as the injecting seed source, providing a tunable single-frequency power of up to 40 mW. The ring laser emits a single-frequency power of 17.2 W with a Gaussian beam profile and a beam propagation factor of M2beam profile and a beam propagation factor of M2lasers. This work opens possibilities in cold atoms experiments with lithium, allowing the use of larger ensembles in magneto-optical traps or higher diffraction orders in atomic beam interferometers.

  9. Regional bronchoconstriction in asthma. 133Xenon washout scans following parenteral methacholine

    International Nuclear Information System (INIS)

    Riley, D.J.; Fisher, A.B.; Hansell, J.R.; Brody, J.S.

    1976-01-01

    To determine the influence of bronchoconstriction on the distribution of ventilation during an asthma attack, pulmonary clearance of 133 xenon was evaluated in four normal and eight asthmatic subjects within three to five minutes after intramuscular injection of methacholine. In asthmatics, administration of 4-10 mg methacholine resulted in a decrease of forced vital capacity of 28.5 +- 5.1 (SE) percent and a decrease in expiratory flow at 60 percent vital capacity of 44.2 +- 6.9 percent (P less than 0.001). The cumulative ventilation required to reach 50 percent of the pre-washout radioactivity increased from 3.6 +- 0.8 to 9.9 +- 1.6 L after administration of the drug (P less than 0.05). The normal subjects showed no ventilatory effects after receiving 10 mg methacholine. Comparison of clearance of 133 xenon from ten areas of lung (each representing approximately 6 percent of the surface area of one lung) showed that all areas were affected to approximately the same extent during drug-induced asthma. These findings suggest that parenteral methacholine is an effective way to demonstrate airway hyperreactivity and that the airway response to methacholine in asthmatics is relatively generalized throughout the lung

  10. Arterio-venous concentration difference of [51Cr]EDTA after a single injection in man. Significance of renal function and local blood flow

    DEFF Research Database (Denmark)

    Rehling, M; Hyldstrup, L; Henriksen, Jens Henrik Sahl

    1989-01-01

    , whereas the difference was very sensitive to even small changes in forearm blood flow within the physiological range. For measurement of renal plasma clearance it is recommended to use one long period: from the time of injection until 300 min p.i. or longer. If the clearance period is too short, the use......, different results may be obtained from venous and arterial samples. The simplified techniques using venous blood samples--which usually include some empirical corrections--should be sufficiently reliable in daily clinical practice provided the forearm blood flow is reasonably high, e.g. exposure to cold...... introduced in the measurement of renal plasma clearance and total plasma clearance by using venous blood samples instead of arterial. In 13 patients with GFR ranging from 29 to 150 ml min-1, Ca was higher than Cv immediately after the injection. After mean 38 min (range 12-82 min) the two curves crossed...

  11. Experimental investigations of a four-stroke single cylinder direct injection diesel engine operated on dual fuel mode with producer gas as inducted fuel and Honge oil and its methyl ester (HOME) as injected fuels

    Energy Technology Data Exchange (ETDEWEB)

    Banapurmath, N.R.; Tewari, P.G. [Department of Mechanical Engineering, B.V.B. College of Engineering and Technology, Hubli 580031, Karnataka (India); Hosmath, R.S. [Department of Mechanical Engineering, K.L.E Society' s College of Engineering and Technology, Belgaum, Karnataka (India)

    2008-09-15

    In order to meet the energy requirements, there has been growing interest in alternative fuels like biodiesels, methyl alcohol, ethyl alcohol, biogas, hydrogen and producer gas to provide a suitable diesel oil substitute for internal combustion engines. Vegetable oils present a very promising alternative to diesel oil since they are renewable and have similar properties. Vegetable oils offer almost the same power output with slightly lower thermal efficiency when used in diesel engine [Srivastava A, Prasad R. Triglycerides-based diesel fuels. Renew Sustain Energy Rev 2000;4:111-33.; Vellguth G. Performance of vegetable oils and their monoesters as fuels for diesel engines. SAE 831358, 1983.; Demirbas A. Biodiesel production from vegetable oils via catalytic and non-catalytic supercritical methanol transesterification methods. Int J Prog Energy Combust Sci 2005;31:466-87.; Jajoo BN, Keoti RS. Evaluation of vegetable oils as supplementary fuels for diesel engines. In: Proceedings of the XV national conference on IC engines and combustion, Anna University Chennai, 1997.; Altin R, Cetinkaya S, Yucesu HS. The potential of using vegetable oil fuels as fuel for diesel engines. Int J Energy Convers Manage 2000;42:529-38, 248.; Gajendra Babu MK, Chandan Kumar Das LM. Experimental investigations on a Karanja oil methyl ester fuelled DI diesel engine. SAE 2006-01-0238, 2006.; Agarwal D, Kumar Agarwal A. Performance and emission characteristics of a Jatropha oil (preheated and blends) in a direct injection compression ignition engine. Int J Appl Therm Eng 2007;27:2314-23. ]. Research in this direction with edible oils have yielded encouraging results, but their use as fuel for diesel engine has limited applications due to higher domestic requirement [Scholl Kyle W, Sorenson Spencer C. Combustion Analysis of soyabean oil methyl ester in a direct injection diesel engine. SAE 930934, 1993.; Nwafor OMI. Effect of advanced injection timing on the performance of rapeseed oil in

  12. Effect of Pilot Injection Timings on the Combustion Temperature Distribution in a Single-Cylinder CI Engine Fueled with DME and ULSD

    OpenAIRE

    Jeon Joonho; Park Yong Hee; Kwon Sang Il; Park Sungwook

    2016-01-01

    Many studies of DiMethyl Ether (DME) as an alternative fuel in Compression-Ignition (CI) engines have been performed. Although diverse DME engine research has been conducted, the investigation of combustion behavior and temperature distribution in the combustion engine has not progressed due to the fact that there is no sooting flame in DME combustion. In order to investigate the combustion characteristics in this study, the KIVA-3 V code was implemented to research various pilot injection st...

  13. Axonal transport in rats rendered paraplegic following a single subarachnoid injection of either batrachotoxin or 6-aminonicotinamide into the spinal cord.

    Science.gov (United States)

    Boegman, R J; Albuquerque, E X

    1980-05-01

    Batrachotoxin (BTX) or 6-aminonicotinamide (6-AN) when injected into the subarachnoidal space of the lumbar spinal cord block fast axonal transport of 3H-protein in motor nerves. Axonal transport recovers partially within one day after administering BTX while the effect of 6-AN lasts for more than 21 days. These observations are discussed in relation to the onset and recovery of membrane depolarization observed in the extensor muscle.

  14. Single center experience with endoscopic subureteral dextranomer/hyaluronic acid injection as first line treatment in 1,551 children with intermediate and high grade vesicoureteral reflux.

    Science.gov (United States)

    Puri, Prem; Kutasy, Balazs; Colhoun, Eric; Hunziker, Manuela

    2012-10-01

    In recent years the endoscopic injection of dextranomer/hyaluronic acid has become an established alternative to long-term antibiotic prophylaxis and the surgical management of vesicoureteral reflux. We determined the safety and effectiveness of the endoscopic injection of dextranomer/hyaluronic acid as first line treatment for high grade vesicoureteral reflux. Between 2001 and 2010, 1,551 children (496 male, 1,055 female, median age 1.6 years) underwent endoscopic correction of intermediate and high grade vesicoureteral reflux using dextranomer/hyaluronic acid soon after the diagnosis of vesicoureteral reflux on initial voiding cystourethrogram. Vesicoureteral reflux was unilateral in 761 children and bilateral in 790. Renal scarring was detected in 369 (26.7%) of the 1,384 patients who underwent dimercapto-succinic acid imaging. Reflux grade in the 2,341 ureters was II in 98 (4.2%), III in 1,340 (57.3%), IV in 818 (34.9%) and V in 85 (3.6%). Followup ultrasound and voiding cystourethrogram were performed 3 months after the outpatient procedure, and renal ultrasound was performed annually thereafter. Patients were followed for 3 months to 10 years (median 5.6 years). Vesicoureteral reflux resolved after the first, second and third endoscopic injection of dextranomer/hyaluronic acid in 2,039 (87.1%), 264 (11.3%) and 38 (1.6%) ureters, respectively. Febrile urinary tract infections developed during followup in 69 (4.6%) patients. None of the patients in the series needed reimplantation of ureters or experienced any significant complications. Our results confirm the safety and efficacy of the endoscopic injection of dextranomer/hyaluronic acid in the eradication of high grade vesicoureteral reflux. We recommend this 15-minute outpatient procedure as the first line of treatment for high grade vesicoureteral reflux. Copyright © 2012 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  15. Single intradiscal injection of the interleukin-6 receptor antibody tocilizumab provides short-term relief of discogenic low back pain; prospective comparative cohort study.

    Science.gov (United States)

    Sainoh, Takeshi; Orita, Sumihisa; Miyagi, Masayuki; Inoue, Gen; Yamauchi, Kazuyo; Suzuki, Miyako; Sakuma, Yoshihiro; Kubota, Go; Oikawa, Yasuhiro; Inage, Kazuhide; Sato, Jun; Nakata, Yukio; Aoki, Yasuchika; Takahashi, Kazuhisa; Ohtori, Seiji

    2016-01-01

    Inflammatory cytokines, such as interleukin-6 and tumor necrosis factor-α, are gaining attention as important etiologic factors associated with discogenic low back pain. We conducted a prospective cohort study to evaluate the efficacy and safety of intradiscal injection of the interleukin-6 receptor antibody tocilizumab in patients with discogenic low back pain. Thirty-two consecutive patients were intradiscally injected with 2 mL of 0.5% bupivacaine (control group). Another 31 consecutive patients were intradiscally injected with 40 mg tocilizumab and 1-2 mL of 0.5% bupivacaine (tocilizumab group) at the same time. Prior to treatment, the vertebral origin of low back pain was confirmed in all patients based on pain provocation during discography and pain relief with 1 mL of 1% xylocaine. Numeric rating scale and Oswestry disability index scores were used to evaluate pain level before and after treatment between the 2 groups. The association between pain relief with tocilizumab and intervertebral disc degeneration grade was also determined. At the end of the study (8 weeks after treatment), 30 patients in each group were evaluable. In the tocilizumab group, numeric rating scale and Oswestry disability index scores improved significantly at 2 and 4 weeks after treatment, respectively. Intervertebral disc degeneration was not associated with improvement of numeric rating scale score in the tocilizumab group. Local infection (i.e., discitis) was observed in 1 patient in the tocilizumab group. The results demonstrate the clinical relevance of interleukin-6 in discogenic low back pain. Intradiscal tocilizumab injection was shown to exert a short-term analgesic effect in patients with discogenic low back pain. Further research is required to determine the long-term effects of intradiscal tocilizumab therapy in patients with discogenic low back pain. Copyright © 2015 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.

  16. Oxytocin via Uniject (a prefilled single-use injection) versus oral misoprostol for prevention of postpartum haemorrhage at the community level: a cluster-randomised controlled trial

    OpenAIRE

    Ayisha Diop, MPH; Bocar Daff, MD; Maimouna Sow, MA; Jennifer Blum, MPH; Mamadou Diagne, PhD; Nancy L Sloan, DrPH; Beverly Winikoff, MD

    2016-01-01

    Background: Access to injectable uterotonics for management of postpartum haemorrhage remains limited in Senegal outside health facilities, and misoprostol and oxytocin delivered via Uniject have been deemed viable alternatives in community settings. We aimed to compare the efficacy of these drugs when delivered by auxiliary midwives at maternity huts. Methods: We did an unmasked cluster-randomised controlled trial at maternity huts in three districts in Senegal. Maternity huts with auxili...

  17. Pharmacokinetics and Bioavailability of the GnRH Analogs in the Form of Solution and Zn2+-Suspension After Single Subcutaneous Injection in Female Rats.

    Science.gov (United States)

    Suszka-Świtek, Aleksandra; Ryszka, Florian; Dolińska, Barbara; Dec, Renata; Danch, Alojzy; Filipczyk, Łukasz; Wiaderkiewicz, Ryszard

    2017-04-01

    Although many synthetic gonadoliberin analogs have been developed, only a few of them, including buserelin, were introduced into clinical practice. Dalarelin, which differs from buserelin by just one aminoacid in the position 6 (D-Ala), is not widely used so far. Gonadotropin-releasing hormone (GnRH) analogs are used to treat many different illnesses and are available in different forms like solution for injection, nasal spray, microspheres, etc. Unfortunately, none of the above drug formulations can release the hormones for 24 h. We assumed that classical suspension could solve this problem. Two sets of experiments were performed. In the first one, buserelin and dalarelin were injected into mature female rats in two forms: suspension, in which the analogs are bounded by Zn 2+ ions and solution. The pharmacokinetic parameters and bioavailability of the analogs were calculated, based on their concentration in the plasma measured by high-performance liquid chromatography method (HPLC). In the second experiment, the hormones in two different forms were injected into superovulated immature female rats and then the concentration of Luteinizing hormone (LH), Follicle-stimulating hormone (FSH) and 17β-estradiol in the serum was measured by radioimmunological method. The Extent of Biological Availability (EBA), calculated on the base of AUC 0-∞ , showed that in the form of solution buserelin and dalarelin display, respectively, only 13 and 8 % of biological availability of their suspension counterparts. Comparing both analogs, the EBA of dalarelin was half (53 %) that of buserelin delivered in the form of solution and 83 % when they were delivered in the form of suspension. The injection of buserelin or dalarelin, in the form of solution or suspension, into superovulated female rats increased LH, FSH and estradiol concentration in the serum. However, after injection of the analogs in the form of suspension, the high concentration of LH and FSH in the serum persisted

  18. Maximal standard dose of parenteral iron for hemodialysis patients: an MRI-based decision tree learning analysis.

    Directory of Open Access Journals (Sweden)

    Guy Rostoker

    Full Text Available Iron overload used to be considered rare among hemodialysis patients after the advent of erythropoesis-stimulating agents, but recent MRI studies have challenged this view. The aim of this study, based on decision-tree learning and on MRI determination of hepatic iron content, was to identify a noxious pattern of parenteral iron administration in hemodialysis patients.We performed a prospective cross-sectional study from 31 January 2005 to 31 August 2013 in the dialysis centre of a French community-based private hospital. A cohort of 199 fit hemodialysis patients free of overt inflammation and malnutrition were treated for anemia with parenteral iron-sucrose and an erythropoesis-stimulating agent (darbepoetin, in keeping with current clinical guidelines. Patients had blinded measurements of hepatic iron stores by means of T1 and T2* contrast MRI, without gadolinium, together with CHi-squared Automatic Interaction Detection (CHAID analysis.The CHAID algorithm first split the patients according to their monthly infused iron dose, with a single cutoff of 250 mg/month. In the node comprising the 88 hemodialysis patients who received more than 250 mg/month of IV iron, 78 patients had iron overload on MRI (88.6%, 95% CI: 80% to 93%. The odds ratio for hepatic iron overload on MRI was 3.9 (95% CI: 1.81 to 8.4 with >250 mg/month of IV iron as compared to <250 mg/month. Age, gender (female sex and the hepcidin level also influenced liver iron content on MRI.The standard maximal amount of iron infused per month should be lowered to 250 mg in order to lessen the risk of dialysis iron overload and to allow safer use of parenteral iron products.

  19. Rapid Quantitative Analysis of Multiple Explosive-Compound Classes on a Single Instrument via Flow-Injection Analysis Tandem Mass Spectrometry

    Science.gov (United States)

    2017-06-09

    tailoring the ionization method , declustering potentials, and collision energies for each specific analyte. In doing so, a single instrument can be...of both conventional explosives, homemade explosives, and their related compounds, and many of these methods require special instrumentation . A...10%, respectively, compare favorably to existing methods . Use of a single instrument for detection of multiple explosive classes also reduces the

  20. Evaluation of the impact of viscosity, injection volume, and injection flow rate on subcutaneous injection tolerance

    Directory of Open Access Journals (Sweden)

    Berteau C

    2015-11-01

    Full Text Available Cecile Berteau,1 Orchidée Filipe-Santos,1 Tao Wang,2 Humberto E Rojas,2 Corinne Granger,1 Florence Schwarzenbach1 1Becton-Dickinson Medical Pharmaceutical Systems, Le Pont de Claix, France; 2Eli Lilly and Company, Indianapolis, IN, USA Aim: The primary objective of this study was to evaluate the impact of fluid injection viscosity in combination with different injection volumes and flow rates on subcutaneous (SC injection pain tolerance. Methods: The study was a single-center, comparative, randomized, crossover, Phase I study in 24 healthy adults. Each participant received six injections in the abdomen area of either a 2 or 3 mL placebo solution, with three different fluid viscosities (1, 8–10, and 15–20 cP combined with two different injection flow rates (0.02 and 0.3 mL/s. All injections were performed with 50 mL syringes and 27G, 6 mm needles. Perceived injection pain was assessed using a 100 mm visual analog scale (VAS (0 mm/no pain, 100 mm/extreme pain. The location and depth of the injected fluid was assessed through 2D ultrasound echography images. Results: Viscosity levels had significant impact on perceived injection pain (P=0.0003. Specifically, less pain was associated with high viscosity (VAS =12.6 mm than medium (VAS =16.6 mm or low (VAS =22.1 mm viscosities, with a significant difference between high and low viscosities (P=0.0002. Target injection volume of 2 or 3 mL was demonstrated to have no significant impact on perceived injection pain (P=0.89. Slow (0.02 mL/s or fast (0.30 mL/s injection rates also showed no significant impact on perceived pain during SC injection (P=0.79. In 92% of injections, the injected fluid was located exclusively in SC tissue whereas the remaining injected fluids were found located in SC and/or intradermal layers. Conclusion: The results of this study suggest that solutions of up to 3 mL and up to 15–20 cP injected into the abdomen within 10 seconds are well tolerated without pain. High

  1. Comparative efficacy of intra-articular hyaluronic acid and corticoid injections in osteoarthritis of the first carpometacarpal joint: results of a 6-month single-masked randomized study.

    Science.gov (United States)

    Monfort, Jordi; Rotés-Sala, Delfin; Segalés, Nuria; Montañes, Francisco-Jose; Orellana, Cristobal; Llorente-Onaindia, Jone; Mojal, Sergi; Padró, Isabel; Benito, Pere

    2015-03-01

    The study aim was to compare the efficacy and safety of ultrasound-guided intra-articular injections of hyaluronic acid and betamethasone in the management of patients with osteoarthritis of the thumb. Eighty-eight evaluable patients diagnosed with osteoarthritis of the thumb (Kellgren-Lawrence grade II-III) received ultrasound-guided intra-articular treatment with hyaluronic acid (48) or betamethasone (40). In total, 3 local injections were scheduled at 7-day intervals. Assessments were performed at baseline and at 7, 14, 30, 90, and 180 days. In both study groups, the pain Visual Analogue Scale and Functional Index for Hand Osteoarthritis scores decreased significantly during follow-up compared to baseline. There were no significant differences between the groups. However, at 90 days, the functional score showed a trend towards greater clinical improvement in the hyaluronic acid group (P 0.071). A subanalysis of patients with Functional Index score≥5 and Visual Analogue Scale score≥3 at baseline showed a significantly higher median functionality score in the hyaluronic acid group (P 0.005 at 90 days and P 0.020 at 180 days). Further limiting analysis to a baseline pain score≥5 showed significantly greater improvement in functionality score (P 0.004 at 180 days), which was already apparent after the second intra-articular injection at 14 days (P 0.028). In this patient subset, the mean pain score also improved significantly at 180 days (P 0.02). Both hyaluronic acid and betamethasone were effective and well-tolerated for the management of rhizarthrosis. Hyaluronic acid was more effective over time and more efficiently improved functionality and pain in patients with more severe symptoms. Copyright © 2014 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.

  2. Bringing SASI back: Single session selective arterial secretin injection and transarterial embolization of intrahepatic pancreatic neuroendocrine metastasis in a MEN-1 patient

    Directory of Open Access Journals (Sweden)

    Jawad S. Hussain, MD, MS

    2018-04-01

    Full Text Available SASI (selective arterial secretin injection is a form of ASVS (arterial stimulation and venous sampling used to localize pancreatic gastrinomas. This report aims to review the protocol for SASI and demonstrate its utility in localizing functional and nonfunctional gastrinomas. Even if a patient has a pancreatic mass and a laboratory profile fitting a specific endocrine syndrome, these may or may not be associated as has been previously demonstrated with adrenal vein sampling. We present a case where a patient underwent simultaneous SASI and bland embolization of a hepatic metastasis to facilitate partial pancreatectomy for Zollinger-Ellison syndrome. Keywords: SASI, ASVS, Gastrinoma, Sampling

  3. Ceftazidime Injection

    Science.gov (United States)

    ... is used to treat certain infections caused by bacteria including pneumonia and other lower respiratory tract (lung) infections; meningitis (infection of the membranes that surround the brain and spinal cord) and ... killing bacteria.Antibiotics such as ceftazidime injection will not work ...

  4. Teduglutide Injection

    Science.gov (United States)

    ... who need additional nutrition or fluids from intravenous (IV) therapy. Teduglutide injection is in a class of medications ... of the ingredients.tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking ...

  5. Dexrazoxane Injection

    Science.gov (United States)

    ... are used to treat or prevent certain side effects that may be caused by chemotherapy medications. Dexrazoxane injection (Zinecard) is used to prevent or decrease heart damage caused by doxorubicin in women who are taking the medication to treat breast cancer that has spread to other parts of the ...

  6. Dulaglutide Injection

    Science.gov (United States)

    ... thyroid carcinoma (MTC; a type of thyroid cancer). Laboratory animals who were given dulaglutide developed tumors, but it ... your doctor will probably tell you not to use dulaglutide injection. If you ... doctor and the laboratory. Your doctor may order certain tests to check ...

  7. Albiglutide Injection

    Science.gov (United States)

    ... thyroid carcinoma (MTC; a type of thyroid cancer). Laboratory animals who were given medications similar to albiglutide developed ... your doctor will probably tell you not to use albiglutide injection. If you ... doctor and the laboratory. Your doctor may order certain tests to check ...

  8. Semaglutide Injection

    Science.gov (United States)

    ... thyroid carcinoma (MTC; a type of thyroid cancer). Laboratory animals who were given semaglutide developed tumors, but it ... your doctor will probably tell you not to use semaglutide injection. If you ... doctor and the laboratory. Your doctor may order certain tests to check ...

  9. Liraglutide Injection

    Science.gov (United States)

    ... thyroid carcinoma (MTC; a type of thyroid cancer). Laboratory animals who were given liraglutide developed tumors, but it ... your doctor will probably tell you not to use liraglutide injection. If you ... doctor and the laboratory. Your doctor may order certain tests to check ...

  10. Exenatide Injection

    Science.gov (United States)

    ... thyroid carcinoma (MTC; a type of thyroid cancer). Laboratory animals who were given exenatide developed tumors, but it ... your doctor will probably tell you not to use exenatide injection. If you ... doctor and the laboratory. Your doctor may order certain tests to check ...

  11. Etoposide Injection

    Science.gov (United States)

    ... used in combination with other medications to treat cancer of the testicles that has not improved or that has worsened after treatment with other medications or radiation therapy. Etoposide injection ... type of lung cancer (small cell lung cancer; SCLC). Etoposide is in ...

  12. Cefepime Injection

    Science.gov (United States)

    ... infection because they have a low number of white blood cells. Cefepime injection is in a class ... In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has ...

  13. Triptorelin Injection

    Science.gov (United States)

    ... puberty too soon, resulting in faster than normal bone growth and development of sexual characteristics) in children 2 years and older. Triptorelin injection is in a class of medications called gonadotropin-releasing hormone (GnRH) agonists. It works by decreasing the amount ...

  14. Out-of-plane integration of a multimode optical fiber for single particle/cell detection at multiple points on a microfluidic device with applications to particle/cell counting, velocimetry, size discrimination and the analysis of single cell lysate injections.

    Science.gov (United States)

    Sadeghi, Jalal; Patabadige, Damith E W; Culbertson, Anne H; Latifi, Hamid; Culbertson, Christopher T

    2016-12-20

    In this paper a single particle/cell-tracking microfluidic device that integrates an out-of-plane multimode optical fiber (OP-MMF) is reported. This OP-MMF is used to generate three excitation light-lines and three detection spots using only one excitation source and one detector. It takes advantage of an optical tunneling mode to create two excitation lines in a microfluidic channel emanating from a single fiber end. This method was used to accurately count particles/cells and perform velocity measurements and size discrimination. The velocity and size distributions of 5, 7, and 10 μm fluorescently labeled polystyrene beads were determined using the OP-MMF. Additionally, this method was used to analyze cell lysates with the third excitation line in the separation channel. The OP-MMF setup accurately detected an intact cell twice ∼2 mm prior to lysis, determined its velocity, and detected the injected cell lysate 3 mm downstream of the injection point in the separation channel. Using this setup, the velocity of cells entering the lysis intersection and the absolute migration times of fluorescently labeled analytes injected into the separation channel were determined in an automated fashion. This method enabled us to determine a lysing/injection efficiency coefficient (K) using signals from the injected lysate signal and from the intact cell before lysing. K provided a reliable measurement of the amount of cell lysate that was injected into the separation channel. The approach reported here could be used in the future to track particles, cells or droplets in a variety of existing microfluidic devices without the need for multiplexed masks, layers, bulky optical elements or complex optical designs.

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

    Science.gov (United States)

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

    2015-08-01

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

  16. Canadian home parenteral nutrition (HPN) registry: validation and patient outcomes.

    Science.gov (United States)

    Fernandes, G; Kaila, B; Jeejeebhoy, K N; Gramlich, L; Armstrong, D; Allard, J P

    2012-07-01

    In Canada, there are an estimated 400 home parenteral nutrition (HPN) patients. In 2006, a registry was created to gather patient outcome information. The aim of this study was to validate the registry and report on HPN patient outcomes. Several demographic, clinical parameters were collected. For the validation, paired t test and intraclass correlation coefficient (ICC) were used to assess agreement between repeat entries. For the outcome report, paired t test was used to assess changes, and survival analysis was performed using the Kaplan-Meier method. Results are expressed as mean ± SEM. On validation, there was high correlation/agreement (P calories (P = .001) and proteins (P good nutrition status while PN is reduced but do have a reduced quality of life.

  17. Optimum time of blood sampling for determination of glomerular filtration rate by single-injection [51Cr]EDTA plasma clearance

    International Nuclear Information System (INIS)

    Broechner-Mortensen, J.; Roedbro, P.

    1976-01-01

    We have investigated the influence on reproducibility of total [ 51 Cr]EDTA plasma clearance (E) of various times and numbers of blood samples in patients with normal (13 patients) and low (14 patients) renal function. The study aims at fixing a clinically useful procedure suitable for all levels of renal function. Six different types of E were evaluated with time periods for blood sampling between 3 and 5 h after tracer injection, and the variation from counting radioactivity, s 1 , was determined as part of the total variation, s 2 . Optimum mean time, t(E), for blood sampling was calculated as a function of E, as the mean time giving the least change in E for a given change in the 'final slope' of the plasma curve. For patients with normal E, s 1 did not contribute significantly to s 2 , and t(E) was about 2h. For patients with low renal function s 1 contributed significantly to s 2 , and t(E) increased steeply with decreasing E. The relative error in s 1 from fixed Etypes was calculated for all levels of renal function. The results indicate that blood sampling individualized according to predicted E values is not necessary. A sufficient precision of E can be achieved for all function levels from three blood samples drawn at 180, 240, and 300 min after injection. (Auth.)

  18. Experimental study of the injection conditions influence over n-dodecane and diesel sprays with two ECN single-hole nozzles. Part I: Inert atmosphere

    International Nuclear Information System (INIS)

    Gimeno, Jaime; Bracho, Gabriela; Martí-Aldaraví, Pedro; Peraza, Jesús E.

    2016-01-01

    In this research, two Engine Combustion Network (ECN) mono-orifice nozzles, referred to as Spray C and Spray D respectively, were analyzed by performing visualization tests through Schlieren and Diffused Backlight Illumination (DBI) techniques under a wide range of ambient conditions in a non-reactive atmosphere. Spray C presents a straight nozzle designed with a sharp fillet in opposition to Spray D that has similar hydraulic properties, but with a convergent nozzle construction and a smoother corner. The experiments were carried out injecting two distinct fuels at different injection pressure ranges, from 50 MPa to 150 MPa with n-dodecane and to 200 MPa for diesel. The images were processed with Matlab home-built routines to calculate parameters as spray penetration, spreading angle, quasi-steady liquid length, as well as the spray penetration derivative respect to the square root of time, presented in this document as R-parameter. The results showed a clear influence of nozzle geometry in all measured parameters, due mainly to the nature of Spray C to cavitation, which increase the spreading angle and consequently a reduction in vapor penetration. On the other hand, fuel properties also affected spray penetration due to its dependency on viscous forces expressed in terms of the Reynolds number and its volatility in case of liquid length. This last parameter was calculated employing two processing methodologies, finding a good general agreement between them.

  19. High-voltage leak detection of a parenteral proteinaceous solution product packaged in form-fill-seal plastic laminate bags. Part 1. Method development and validation.

    Science.gov (United States)

    Damgaard, Rasmus; Rasmussen, Mats; Buus, Peter; Mulhall, Brian; Guazzo, Dana Morton

    2013-01-01

    In Part 1 of this three-part research series, a leak test performed using high-voltage leak detection (HVLD) technology, also referred to as an electrical conductivity and capacitance leak test, was developed and validated for container-closure integrity verification of a small-volume laminate plastic bag containing an aqueous solution for injection. The sterile parenteral product is the rapid-acting insulin analogue, insulin aspart (NovoRapid®/NovoLog®, by Novo Nordisk A/S, Bagsværd, Denmark). The aseptically filled and sealed package is designed to preserve product sterility through expiry. Method development and validation work incorporated positive control packages with a single hole laser-drilled through the laminate film of each bag. A unique HVLD method characterized by specific high-voltage and potentiometer set points was established for testing bags positioned in each of three possible orientations as they are conveyed through the instrument's test zone in each of two possible directions-resulting in a total of six different test method options. Validation study results successfully demonstrated the ability of all six methods to accurately and reliably detect those packages with laser-drilled holes from 2.5-11.2 μm in nominal diameter. Part 2 of this series will further explore HVLD test results as a function of package seal and product storage variables. The final Part 3 will report the impact of HVLD exposure on product physico-chemical stability. In this Part 1 of a three-part research series, a leak test method based on electrical conductivity and capacitance, called high voltage leak detection (HVLD), was used to find leaks in small plastic bags filled with an insulin pharmaceutical solution for human injection by Novo Nordisk A/S (Bagsværd, Denmark). To perform the test, the package is electrically grounded while being conveyed past an electrode linked to a high-voltage, low-amperage transformer. The instrument measures the current that passes

  20. Shielding Parenteral Nutrition Solutions From Light: A Randomized Controlled Trial.

    Science.gov (United States)

    Laborie, Sophie; Denis, Angélique; Dassieu, Gilles; Bedu, Antoine; Tourneux, Pierre; Pinquier, Didier; Kermorvant, Elsa; Millet, Véronique; Klosowski, Serge; Patural, Hugues; Clamadieu, Catherine; Brunhes, Anne; Walther, Marie; Jaisson-Hot, Isabelle; Mandy, Bruno; Claris, Olivier

    2015-08-01

    Oxidant stress is implicated in the pathogenesis of bronchopulmonary dysplasia (BPD). Light induces peroxide generation in parenteral nutrition (PN) solutions, creating an oxidant stress. Shielding PN from light decreases its peroxide content, which has nutrition and biochemical benefits in animals and humans. This study aims at determining whether full light protection of PN decreases the rate of bronchopulmonary dysplasia and/or death in very low-birth-weight infants. Multicenter randomized controlled trial of photoprotection, using amber bags and tubing initiated during compounding of PN and maintained throughout infusion in the light-protected (LP) group. The control group (light exposed [LE]) received PN exposed to ambient light. Depending on centers, lipids were infused either separately or as all-in-one PN. In total, 590 infants born <30 weeks gestational age were included. At randomization, LE and LP groups did not differ clinically except for maximal FiO2 before 12 hours. The rate of BPD/death was not different between groups at 28 days (77% LP vs 72% LE, P = .16) or at 36 weeks corrected age (30% LP vs 27% LE, P = .55). Multivariate analysis showed no significant effect of photoprotection on BPD and/or death. The rate of BPD/death was significantly lower (odds ratio, 0.54; 95% confidence interval, 0.32-0.93; P = .02) in infants receiving all-in-one PN vs those who received lipids separately. This study did not show significant beneficial effects of photoprotection. Since the decreased rate of BPD/death found with all-in-one PN relates to a center-dependent variable, this warrants further investigation. © 2014 American Society for Parenteral and Enteral Nutrition.

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

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

    2009-11-01

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

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

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    A. A. Asratyan

    2014-01-01

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

  3. Survey on the use of zinc sulfate in parenteral nutrition in spanish hospitals

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    Cristina Crespo-Martínez

    2018-03-01

    Full Text Available Objective: In certain situations parenteral nutrition subsidiary patients may have an increase in zinc demand (Zn. The objective of the study was to know the scope of the use of Zn sulfate in patients with parenteral nutrition in Spanish hospitals. Method: A survey was designed focusing on the incorporation of Zn sulfate into parenteral nutrition, under real practice conditions, in the adult and pediatric population. We asked about the number of parenteral nutrition supplemented with zinc in the last year, by the doses used, and the situations in which it was added to parenteral nutrition formula. The survey was conducted by telephone interview to the pharmacists responsible for the parenteral nutrition units. Results: A total of 53.9% (n = 69 of the contacted hospitals responded to the survey. 60.9% incorporated Zn sulfate into the parenteral nutrition of adults, and 76.2% used it in pediatric patients. In adults, 31.1% used Zn to complete the dose provided by the solution of trace elements, 46.7% supplemented Zn in patients with high intestinal losses, and 28.6% did it in critically ill patients with a high degree of metabolic stress. The majority supplementation regimen was 10 mg/day (55.6%. In the pediatric population Zn ampules were used mainly in preterm infants, with the most used doses being 200 mcg/kg/day and 400 mcg/kg/day (42.6% and 23.4%, respectively. Conclusions: The use of zinc sulfate in adult parenteral nutrition to complete the dosages suggests that solutions of trace elements could be deficient in Zn. Its use as a supplement in adult parenteral nutrition is not an extended practice in specialized nutritional support protocols in Spanish hospitals, highlighting its low employment in patients with significant catabolism.

  4. Comparative effects of pulmonary and parenteral Δ⁹-tetrahydrocannabinol exposure on extinction of opiate-induced conditioned aversion in rats.

    Science.gov (United States)

    Manwell, Laurie A; Mallet, Paul E

    2015-05-01

    Evidence suggesting that the endogenous cannabinoid (eCB) system can be manipulated to facilitate or impair extinction of learned behaviours has important consequences for opiate withdrawal and abstinence. We demonstrated that the fatty acid amide hydrolase (FAAH) inhibitor URB597, which increases eCB levels, facilitates extinction of a naloxone-precipitated morphine withdrawal-induced conditioned place aversion (CPA). The potential of the exogenous CB1 ligand, Δ(9)-tetrahydrocannabinol (Δ(9)-THC), to facilitate extinction of this CPA was tested. Effects of both pulmonary and parenteral Δ(9)-THC exposure were evaluated using comparable doses previously determined. Rats trained to associate a naloxone-precipitated morphine withdrawal with a floor cue were administered Δ(9)-THC-pulmonary (1, 5, 10 mg vapour inhalation) or parenteral (0.5, 1.0, 1.5 mg/kg intraperitoneal injection)-prior to each of 20 to 28 extinction/testing trials. Vapourized Δ(9)-THC facilitated extinction of the CPA in a dose- and time-dependent manner: 5 and 10 mg facilitated extinction compared to vehicle and 1 mg Δ(9)-THC. Injected Δ(9)-THC significantly impaired extinction only for the 1.0-mg/kg dose: it prolonged the CPA fourfold longer than the vehicle and 0.5- and 1.5-mg/kg doses. These data suggest that both dose and route of Δ(9)-THC administration have important consequences for its pharmacokinetic and behavioural effects; specifically, pulmonary exposure at higher doses facilitates, whereas pulmonary and parenteral exposure at lower doses impairs, rates of extinction learning for CPA. Pulmonary-administered Δ(9)-THC may prove beneficial for potentiation of extinction learning for aversive memories, such as those supporting drug-craving/seeking in opiate withdrawal syndrome, and other causes of conditioned aversions, such as illness and stress.

  5. The efficacy of preventive parasternal single injection of bupivacaine on intubation time, blood gas parameters, narcotic requirement, and pain relief after open heart surgery: A randomized clinical trial study

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    Mahmoud Saeidi

    2011-01-01

    Full Text Available Background: Postsurgical pain usually results in some complications in the patients. This study has tried to investigate the effects of parasternal single injection of bupivacaine on postoperative pulmonary and pain consequences in patients after open heart surgery. Methods: : In a prospective double blind clinical study, 100 consenting patients undergoing elective open heart surgery were randomized into two groups. In case group, bupivacaine was injected at both sides of sternum, immediately before sternal closure. In the control group, no intervention was performed. Then, the patients were investigated regarding intubation period, length of ICU stay, arterial blood gas (ABG parameters, morphine requirement, and their severity of postoperative pain using a visual analogue scale (VAS device. Results: No differences were found between the two groups regarding to age, sex, pump time, operation time, and body mass index and preoperative cardiac ejection fraction. Mean intubation length in case group was much shorter than that in control group. Mean PaO 2 in case group was lower in different checking times in postoperative period. The patients in the case group needed less morphine compared to those in the control group during the 24-hour observation period in the ICU. Finally, mean VAS scores of pain in case group were significantly lower than those in control group at 6, 12, and 24 hours postoperatively. Conclusions: Patients′ pain relief by parasternal single injection of bupivacaine in early postoperative period can facilitate earlier ventilator weaning and tracheal extubation after open heart surgery as well as achieving lower pain scores and narcotic requirements.

  6. Predictive factors of adverse events after intravesical suburothelial onabotulinumtoxina injections for overactive bladder syndrome-A real-life practice of 290 cases in a single center.

    Science.gov (United States)

    Jiang, Yuan-Hong; Ong, Hueih-Ling; Kuo, Hann-Chorng

    2017-01-01

    Patients often experience adverse events (AEs) after intravesical onabotulinumtoxinA (BoNT-A) treatment for overactive bladder refractory to antimuscarinic agents. We investigated the prevalence and predictive factors of AEs in such patients. A total of 290 patients underwent intravesical BoNT-A (100 U) suburothelial injection. The age, gender, overactive bladder subtypes, medical co-morbidities, and neurological diseases of the patients were recorded. The maximum flow rate (Q max ), voided volume, post-void residual (PVR) volume, and voiding efficiency (VE) at baseline were analyzed to identify adverse events within 3 months after treatment. Acute urinary retention (AUR) developed in 24 patients (8.3%), and urinary tract infection (UTI) occurred in 44 (15.2%) within 3 months of treatment. Large PVR volume (>200 ml) occurred in 81 (27.9%), 68 (24.3%), and 49 (18.4%) patients 1, 3, and 6 months after treatment, respectively. AUR developed significantly more often in men, patients >61 years old, those with a baseline Q max ≤15 ml/sec, PVR ≥100 ml, and VE 61 years, low Q max , low voiding efficiency, and large PVR at baseline were also risk factors for adverse events. AUR, UTI, and large PVR volume are common AEs after BoNT-A treatment. Patients with overactive bladders that are at risk of developing AEs after BoNT-A injection should be informed of the possible AEs. Neurourol. Urodynam. 36:142-147, 2017. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

  7. Significant changes in endogenous retinal gene expression assessed 1 year after a single intraocular injection of AAV-CNTF or AAV-BDNF

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    Chrisna J LeVaillant

    2016-01-01

    Full Text Available Use of viral vectors to deliver therapeutic genes to the central nervous system holds promise for the treatment of neurodegenerative diseases and neurotrauma. Adeno-associated viral (AAV vectors encoding brain-derived neurotrophic factor (BDNF or ciliary derived neurotrophic factor (CNTF promote the viability and regeneration of injured adult rat retinal ganglion cells. However, these growth-inducing transgenes are driven by a constitutively active promoter, thus we examined whether long-term AAV-mediated secretion of BDNF or CNTF affected endogenous retinal gene expression. One year after the intravitreal injection of AAV-green fluorescent protein (GFP, bi-cistronic AAV-BDNF-GFP or AAV-CNTF-GFP, mRNA was extracted and analyzed using custom 96 well polymerase chain reaction arrays. Of 93 test genes, 56% showed significantly altered expression in AAV-BDNF-GFP and/or AAV-CNTF-GFP retinas compared with AAV-GFP controls. Of these genes, 73% showed differential expression in AAV-BDNF versus AAV-CNTF injected eyes. To focus on retinal ganglion cell changes, quantitative polymerase chain reaction was undertaken on mRNA (16 genes obtained from fixed retinal sections in which the ganglion cell layer was enriched. The sign and extent of fold changes in ganglion cell layer gene expression differed markedly from whole retinal samples. Sustained and global alteration in endogenous mRNA expression after gene therapy should be factored into any interpretation of experimental/clinical outcomes, particularly when introducing factors into the central nervous system that require secretion to evoke functionality.

  8. Treatment of pediatric vesicoureteral reflux using endoscopic injection of hyaluronic acid/dextranomer gel: intermediate-term experience by a single surgeon.

    Science.gov (United States)

    Hsieh, Michael H; Madden-Fuentes, Ramiro J; Lindsay, Nicholas E; Roth, David R

    2010-07-01

    Endoscopic injection of non-animal-stabilized hyaluronic acid/dextranomer gel is an increasingly recognized treatment option for vesicoureteral reflux. The procedure is minor compared with open surgery and, when successful, avoids the need for long-term antibiotic prophylaxis. We present data from 3 years of using non-animal-stabilized hyaluronic acid/dextranomer gel to treat children with vesicoureteral reflux. Pediatric patients aged 16 years with uncomplicated primary vesicoureteral reflux were recruited for endoscopic treatment with non-animal-stabilized hyaluronic acid/dextranomer gel. A follow-up voiding cystourethrogram was scheduled at 2 weeks after treatment, and vesicoureteral reflux resolution was defined as grade 0. Repeat non-animal-stabilized hyaluronic acid/dextranomer gel treatment was offered to patients with persistent vesicoureteral reflux. Of 178 patients treated, 12 were lost to follow-up or yet to undergo post-treatment voiding cystourethrogram. The 166 remaining patients (efficacy population) had a mean age of 4.21 years (range: 0-16), and the median reflux grade was 3 (range: 1-5). Vesicoureteral reflux was resolved in 81.9% of patients and 86.4% of ureters after initial endoscopic treatment with non-animal-stabilized hyaluronic acid/dextranomer gel. The overall reflux resolution rate for patients increased to 89.6% after a second treatment in 19 patients, and 90.2% after a third treatment in 1 patient. No adverse events were reported. Five patients underwent open ureteral reimplantation after failed endoscopic injections. Endoscopic treatment with non-animal-stabilized hyaluronic acid/dextranomer gel is effective in a high proportion of children with vesicoureteral reflux and, in our opinion, should be considered as a first-line treatment option. Copyright 2010 Elsevier Inc. All rights reserved.

  9. Single-frequency operation of a broad-area laser diode by injection locking of a complex spatial mode via a double phase conjugate mirror

    NARCIS (Netherlands)

    van Voorst, P.D.; Offerhaus, Herman L.; Boller, Klaus J.

    2006-01-01

    We demonstrate what is believed to be the first phase-coherent locking of a high-power broad-area diode to a single-frequency master laser. We use photorefractive double phase conjugation to lock the diode in a selfoptimized complex spatial mode while the photorefractive crystal diffracts that

  10. Identification of Drugs in Parenteral Pharmaceutical Preparations from a Quality Assurance and a Diversion Program by Direct Analysis in Real-Time AccuTOFTM-Mass Spectrometry (DART-MS).

    Science.gov (United States)

    Poklis, Justin L; Mohs, Amanda J; Wolf, Carl E; Poklis, Alphonse; Peace, Michelle R

    2016-10-01

    In healthcare settings drug diversion and impairment of physicians are major concerns requiring a rapid and efficient method for surveillance and detection. A Direct Analysis in Real Time ion source coupled to a JEOL AccuTOF TM time-of-flight mass spectrometer (DART-MS) method was developed to screen parenteral pharmaceutical formulations for potential drug diversion. Parenteral pharmaceutical formulations are also known as injectable formulations and are used with intravenous, subcutaneous, intramuscular and intra-articular administration. A library was created using the mass spectra data collected by a DART-MS operated in switching mode at 20, 60 and 90 V settings. This library contained 17 commonly encountered drugs in parenteral pharmaceutical formulations that included the surgical analgesic: fentanyl, hydromorphone and morphine; anesthetic: baclofen, bupivacaine, ketamine, midazolam, ropivacaine and succinylcholine; and a mixture of other drug classes: caffeine, clonidine, dexamethasone, ephedrine, heparin, methadone, oxytocin and phenylephrine. Randomly selected 200 de-identified parenteral pharmaceutical formulations containing one or more drugs were submitted for analysis to the FIRM Toxicology Laboratory at Virginia Commonwealth University Health and were screened using the DART-MS. The drug contents of the de-identified formulations were previously confirmed by a published high performance liquid chromatography (HPLC) method. The drugs in the formulations were rapidly and successfully identified using the generated library. The DART-MS and HPLC results were in complete agreement for all 200 parenteral pharmaceutical formulations. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  11. Parenteral medication prescriptions, dispensing and administration habits in Mongolia.

    Science.gov (United States)

    Dorj, Gereltuya; Sunderland, Bruce; Hendrie, Delia; Parsons, Richard

    2014-01-01

    High levels of injection prescribing were reported in Mongolia. Understanding the factors influencing the injection prescribing is essential to reduce their inappropriate use. The study evaluated the views, experiences and attitudes of community members associated with the prescribing of injections in Mongolia. A structured questionnaire focusing on respondents' characteristics, experiences and views about injections was developed and administered face-to-face to community members in Ulaanbaatar, Mongolia. Standard descriptive statistics were used to summarize demographic data and responses to the questionnaires. Dependent variables were compared using Kruskal-Wallis Tests for independence. Statistical analyses were performed using SPSS Version 21.0. Six hundred participants were approached and the response rate was 79% (n = 474). Almost half of the respondents were aged between 31 and 50 (n = 228, 48.1%) and 40.9% of respondents were male (n = 194). Most respondents were from Ulaanbaatar city (n = 407, 85.7%). All respondents had received injections in the past and 268 (56.5%) had received injection in the past year. The most common reason for having an injection in the past year was reported as treatment of a disease (n = 163, 60.8%), or for administration of vitamins (n = 70, 26.1%). Injections were prescribed by a doctor (n = 353, 74.9%), dispensed by a pharmacist (n = 283, 59.7%) and administered by a nurse (n = 277, 54.9%). Only 16% of all respondents had the expectation of receiving injections when they visited a doctor (n = 77). An important perception regarding injections was that they hastened the recovery process (n = 269, 56.8%). When asked their opinion about therapeutic injections, 40% of all respondents agreed that injections were a better medicine (n = 190) than oral medications, with older respondents strongly agreeing (p<0.001). Based on this total sample, approximately 1891 injections per 1000 patients were administered. The excessive injection

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

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    Josiel Paiva Vieira

    2010-10-01

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

  13. Validating hyperbilirubinemia and gut mucosal atrophy with a novel ultramobile ambulatory total parenteral nutrition piglet model

    Science.gov (United States)

    Total parenteral nutrition (TPN) provides all nutrition intravenously. Although TPN therapy has grown enormously, it causes significant complications, including gut and hepatic dysfunction. Current models use animal tethering which is unlike ambulatory human TPN delivery and is cost prohibitive. We ...

  14. Comparison of topical versus parenteral testosterone in children with microphallic hypospadias.

    Science.gov (United States)

    Nerli, R B; Koura, Ashish; Prabha, Vikram; Reddy, Mallikarjun

    2009-01-01

    Surgical correction of genital defects was formerly proposed when the size of the penis was sufficient to permit easy surgical repair. To enlarge penile size, temporary stimulation with testosterone either topical or parenteral has been reported. Parenteral testosterone has been found to be effective; however, variable results have been reported with topical testosterone. This study was taken up as an attempt to compare the efficacy of parenteral versus topical testosterone application. Twenty-one consecutive children with microphallic hypospadias were randomized to receive either topical or parenteral testosterone prior to surgery. Penile length, glans circumference and secondary effects were recorded before and after therapy by the same observer. Significant penile growth was noticed in both the groups of children when compared with pre-therapy size. The desired therapeutic effect of significant penile growth following testosterone was achieved in both the groups of children. There was no significant difference between the two routes of administration.

  15. Testosterone therapy in microphallic hypospadias: topical or parenteral?

    Science.gov (United States)

    Chalapathi, G; Rao, K L N; Chowdhary, S K; Narasimhan, K L; Samujh, Ram; Mahajan, J K

    2003-02-01

    Local or systemic application of testosterone is reported to stimulate penile growth. Intramuscular testosterone has been found to be effective in 50% of patients; however, variable results have been reported with topical testosterone. The current study is an attempt to compare the efficacy of intramuscular versus topical testosterone application. A total of 26 consecutive patients with hypospadias and small penis (growth was accomplished by topical application of testosterone (Testoviron, oily solution containing testosterone propionate, 25 mg, and testosterone enanthate, 110 mg, equivalent to about 100 mg of testosterone, Schering, Germany) with a dose of 2 mg/kg/wk, for 3 weeks. While in group B, testosterone (same preparation as above) was administered by intramuscular injection weekly for 3 consecutive weeks. Penile length, diameter, and secondary effects were recorded before, during, and 3 weeks after the therapy by a single observer. Significant penile growth (P growth of at least 50% compared with the initial size. The basal serum testosterone was within the normal range in both the groups. During therapy the serum testosterone was elevated above the basal level in all patients, but within the normal range except in 2 patients of group A. In these 2 children the serum testosterone level crossed the normal range. Linear growth did not alter significantly for the chronological age. Two patients of group A went on to have pubic hair, one of them had elevated testosterone level above the normal range. There was a surge in serum testosterone in all children, although significant penile enlargement was observed in 60% children in group A and 75% in group B. Although the desired therapeutic effect of testosterone was achieved in both the groups, this study failed to show any significant difference between the 2 routes of administration. However, in group A, (topical) serum testosterone crossed the normal range in 15% of patients and was associated with significant

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

    Directory of Open Access Journals (Sweden)

    Farzad Khademi

    2018-02-01

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

  17. Ecological effects of a single intraperitoneal injection of [{sup 14}C]-2,3,4,7,8-pentachlorodibenzofuran on feral populations of lake trout and white suckers

    Energy Technology Data Exchange (ETDEWEB)

    Delorme, P.D. [Univ. of Manitoba, Winnipeg (Canada); Lockhart, W.L.; Muir, D.C.G.; Mills, K.H.; Brown, S.B. [Dept. of Fisheries and Oceans, Winnipeg, Manitoba (Canada). Freshwater Inst.

    1994-12-31

    In 1989 a total of 24 lake trout and 35 white suckers from a small lake located in the Experimental Lakes Area (ELA) in northwestern Ontario were each targeted with an I.P. injection of [{sup 14}C]-s,3,4,7,8-pentachlorodibenzofuran in corn oil, to a dose of 1 ng{center_dot}g{sup {minus}1}. Fish were tagged, returned to the lake and recaptured during spawning runs in 1990, 1991 and 1992. Sub-samples of treated and control fish were sacrificed each year for residue and biochemical analyses. Treated females were spawned in 1990 and 1991. Analysis of tag-recapture data showed lower survival of treated lake trout over four years. Growth was significantly lower in white suckers in all years but unaffected in lake trout. Fertilization rate of eggs was lower in eggs from treated female white suckers, but not in lake trout. However, only 1 of 4 treated female lake trout recaptured had undergone oogenesis in the last two years of recaptures. Measurements of EROD showed sustained induction in both lake trout and white suckers. Hepatic levels of retinoids were significantly decreased in lake trout but not in white suckers. Calculated half-lives of P{sub 5}CDF were 9.6 years for lake trout and 4.3 years for white suckers. It appears that long term ecological performance was impaired in both species.

  18. Effect of palm methyl ester-diesel blends performance and emission of a single-cylinder direct-injection diesel engine

    Science.gov (United States)

    Said, Mazlan; Aziz, Azhar Abdul; Said, Mohd Farid Muhamad

    2012-06-01

    The purpose of this study is to investigate engine performance and exhaust emission when using several blends of neat palm oil methyl ester (POME) with conventional diesel (D2) in a small direct injection diesel engine, and to compare the outcomes to that of the D2 fuel. Engine performances, exhaust emissions, and some other important parameters were observed as a function of engine load and speed. In addition, the effect of modifying compression ratio was also carried out in this study. From the engine experimental work, neat and blended fuels behaved comparably to diesel (D2) in terms of fuel consumption, thermal efficiency and rate of heat released. Smoke density showed better results than that emitted by D2, operating under similar conditions due to the presence of inherited oxygen and lower sulphur content in the biofuel and its blends. The emissions of CO, CO2, and HC were also lower using blended mixtures and in its neat form. However, NOx concentrations were found to be slight higher for POME and its blends and this was largely due to higher viscosity of POME and possibly the presence of nitrogen in the palm methyl ester. General observation indicates that biofuel blends can be use without many difficulties in this type of engine but for optimized operation minor modifications to the engine and its auxiliaries are required.

  19. Efficacy of Intra-articular Injection of a Newly Developed Plasma Rich in Growth Factor (PRGF) Versus Hyaluronic Acid on Pain and Function of Patients with Knee Osteoarthritis: A Single-Blinded Randomized Clinical Trial

    Science.gov (United States)

    Raeissadat, Seyed Ahmad; Rayegani, Seyed Mansoor; Ahangar, Azadeh Gharooee; Abadi, Porya Hassan; Mojgani, Parviz; Ahangar, Omid Gharooi

    2017-01-01

    Background and objectives: Knee osteoarthritis is the most common joint disease. We aimed to compare the efficacy and safety of intra-articular injection of a newly developed plasma rich in growth factor (PRGF) versus hyaluronic acid (HA) on pain and function of patients with knee osteoarthritis. Methods: In this single-blinded randomized clinical trial, patients with symptomatic osteoarthritis of knee were assigned to receive 2 intra-articular injections of our newly developed PRGF in 3 weeks or 3 weekly injections of HA. Our primary outcome was the mean change from baseline until 2 and 6 months post intervention in scores of visual analog scale, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Lequesne index. We used analysis of variance for repeated-measures statistical test. Results: A total of 69 patients entered final analysis. The mean age of patients was 58.2 ± 7.41 years and 81.2% were women. In particular, total WOMAC index decreased from 42.9 ± 13.51 to 26.8 ± 13.45 and 24.4 ± 16.54 at 2 and 6 months in the newly developed PRGF group (within subjects P = .001), and from 38.8 ± 12.62 to 27.8 ± 11.01 and 27.4 ± 11.38 at 2 and 6 months in the HA group (within subjects P = .001), respectively (between subjects P = .631). There was no significant difference between PRGF and HA groups in patients’ satisfaction and minor complications of injection, whereas patients in HA group reported significantly lower injection-induced pain. Conclusions: In 6 months follow up, our newly developed PRGF and HA, both are effective options to decrease pain and improvement of function in patients with symptomatic mild to moderate knee osteoarthritis. PMID:29051707

  20. [Parenteral hyperalimentation in the treatment of esophageal, gastric and intestinal fistulas (author's transl)].

    Science.gov (United States)

    Launois, B; Roumane, H; Campion, J P; Malledant, Y; Trebuchet, G

    Parenteral hyperalimentation and complete bowel rest reduce fistula output, and permit sufficient caloric and nitrogen intakes needed for healing. It corrects metabolic and nutritional deficiencies due to digestive fistulas, and allows spontaneous closure of fistulas in two out of three patients. If spontaneous healing is not obtained after six weeks of parenteral alimentation, surgical treatment may be undertaken more safety, as the patient will be in better nutritional condition.

  1. Coverage of pilot parenteral vaccination campaign against canine rabies in N'Djaména, Chad.

    OpenAIRE

    Kayali, U.; Mindekem, R.; Yémadji, N.; Vounatsou, P.; Kaninga, Y.; Ndoutamia, A. G.; Zinsstag, J.

    2003-01-01

    Canine rabies, and thus human exposure to rabies, can be controlled through mass vaccination of the animal reservoir if dog owners are willing to cooperate. Inaccessible, ownerless dogs, however, reduce the vaccination coverage achieved in parenteral campaigns. This study aimed to estimate the vaccination coverage in dogs in three study zones of N'Djaména, Chad, after a pilot free parenteral mass vaccination campaign against rabies. We used a capture-mark-recapture approach for population est...

  2. Application of refractometry to quality assurance monitoring of parenteral nutrition solutions.

    Science.gov (United States)

    Chang, Wei-Kuo; Chao, You-Chen; Yeh, Ming-Kung

    2008-01-01

    Parenteral nutrition (PN) solution contains various concentrations of dextrose, amino acids, lipids, vitamins, electrolytes, and trace elements. Incorrect preparation of PN solution could lead to patient death. In this study we used the refractive index as a quality assurance tool to monitor the preparation of PN solution. Refractive indices of single nutrient components and PN solutions consisting of various concentrations of dextrose, amino acids, electrolytes, and lipids were measured. A mathematical equation and its linear plot were generated then used to predict the refractive index of the PN solution. The best-fit refractive index for PN solution (i.e., the predicted refractive index)=0.9798x(% dextrose)+1.2889x(% amino acids)+1.1017x(% lipids)+0.9440x(% sum of the electrolytes)+0.5367 (r2=0.99). This equation was validated by comparing the measured refractive indices of 500 clinical PN solutions to their predicted refractive indices. We found that 2 of the 500 prepared samples (0.4%) had less than the predicted refractive index (<95%). Refractive index can be used as a reliable quality assurance tool for monitoring PN preparation. Such information can be obtained at the bedside and used to confirm the accuracy of the PN solution composition.

  3. Preformulation studies for the development of a parenteral liquid formulation of the immunomodulator, peldesine.

    Science.gov (United States)

    Viegas, T X; Van Winkle, L L

    1999-01-01

    Peldesine (BCX-34) is a potent inhibitor of the enzyme purine nucleoside phosphorylase (PNP). The object of this study was to determine the preformulation parameters of BCX-34 and subsequently prepare a sterile liquid formulation for intravenous infusion. Ionization and solubility parameters were assessed prior to formulation development. Three pKa values of approximately 4.0, 5.2 and 10.3 were assigned for BCX-34. The pH-solubility profile showed an increase in solubility when the pH of the solution was less than the pKa1 value of 4.0 and when the pH was more than the pKa3 value of 10.3. BCX-34 has an octanol-water partition coefficient of approximately 7:1 (Log P = 0.8). The Van't Hoff temperature dependent solubility when measured over a range of 4-40 degrees C produced a heat of solution (delta Hc) of 7.68 kcal/mole. Based on these preformulation observations, two parenteral formulations containing 1 and 5 mg/mL of BCX-34 were prepared in an acidified saline solution and filled into 30 cc and 100 cc glass vials. Both formulation batches were sterile filtered, while only one 1 mg/mL batch was terminally autoclaved. The long-term stability of both solutions was performed and compared. Results of this study show that the drug product was stable. Following a screening study, Lactated Ringer's injection USP was selected as a suitable infusion medium for the dilution of the drug concentrate solutions.

  4. Effects of parenteral papaverine and piracetam administration on cochlea following acoustic trauma.

    Science.gov (United States)

    Kum, Nurcan Yurtsever; Yilmaz, Yavuz F; Gurgen, Seren G; Kum, Rauf O; Ozcan, Muge; Unal, Adnan

    2018-01-01

    Noise exposure, the main cause of hearing loss in countries with lot of industries, may result both in temporary or permanent hearing loss. The goal of this study was to investigate the effects of parenteral papaverine and piracetam administration following an acoustic trauma on hearing function with histopathologic correlation. Eighteen Wistar albino rats exposed to noise for 8 h in a free environment were included. We divided the study population into three groups, and performed daily intraperitoneal injections of papaverine, piracetam, and saline, respectively, throughout the study. We investigated the histopathologic effects of cellular apoptosis on inner hair cells (IHCs) and outer hair cells (OHCs) and compared the distortion product otoacoustic emissions (DPOAEs) thresholds among the groups. On the 3 rd and 7 th days, DPOAE thresholds at 8 kHz were significantly higher both in papaverine and piracetam groups compared with the control group (P = 0.004 for 3 rd day, P = 0.016 and P = 0.028 for 7 th day, respectively). On the 14 th day, piracetam group had significantly higher mean thresholds at 8 kHz (P = 0.029); however, papaverine group had similar mean thresholds compared to the control group (P = 0.200). On the 3 rd and 7 th days following acoustic trauma, both IHC and OHC loss were significantly lower in both papaverine and piracetam groups. On the 7 th day, the mean amount of apoptotic IHCs and OHCs identified using Caspase-3 method were significantly lower in both groups, but the mean amount identified using terminal deoxynucleotidyl transferase dUTP nick end labeling method were similar in both groups compared to the control group. We demonstrated the effects of papaverine and piracetam on the recovery of cochlear damage due to acoustic trauma on experimental animals using histopathologic and electrophysiologic examinations.

  5. Port Site Local Anesthetic Infiltration Vs Single-dose Intrathecal Opioid Injection to Control Perioperative Pain in Children Undergoing Minimal Invasive Surgery: A Comparative Analysis.

    Science.gov (United States)

    Srinivasan, Arun K; Shrivastava, Dhiren; Kurzweil, Rebecca E; Weiss, Dana A; Long, Christopher J; Shukla, Aseem R

    2016-11-01

    To compare the efficacy of the intrathecal opiate vs wound site local anesthetic infiltration for perioperative pain control during and after surgery in patients undergoing minimally invasive pediatric urologic procedures. Using an Institutional Review Board-approved registry database, we identified patients who underwent minimally invasive urologic procedures at our institution between 2009 and 2013. We collected all relevant preoperative variables and postoperative outcomes. Patients in intrathecal injection of opioids (ITO) group were matched with patients who received local anesthetic infiltration (LAI) based on age, diagnosis, and procedure. Perioperative analgesic requirements were converted to morphine equivalents standardized to body weight. Statistical analysis was performed using SPSS, and parametric comparisons were completed to determine difference in morphine equivalents between the 2 groups. One hundred thirty children (78 girls and 52 boys) were included in our study. Sixty-six patients underwent ITO and 66 received LAI. Sixty-six patients underwent ureteral reimplantation, 60 underwent pyeloplasty, and 4 underwent nephrectomy. Ages ranged from 0.5 to 19.9 years. There was no significant difference in cumulative morphine equivalents or weight administered between the ITO and LAI groups for the total period of hospitalization (0.76 units vs 0.79 units, P > .05). Multivariate regression analysis predicted that older age corresponds to higher analgesic requirements. ITO does not impact total analgesic requirements during the hospital stay compared to LAI following minimally invasive surgery. Considering the potential complications of ITO, LAI may be the preferred modality for pain management for minimally invasive surgery in children. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Presurgical localization of abnormal parathyroid glands using a single injection of technetium-99m methoxyisobutylisonitrile: comparison of different techniques including factor analysis of dynamic structures

    Energy Technology Data Exchange (ETDEWEB)

    Blocklet, D. [Hopital Universitaire Erasme, Univ. Libre de Bruxelles (Belgium); Martin, P. [Hopital Universitaire Brugmann, Univ. Libre de Bruxelles (Belgium); Schoutens, A. [Hopital Universitaire Erasme, Univ. Libre de Bruxelles (Belgium); Verhas, M. [Hopital Universitaire Brugmann, Univ. Libre de Bruxelles (Belgium); Hooghe, L. [Hopital Universitaire Brugmann, Univ. Libre de Bruxelles (Belgium); Kinnaert, P. [Hopital Universitaire Erasme, Univ. Libre de Bruxelles (Belgium)

    1997-01-01

    The aims of this study were to determine which of the analytical techniques described for this method time-activity curves analysis of dynamic structures corresponds best with surgical findings, and to ascertain the potential overall contribution of presurgical scintigraphy. 55P patients were studied, 34 of whom presented with primary hyperparathyroidism (HPT) and 21 with secondary HPT. After a 925 MBq injection of technetium-99m MIBI, a 40-min dynamic acquisition was performed and static images were acquired at 5, 20, 40 and 120 min using a gamma camera equipped with a pinhole collimator. Sensitivity was 84.4%, 74% and 65% in adenoma and 76%, 66.6% and 45% in hyperplasia for 15`-120`, FADS and TACs, respectively. Surgical accuracy was 72%, 56% and 59% in adenoma and 53%, 30% and 22% in hyperplasia for 15`-120`, FADS and TACs, respectively. The visual comparison method scored best in all cases. FADS was found to be sensitive in cases of adenoma but was handicapped by more false-positive localizations. TACs were particular inefficient in hyperplasia. With respect to the detection of adenomas, we found a relationship between the gland weight and scintigraphic positivity. This dependence was not found in hyperplasia. The poorer results obtained with all techniques for surgical accuracy can be explained by the need for a complete scintigraphic description of all pathological glands found by the surgeon in a patient. This study demonstrates that the 15`-120` visual comparison method is more efficient However, it was less efficient than neck exploration by an experienced surgeon. (orig./ vhe) (orig.). With 4 figs., 4 tabs.

  7. Impact of intracoronary injection of mononuclear bone marrow cells in acute myocardial infarction on left ventricular perfusion and function: a 6-month follow-up gated {sup 99m}Tc-MIBI single-photon emission computed tomography study

    Energy Technology Data Exchange (ETDEWEB)

    Lipiec, Piotr [Medical University of Lodz, 2nd Department of Cardiology, Lodz (Poland); Medical University of Lodz, 2nd Department of Cardiology, Bieganski Hospital, Lodz (Poland); Krzeminska-Pakula, Maria; Plewka, Michal; Kasprzak, Jaroslaw D. [Medical University of Lodz, 2nd Department of Cardiology, Lodz (Poland); Kusmierek, Jacek; Plachcinska, Anna; Szuminski, Remigiusz [Medical University of Lodz, Department of Nuclear Medicine, Lodz (Poland); Robak, Tadeusz; Korycka, Anna [Medical University of Lodz, Department of Hematology, Lodz (Poland)

    2009-04-15

    We investigated the impact of intracoronary injection of autologous mononuclear bone marrow cells (BMC) in patients with acute ST elevation myocardial infarction (STEMI) on left ventricular volumes, global and regional systolic function and myocardial perfusion. The study included 39 patients with first anterior STEMI treated successfully with primary percutaneous coronary intervention. They were randomly assigned to the treatment group or the control group in a 2:1 ratio. The patients underwent baseline gated single-photon emission computed tomography (G-SPECT) 3-10 days after STEMI with quantitative and qualitative analysis of left ventricular perfusion and systolic function. On the following day, patients from the BMC treatment group were subjected to bone marrow aspiration, mononuclear BMC isolation and intracoronary injection. No placebo procedure was performed in the control group. G-SPECT was repeated 6 months after STEMI. Baseline and follow-up G-SPECT studies were available for 36 patients. At 6 months in the BMC group we observed a significantly enhanced improvement in the mean extent of the perfusion defect, the left ventricular perfusion score index, the infarct area perfusion score and the infarct area wall motion score index compared to the control group (p=0.01-0.04). However, the changes in left ventricular volume, ejection fraction and the left ventricular wall motion score index as well as the relative changes in the infarct area wall motion score index did not differ significantly between the groups. Intracoronary injection of autologous mononuclear BMC in patients with STEMI improves myocardial perfusion at 6 months. The benefit in infarct area systolic function is less pronounced and there is no apparent improvement of global left ventricular systolic function. (orig.)

  8. Total parenteral nutrition in management of hyperlipidemic pancreatitis during pregnancy.

    Science.gov (United States)

    Loh, Jennifer A; Rickels, Michael R; Williams, Jennifer; Iqbal, Nayyar

    2005-01-01

    To describe a case of severe gestational hyperlipidemic pancreatitis successfully managed with minimal-lipid-containing parenteral nutrition (PN) followed by a minimal-fat diet, which resulted in delivery of a healthy full-term neonate. We present the case of a young woman with gestational hyperlipidemic pancreatitis whose management included the use of PN during pregnancy. In addition, we review the literature pertaining to the management of hyperlipidemic pancreatitis during pregnancy and discuss the role for PN. A 32-year-old gravida 2, para 1 woman at 27 weeks 3 days of gestation presented with 1 day of nausea, bilious emesis, and severe abdominal pain caused by pancreatitis attributable to hypertriglyceridemia. Her initial serum triglyceride concentration was 9,450 mg/dL. She received fluids intravenously and minimal-lipid PN until resolution of her symptoms. The serum triglyceride level remained less than 850 mg/dL during administration of PN. She subsequently tolerated a minimal-fat diet, while the serum triglyceride level was maintained at less than 1,400 mg/dL, until delivery of a full-term, healthy neonate. In severe gestational hyperlipidemic pancreatitis, PN offers a safe and flexible treatment option by providing pancreatic rest and controlling serum triglyceride concentrations while maintaining fetal and maternal nutritional support.

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

    Science.gov (United States)

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

    1996-01-01

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

  10. Prediction of parenteral nutrition osmolarity by digital refractometry.

    Science.gov (United States)

    Chang, Wei-Kuo; Yeh, Ming-Kung

    2011-05-01

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

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

    Directory of Open Access Journals (Sweden)

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

    2009-11-01

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

  12. Carbohydrates – Guidelines on Parenteral Nutrition, Chapter 5

    Directory of Open Access Journals (Sweden)

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

    2009-11-01

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

  13. Carbohydrates – Guidelines on Parenteral Nutrition, Chapter 5

    Science.gov (United States)

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

    2009-01-01

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

  14. Total parenteral nutrition treatment efficacy in adolescent eating disorders.

    Science.gov (United States)

    Tamura, Akira; Minami, Koichi; Tsuda, Yuuko; Yoshikawa, Norishige

    2015-10-01

    Management of adolescent patients with severe eating disorders who refuse treatment for weight loss is complicated. Nutritional rehabilitation is most important during the growth period; thus, strong support in the form of total parenteral nutrition (TPN) as soon as possible is necessary in severe cases. No studies involving detailed, long-term follow up have evaluated biochemical markers and gonadotropin in patients undergoing TPN treatment. Twenty-five adolescent female patients admitted to hospital received TPN immediately, and biochemical marker and gonadotropin levels were measured and analyzed. If subsequent weight gain was observed, TPN treatment was gradually reduced and stopped. No patients dropped out of the study. A significant increase in weight was observed during hospitalization (average, 8.0 kg). Under this treatment, serum total bilirubin was significantly decreased at 3 months, total cholesterol was significantly decreased at 2 months, and alkaline phosphatase (ALP) was significantly increased at 3 and 6 months. Follicle-stimulating hormone response significantly preceded both luteinizing hormone response and appetite recovery. After this treatment, nine of the 25 patients were readmitted for recurrence of appetite loss. Two patients required additional TPN treatment, but seven immediately recovered their appetite after hospitalization without TPN treatment. Bodyweight gain per day was significantly lower and ALP on admission was significantly higher in patients with than without recurrence. Most patients had a remarkable recovery of appetite without refusal behaviors and without evidence of malnutrition after admission. Nutrition maintenance with TPN support is particularly important during the growth period. © 2015 Japan Pediatric Society.

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

    LENUS (Irish Health Repository)

    McCarthy, R

    2016-04-01

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

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

    Directory of Open Access Journals (Sweden)

    Fusch, C.

    2009-11-01

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

  17. Hunger and appetitive factors during total parenteral nutrition.

    Science.gov (United States)

    McCutcheon, N B; Tennissen, A M

    1989-10-01

    A previous study of short-term (average of 31 days) Total Parenteral Nutrition (TPN) patients indicated that they experienced hunger even though they received adequate calories for energy balance. A prolonged suppression of hunger was noted when lipid was added to the total nutrient intake. Recent experiments with intravenous infusion of lipids in normal volunteers have failed to show appetite suppression beyond that expected from caloric regulation. The goal of our study was to collect information regarding hunger and appetitive experiences associated with intravenous alimentation of healthy, long-term, home TPN patients. Our results from questionnaire returns of 29 respondents showed hunger to be generally low during most of the day. Those patients taking small amounts of food orally typically reported moderate hunger before eating. There was no evidence of any significant difference between hunger reports given on days when lipid was infused vs. days when lipid was omitted. Aversive sensations were frequently associated with lipid infusion but not with nonlipid nutrient infusion. Hunger in TPN patients is discussed in terms of expectancy and hedonic factors as contrasted with physiological need.

  18. Home parenteral nutrition: results in 34 pediatric patients.

    Science.gov (United States)

    Strobel, C T; Byrne, W J; Fonkalsrud, E W; Ament, M E

    1978-01-01

    Although home parenteral nutrition (HPN) has been used successfully for adult patients, no extensive experience with children has been reported. During the past three years, we have managed 34 patients, ages 1 1/2 months to 20 1/2 years, on a HPN program for periods ranging from 23 to 786 days. Silastic Broviac catheters were inserted into the superior vena cava through the jugular or cephalic veins or into the inferior vena cava through the saphenous vein. The catheters were brought out onto the chest or lower abdominal wall through a subcutaneous tunnel. Solutions were infused over a 10--14-hour period each day, using a volumetric pump system. All patients improved their nutritional status. Twenty-three of 29 on the program for more than two months showed an increase in height. All patients evidenced a significant decrease in symptomatology. All resumed per group activities while on HPN and were able to continue their education or work. At present 24 patients including 15 with Crohn's disease no longer receive HPN. Administration of HPN through a Broviac catheter is a safe, successful technique for maintaining an optimal nutritional status in children with severe digestive disorders, and permits resumption of a more normal daily lifestyle. Following HPN, bowel adaptation and initiation of full oral alimentation become possible in many patients. Images Fig. 1. Fig. 2. PMID:99097

  19. Technological development of injectable cisplatin solution

    International Nuclear Information System (INIS)

    Gato del Monte, Armando; Padron Yaquis, Alejandro Saul

    2012-01-01

    To develop a cisplatin formulation at 1mg/mL concentration by setting the solution preparation procedure for parenteral administration, with good physical, chemical, biological and microbiological stability. two formulation variants of cisplatin: one solution with and the other without acetate buffer. Both were followed in terms of physical and chemical stability for 3 months. The formulations used raw material from IMPEX SA company, which has 99.74 % power as certified by the manufacturer analysis. Three batches of 10mg cistoplatin at pilot scale in amber 10 R vials, 3 batches of 50 mg cisplatin in amber 50 H vials and the dose was 1mg/ml. Excipients were used to give isotony and stability to the formulation with 0.1 N chlorhydric acid and injection water for vehicle. The high performance liquid chromatography allowed evaluating the stability to determine the expiry date of the drug. The biological and microbiological methods determined lack of pyrogens and sterility respectively

  20. Correlation between HIV and HCV in Brazilian prisoners: evidence for parenteral transmission inside prison Correlação entre HIV e HCV em prisioneiros brasileiros: evidência de transmissão parenteral no encarceramento

    Directory of Open Access Journals (Sweden)

    MN Burattini

    2000-10-01

    Full Text Available OBJECTIVE: It is an accepted fact that confinement conditions increase the risk of some infections related to sexual and/or injecting drugs practices. Mathematical techniques were applied to estimate time-dependent incidence densities of HIV infection among inmates. METHODS: A total of 631 prisoners from a Brazilian prison with 4,900 inmates at that time were interviewed and their blood drawn. Risky behavior for HIV infection was analyzed, and serological tests for HIV, hepatitis C and syphilis were performed, intended as surrogates for parenteral and sexual HIV transmission, respectively. Mathematical techniques were used to estimate the incidence density ratio, as related to the time of imprisonment. RESULTS: Prevalence were: HIV -- 16%; HCV -- 34%; and syphilis -- 18%. The main risk behaviors related to HIV infection were HCV prevalence (OR=10.49 and the acknowledged use of injecting drugs (OR=3.36. Incidence density ratio derivation showed that the risk of acquiring HIV infection increases with the time of imprisonment, peaking around three years after incarceration. CONCLUSIONS: The correlation between HIV and HCV seroprevalence and the results of the mathematical analysis suggest that HIV transmission in this population is predominantly due to parenteral exposure by injecting drug, and that it increases with time of imprisonment.OBJETIVO: É um fato correntemente aceito que as condições de confinamento aumentam o risco de algumas infecções relacionadas às práticas sexuais e/ou ao uso de drogas injetáveis. Realizou-se estudo para estimar a densidade de incidência da infecção pelo HIV na população prisional com aplicação de técnicas matemáticas. MÉTODOS: Foram entrevistados em São Paulo, SP, 631 prisioneiros da maior prisão da América do Sul, que abrigava aproximadamente 4.900 presos na ocasião do estudo. Foi colhido sangue da população entrevistada, analisado o risco para a infecção pelo HIV e realizados testes

  1. VCSEL Transmission at 10 Gb/s for 20 km Single Mode Fiber WDM-PON without Dispersion Compensation or Injection Locking

    DEFF Research Database (Denmark)

    Gibbon, Timothy Braidwood; Prince, Kamau; Pham, Tien Thang

    2011-01-01

    how off-center wavelength filtering of the VCSEL spectrum at an array waveguide grating can be used to mitigate the effect of chirp and the dispersion penalty. Transmission at 10Gb/s VCSEL over 23.6 km of single mode fiber is experimentally demonstrated, with a dispersion penalty of only 2.9 d......B. Simulated results are also presented which show that off-center wavelength filtering can extend the 10 Gb/s network reach from 11.7 km to 25.8 km for a 4 dB dispersion penalty. This allows for cheap and simple dispersion mitigation in next generation VCSEL based optical access networks....

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

    Science.gov (United States)

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

  3. Vitamin E in new Generation Lipid Emulsions Protects Against Parenteral Nutrition-Associated Liver disease in Parenteral Nutrition-Fed Preterm Pigs

    DEFF Research Database (Denmark)

    Kenneth, Ng; Stoll, Barbara; Chacko, Shaji

    2016-01-01

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

  4. Oxytocin via Uniject (a prefilled single-use injection) versus oral misoprostol for prevention of postpartum haemorrhage at the community level: a cluster-randomised controlled trial.

    Science.gov (United States)

    Diop, Ayisha; Daff, Bocar; Sow, Maimouna; Blum, Jennifer; Diagne, Mamadou; Sloan, Nancy L; Winikoff, Beverly

    2016-01-01

    Access to injectable uterotonics for management of postpartum haemorrhage remains limited in Senegal outside health facilities, and misoprostol and oxytocin delivered via Uniject have been deemed viable alternatives in community settings. We aimed to compare the efficacy of these drugs when delivered by auxiliary midwives at maternity huts. We did an unmasked cluster-randomised controlled trial at maternity huts in three districts in Senegal. Maternity huts with auxiliary midwives located 3-21 km from the closest referral centre were randomly assigned (1:1; via a computer-generated random allocation overseen by Gynuity Health Projects) to either 600 μg oral misoprostol or 10 IU oxytocin in Uniject (intramuscular), stratified by reported previous year clinic volume (deliveries) and geographical location (inland or coastal). Maternity huts that had been included in a previous study of misoprostol for prevention of postpartum haemorrhage were excluded to prevent contamination. Pregnant women in their third trimester were screened for eligibility either during community outreach or at home-based prenatal visits. Only women delivered by the auxiliary midwives in the maternity huts were eligible for the study. Women with known allergies to prostaglandins or pregnancy complications were excluded. The primary outcome was mean change in haemoglobin concentration measured during the third trimester and after delivery. This study was registered with ClinicalTrials.gov, number NCT01713153. 28 maternity hut clusters were randomly assigned-14 to the misoprostol group and 14 to the oxytocin group. Between June 6, 2012, and Sept 21, 2013, 1820 women were recruited. 647 women in the misoprostol group and 402 in the oxytocin group received study drug and had recorded pre-delivery and post-delivery haemoglobin concentrations, and overall 1412 women delivered in the study maternity huts. The mean change in haemoglobin concentrations was 3·5 g/L (SD 16·1) in the misoprostol group

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

    Directory of Open Access Journals (Sweden)

    Hossein Vatanpour

    2016-08-01

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

  6. Safety, pharmacokinetics, and pharmacodynamics of TV-1380, a novel mutated butyrylcholinesterase treatment for cocaine addiction, after single and multiple intramuscular injections in healthy subjects.

    Science.gov (United States)

    Cohen-Barak, Orit; Wildeman, Jacqueline; van de Wetering, Jeroen; Hettinga, Judith; Schuilenga-Hut, Petra; Gross, Aviva; Clark, Shane; Bassan, Merav; Gilgun-Sherki, Yossi; Mendzelevski, Boaz; Spiegelstein, Ofer

    2015-05-01

    Human plasma butyrylcholinesterase (BChE) contributes to cocaine metabolism and has been considered for use in treating cocaine addiction and cocaine overdose. TV-1380 is a recombinant protein composed of the mature form of human serum albumin fused at its amino terminus to the carboxy-terminus of a truncated and mutated BChE. In preclinical studies, TV-1380 has been shown to rapidly eliminate cocaine in the plasma thus forestalling entry of cocaine into the brain and heart. Two randomized, blinded phase I studies were conducted to evaluate the safety, pharmacokinetics, and pharmacodynamics of TV-1380, following single and multiple administration in healthy subjects. TV-1380 was found to be safe and well tolerated with a long half-life (43-77 hours) and showed a dose-proportional increase in systemic exposure. Consistent with preclinical results, the ex vivo cocaine hydrolysis, TV-1380 activity clearly increased upon treatment in a dose-dependent manner. In addition, there was a direct relationship between ex vivo cocaine hydrolysis (kel ) and TV-1380 serum concentrations. There was no evidence that TV-1380 affected heart rate, the uncorrected QT interval, or the heart-rate-corrected QTcF interval. TV-1380, therefore, offers a safe once-weekly therapy to increase cocaine hydrolysis. © 2015 The Authors. The Journal of Clinical Pharmacology Published by Wiley Periodicals, Inc. on behalf of American College of Clinical Pharmacology.

  7. Study on a Single-Dose Toxicity Test of D-Amino Acid Oxidase (DAAO Extracts Injected into the Tail Vein of Rats

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    Kang Jungue

    2013-06-01

    Full Text Available Objective: This study was performed to analyze the single-dose toxicity of D-amino acid oxidase (DAAO extracts. Methods: All experiments were conducted at the Korea Testing & Research Institute (KTR, an institution authorized to perform non-clinical studies, under the regulations of Good Laboratory Practice (GLP. Sprague-Dawley rats were chosen for the pilot study. Doses of DAAO extracts, 0.1 to 0.3 cc, were administered to the experimental group, and the same doses of normal saline solution were administered to the control group. This study was conducted under the approval of the Institutional Animal Ethics Committee. Results: In all 4 groups, no deaths occurred, and the LD50 of DAAO extracts administered by IV was over 0.3 ml/kg. No significant changes in the weight between the control group and the experimental group were observed. To check for abnormalities in organs and tissues, we used microscopy to examine representative histological sections of each specified organ, the results showed no significant differences in any organs or tissues. Conclusion: The above findings suggest that treatment with D-amino acid oxidase extracts is relatively safe. Further studies on this subject should be conducted to yield more concrete evidence.

  8. Safety and immunogenicity of a parenteral P2-VP8-P[8] subunit rotavirus vaccine in toddlers and infants in South Africa: a randomised, double-blind, placebo-controlled trial.

    Science.gov (United States)

    Groome, Michelle J; Koen, Anthonet; Fix, Alan; Page, Nicola; Jose, Lisa; Madhi, Shabir A; McNeal, Monica; Dally, Len; Cho, Iksung; Power, Maureen; Flores, Jorge; Cryz, Stanley

    2017-08-01

    Efficacy of live oral rotavirus vaccines is reduced in low-income compared with high-income settings. Parenteral non-replicating rotavirus vaccines might offer benefits over oral vaccines. We assessed the safety and immunogenicity of the P2-VP8-P[8] subunit rotavirus vaccine at different doses in South African toddlers and infants. This double-blind, randomised, placebo-controlled, dose-escalation trial was done at a single research unit based at a hospital in South Africa in healthy HIV-uninfected toddlers (aged 2 to placebo injection. The two highest tolerated doses were then assessed in an expanded cohort (in a 1:1:1 ratio). Parents of participants and clinical, data, and laboratory staff were masked to treatment assignment. P2-VP8-P[8] vaccine versus placebo was assessed first in toddlers (single injection) and then in infants (three injections 4 weeks apart). The primary safety endpoints were local and systemic reactions within 7 days after each injection, adverse events within 28 days after each injection, and all serious adverse events, assessed in toddlers and infants who received at least one dose. In infants receiving all study injections, primary immunogenicity endpoints were anti-P2-VP8-P[8] IgA and IgG and neutralising antibody seroresponses and geometric mean titres 4 weeks after the third injection. This trial is registered at ClinicalTrials.gov, number NCT02109484. Between March 17, 2014, and Sept 29, 2014, 42 toddlers (36 to vaccine and six to placebo) and 48 infants (36 to vaccine and 12 to placebo) were enrolled in the dose-escalation phase, in which the 30 μg and 60 μg doses where found to be the highest tolerated doses. A further 114 infants were enrolled in the expanded cohort between Nov 3, 2014, and March 20, 2015, and all 162 infants (12 assigned to 10 μg, 50 to 30 μg, 50 to 60 μg, and 50 to placebo) were included in the safety analysis. Serum IgA seroresponses were observed in 38 (81%, 95% CI 67-91) of 47 infants in the 30 μg group

  9. A enfermeira avaliando o cuidar do paciente em nutrição parenteral La enfermera evaluando el cuidar al paciente en nutrición parenteral When a nurse assesses the care of a patient under parenteral nutrition

    Directory of Open Access Journals (Sweden)

    Consuelo Helena Aires de Freitas Lopes

    2004-10-01

    Full Text Available O presente estudo teve como objetivo compreender a vivência da enfermeira avaliando o processo de cuidar do paciente em nutrição parenteral. Utilizamos o Interacionismo Simbólico e a Teoria Fundamentada nos Dados para o referencial teórico - metodológico. Fizeram parte do estudo dez enfermeiras que vivenciaram esta prática em hospital público da cidade de Fortaleza, Ceará. A coleta de dados foi realizada no período de 01 de abril a 30 de dezembro de 2001 através da observação participante e entrevista semi - estruturada. Identificamos o fenômeno - Avaliando o processo de cuidar do paciente em nutrição parenteral- que expressa a enfermeira vivenciando o cuidado mostrando atitudes, sentimentos e significados para o cuidar.El presente estudio tuvo como objetivo comprender la vivencia de la enfermera evaluando el proceso de cuidar al paciente en nutrición parenteral. Utilizamos el Interaccionismo Simbólico y la Teoría Fundamentada en los Datos para el referencial teórico - metodológico. Formaron parte del estudio diez enfermeras que vivieron esta práctica en un hospital público de la ciudad de Fortaleza, Ceará. La colecta de datos se realizó en el período de 01 de abril a 30 de diciembre de 2001 a través de la observación participante y entrevista semiestructurada. Identificamos el fenómeno - Evaluando el proceso de cuidar al paciente en nutrición parenteral - que expresa la enfermera viviendo el cuidado mostrando actitudes, sentimientos y significados para el cuidar.The present study aimed at understanding the nurses' experiences by assessing the process of caring for a patient under parenteral nutrition. We used symbolic interactionism and a data-based theory as a theoretical and methodological referential. Ten nurses that experienced this practice in a public hospital in Fortaleza, state of Ceará, took part. Data collection took place during the period from April 1st to December 30th, 2001 through participatory

  10. Consensus statement of the Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition: indicators recommended for the identification and documentation of pediatric malnutrition (undernutrition).

    Science.gov (United States)

    Becker, Patricia; Carney, Liesje Nieman; Corkins, Mark R; Monczka, Jessica; Smith, Elizabeth; Smith, Susan E; Spear, Bonnie A; White, Jane V

    2015-02-01

    The Academy of Nutrition and Dietetics (the Academy) and the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.), utilizing an evidence-informed, consensus-derived process, recommend that a standardized set of diagnostic indicators be used to identify and document pediatric malnutrition (undernutrition) in routine clinical practice. The recommended indicators include z scores for weight-for-height/length, body mass index-for-age, or length/height-for-age or mid-upper arm circumference when a single data point is available. When 2 or more data points are available, indicators may also include weight gain velocity (Dietetics.

  11. Semi-quantification of endolymphatic size on MR imaging after intravenous injection of single-dose gadodiamide: comparison between two types of processing strategies.

    Science.gov (United States)

    Naganawa, Shinji; Suzuki, Kojiro; Nakamichi, Rei; Bokura, Kiminori; Yoshida, Tadao; Sone, Michihiko; Homann, Georg; Nakashima, Tsutomu; Ikeda, Mitsuru

    2013-12-25

    Many inner ear disorders, including Ménière's disease, are believed to be based on endolymphatic hydrops. We evaluated a newly proposed method for semi-quantification of endolymphatic size in patients with suspected endolymphatic hydrops that uses 2 kinds of processed magnetic resonance (MR) images. Twenty-four consecutive patients underwent heavily T2-weighted (hT2W) MR cisternography (MRC), hT2W 3-dimensional (3D) fluid-attenuated inversion recovery (FLAIR) with inversion time of 2250 ms (positive perilymph image, PPI), and hT2W-3D-IR with inversion time of 2050 ms (positive endolymph image, PEI) 4 hours after intravenous administration of single-dose gadolinium-based contrast material (IV-SD-GBCM). Two images were generated using 2 new methods to process PPI, PEI, and MRC. Three radiologists contoured the cochlea and vestibule on MRC, copied regions of interest (ROIs) onto the 2 kinds of generated images, and semi-quantitatively measured the size of the endolymph for the cochlea and vestibule by setting a threshold pixel value. Each observer noted a strong linear correlation between endolymphatic size of both the cochlea and vestibule of the 2 kinds of generated images. The Pearson correlation coefficients (r) were 0.783, 0.734, and 0.800 in the cochlea and 0.924, 0.930, and 0.933 in the vestibule (P<0.001, for all). In both the cochlea and vestibule, repeated-measures analysis of variance showed no statistically significant difference between observers. Use of the 2 kinds of generated images generated from MR images obtained 4 hours after IV-SD-GBCM might enable semi-quantification of endolymphatic size with little observer dependency.

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

    Science.gov (United States)

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

    2017-07-25

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

  13. Antimicrobial Agents and Catheter Complications in Outpatient Parenteral Antimicrobial Therapy.

    Science.gov (United States)

    Keller, Sara C; Dzintars, Kathryn; Gorski, Lisa A; Williams, Deborah; Cosgrove, Sara E

    2018-03-01

    Debate about whether certain antimicrobial agents traditionally considered vesicants increase the risk of catheter complications has led to uncertainty in venous catheter placement protocols. To understand whether patients requiring home-based outpatient parenteral antimicrobial therapy (OPAT) should receive peripheral catheters (e.g., midline catheters) versus central venous catheters, and to understand whether certain antimicrobial agents place home-based OPAT patients at higher risk for catheter complications, we investigated associations between antimicrobial agent(s) and catheter complications. We performed a prospective cohort study of patients requiring home-based OPAT discharged from two urban tertiary care academic medical centers, including telephone surveys and chart abstractions. Multivariable Poisson regressions were used to evaluate: (i) associations between antimicrobial agents traditionally considered vesicants, based on pH or osmolarity, and catheter complication rates, and (ii) associations between antimicrobial agent and rates of catheter complications. Vesicant antimicrobials defined using pH or osmolarity criteria were not associated with an increased rate of catheter complications (adjusted incidence rate ratio [aIRR]: 1.63, 95% confidence interval [CI]: 0.89-2.96). Vancomycin was associated with an increased rate of catheter complications, as was daptomycin (aIRR: 2.32 [95% CI: 1.20-4.46] and 4.45 [95% CI: 1.02-19.41], respectively). Staphylococcus aureus infections were also associated with an increased rate of catheter complications (aIRR: 2.13, 95% CI: 1.09-4.19), as were midline catheters (aIRR: 9.44, 95% CI: 2.12-41.97). Our study supports recent guidance identifying vancomycin as a vesicant, among a subset of antimicrobial agents, and removal of pH criteria for identification of vesicants. © 2018 Pharmacotherapy Publications, Inc.

  14. Gastroenterology – Guidelines on Parenteral Nutrition, Chapter 15

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    Schulz, R. J.

    2009-11-01

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

  15. Oral anabolic steroid treatment, but not parenteral androgen treatment, decreases abdominal fat in obese, older men.

    Science.gov (United States)

    Lovejoy, J C; Bray, G A; Greeson, C S; Klemperer, M; Morris, J; Partington, C; Tulley, R

    1995-09-01

    To compare the effects of testosterone enanthate (TE), anabolic steroid (AS) or placebo (PL) on regional fat distribution and health risk factors in obese middle-aged men undergoing weight loss by dietary means. Randomized, double-blind, placebo-controlled clinical trial, carried out for 9 months with primary assessments at 3 month intervals. Due to adverse blood lipid changes, the AS group was switched from oral oxandrolone (ASOX) to parenteral nandrolone decaoate (ASND) after the 3 month assessment point. Thirty healthy, obese men, aged 40-60 years, with serum testosterone (T) levels in the low-normal range (2-5 ng/mL). Abdominal fat distribution and thigh muscle volume by CT scan, body composition by dual energy X-ray absorptiometry (DEXA), insulin sensitivity by the Minimal Model method, blood lipids, blood chemistry, blood pressure, thyroid hormones and urological parameters. After 3 months, there was a significantly greater decrease in subcutaneous (SQ) abdominal fat in the ASOX group compared to the TE and PL groups although body weight changes did not differ by treatment group. There was also a tendency for the ASOX group to exhibit greater losses in visceral fat, and the absolute level of visceral fat in this group was significantly lower at 3 months than in the TE and PL groups. There were significant main effects of treatment at 3 months on serum T and free T (increased in the TE group and decreased in the ASOX group) and on thyroid hormone parameters (T4 and T3 resin uptake significantly decreased in the ASOX group compared with the other two groups). There was a significant decrease in HDL-C, and increase in LDL-C in the ASOX group, which led to their being switched to the parenteral nandrolone decanoate (ASND) after 3 months. ASND had opposite effects on visceral fat from ASOX, producing a significant increase from 3 to 9 months while continuing to decrease SQ abdominal fat. ASND treatment also decreased thigh muscle area, while ASOX treatment

  16. Glutathione and tissue amino acid responses to light-exposed parenteral nutrients.

    Science.gov (United States)

    Bhatia, J; Moslen, M T; Kaphalia, L; Rassin, D K

    1992-10-01

    Effects of infusion of light-exposed (+L) or light-protected (-L) total parenteral nutrition solutions were investigated in rats. The parenteral infusions were carried out for 7 days through jugular cannulas in freely moving rats in metabolic cages. Plasma tyrosine and citrulline, hepatic methionine, valine, isoleucine, leucine and tyrosine, and biliary cystathionine were significantly greater in the -L than +L rats, whereas biliary arginine was significantly lower in the -L compared to +L rats. Bile flow, biliary inorganic phosphate and glucose were significantly lower, whereas biliary total glutathione (GSH+GSSG) was significantly greater in the -L compared to +L animals. These data suggest adverse effects on hepatobiliary function due to light exposure of parenteral nutrients. The endogenous markers used suggest that tight junction permeability, bile acid-independent flow, glutathione and amino acid homeostasis are altered by light exposure and that these changes can be minimized by light protection. The mechanisms involved in the induction of these changes need to be elucidated. The role of light exposure of parenteral nutrients during routine clinical use in the induction of hepatic dysfunction, a common metabolic complication of parenteral nutrition, needs to be considered.

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

    Science.gov (United States)

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

    1976-06-01

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

  18. Evaluation of Parenteral Nutritional Support in the Surgical and Medical Wards of a Referral Teaching Hospital

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    Samaneh Bairami

    2012-10-01

    Full Text Available Background and purpose:Malnutrition is a common problem in patients who are hospitalized in surgical and medical wards. Surgical patients, geriatric populations and individuals with severe illness are more vulnerable to malnutrition during their hospitalization course.The purpose of this study was evaluation of parenteral nutrition services in a referral teaching hospital, Tehran, Iran.Method:Medical records of 72 patients who received parenteral nutrition during one year period in different surgical and medical wards of Imam Khomeini hospital were reviewed retrospectively by clinical pharmacists. Criteria for initiation of parenteral nutrition, selection of appropriate formulation and monitoring parameters were assessed based on the American Society of Parenteral and Enteral Nutrition recommendations.Results:Based on the patients’ anthropometric parameters and serum albumin levels, 4.2%, 75% and 20.8% of the patients were well-nourished, moderately malnourished and severely malnourished respectively at the hospital admission and before nutritional support. Adequate calorie, protein, carbohydrate and lipid supports were achieved in 21.1%, 32.4%, 23.7% and 10.5% of the patients respectively. About 91% of the patients experienced at least onecomplication of the nutritional support.Conclusion:In this evaluation, several errors in assessment, establishing goals, and monitoring of parenteral nutrition regimens have been detected. Approximately all of the patients did notreceive to the trace elements supports goals.

  19. Evaluation of parenteral nutritional support in the surgical and medical wards of a referral teaching hospital

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    Bairami Samaneh

    2012-10-01

    Full Text Available Abstract Background and purpose Malnutrition is a common problem in patients who are hospitalized in surgical and medical wards. Surgical patients, geriatric populations and individuals with severe illness are more vulnerable to malnutrition during their hospitalization course. The purpose of this study was evaluation of parenteral nutrition services in a referral teaching hospital, Tehran, Iran. Method Medical records of 72 patients who received parenteral nutrition during one year period in different surgical and medical wards of Imam Khomeini hospital were reviewed retrospectively by clinical pharmacists. Criteria for initiation of parenteral nutrition, selection of appropriate formulation and monitoring parameters were assessed based on the American Society of Parenteral and Enteral Nutrition recommendations. Results Based on the patients' anthropometric parameters and serum albumin levels, 4.2%, 75% and 20.8% of the patients were well-nourished, moderately malnourished and severely malnourished respectively at the hospital admission and before nutritional support. Adequate calorie, protein, carbohydrate and lipid supports were achieved in 21.1%, 32.4%, 23.7% and 10.5% of the patients respectively. About 91% of the patients experienced at least one complication of the nutritional support. Conclusion In this evaluation, several errors in assessment, establishing goals, and monitoring of parenteral nutrition regimens have been detected. Approximately all of the patients did not receive to the trace elements supports goals.

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

    Directory of Open Access Journals (Sweden)

    Consuelo Helena Aires de Freitas Lopes

    1996-06-01

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

  1. Effect of parenteral and early intrajejunal nutrition on pancreatic digestive enzyme synthesis, storage and discharge in dog models of acute pancreatitis.

    Science.gov (United States)

    Qin, Huan-Long; Su, Zhen-Dong; Hu, Lei-Guang; Ding, Zai-Xian; Lin, Qing-Tian

    2007-02-21

    To study the effect of early intrajejunal nutrition on enzyme-protein synthesis and secretion during acute pancreatitis. Fifteen dogs were randomly divided into parenteral nutrition (n = 7) and early intrajejunal nutrition groups (n = 8). An acute pancreatitis model was induced by injecting 5% sodium taurocholate and trypsin into the pancreas via the pancreatic duct. Intrajejunal nutrition was delivered with a catheter via a jejunostomy tube after the model was established for 24 h. On d 1 and 7 and at the beginning of nutritional support, radioactive tracing and electron microscopes were used to evaluate the enzyme-protein synthesis in acinar cells, the subcellular fractionation and the change in zymogen granules after 1.85 x 10(6) Bq L-(3)H phenylalanine was infused at 30, 60, 120, and 180 min. The 3H radioactivity in pancreatic acinar cells reached its peak level at 60 min, and the contents in the early intrajejunal nutrition group were higher than those in the parenteral nutrition group, which were then decreased. The mean number and area of zymogen granules did not show any significant statistical difference in both groups on d 1 or on d 7 (P > 0.05). Early intrajejunal nutrition might be effective in dogs with acute pancreatitis.

  2. Effects of parenteral gibberellic acid and dietary supplementaion of vitamin D3 on egg quality and physiological characteristics in aged laying hens

    Directory of Open Access Journals (Sweden)

    Waleed M. Razuki

    2014-12-01

    Full Text Available The aim of this study was to determine the effect of parenteral gibberellic acid (GA3 and/or vitamin D3 supplementation in diet on egg quality and blood physiological characteristics in aged laying hens. A total of 270 Lohmann Brown Classic laying hens aging 73-week were randomly assigned to equal three treatment groups (T1, T2 and T3 with equal 3 replicas in each group. The birds of group T1 (control group were injected subcutaneously (SC with sesame oil at 0.2 mL/kg body weight. The birds of group T2 were given with GA3 at 400 µg/kg b.wt., SC, whereas group T3 had diet containing vitamin D3 at 500 IU/kg feed. Relative weight of albumen and egg shell, Haugh unit, shell thickness, serum glucose, serum calcium, serum phosphorous, serum estradiol, and bone calcium absorption were significantly increased in the birds of group T2 and T3. On the other hand, relative weight of yolk, yolk cholesterol, and serum cholesterol were significantly decreased in group T2 and T3 as compared to group T1. However, serum protein and albumen were unaffected in the treatments. In conclusion, the parenteral GA3 and vitamin D3 supplementation in diet could improve egg quality traits and serum blood biochemical perperties in agend laying hens.

  3. Effect of injection timing and injection pressure on the performance ...

    African Journals Online (AJOL)

    This paper discusses the feasibility study on the utilization of biodiesel ester of Honge oil (EHO) in common rail direct injection (CRDI) engine. Biodiesel of EHO has been obtained by transesterification process and characterization has been done. Existing single cylinder diesel engine fitted with conventional mechanical ...

  4. Effect of injection timing and injection pressure on the performance ...

    African Journals Online (AJOL)

    DR OKE

    This paper discusses the feasibility study on the utilization of biodiesel ester of Honge oil (EHO) in common rail direct injection. (CRDI) engine. Biodiesel of EHO has been obtained by transesterification process and characterization has been done. Existing single cylinder diesel engine fitted with conventional mechanical ...

  5. Effect of a single injection of gonadotropin-releasing hormone (GnRH) and human chorionic gonadotropin (hCG) on testicular blood flow measured by color doppler ultrasonography in male Shiba goats.

    Science.gov (United States)

    Samir, Haney; Sasaki, Kazuaki; Ahmed, Eman; Karen, Aly; Nagaoka, Kentaro; El Sayed, Mohamed; Taya, Kazuyoshi; Watanabe, Gen

    2015-05-01

    Although color Doppler ultrasonography has been used to evaluate testicular blood flow in many species, very little has been done in goat. Eight male Shiba goats were exposed to a single intramuscular injection of either gonadotropin-releasing hormone (GnRH group; 1 µg/kg BW) or human chorionic gonadotropin (hCG group; 25 IU/kg BW). Plasma testosterone (T), estradiol (E2) and inhibin (INH) were measured just before (0 hr) and at different intervals post injection by radioimmunoassay. Testis volume (TV) and Doppler indices, such as resistive index (RI) and pulsatility index (PI) of the supratesticular artery, were measured by B-mode and color Doppler ultrasonography, respectively. The results indicated an increase in testicular blood flow in both groups, as RI and PI decreased significantly (P<0.05), but this increase was significant higher and earlier in hCG group (1 hr) than in the GnRH group (2 hr). A high correlation was found for RI and PI with both T (RI, r= -0.862; PI, r= -0.707) and INH in the GnRH group (RI, r=0.661; PI, r=0.701). However, a significant (P<0.05) correlation was found between E2 and both RI (r= -0.610) and PI (r= -0.763) in hCG group. In addition, TV significantly increased and was highly correlated with RI in both groups (GnRH, r= -0.718; hCG, r= -0.779). In conclusion, hCG and GnRH may improve testicular blood flow and TV in Shiba goats.

  6. Double-Blind Comparative Trial of Parenteral Lorazepam and ...

    African Journals Online (AJOL)

    1974-04-27

    Apr 27, 1974 ... by deep injection into the triceps muscle. The patients were reassessed one hour later in the quiet environment ... 7 - 10 well sedated. Measurement of Forearm Blood Flow. In 10 patients (5 from each group) forearm blood flow was measured using a mercury-in-Silastic strain-gauge plethysmograph.

  7. Standardized Follow-up of Patients with Symptomatic Knee Osteoarthritis Treated with a Single Intra-articular Injection of a Combination of Cross-Linked Hyaluronic Acid and Mannitol

    Directory of Open Access Journals (Sweden)

    Thierry Conrozier

    2016-01-01

    Full Text Available Objectives The objective of this study is to obtain pilot data from daily practice conditions of a viscosupplement made of a cross-linked high-molecular-weight hyaluronic acid (HA combined with mannitol in patients with knee osteoarthritis (KOA. Methods The data of 40 consecutive patients, 29 women and 11 men, who were prospectively followed up for 6 months, using a standardized procedure, were retrospectively analyzed. All patients have received a single intra-articular injection of H Anox-M-XL (4.4 mL, viscosupplement made of a cross-linked HA (16 mg/mL + mannitol (35 mg/mL, in the target knee. The primary outcome was safety. The secondary end points included 3- and 6-month change in the WOMAC pain (0–50 and WOMAC total (0–240 and patient's global assessment (PGA. Patient's self-assessment of treatment efficacy (0–3 and analgesic consumption were obtained at months 3 and 6. An intent-to-treat analysis was performed. Results Mean (SD age was 60.7 (13.9 years, and mean BMI was 28.6 (5.0. Kellgren–Lawrence radiological grade was I/II and III/IV in 13 and 27 of the subjects, respectively. The average WOMAC pain and WOMAC total scores at baseline were 21.5 (9.8 and 89.9 (42.8, respectively. Thirty-nine patients completed the follow-up. HAnox-M-XL was well tolerated; two patients experienced knee pain after injection, which resolved within three days. No treatment-related severe adverse event was reported. Mean (SD variations in WOMAC pain and WOMAC total scores were –8.2 (8.9 and –38.4 (35.6, respectively, at month 6 ( P = 0.001. PGA decreased from 5.5 (2.0 to 3.0 (2.2 ( P = 0.006. Efficacy was rated as good or very good in 76.9% of the cases. Most of the regular analgesics users decreased their consumption. Conclusion Treatment with one injection of 4.4 mL HAnox-M-XL is effective to alleviate KOA symptoms over six months, without safety concern. Controlled trials are needed to confirm these pilot data.

  8. Safe injection procedures, injection practices, and needlestick ...

    African Journals Online (AJOL)

    Safe injection procedures, injection practices, and needlestick injuries among health care workers in operating rooms. Nermine Mohamed Tawfik Foda, Noha Selim Mohamed Elshaer, Yasmine Hussein Mohamed Sultan ...

  9. Outbreak of Serratia marcescens bloodstream infections in patients receiving parenteral nutrition prepared by a compounding pharmacy.

    Science.gov (United States)

    Gupta, Neil; Hocevar, Susan N; Moulton-Meissner, Heather A; Stevens, Kelly M; McIntyre, Mary G; Jensen, Bette; Kuhar, David T; Noble-Wang, Judith A; Schnatz, Rick G; Becker, Shawn C; Kastango, Eric S; Shehab, Nadine; Kallen, Alexander J

    2014-07-01

    Compounding pharmacies often prepare parenteral nutrition (PN) and must adhere to rigorous standards to avoid contamination of the sterile preparation. In March 2011, Serratia marcescens bloodstream infections (BSIs) were identified in 5 patients receiving PN from a single compounding pharmacy. An investigation was conducted to identify potential sources of contamination and prevent further infections. Cases were defined as S. marcescens BSIs in patients receiving PN from the pharmacy between January and March 2011. We reviewed case patients' clinical records, evaluated pharmacy compounding practices, and obtained epidemiologically directed environmental cultures. Molecular relatedness of available Serratia isolates was determined by pulsed-field gel electrophoresis (PFGE). Nineteen case patients were identified; 9 died. The attack rate for patients receiving PN in March was 35%. No case patients were younger than 18 years. In October 2010, the pharmacy began compounding and filter-sterilizing amino acid solution for adult PN using nonsterile amino acids due to a national manufacturer shortage. Review of this process identified breaches in mixing, filtration, and sterility testing practices. S. marcescens was identified from a pharmacy water faucet, mixing container, and opened amino acid powder. These isolates were indistinguishable from the outbreak strain by PFGE. Compounding of nonsterile amino acid components of PN was initiated due to a manufacturer shortage. Failure to follow recommended compounding standards contributed to an outbreak of S. marcescens BSIs. Improved adherence to sterile compounding standards, critical examination of standards for sterile compounding from nonsterile ingredients, and more rigorous oversight of compounding pharmacies is needed to prevent future outbreaks. Published by Oxford University Press on behalf of the Infectious Diseases Society of America 2014. This work is written by (a) US Government employee(s) and is in the public

  10. Parenteral nutrition suppresses the bactericidal response of the small intestine.

    Science.gov (United States)

    Omata, Jiro; Pierre, Joseph F; Heneghan, Aaron F; Tsao, Francis H C; Sano, Yoshifumi; Jonker, Mark A; Kudsk, Kenneth A

    2013-01-01

    Parenteral nutrition (PN) increases infectious risk in critically ill patients compared with enteral feeding. Previously, we demonstrated that PN feeding suppresses the concentration of the Paneth cell antimicrobial protein secretory phospholipase A2 (sPLA2) in the gut lumen. sPLA2 and other Paneth cell proteins are released in response to bacterial components, such as lipopolysaccharide (LPS), and they modulate the intestinal microbiome. Because the Paneth cell protein sPLA2 was suppressed with PN feeding, we hypothesized PN would diminish the responsiveness of the small bowel to LPS through reduced secretions and as a result exhibit less bactericidal activity. The distal ileum was harvested from Institute of Cancer Research mice, washed, and randomized for incubation with LPS (0, 1, or 10 μg/mL). Culture supernatant was collected and sPLA2 activity was measured. Bactericidal activity of the ileum segment secretions was assessed against Pseudomonas aeruginosa with and without an sPLA2 inhibitor at 2 concentrations, 100 nmol/L and 1 μmol/L. Institute of Cancer Research mice were randomized to chow or PN for 5 days. Tissue was collected for immunohistochemistry (IHC) and ileal segments were incubated with LPS (0 or 10 μg/mL). sPLA2 activity and bactericidal activity were measured in secretions from ileal segments. Ileal segments responded to 10 μg/mL LPS with significantly greater sPLA2 activity and bactericidal activity. The bactericidal activity of secretions from LPS stimulated tissue was suppressed 50% and 70%, respectively, with the addition of the sPLA2-inhibitor. Chow displayed greater sPLA2 in the Paneth cell granules and secreted higher levels of sPLA2 than PN before and after LPS. Accordingly, media collected from chow was more bactericidal than PN. IHC confirmed a reduction in Paneth cell granules after PN. This work demonstrates that ileal segments secrete bactericidal secretions after LPS exposure and the inhibition of the Paneth cell antimicrobial

  11. Identification of Particles in Parenteral Drug Raw Materials.

    Science.gov (United States)

    Lee, Kathryn; Lankers, Markus; Valet, Oliver

    2018-04-18

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

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

    Science.gov (United States)

    2013-01-01

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

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

    Science.gov (United States)

    Total parenteral nutrition (TPN) is essential for patients with impaired gut function but leads to parenteral nutrition-associated liver disease (PNALD). TPN disrupts the normal enterohepatic circulation of bile acids, and we hypothesized that it would decrease intestinal expression of the newly des...

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

    NARCIS (Netherlands)

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

    2014-01-01

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

  15. Safe injection procedures, injection practices, and needlestick ...

    African Journals Online (AJOL)

    Nermine Mohamed Tawfik Foda

    2017-01-10

    Jan 10, 2017 ... tionnaire was administered to HCWs (n = 318) at the Alexandria Main University Hospital. Results: Safe injection procedures regarding final waste disposal were sufficiently adopted, while mea- sures regarding disposable injection equipment, waste containers, hand hygiene, as well as injection practices ...

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

    Science.gov (United States)

    2014-01-01

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

  17. Aspectos biofarmacéuticos de liposomas administrados por vía parenteral

    OpenAIRE

    Lairion, Fabiana; Di Rocco, Pedro; Nacucchio, Marcelo Carlos

    1994-01-01

    La administración parenteral de drogas en el hombre es, de hecho, la ruta más investigada y no sólo involucra la ruta intravenosa, sino también la vía subcutánea, intramuscular, intraperitoneal, intraarticular, intraarterial, etc., siendo la administración intravenosa de liposomas una de las principales rutas de administración de dicho sistema terapéutico. El empleo de sistemas terapéuticos para lograr la administración selectiva y controlada de drogas por vía parenteral es sujeto de constant...

  18. Classification of glass particles in parenteral product vials by visual, microscopic, and spectroscopic methods.

    Science.gov (United States)

    Li, Gary Guiyang; Cao, Shawn; Jiao, Nancy; Wen, Zai-Qing

    2014-01-01

    Glass vials have been used as primary containers for parenteral drugs including biopharmaceuticals. Different types of glass-related particles, although in low occurrence rate, may be adventitiously introduced in these parenterals. Proper classification and investigations of these glass-related particles may help to understand their formation, improve process control, reduce glass-related particles, and deliver safe parenteral drugs to patients. In this article, we introduced a classification scheme, and identification procedures and methods, for the glass-related particles. We propose to classify them as glass chip, glass lamella/flake, and silica gel. Eight characteristics for each glass particle type have been identified and described for the visual inspection method. The limitations of the visual method and the need to correlate visual results with forensic analysis are discussed. Using representative examples from each type of glass particle, this study summarized their forensic differentiations based on microscopic methods of optical microscopy, scanning electron microscopy, micro-flow imaging, and spectroscopic methods of dnergy-dispersive spectroscopy and Fourier transform infrared spectroscopy. The mechanisms of glass particle formation are listed as references for drug development scientists to investigate the root causes and improve process control on visible glass particles in parenteral vials. Glass vials have been used as primary containers for parenteral drugs including biopharmaceuticals. Different types of glass-related particles, although in low occurrence rate, may be adventitiously introduced in these parenterals. Proper classification and investigations of these glass-related particles may help to understand their formation, improve process control, reduce glass-related particles, and deliver safe parenteral drugs to patients. In this article, we introduced a classification scheme, and identification procedures and methods, for the glass

  19. Penicillin G Procaine Injection

    Science.gov (United States)

    Penicillin G procaine injection is used to treat certain infections caused by bacteria. Penicillin G procaine injection should not be used to treat ... in the treatment of certain serious infections. Penicillin G procaine injection is in a class of medications ...

  20. Anemia and leukopenia in a long-term parenteral nutrition patient during a shortage of parenteral trace element products in the United States.

    Science.gov (United States)

    Pramyothin, Pornpoj; Kim, Dong Wook; Young, Lorraine S; Wichansawakun, Sanit; Apovian, Caroline M

    2013-01-01

    Recently, drug shortages in the United States have affected multiple components of the parenteral nutrition (PN) solution. A 62-year-old patient with systemic sclerosis who was dependent on home PN due to intestinal dysmotility developed anemia and leukopenia approximately 4 months after parenteral copper was withheld from her PN solution due to drug shortages. The patient was not able to tolerate a sufficient amount of oral multivitamins with trace elements due to severe dysphagia. Her serum copper and ceruloplasmin concentrations were undetectable, confirming the diagnosis of severe copper deficiency. The hematological abnormalities promptly resolved with copper supplementation. This report emphasizes the importance of close monitoring for nutrient deficiencies during drug shortages and supplementing with oral or enteral nutrition when feasible, particularly in high-risk patients such as those with intestinal malabsorption or short bowel syndrome who are dependent on long-term PN.