WorldWideScience

Sample records for staggered bleed tabs

  1. Bleeding

    Science.gov (United States)

    ... with problems in the joints, or gastrointestinal or urogenital tracts. Symptoms You may have symptoms such as: Blood ... may be internal bleeding or shock. Signs of infection develop, including increased pain, redness, swelling, yellow or ...

  2. Staggering but not knocked out

    Energy Technology Data Exchange (ETDEWEB)

    Anon.

    2012-11-01

    Italy's PV market is staggering like a boxer almost knocked out. It has been hit hard by the country's deep economic recession. Conto Energia V has been yet another blow with cuts of up to 40 % in the solar feed-in tariffs. But the situation is not hopeless.

  3. Taste changing in staggered quarks

    International Nuclear Information System (INIS)

    Quentin Mason

    2004-01-01

    The authors present results from a systematic perturbative investigation of taste-changing in improved staggered quarks. They show one-loop taste-changing interactions can be removed perturbatively by an effective four-quark term and calculate the necessary coefficients

  4. On staggered indecomposable Virasoro modules

    International Nuclear Information System (INIS)

    Kytoelae, Kalle; Ridout, David

    2009-06-01

    In this article, certain indecomposable Virasoro modules are studied. Specifically, the Virasoro mode L0 is assumed to be non-diagonalisable, possessing Jordan blocks of rank two. Moreover, the module is further assumed to have a highest weight submodule, the ''left module'', and that the quotient by this submodule yields another highest weight module, the ''right module''. Such modules, which have been called staggered, have appeared repeatedly in the logarithmic conformal field theory literature, but their theory has not been explored in full generality. Here, such a theory is developed for the Virasoro algebra using rather elementary techniques. The focus centres on two different but related questions typically encountered in practical studies: How can one identify a given staggered module, and how can one demonstrate the existence of a proposed staggered module. Given just the values of the highest weights of the left and right modules, themselves subject to simple necessary conditions, invariants are defined which together with the knowledge of the left and right modules uniquely identify a staggered module. The possible values of these invariants form a vector space of dimension zero, one or two, and the structures of the left and right modules limit the isomorphism classes of the corresponding staggered modules to an affine subspace (possibly empty). The number of invariants and affine restrictions is purely determined by the structures of the left and right modules. Moreover, in order to facilitate applications, the expressions for the invariants and restrictions are given by formulae as explicit as possible (they generally rely on expressions for Virasoro singular vectors). Finally, the text is liberally peppered throughout with examples illustrating the general concepts. These have been carefully chosen for their physical relevance or for the novel features they exhibit. (orig.)

  5. On staggered indecomposable Virasoro modules

    Science.gov (United States)

    Kytölä, Kalle; Ridout, David

    2009-12-01

    In this article, certain indecomposable Virasoro modules are studied. Specifically, the Virasoro mode L0 is assumed to be nondiagonalizable, possessing Jordan blocks of rank 2. Moreover, the module is further assumed to have a highest weight submodule, the "left module," and that the quotient by this submodule yields another highest weight module, the "right module." Such modules, which have been called staggered, have appeared repeatedly in the logarithmic conformal field theory literature, but their theory has not been explored in full generality. Here, such a theory is developed for the Virasoro algebra using rather elementary techniques. The focus centers on two different but related questions typically encountered in practical studies: How can one identify a given staggered module, and how can one demonstrate the existence of a proposed staggered module. Given just the values of the highest weights of the left and right modules, themselves subject to simple necessary conditions, invariants are defined which together with the knowledge of the left and right modules uniquely identify a staggered module. The possible values of these invariants form a vector space of dimension 0, 1, or 2, and the structures of the left and right modules limit the isomorphism classes of the corresponding staggered modules to an affine subspace (possibly empty). The number of invariants and affine restrictions is purely determined by the structures of the left and right modules. Moreover, in order to facilitate applications, the expressions for the invariants and restrictions are given by formulas as explicit as possible (they generally rely on expressions for Virasoro singular vectors). Finally, the text is liberally peppered throughout with examples illustrating the general concepts. These have been carefully chosen for their physical relevance or for the novel features they exhibit.

  6. On staggered indecomposable Virasoro modules

    Energy Technology Data Exchange (ETDEWEB)

    Kytoelae, Kalle [Geneve Univ. (Switzerland); Ridout, David [Deutsches Elektronen-Synchrotron (DESY), Hamburg (Germany)

    2009-06-15

    In this article, certain indecomposable Virasoro modules are studied. Specifically, the Virasoro mode L0 is assumed to be non-diagonalisable, possessing Jordan blocks of rank two. Moreover, the module is further assumed to have a highest weight submodule, the ''left module'', and that the quotient by this submodule yields another highest weight module, the ''right module''. Such modules, which have been called staggered, have appeared repeatedly in the logarithmic conformal field theory literature, but their theory has not been explored in full generality. Here, such a theory is developed for the Virasoro algebra using rather elementary techniques. The focus centres on two different but related questions typically encountered in practical studies: How can one identify a given staggered module, and how can one demonstrate the existence of a proposed staggered module. Given just the values of the highest weights of the left and right modules, themselves subject to simple necessary conditions, invariants are defined which together with the knowledge of the left and right modules uniquely identify a staggered module. The possible values of these invariants form a vector space of dimension zero, one or two, and the structures of the left and right modules limit the isomorphism classes of the corresponding staggered modules to an affine subspace (possibly empty). The number of invariants and affine restrictions is purely determined by the structures of the left and right modules. Moreover, in order to facilitate applications, the expressions for the invariants and restrictions are given by formulae as explicit as possible (they generally rely on expressions for Virasoro singular vectors). Finally, the text is liberally peppered throughout with examples illustrating the general concepts. These have been carefully chosen for their physical relevance or for the novel features they exhibit. (orig.)

  7. Vaginal Bleeding

    Science.gov (United States)

    ... Gynecology. ACOG Practice Bulletin No. 128. Diagnosis of abnormal uterine bleeding in reproductive-aged women. Obstetrics and Gynecology. 2012;120:197. Kaunitz AM. Approach to abnormal uterine bleeding in nonpregnant reproductive-age women. http://www.uptodate. ...

  8. Staggering towards a calculation of weak amplitudes

    Energy Technology Data Exchange (ETDEWEB)

    Sharpe, S.R.

    1988-09-01

    An explanation is given of the methods required to calculate hadronic matrix elements of the weak Hamiltonians using lattice QCD with staggered fermions. New results are presented for the 1-loop perturbative mixing of the weak interaction operators. New numerical techniques designed for staggered fermions are described. A preliminary result for the kaon B parameter is presented. 24 refs., 3 figs.

  9. Staggering towards a calculation of weak amplitudes

    International Nuclear Information System (INIS)

    Sharpe, S.R.

    1988-09-01

    An explanation is given of the methods required to calculate hadronic matrix elements of the weak Hamiltonians using lattice QCD with staggered fermions. New results are presented for the 1-loop perturbative mixing of the weak interaction operators. New numerical techniques designed for staggered fermions are described. A preliminary result for the kaon B parameter is presented. 24 refs., 3 figs

  10. Tool kit for staggered fermions

    International Nuclear Information System (INIS)

    Kilcup, G.W.; Sharpe, S.R.

    1986-01-01

    The symmetries of staggered fermions are analyzed both discrete and continuous. Tools are presented that allow a simple decomposition of representations of the continuum symmetries into representations of the discrete lattice symmetries, both at zero and non-zero spatial momenta. These tools are used to find the lattice transcriptions of the operators that appear in the weak interaction Hamiltonian. The lattice Ward Identities are derived that follow from the single partially conserved axial symmetry. Using these identities, the lattice equivalents of the continuum PCAC relations are found. Combining all these tools, Ward Identities are obtained, for the matrix elements of the weak interaction Hamiltonian, from which the behavior of the matrix elements as the pion and kaon masses vanish are derived. The same behavior as in the continuum is found

  11. Perimenopausal Bleeding and Bleeding After Menopause

    Science.gov (United States)

    ... Patients About ACOG Perimenopausal Bleeding and Bleeding After Menopause Home For Patients Search FAQs Perimenopausal Bleeding and ... 2011 PDF Format Perimenopausal Bleeding and Bleeding After Menopause Gynecologic Problems What are menopause and perimenopause? What ...

  12. [Gastrointestinal bleeding].

    Science.gov (United States)

    Lanas, Ángel

    2015-09-01

    In the Digestive Disease Week in 2015 there have been some new contributions in the field of gastrointestinal bleeding that deserve to be highlighted. Treatment of celecoxib with a proton pump inhibitor is safer than treatment with nonselective NSAID and a proton pump inhibitor in high risk gastrointestinal and cardiovascular patients who mostly also take acetylsalicylic acid. Several studies confirm the need to restart the antiplatelet or anticoagulant therapy at an early stage after a gastrointestinal hemorrhage. The need for urgent endoscopy before 6-12 h after the onset of upper gastrointestinal bleeding episode may be beneficial in patients with hemodynamic instability and high risk for comorbidity. It is confirmed that in Western but not in Japanese populations, gastrointestinal bleeding episodes admitted to hospital during weekend days are associated with a worse prognosis associated with delays in the clinical management of the events. The strategy of a restrictive policy on blood transfusions during an upper GI bleeding event has been challenged. Several studies have shown the benefit of identifying the bleeding vessel in non varicose underlying gastric lesions by Doppler ultrasound which allows direct endoscopic therapy in the patient with upper GI bleeding. Finally, it has been reported that lower gastrointestinal bleeding diverticula band ligation or hemoclipping are both safe and have the same long-term outcomes. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  13. Rectal Bleeding

    Science.gov (United States)

    ... rectal bleeding and any signs of shock: Rapid, shallow breathing Dizziness or lightheadedness after standing up Blurred ... shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research. © 1998-2018 Mayo ...

  14. Aircraft rotor blade with passive tuned tab

    Science.gov (United States)

    Campbell, T. G. (Inventor)

    1985-01-01

    A structure for reducing vibratory airloading in a rotor blade with a leading edge and a trailing edge includes a cut out portion at the trailing edge. A substantially wedge shaped cross section, inertially deflectable tab, also with a leading edge and a trailing edge is pivotally mounted in the cut out portion. The trailing edge of the tab may move above and below the rotor blade. A torsion strap applies force against the tab when the trailing edge of the tab is above and below the rotor blade. A restraining member is slidably movable along the torsion strap to vary torsional biasing force supplied by the torsion bar to the tab. A plurality of movable weights positioned between plates vary a center of gravity of the tab. Skin of the tab is formed from unidirectional graphite and fiberglass layers. Sliders coupled with a pinned degree of freedom at rod eliminate bending of tab under edgewise blade deflection.

  15. Weak interaction matrix elements with staggered fermions

    International Nuclear Information System (INIS)

    Sharpe, S.R.

    1986-08-01

    An overview of the results of the Los Alamos Advanced Computing Group is given. The theory behind the measurement of Weak Interaction Matrix Elements using staggered fermions is presented, and contrasted with that for Wilson fermions. This is followed by a preliminary discussion of numerical results on a 12 3 x 30 lattice. 10 refs., 4 figs

  16. Kaon decay amplitudes using staggered fermions

    International Nuclear Information System (INIS)

    Sharpe, S.R.

    1986-12-01

    A status report is given of an attempt, using staggered fermions to calculate the real and imaginary parts of the amplitudes for K → ππ,. Semi-quantitative results are found for the imaginary parts, and these suggest that ε' might be smaller than previously expected in the standard model

  17. Bleeding Disorders

    Science.gov (United States)

    ... study of intranasal desmopressin and oral tranexamic acid . British Journal of Haematology; 145(2): 212-220. Bleeding ... Ayisyen Français Polski Português Italiano Deutsch 日本語 فارسی English A federal government website managed by the Office ...

  18. Abnormal uterine bleeding

    Science.gov (United States)

    Anovulatory bleeding; Abnormal uterine bleeding - hormonal; Polymenorrhea - dysfunctional uterine bleeding ... ACOG committee opinion no. 557: Management of acute abnormal uterine bleeding in nonpregnant reproductive-aged women. Reaffirmed 2015. ACOG. ...

  19. Fan Stagger Angle for Dirt Rejection

    Science.gov (United States)

    Gallagher, Edward J. (Inventor); Rose, Becky E. (Inventor); Brilliant, Lisa I. (Inventor)

    2015-01-01

    A gas turbine engine includes a spool, a turbine coupled to drive the spool, a propulsor coupled to be rotated about an axis by the turbine through the spool, and a gear assembly coupled between the propulsor and the spool such that rotation of the turbine drives the propulsor at a different speed than the spool. The propulsor includes a hub and a row of propulsor blades that extend from the hub. Each of the propulsor blades has a span between a root at the hub and a tip, and a chord between a leading edge and a trailing edge. The chord forms a stagger angle alpha with the axis, and the stagger angle alpha is less than 15 deg. at a position along the propulsor blade that is within an inboard 20% of the span.

  20. Staggered broad-band reflecting multilayers.

    Science.gov (United States)

    Heavens, O S; Liddell, H M

    1966-03-01

    Considerable broadening of the reflectance band of a multilayer stack may be obtained by staggering the layer thicknesses in such a way that they form either an arithmetic or geometric progression. Results are shown for asymmetric and symmetric filters of 15, 25, and 35 layers. The presence of the narrowband transmission peaks exhibited by the symmetric filters is explained, and the advantages of the use of this type of filter as an interference filter is discussed.

  1. Samsung Galaxy Tab S for dummies

    CERN Document Server

    Gookin, Dan

    2015-01-01

    Explore your Galaxy Tab S with an expert tour guide at your side Samsung Galaxy Tab S For Dummies is a user-friendly guide to getting the most out of your new tablet. You'll discover how different the tablet experience is from the desktop, laptop, or smartphone, and learn how to take advantage of everything your Galaxy Tab S has to offer. This entertaining guide walks you through each feature one by one, helping you learn exactly what your tablet can do for you. With everything from reading to playing games and surfing the Internet, you will learn how to be productive and have fun, too! Nav

  2. Power module assemblies with staggered coolant channels

    Science.gov (United States)

    Herron, Nicholas Hayden; Mann, Brooks S; Korich, Mark D

    2013-07-16

    A manifold is provided for supporting a power module assembly with a plurality of power modules. The manifold includes a first manifold section. The first face of the first manifold section is configured to receive the first power module, and the second face of the first manifold section defines a first cavity with a first baseplate thermally coupled to the first power module. The first face of the second manifold section is configured to receive the second power module, and the second face of the second manifold section defines a second cavity with a second baseplate thermally coupled to the second power module. The second face of the first manifold section and the second face of the second manifold section are coupled together such that the first cavity and the second cavity form a coolant channel. The first cavity is at least partially staggered with respect to second cavity.

  3. Perturbative improvement of staggered fermions using fat links

    International Nuclear Information System (INIS)

    Lee, Weonjong

    2002-01-01

    We study the possibility of improving staggered fermions using various fat links in order to reduce perturbative corrections to the gauge-invariant staggered fermion operators. We prove five theorems on SU(3) projection, triviality in renormalization, multiple SU(3) projections, uniqueness, and equivalence. As a result of these theorems, we show that, at the one-loop level, the renormalization of staggered fermion operators is identical between SU(3) projected Fat7 links and hypercubic links, as long as the action and operators are constructed by imposing the same perturbative improvement condition. In addition, we propose a new view of SU(3) projection as a tool of tadpole improvement for the staggered fermion doublers. As a conclusion, we present alternative choices of constructing fat links to improve the staggered fermion action and operators, which deserve further investigation

  4. Salmonella Dublin kan give store tab

    DEFF Research Database (Denmark)

    Nielsen, Torben Dahl; Nielsen, Liza Rosenbaum; Kudahl, Anne Margrethe Braad

    2012-01-01

    Store besætninger lider størst økonomisk tab ved infektion med Salmonella Dublin. Selv i en veldrevet besætning kan tabet løbe op i mellem 1,3 og 3,3 millioner kr. over en tiårs periode. Ved uhensigtsmæssige hygiejne- og managementrutiner kan tabet nemt blive meget højere.......Store besætninger lider størst økonomisk tab ved infektion med Salmonella Dublin. Selv i en veldrevet besætning kan tabet løbe op i mellem 1,3 og 3,3 millioner kr. over en tiårs periode. Ved uhensigtsmæssige hygiejne- og managementrutiner kan tabet nemt blive meget højere....

  5. Staggered Pairing Phenomenology for UBe_13

    Science.gov (United States)

    Martisovits, V.; Cox, D. L.

    1998-03-01

    The staggered-pairing Ginzburg-Landau phenomenology based upon Cooper pairs with a finite center-of-mass momentum was previously applied to the hexagonal heavy-fermion superconductors UPt_3,(R. Heid, Ya. B. Bazaliy, V. Martisovits, and D. L. Cox, Phys. Rev. Lett. 74), 2571 (1995). UPd_2Al_3, and UNi_2Al_3.(V. Martisovits and D. L. Cox (to be published); Report No. cond-mat/9706245.) Here we apply this phenomenology to study the cubic heavy-fermion superconductor UBe_13. We find the momentum of Cooper pairs to be at X points on the Brillouin-zone boundary and identify a three-component superconducting order parameter transforming as an X-point irreducible representation of the space group. Minimizing the free energy, we find possible superconducting phases and the upper critical field H_c2. We investigate coupling to strain fields and the possibility of magnetic order and charge-density waves induced by superconductivity. To explain multiple superconducting phases in the temperature-thorium-concentration phase diagram of U_1-xTh_xBe_13, we model the influence of thorium in terms of random tetragonal strain fields.

  6. Estimation of Parameters of CCF with Staggered Testing

    International Nuclear Information System (INIS)

    Kim, Myung-Ki; Hong, Sung-Yull

    2006-01-01

    Common cause failures are extremely important in reliability analysis and would be dominant to risk contributor in a high reliable system such as a nuclear power plant. Of particular concern is common cause failure (CCF) that degrades redundancy or diversity implemented to improve a reliability of systems. Most of analyses of parameters of CCF models such as beta factor model, alpha factor model, and MGL(Multiple Greek Letters) model deal a system with a nonstaggered testing strategy. Non-staggered testing is that all components are tested at the same time (or at least the same shift) and staggered testing is that if there is a failure in the first component, all the other components are tested immediately, and if it succeeds, no more is done until the next scheduled testing time. Both of them are applied in the nuclear power plants. The strategy, however, is not explicitly described in the technical specifications, but implicitly in the periodic test procedure. For example, some redundant components particularly important to safety are being tested with staggered testing strategy. Others are being performed with non-staggered testing strategy. This paper presents the parameter estimator of CCF model such as beta factor model, MGL model, and alpha factor model with staggered testing strategy. In addition, a new CCF model, rho factor model, is proposed and its parameter is presented with staggered testing strategy

  7. Heavy-light semileptonic decays in staggered chiral perturbation theory

    Science.gov (United States)

    Aubin, C.; Bernard, C.

    2007-07-01

    We calculate the form factors for the semileptonic decays of heavy-light pseudoscalar mesons in partially quenched staggered chiral perturbation theory (SχPT), working to leading order in 1/mQ, where mQ is the heavy-quark mass. We take the light meson in the final state to be a pseudoscalar corresponding to the exact chiral symmetry of staggered quarks. The treatment assumes the validity of the standard prescription for representing the staggered “fourth-root trick” within SχPT by insertions of factors of 1/4 for each sea-quark loop. Our calculation is based on an existing partially quenched continuum chiral perturbation theory calculation with degenerate sea quarks by Bećirević, Prelovsek, and Zupan, which we generalize to the staggered (and nondegenerate) case. As a byproduct, we obtain the continuum partially quenched results with nondegenerate sea quarks. We analyze the effects of nonleading chiral terms, and find a relation among the coefficients governing the analytic valence mass dependence at this order. Our results are useful in analyzing lattice computations of form factors B→π and D→K, when the light quarks are simulated with the staggered action.

  8. Advances in gastrointestinal bleeding.

    Science.gov (United States)

    Lanas, Ángel

    2016-09-01

    The main innovations of the latest meeting of the Gastroenterological Association (2016) concerning upper gastrointestinal bleeding from the clinician's perspective can be summarised as follows: a) The Glasgow-Blatchford scale has the best accuracy in predicting the need for surgical intervention and hospital mortality; b) Prognostic scales for non-variceal upper gastrointestinal bleeding are also useful for lower gastrointestinal bleeding; c) Preliminary data suggest that treatment with hemospray does not seem to be superior to current standard treatment in controlling active peptic ulcer bleeding; d) Either famotidine or a proton pump inhibitor may be effective in preventing haemorrhagic recurrence in patients taking aspirin, but this finding needs to be confirmed in further studies; e) There was confirmation of the need to re-introduce antiplatelet therapy as early as possible in patients with antiplatelet-associated gastrointestinal bleeding in order to prevent cardiovascular mortality; f) Routine clinical practice suggests that gastrointestinal or cardiovascular complications with celecoxib or traditional NSAIDs are very low; g) Dabigatran is associated with an increased incidence of gastrointestinal bleeding compared with apixaban or warfarin. At least half of the episodes are located in the lower gastrointestinal tract; h) Implant devices for external ventricular circulatory support are associated with early gastrointestinal bleeding in up to one third of patients; the bleeding is often secondary to arteriovenous malformations. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  9. Bleeding esophageal varices

    Science.gov (United States)

    ... amount of bleeding, the only symptom may be dark or black streaks in the stools. If larger amounts of bleeding occur, symptoms ... exam which may show: Bloody or black stool (in a rectal exam) Low ... the use of a camera on a flexible tube to examine the esophagus ...

  10. Assessment of Postmenopausal Bleeding

    Directory of Open Access Journals (Sweden)

    Chin-Yuan Hsu

    2008-06-01

    Full Text Available Postmenopausal bleeding is bleeding that occurs 12 or more months after the last menstrual period and accounts for 5% of all gynecologic office visits. While it is not always a symptom of cancer, the exclusion of endometrial hyperplasia and carcinoma is the key issue in the evaluation of patients with postmenopausal bleeding. The primary evaluation of postmenopausal women who present with abnormal uterine bleeding includes a medical history and a pelvic examination. Investigative studies, such as a uterine biopsy, ultrasound, hysteroscopy or dilation and curettage, may be required. Treatment will depend on the cause determined. The most important point is that irregular perimenopausal or postmenopausal bleeding should not be ignored or assumed to be a normal phenomenon.

  11. The Office for Technology Assessment with the German Parliament (TAB)

    International Nuclear Information System (INIS)

    Grunwald, A.; Petermann, T.

    2004-01-01

    TAB was created in 1990 with the aim of providing contributions to the improvement of the information base, particularly for parliamentary decision-making concerning science and technology. Among TAB's tasks are above all the conception and execution of technology assessment projects and the monitoring and analysis of important scientific and technological trends and related societal developments. TAB is managed by the Institute for Technology Assessment and Systems Analysis (ITAS) of the Karlsruhe Research Center. (orig.)

  12. Abnormal Uterine Bleeding

    Science.gov (United States)

    ... uterine cancer isn’t the cause. Women after menopause Hormone replacement therapy is a common cause of uterine bleeding after menopause. Other causes include endometrial and uterine cancer. These ...

  13. Reaction mechanisms and staggering in S+Ni collisions

    International Nuclear Information System (INIS)

    D'Agostino, M.; Bruno, M.; Gulminelli, F.; Morelli, L.; Baiocco, G.; Bardelli, L.; Barlini, S.; Cannata, F.; Casini, G.; Geraci, E.; Gramegna, F.; Kravchuk, V.L.; Marchi, T.; Moroni, A.; Ordine, A.; Raduta, Ad.R.

    2011-01-01

    The reactions 32 S+ 58 Ni and 32 S+ 64 Ni are studied at 14.5 A MeV. After a selection of the collision mechanism, we show that important even-odd effects are present in the isotopic fragment distributions when the excitation energy is small. Close to the multifragmentation threshold this staggering appears hidden by the rapid variation of the production yields with the fragment size. Once this effect is accounted for, the staggering appears to be a universal feature of fragment production, slightly enhanced when the emission source is neutron poor. A closer look at the behavior of the production yields as a function of the neutron excess N-Z, reveals that odd-even effects cannot be explained by pairing effects in the nuclear masses alone, but depend in a more complex way on the de-excitation chain.

  14. LES investigation of infinite staggered wind-turbine arrays

    International Nuclear Information System (INIS)

    Yang, Xiaolei; Sotiropoulos, Fotis

    2014-01-01

    The layouts of turbines affect the turbine wake interactions and thus the wind farm performance. The wake interactions in infinite staggered wind-turbine arrays are investigated and compared with infinite aligned turbine arrays in this paper. From the numerical results we identify three types of wake behaviours, which are significantly different from wakes in aligned wind-turbine arrays. For the first type, each turbine wake interferes with the pair of staggered downstream turbine wakes and the aligned downstream turbine. For the second type, each turbine wake interacts with the first two downstream turbine wakes but does not show significant interference with the second aligned downstream turbine. For the third type, each turbine wake recovers immediately after passing through the gap of the first two downstream turbines and has little interaction with the second downstream turbine wakes The extracted power density and power efficiency are also studied and compared with aligned wind-turbine arrays

  15. MILC staggered conjugate gradient performance on Intel KNL

    Energy Technology Data Exchange (ETDEWEB)

    Li, Ruiz [Indiana Univ., Bloomington, IN (United States). Dept. of Physics; Detar, Carleton [Univ. of Utah, Salt Lake City, UT (United States). Dept. of Physics and Astronomy; Doerfler, Douglas W. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). National Energy Research Scientific Computing Center (NERSC); Gottlieb, Steven [Indiana Univ., Bloomington, IN (United States). Dept. of Physics; Jha, Asish [Intel Corp., Hillsboro, OR (United States). Sofware and Services Group; Kalamkar, Dhiraj [Intel Labs., Bangalore (India). Parallel Computing Lab.; Toussaint, Doug [Univ. of Arizona, Tucson, AZ (United States). Physics Dept.

    2016-11-03

    We review our work done to optimize the staggered conjugate gradient (CG) algorithm in the MILC code for use with the Intel Knights Landing (KNL) architecture. KNL is the second gener- ation Intel Xeon Phi processor. It is capable of massive thread parallelism, data parallelism, and high on-board memory bandwidth and is being adopted in supercomputing centers for scientific research. The CG solver consumes the majority of time in production running, so we have spent most of our effort on it. We compare performance of an MPI+OpenMP baseline version of the MILC code with a version incorporating the QPhiX staggered CG solver, for both one-node and multi-node runs.

  16. 14 CFR 25.407 - Trim tab effects.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Trim tab effects. 25.407 Section 25.407 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS... in the direction that would assist the pilot, and the deflections are— (a) For elevator trim tabs...

  17. TAB: A Six Month Profile. October, 1978-March, 1979.

    Science.gov (United States)

    Lachat, Mary Ann; Musumeci, Marilyn

    The Technical Assistance Base (TAB) of the National Diffusion Network (NDN) maintains a central agency and five regional service units across the United States. This report encompasses the project's activities in the first six months of its second year within NDN. At the time, TAB staff had just completed a transition from serving as brokers of…

  18. SMA actuator for tab-assisted control surface application

    Science.gov (United States)

    Nguyen, Thang D.; Gowing, Scott; Bochinski, David; Carpenter, Bernie F.

    1999-07-01

    This study, started in late 1997, evaluates the concept of tab-assisted control (TAC), and the use of shape memory alloy (SMA) actuator in that connection. Under the TAC concept, a small tab, typically 10 percent of the mean chord of the entire control surface structure, is appended to the trailing edge of the primary control surface, or flap. This small tab vastly enhances the versatility of the control surface system. Depending on the orientation of the tab with respect to the flap and the amount of tab deflection, this tab may be used to modify lift and torque, actuate the flap, or provide precision control; if the tab is aligned with the flap, TAC reverts itself to the conventional configuration. Despite its many benefits, TAC faces one practical challenge in implementation. Due to the particular TAC configuration, the actuating system for the tab must be compact enough to fit in the limited real estate available within the flap. This makes SMA actuator a promising contender for TAC implementation. This paper presents some of the experimental result relevant to the design of the SMA actuator and addresses implementation issues such as power usage, life cycle, frequency response, and reliability.

  19. Piles, tabs and overlaps in navigation among documents

    DEFF Research Database (Denmark)

    Jakobsen, Mikkel Rønne; Hornbæk, Kasper

    2010-01-01

    Navigation among documents is a frequent, but ill supported activity. Overlapping or tabbed documents are widespread, but they offer limited visibility of their content. We explore variations on navigation support: arranging documents with tabs, as overlapping windows, and in piles. In an experim...

  20. An interpretation of staggering effects by correlation observables

    Directory of Open Access Journals (Sweden)

    Baiocco G.

    2012-07-01

    Full Text Available The reactions 32S+58,64Ni are studied at 14.5 A MeV. Evidence is found for odd-even effects in isotopic observables of the decay of a projectile-like source. The influence of secondary decays on the staggering is studied with a correlation function technique, showing that odd-even effects are due to interplay between pairing effects in the nuclear masses and in the level densities.

  1. An optimal staggered harvesting strategy for herbaceous biomass energy crops

    Energy Technology Data Exchange (ETDEWEB)

    Bhat, M.G.; English, B.C. [Univ. of Tennessee, Knoxville, TN (United States)

    1993-12-31

    Biofuel research over the past two decades indicates lignocellulosic crops are a reliable source of feedstock for alternative energy. However, under the current technology of producing, harvesting and converting biomass crops, the cost of biofuel is not competitive with conventional biofuel. Cost of harvesting biomass feedstock is a single largest component of feedstock cost so there is a cost advantage in designing a biomass harvesting system. Traditional farmer-initiated harvesting operation causes over investment. This study develops a least-cost, time-distributed (staggered) harvesting system for example switch grass, that calls for an effective coordination between farmers, processing plant and a single third-party custom harvester. A linear programming model explicitly accounts for the trade-off between yield loss and benefit of reduced machinery overhead cost, associated with the staggered harvesting system. Total cost of producing and harvesting switch grass will decline by 17.94 percent from conventional non-staggered to proposed staggered harvesting strategy. Harvesting machinery cost alone experiences a significant reduction of 39.68 percent from moving from former to latter. The net return to farmers is estimated to increase by 160.40 percent. Per tonne and per hectare costs of feedstock production will decline by 17.94 percent and 24.78 percent, respectively. These results clearly lend support to the view that the traditional system of single period harvesting calls for over investment on agricultural machinery which escalates the feedstock cost. This social loss to the society in the form of escalated harvesting cost can be avoided if there is a proper coordination among farmers, processing plant and custom harvesters as to when and how biomass crop needs to be planted and harvested. Such an institutional arrangement benefits producers, processing plant and, in turn, end users of biofuels.

  2. Optimization of the Single Staggered Wire and Tube Heat Exchanger

    Directory of Open Access Journals (Sweden)

    Arsana I Made

    2016-01-01

    Full Text Available Wire and tube heat exchanger consists of a coiled tube, and wire is welded on the two sides of it in normal direction of the tube. Generally,wire and tube heat exchanger uses inline wire arrangement between the two sides, whereas in this study, it used staggered wire arrangement that reduces the restriction of convection heat transfer. This study performed the optimization of single staggered wire and tube heat exchanger to increase the capacity and reduce the mass of the heat exchanger. Optimization was conducted with the Hooke-Jeeves method, which aims to optimize the geometry of the heat exchanger, especially on the diameter (dw and the distance between wires (pw. The model developed to present heat transfer correlations on single staggered wire and tube heat exchanger was valid. The maximum optimization factor obtained when the diameter wire was 0.9 mm and the distance between wires (pw was 11 mm with the fref value = 1.5837. It means that the optimized design only using mass of 59,10 % and could transfer heat about 98,5 % from the basis design.

  3. HYSTEROSCOPY IN POSTMENOPAUSAL BLEEDING.

    Science.gov (United States)

    Vardhan, S; Mohan, S; Ranjan, P

    2001-04-01

    The purpose of the present study was to evaluate the utility of hysteroscopy as a diagnostic tool in cases of postmenopausal bleeding. The study includes 42 cases presenting with postmenopausal bleeding on which hysterscopy was performed using rigid hysteroscope (CIRCON) with glycine 1.5% as the distension medium. In 17 of the 42 cases positive hysteroscopic findings were noted which included 2 cases of endometrial carcinoma, 2 cases of postmenopausal endometritis, 4 cases of endometrial polyp, 5 cases of endometrial hyperplasia, 1 case of submucous myoma and 3 cases of endocervical polyp whereas normal postmenopausal endometrium was noticed in rest of the 25 cases. Endometrial biopsy was done in all these cases so that the hysteroscopic findings could be corroborated with tissue diagnosis. Hysteroscopy along with directed endometrial biopsy proved to be a useful diagnostic aid in cases of postmenopausal bleeding.

  4. Heavy Menstrual Bleeding

    Science.gov (United States)

    ... option. It also is used to treat endometrial cancer. After the uterus is removed, a woman can no longer get ... to stop or reduce menstrual bleeding. Endometrial Cancer: Cancer of the lining of the uterus. Endometrial Biopsy: A procedure in which a small ...

  5. Bleeding Disorders Treatment Options

    Science.gov (United States)

    ... rare bleeding disorders are usually made from human plasma and are treated to eliminate viruses like HIV and hepatitis B and C. ... concentrate (PCC) This concentrate is made from human plasma and ... (VKCFD). It is treated to eliminate viruses like HIV and hepatitis B and C. ...

  6. Towards an understanding of staggering effects in dissipative binary collisions

    International Nuclear Information System (INIS)

    D'Agostino, M.; Bruno, M.; Gulminelli, F.; Morelli, L.; Baiocco, G.; Bardelli, L.; Barlini, S.; Cannata, F.; Casini, G.; Geraci, E.; Gramegna, F.; Kravchuk, V.L.; Marchi, T.; Moroni, A.; Ordine, A.; Raduta, Ad.R.

    2012-01-01

    The reactions 32 S+ 58,64 Ni are studied at 14.5 A MeV. Evidence is found for important odd–even effects in isotopic observables of selected peripheral collisions corresponding to the decay of a projectile-like source. The influence of secondary decays on the staggering is studied with a correlation function technique. It is shown that this method is a powerful tool to get experimental information on the evaporation chain, in order to constrain model calculations. Specifically, we show that odd–even effects are due to interplay between pairing effects in the nuclear masses and in the level densities.

  7. Improving the quark number susceptibilities for staggered fermions

    International Nuclear Information System (INIS)

    Gavai, Rajiv V.

    2003-01-01

    Quark number susceptibilities approach their ideal gas limit at sufficiently high temperatures. As in the case of other thermodynamic quantities, this limit itself is altered substantially on lattices with small temporal extent, N t = 4-8, making it thus difficult to check the validity of perturbation theory. Unlike other observables, improving susceptibilities or number densities is subject to constraints of current conservation and absence of chemical potential (μ) dependent divergences. We construct such an improved number density and susceptibility for staggered fermions and show that they approximate the continuum ideal gas limit better on small temporal lattices

  8. XFEM Modelling of Multi-holes Plate with Single-row and Staggered Holes Configurations

    Directory of Open Access Journals (Sweden)

    Supar Khairi

    2017-01-01

    Full Text Available Joint efficiency is the key to composite structures assembly design, good structures response is dependent upon multi-holes behavior as subjected to remote loading. Current benchmarking work were following experimental testing series taken from literature on multi-holes problem. Eleven multi-hole configurations were investigated with various pitch and gage distance of staggered holes and non-staggered holes (single-row holes. Various failure modes were exhibited, most staggered holes demonstrates staggered crack path but non-staggered holes series displayed crack path along net-section plane. Stress distribution were carried out and good agreement were exhibited in experimental observation as reported in the respective literature. Consequently, strength prediction work were carried out under quasi-static loading, most showed discrepancy between 8% -31%, better prediction were exhibited in thicker and non-staggered holes plate combinations.

  9. Vaginal or uterine bleeding - overview

    Science.gov (United States)

    ... Metrorrhagia and other menstrual conditions; Abnormal menstrual periods; Abnormal vaginal bleeding ... of regular ovulation (anovulation). Doctors call the problem abnormal uterine bleeding (AUB) . AUB is more common in teenagers and ...

  10. Global phenomenological descriptions of nuclear odd-even mass staggering

    DEFF Research Database (Denmark)

    Hove, Dennis; Jensen, Aksel Stenholm; Riisager, Karsten

    2013-01-01

    We examine the general nature of nuclear odd-even mass differences by employing neutron and proton mass relations that emphasize these effects. The most recent mass tables are used. The possibility of a neutron excess dependence of the staggering is examined in detail in separate regions defined ...... into a global phenomenological expression, ready to use in a binding energy formula. The results deviate from previous parametrizations, and in particular found to be significantly superior to a recent two term, A−1 dependence.......We examine the general nature of nuclear odd-even mass differences by employing neutron and proton mass relations that emphasize these effects. The most recent mass tables are used. The possibility of a neutron excess dependence of the staggering is examined in detail in separate regions defined...... by the main nuclear shells, and a clear change in this dependency is found at Z=50 for both neutrons and protons. A further separation into odd and even neutron (proton) number produces very accurate local descriptions of the mass differences for each type of nucleons. These odd-even effects are combined...

  11. ΔI = 2 Nuclear Staggering in Superdeformed Rotational Bands

    Directory of Open Access Journals (Sweden)

    Okasha M. D.

    2014-01-01

    Full Text Available A four parameters model including collective rotational en ergies to fourth order is ap- plied to reproduce the ∆ I = 2 staggering in transition energies in four selected super deformed rotational bands, namely, 148 Gd (SD6, 194 Hg (SD1, SD2, SD3. The model parameters and the spin of the bandhead have been extracted a ssuming various val- ues to the lowest spin of the bandhead at nearest integer, in o rder to obtain a minimum root mean square deviation between calculated and the exper imental transition energies. This allows us to suggest the spin values for the energy level s which are experimentally unknown. For each band a staggering parameter represent the deviation of the transition energies from a smooth reference has been determined by calc ulating the fourth order derivative of the transition energies at a given spin. The st aggering parameter contains five consecutive transition energies which is denoted here a s the five-point formula. In order to get information about the dynamical moment of ine rtia, the two point for- mula which contains only two consecutive transition energi es has been also considered. The dynamical moment of inertia decreasing with increasing rotational frequency for A ∼ 150, while increasing for A ∼ 190 mass regions.

  12. Pinworms and postmenopausal bleeding.

    OpenAIRE

    al-Rufaie, H K; Rix, G H; Pérez Clemente, M P; al-Shawaf, T

    1998-01-01

    The human pinworm Enterobius vermicularis is normally found within the human gastrointestinal tract. Pregnant females migrate out of their host's anus at night to lay their eggs perianally. As a consequence of this nocturnal migration some worms find their way into adjacent orifices, most commonly the female genitourinary tract, producing irritative symptoms such as vulvovaginitis. A case of pinworm infestation of the uterus presented as postmenopausal bleeding.

  13. Staggered and short-period solutions of the saturable discrete nonlinear Schrodinger equation

    DEFF Research Database (Denmark)

    Khare, A.; Rasmussen, K.O.; Samuelsen, Mogens Rugholm

    2009-01-01

    We point out that the nonlinear Schrodinger lattice with a saturable nonlinearity also admits staggered periodic aswell as localized pulse-like solutions. Further, the same model also admits solutions with a short period. We examine the stability of these solutions and find that the staggered...

  14. Lowrank seismic-wave extrapolation on a staggered grid

    KAUST Repository

    Fang, Gang

    2014-05-01

    © 2014 Society of Exploration Geophysicists. We evaluated a new spectral method and a new finite-difference (FD) method for seismic-wave extrapolation in time. Using staggered temporal and spatial grids, we derived a wave-extrapolation operator using a lowrank decomposition for a first-order system of wave equations and designed the corresponding FD scheme. The proposed methods extend previously proposed lowrank and lowrank FD wave extrapolation methods from the cases of constant density to those of variable density. Dispersion analysis demonstrated that the proposed methods have high accuracy for a wide wavenumber range and significantly reduce the numerical dispersion. The method of manufactured solutions coupled with mesh refinement was used to verify each method and to compare numerical errors. Tests on 2D synthetic examples demonstrated that the proposed method is highly accurate and stable. The proposed methods can be used for seismic modeling or reverse-time migration.

  15. Mild bleeding disorders

    OpenAIRE

    PERROUD, V.

    2011-01-01

    Contrairement aux troubles hémorragiques sévères, les maladies hémorragiques modérées (Mild Bleeding Disorders = MBD) sont difficiles à diagnostiquer chez les enfants, car la limite entre le physiologique et le pathologique est mal définie et l'approche diagnostique est peu systématisée. Qu'entend-on par MBD ? On peut les définir comme des diathèses hémorragiques sans répercussion sévère sur la vie quotidienne et, en principe, sans risque vital : épistaxis, gingivorragies, rect...

  16. Photovoltaic sheathing element with one or more tabs

    Energy Technology Data Exchange (ETDEWEB)

    Keenihan, James R; Langmaid, Joseph A; Lopez, Leonardo C.

    2017-02-07

    The present invention is premised upon an assembly that includes at least a photovoltaic sheathing element capable of being affixed on a building structure. The shingle including at least a photovoltaic cell assembly, a body portion attached to one or more portions of the photovoltaic cell assembly. Wherein the body portion includes one or more top peripheral tabs each capable of fitting under one or more vertically adjoining devices.

  17. Mitos y tabúes en la sexualidad humana

    Directory of Open Access Journals (Sweden)

    Ignacio González Labrador

    2002-06-01

    Full Text Available Se realizan consideraciones muy generales sobre el origen de los géneros y cómo esta formación favorece la presencia de mitos y tabúes en la expresión de la sexualidad de la pareja humana.Very general considerations are presented on the origin of genders and how this formation has favored myths and taboos in the expression of the human couple's sexuality.

  18. The Biocarbon vascular access device (DiaTAB) for haemodialysis.

    Science.gov (United States)

    Smits, P J; Slooff, M J; Lichtendahl, D H; van der Hem, G K

    1985-01-01

    The Biocarbon vascular access device (DiaTAB) is a relatively new method in secondary access surgery. Punctures, often the cause of complications can be avoided because it is a no-needle method of dialysis. However thrombosis due to stenosis of the venous anastomosis or of the efferent vein is a continuing problem. A new experience is the fibrin flap formation under the plug of the device, which can be removed easily.

  19. Spontaneous emission spectra from a staggered-array undulator

    International Nuclear Information System (INIS)

    Shimada, Shigeki; Okada, Kouji; Masuda, Kai; Sobajima, Masaaki; Yoshikawa, Kiyoshi; Ohnishi, Masami; Yamamoto, Yasushi; Toku, Hisayuki

    1997-01-01

    A staggered-array undulator set inside the superconducting solenoid coils is shown to be able to provide high undulator fields larger than the longitudinal magnetic fields, a small undulator period, easy tunability through the solenoid coil current, and compact and easy fabrication. The overall performance characteristics of this undulator were studied mainly with respect to iron and aluminum disk widths, and spontaneous emission spectra through the numerical calculations. The maximum undulator field is found to be obtained for the ratio of the aluminum disk width to the undulator period of 0.45. The line widths (FWHM) of the spontaneous emission spectra, however, do not show N w -1 dependence on the number of the undulator period N w for practical beams with a Gaussian distribution, compared with for a single electron. The energy spread among various parameters is seen to play an important role in reducing the FWHM with increase of N w . The large tunability of the wavelength is proved to cover 6-10 mm by changing the solenoid magnetic field from 0.4 T to 1.6 T. (author)

  20. X-ray imaging bilinear staggered GaAs detectors

    Energy Technology Data Exchange (ETDEWEB)

    Achmadullin, R.A.; Dvoryankin, V.F. E-mail: vfd217@ire216.msk.su; Dvoryankina, G.G.; Dikaev, Y.M.Yu.M.; Krikunov, A.I.; Kudryashov, A.A.; Panova, T.M.; Petrov, A.G.; Telegin, A.A

    2004-09-21

    The multichannel bilinear X-ray detector based on epitaxial GaAs structures is developed to obtain a digital X-ray image. Each detector operates in photovoltaic mode without reverse bias that enables almost complete elimination of detector noise arising due to leakage currents. The sensitivity range of the epitaxial GaAs photovoltaic X-ray detector covers the effective energies from 8 to 120 keV. A maximum response of the detector operating in the short-circuit mode was observed at an energy of 35 keV and amounted to 30 {mu}A min/(Gy cm{sup 2}). The multichannel detector was made of 1024 pixels with pitch of 0.8 mm. The spatial resolution of double staggered sensor row is twice as high as the resolution of that of single sensor row with the same pitch. Measured spatial resolution is 1.2 line-pairs/mm, contrast sensitivity not worse 1% and dynamic range defined as the ratio of maximum detectable X-ray signal to electronic noise level more than 2000 are received.

  1. X-ray imaging bilinear staggered GaAs detectors

    International Nuclear Information System (INIS)

    Achmadullin, R.A.; Dvoryankin, V.F.; Dvoryankina, G.G.; Dikaev, Y.M.Yu.M.; Krikunov, A.I.; Kudryashov, A.A.; Panova, T.M.; Petrov, A.G.; Telegin, A.A.

    2004-01-01

    The multichannel bilinear X-ray detector based on epitaxial GaAs structures is developed to obtain a digital X-ray image. Each detector operates in photovoltaic mode without reverse bias that enables almost complete elimination of detector noise arising due to leakage currents. The sensitivity range of the epitaxial GaAs photovoltaic X-ray detector covers the effective energies from 8 to 120 keV. A maximum response of the detector operating in the short-circuit mode was observed at an energy of 35 keV and amounted to 30 μA min/(Gy cm 2 ). The multichannel detector was made of 1024 pixels with pitch of 0.8 mm. The spatial resolution of double staggered sensor row is twice as high as the resolution of that of single sensor row with the same pitch. Measured spatial resolution is 1.2 line-pairs/mm, contrast sensitivity not worse 1% and dynamic range defined as the ratio of maximum detectable X-ray signal to electronic noise level more than 2000 are received

  2. High temperature QCD with three flavors of improved staggered quarks

    International Nuclear Information System (INIS)

    Bernard, C.; Burch, T.; Tar, C.E. de; Gottlieb, Steven; Gregory, Eric; Heller, U.M.; Osborn, J.; Sugar, R.L.; Toussaint, D.

    2003-01-01

    We present an update of our study of high temperature QCD with three flavors of quarks, using a Symanzik improved gauge action and the Asqtad staggered quark action. Simulations are being carried out on lattices with N t = 4, 6 and 8 for the case of three degenerate quarks with masses less than or equal to the strange quark mass, m s and on lattices with N t = 6 and 8 for degenerate up and down quarks with masses in the range 0.2m s ≤ m u,d ≤ 0.6m s and the strange quark fixed near its physical value. We also report on first computations of quark number susceptibilities with the Asqtad action. These susceptibilities are of interest because they can be related to event-by-event fluctuations in heavy ion collision experiments. Use of the improved quark action leads to a substantial reduction in lattice artifacts. This can be seen already for free fermions and carries over into our results for QCD

  3. Bleeding in children with cancer

    African Journals Online (AJOL)

    Siluan early warning signs of childhood cancer, compiled by the South. African Children's Cancer Study Group (SACCSG). An increased risk of bleeding during the cancer treatment period is almost always present, due to the bone marrow suppressive effect of chemotherapy. Fortunately, death due to bleeding is rare these ...

  4. Treatment of acute variceal bleeding

    DEFF Research Database (Denmark)

    Bendtsen, Flemming; Krag, Aleksander Ahm; Møller, Søren

    2008-01-01

    to failure to control initial bleeding or early re-bleeding occurring in up to 30-40% of patients. Initial procedures are to secure and protect the airway, and administer volume replacement to stabilize the patient. Treatment with vasoactive drugs should be started as soon as possible, since a reduction...

  5. Performance of upper gastrointestinal bleeding risk assessment scores in variceal bleeding

    DEFF Research Database (Denmark)

    Ngu, Jing H.; Laursen, Stig Borbjerg; Chin, YK

    2017-01-01

    Performance of upper gastrointestinal bleeding risk assessment scores in variceal bleeding: a prospective international multicenter study.......Performance of upper gastrointestinal bleeding risk assessment scores in variceal bleeding: a prospective international multicenter study....

  6. Systematics of the K suppi = 2+ gamma vibrational bands and odd-even staggering

    CERN Document Server

    Gupta, J B

    2003-01-01

    The structure of the K suppi = 2+ gamma vibrational bands and the quasi-gamma bands of even-Z-even-N nuclei is investigated on a global scale, vis-a-vis the variation of band head, the moment of inertia of the band and the odd-even spin staggering. The variation with N and Z and with spin J of the odd-even spin energy staggering index is studied and a unified view of the same is presented. (author)

  7. Two-color lattice QCD with staggered quarks

    Energy Technology Data Exchange (ETDEWEB)

    Scheffler, David

    2015-07-20

    The study of quantum chromodynamics (QCD) at finite temperature and density provides important contributions to the understanding of strong-interaction matter as it is present e.g. in nuclear matter and in neutron stars or as produced in heavy-ion collision experiments. Lattice QCD is a non-perturbative approach, where equations of motion for quarks and gluons are discretized on a finite space-time lattice. The method successfully describes the behavior of QCD in the vacuum and at finite temperature, however it cannot be applied to finite baryon density due to the fermion sign problem. Various QCD-like theories, that offer to draw conclusions about QCD, allow simulations also at finite densities. In this work we investigate two-color QCD as a popular example of a QCD-like theory free from the sign problem with methods from lattice gauge theory. For the generation of gauge configurations with two dynamical quark flavors in the staggered formalism with the ''rooting trick'' we apply the Rational Hybrid Monte Carlo (RHMC) algorithm. We carry out essential preparatory work for future simulations at finite density. As a start, we concentrate on the calculation of the effective potential for the Polyakov loop, which is an order parameter for the confinement-deconfinement transition, in dependence of the temperature and quark mass. It serves as an important input for effective models of QCD. We obtain the effective potential via the histogram method from local distributions of the Polyakov loop. To study the influence of dynamical quarks on gluonic observables, the simulations are performed with large quark masses and are compared to calculations in the pure gauge theory. In the second part of the thesis we examine aspects of the chiral phase transition along the temperature axis. The symmetry group of chiral symmetry in two-color QCD is enlarged to SU(2N{sub f}). Discretized two-color QCD in the staggered formalism exhibits a chiral symmetry breaking

  8. The Nucleon Axial Form Factor and Staggered Lattice QCD

    Energy Technology Data Exchange (ETDEWEB)

    Meyer, Aaron Scott [Chicago U.

    2017-01-01

    The study of neutrino oscillation physics is a major research goal of the worldwide particle physics program over the upcoming decade. Many new experiments are being built to study the properties of neutrinos and to answer questions about the phenomenon of neutrino oscillation. These experiments need precise theoretical cross sections in order to access fundamental neutrino properties. Neutrino oscillation experiments often use large atomic nuclei as scattering targets, which are challenging for theorists to model. Nuclear models rely on free-nucleon amplitudes as inputs. These amplitudes are constrained by scattering experiments with large nuclear targets that rely on the very same nuclear models. The work in this dissertation is the rst step of a new initiative to isolate and compute elementary amplitudes with theoretical calculations to support the neutrino oscillation experimental program. Here, the eort focuses on computing the axial form factor, which is the largest contributor of systematic error in the primary signal measurement process for neutrino oscillation studies, quasielastic scattering. Two approaches are taken. First, neutrino scattering data on a deuterium target are reanalyzed with a model-independent parametrization of the axial form factor to quantify the present uncertainty in the free-nucleon amplitudes. The uncertainties on the free-nucleon cross section are found to be underestimated by about an order of magnitude compared to the ubiquitous dipole model parametrization. The second approach uses lattice QCD to perform a rst-principles computation of the nucleon axial form factor. The Highly Improved Staggered Quark (HISQ) action is employed for both valence and sea quarks. The results presented in this dissertation are computed at physical pion mass for one lattice spacing. This work presents a computation of the axial form factor at zero momentum transfer, and forms the basis for a computation of the axial form factor momentum dependence

  9. 25 CFR 542.8 - What are the minimum internal control standards for pull tabs?

    Science.gov (United States)

    2010-04-01

    .... (1) Pull tab inventory (including unused tickets) shall be controlled to assure the integrity of the... of the pull tab sales. (3) The issue of pull tabs to the cashier or sales location shall be... of each month, a person or persons independent of pull tab sales and inventory control shall verify...

  10. Galaxy Tab Covers Samsung TouchWiz Interface

    CERN Document Server

    Gralla, Preston

    2011-01-01

    Galaxy Tab lets you work, play, read, and connect on the go, but mastering its TouchWiz interface and finding the best apps can be tricky-unless you have this Missing Manual. Gadget whiz Preston Gralla provides crystal-clear explanations and step-by-step instructions to get you up to speed quickly, whether you have the 3G/4G or Wi-Fi version of this amazing device. The important stuff you need to know: Design your experience. Add interactive widgets and mini-apps to your screen with TouchWiz.Satisfy your appetite. Download thousands of games and apps from the Android Market.Keep in touch. Ch

  11. Side Effects: Bleeding and Bruising

    Science.gov (United States)

    Cancer treatments, such as chemotherapy and targeted therapy, can increase patients’ risk of bleeding and bruising, also called thrombocytopenia. Learn about steps to take if you are at increased risk of a low platelet count.

  12. recocido simulado, y búsqueda tabú

    Directory of Open Access Journals (Sweden)

    Jorge Hernan Restrepo Correa

    2007-01-01

    Full Text Available Este documento presenta una metodología para conformar portafolios de acciones. En él se expone la técnica usada para inferir precios partiendo de un proceso de preselección a través de un análisis fundamental, seguido de un análisis técnico, posteriormente, se proyectan los precios esperados con la simulación de Monte Carlo para cada acción, tomando cuatro posibles precios para cada uno de los días proyectados, luego se procede a la dinámica de negociación con la matriz de precios proyectados de las acciones de alta bursatilidad, con la aplicación de una meta heurística hibrida conformada por las meta-heurísticas de recocido simulado, búsqueda dispersa y búsqueda tabú, para determinar el volumen de cada una de las acciones en la solución robusta.

  13. Numerical properties of staggered quarks with a taste-dependent mass term

    CERN Document Server

    de Forcrand, Philippe; Panero, Marco

    2012-01-01

    The numerical properties of staggered Dirac operators with a taste-dependent mass term proposed by Adams [1,2] and by Hoelbling [3] are compared with those of ordinary staggered and Wilson Dirac operators. In the free limit and on (quenched) interacting configurations, we consider their topological properties, their spectrum, and the resulting pion mass. Although we also consider the spectral structure, topological properties, locality, and computational cost of an overlap operator with a staggered kernel, we call attention to the possibility of using the Adams and Hoelbling operators without the overlap construction. In particular, the Hoelbling operator could be used to simulate two degenerate flavors without additive mass renormalization, and thus without fine-tuning in the chiral limit.

  14. Gap states and edge properties of rectangular graphene quantum dot in staggered potential

    Science.gov (United States)

    Jeong, Y. H.; Eric Yang, S.-R.

    2017-09-01

    We investigate edge properties of a gapful rectangular graphene quantum dot in a staggered potential. In such a system gap states with discrete and closely spaced energy levels exist that are spatially located on the left or right zigzag edge. We find that, although the bulk states outside the energy gap are nearly unaffected, spin degeneracy of each gap state is lifted by the staggered potential. We have computed the occupation numbers of spin-up and -down gap states at various values of the strength of the staggered potential. The electronic and magnetic properties of the zigzag edges depend sensitively on these numbers. We discuss the possibility of applying this system as a single electron spintronic device.

  15. Single-molecule observation of helix staggering, sliding, and coiled coil misfolding

    Science.gov (United States)

    Xi, Zhiqun; Gao, Ying; Sirinakis, George; Guo, Honglian; Zhang, Yongli

    2012-01-01

    The biological functions of coiled coils generally depend on efficient folding and perfect pairing of their α-helices. Dynamic changes in the helical registry that lead to staggered helices have only been proposed for a few special systems and not found in generic coiled coils. Here, we report our observations of multiple staggered helical structures of two canonical coiled coils. The partially folded structures are formed predominantly by coiled coil misfolding and occasionally by helix sliding. Using high-resolution optical tweezers, we characterized their energies and transition kinetics at a single-molecule level. The staggered states occur less than 2% of the time and about 0.1% of the time at zero force. We conclude that dynamic changes in helical registry may be a general property of coiled coils. Our findings should have broad and unique implications in functions and dysfunctions of proteins containing coiled coils. PMID:22451899

  16. Ergovaline does not alter the severity of ryegrass staggers induced by lolitrem B.

    Science.gov (United States)

    Finch, S C; Vlaming, J B; Sutherland, B L; van Koten, C; Mace, W J; Fletcher, L R

    2018-03-01

    To investigate a possible interaction between lolitrem B and ergovaline by comparing the incidence and severity of ryegrass staggers in sheep grazing ryegrass (Lolium perenne) containing lolitrem B or ryegrass containing both lolitrem B and ergovaline. Ninety lambs, aged approximately 6 months, were grazed on plots of perennial ryegrass infected with either AR98 endophyte (containing lolitrem B), standard endophyte (containing lolitrem B and ergovaline) or no endophyte, for up to 42 days from 2 February 2010. Ten lambs were grazed on three replicate plots per cultivar. Herbage samples were collected for alkaloid analysis and lambs were scored for ryegrass staggers (scores from 0-5) weekly during the study. Any animal which was scored ≥4 was removed from the study. Concentrations of lolitrem B did not differ between AR98 and standard endophyte-infected pastures during the study period (p=0.26), and ergovaline was present only in standard endophyte pastures. Ryegrass staggers was observed in sheep grazing both the AR98 and standard endophyte plots, with median scores increasing in the third week of the study. Prior to the end of the 42-day grazing period, 22 and 17 animals were removed from the standard endophyte and AR98 plots, respectively, because their staggers scores were ≥4. The cumulative probability of lambs having scores ≥4 did not differ between animals grazing the two pasture types (p=0.41). There was no evidence for ergovaline increasing the severity of ryegrass staggers induced by lolitrem B. In situations where the severity of ryegrass staggers appears to be greater than that predicted on the basis of concentrations of lolitrem B, the presence of other tremorgenic alkaloids should be investigated.

  17. Coagulation management in massive bleeding.

    Science.gov (United States)

    Griffee, Matthew J; Deloughery, Thomas G; Thorborg, Per A

    2010-04-01

    To update readers on recent literature regarding treatment of coagulopathy for patients with life-threatening bleeding, highlighting emerging therapeutic options, controversial topics, and ongoing clinical trials. Massive transfusion protocols featuring immediate availability of blood products and multidisciplinary communication reduce mortality and conserve resources. There is a growing consensus that immediate administration of plasma and platelet units in a 1: 1: 1 ratio with red cell units reduces early mortality. Lyophilized and recombinant blood product components may have advantages over traditional blood products in certain clinical circumstances. Massive transfusion protocols standardize treatment of the coagulopathy of massive bleeding, leading to rapid restoration of hemostasis and decrease in early mortality.

  18. Managing oral bleeding in children with hereditary bleeding disorders

    African Journals Online (AJOL)

    All the patients presented with bleeding gingivae secondary to either physiologic processes of eruption, infective or traumatic dental conditions. The management of the patients was comprehensive with a multidisciplinary approach. The prevention of traumatic and infective dental conditions is an important part of oral health ...

  19. Horizontally staggered lightguide solar concentrator with lateral displacement tracking for high concentration applications.

    Science.gov (United States)

    Ma, Hongcai; Wu, Lin

    2015-07-10

    We present the design of a horizontally staggered lightguide solar concentrator with lateral displacement tracking for high concentration applications. This solar concentrator consists of an array of telecentric primary concentrators, a horizontally staggered lightguide layer, and a vertically tapered lightguide layer. The primary concentrator is realized by two plano-aspheric lenses with lateral movement and maintains a high F-number over an angle range of ±23.5°. The results of the simulations show that the solar concentrator achieves a high concentration ratio of 500× with ±0.5° of acceptance angle by a single-axis tracker and dual lateral translation stages.

  20. Predictors of bleeding during heparin therapy.

    Science.gov (United States)

    Walker, A M; Jick, H

    1980-09-12

    Among 2,656 patients receiving heparin sodium therapy, bleeding was a dose-related phenomenon that occurred most commonly among women, severely ill patients, and patients who received asprin during heparin therapy. Except for dose, factors that predisposed patients to bleeding were more strongly associated with major bleeding than with minor bleeding. Heavy alcohol drinkers were at particularly high risk for major bleeding episodes during heparinization. The seven-day cumulative risk for any bleeding was 9.1%. Risk was greatest on the third day of heparin administration.

  1. Management of bleeding gastroduodenal ulcers

    DEFF Research Database (Denmark)

    Laursen, Stig Borbjerg; Jørgensen, Henrik Stig; Schaffalitzky de Muckadell, Ove B.

    2012-01-01

    -risk stigmata. Although selected patients can be discharged promptly after endoscopy, high-risk patients should be hospitalized for at least 3 days after endoscopic hemostasis. Patients with peptic ulcer bleeding who require secondary cardiovascular prophylaxis should start receiving acetylsalicylic acid (ASA...

  2. Abnormal uterine bleeding in perimenopause.

    Science.gov (United States)

    Goldstein, S R; Lumsden, M A

    2017-10-01

    Abnormal uterine bleeding is one of the commonest presenting complaints encountered in a gynecologist's office or primary-care setting. The wider availability of diagnostic tools has allowed prompt diagnosis and treatment of an increasing number of menstrual disorders in an office setting. This White Paper reviews the advantages and disadvantages of transvaginal ultrasound, blind endometrial sampling and diagnostic hysteroscopy. Once a proper diagnosis has been established, appropriate therapy may be embarked upon. Fortunately, only a minority of such patients will have premalignant or malignant disease. When bleeding is sufficient to cause severe anemia or even hypovolemia, prompt intervention is called for. In most of the cases, however, the abnormal uterine bleeding will be disquieting to the patient and significantly affect her 'quality of life'. Sometimes, reassurance and expectant management will be sufficient in such patients. Overall, however, in cases of benign disease, some intervention will be required. The use of oral contraceptive pills especially those with a short hormone-free interval, the insertion of the levonorgestrel intrauterine system, the incorporation of newer medical therapies including antifibrinolytic drugs and selective progesterone receptor modulators and minimally invasive treatments have made outpatient therapy increasingly effective. For others, operative hysteroscopy and endometrial ablation are proven therapeutic tools to provide both long- and short-term relief of abnormal uterine bleeding, thus avoiding, or deferring, hysterectomy.

  3. A superlinearly convergent finite volume method for the incompressible Navier-Stokes equations on staggered unstructured grids

    International Nuclear Information System (INIS)

    Vidovic, D.; Segal, A.; Wesseling, P.

    2004-01-01

    A method for linear reconstruction of staggered vector fields with special treatment of the divergence is presented. An upwind-biased finite volume scheme for solving the unsteady incompressible Navier-Stokes equations on staggered unstructured triangular grids that uses this reconstruction is described. The scheme is applied to three benchmark problems and is found to be superlinearly convergent in space

  4. Spontaneous Bleeding Associated with Ginkgo biloba

    Science.gov (United States)

    Bent, Stephen; Goldberg, Harley; Padula, Amy; Avins, Andrew L

    2005-01-01

    BACKGROUND Ginkgo biloba (ginkgo) is a herbal remedy used by over 2% of the adult population in the United States. Several review articles have suggested that ginkgo may increase the risk of bleeding. OBJECTIVE To report a case of bleeding associated with using ginkgo, to systematically review the literature for similar case reports, and to evaluate whether using ginkgo is causally related to bleeding. DATA SOURCES We searched MEDLINE, EMBASE, IBIDS, and the Cochrane Collaboration Database from 1966 to October 2004 with no language restrictions. REVIEW METHODS Published case reports of bleeding events in persons using ginkgo were selected. Two reviewers independently abstracted a standard set of information to assess whether ginkgo caused the bleeding event. RESULTS Fifteen published case reports described a temporal association between using ginkgo and a bleeding event. Most cases involved serious medical conditions, including 8 episodes of intracranial bleeding. However, 13 of the case reports identified other risk factors for bleeding. Only 6 reports clearly described that ginkgo was stopped and that bleeding did not recur. Bleeding times, measured in 3 reports, were elevated when patients were taking ginkgo. CONCLUSION A structured assessment of published case reports suggests a possible causal association between using ginkgo and bleeding events. Given the widespread use of this herb and the serious nature of the reported events, further studies are needed. Patients using ginkgo, particularly those with known bleeding risks, should be counseled about a possible increase in bleeding risk. PMID:16050865

  5. Weakly coupled S=1/2 quantum Heisenberg antiferromagnetic chains in an effective staggered field

    International Nuclear Information System (INIS)

    Sato, Masahiro; Oshikawa, Masaki

    2002-01-01

    We study weakly coupled S=1/2 quantum Heisenberg antiferromagnetic chains in an effective staggered field. Applying mean-field (MF) theory, spin-wave theory and chain MF (CMF) theory, we can see analytically some effects of the staggered field in this higher dimensional spin system. In particular, when the staggered field and the inter-chain inter-action compete with each other, we conjecture from the MF theory that a nontrivial phase is present. The spin wave theory predicts that the behavior of the gaps induced by a staggered field is different between the competitive case and the non-competitive case. When the inter-chain interactions are weak enough, we can improve the MF phase diagram by using CMF theory and the analytical results of field theories. The ordered phase region predicted by the CMF theory is fairly smaller than one of the MF theory. Cu-benzoate, CuCl 2 · 2DMSO (dimethylsulphoxide), BaCu 2 (Si 1-x Ge x ) 2 O 7 , etc., could be described by our model in enough low temperature. (author)

  6. Kinetics of full scrum and staggered scrum engagement in under 19 ...

    African Journals Online (AJOL)

    Two hundred and eight male Rugby Union players from 13 high schools, whose ages ranged from 16 to 19 years, were used to examine the kinetics of the full scrum versus staggered scrum engagement techniques. Telemetric pressure transducers were used to measure the engagement and sustained forces acting on the ...

  7. Enhancement of Radiative Efficiency with Staggered InGaN Quantum Well Light Emitting Diodes

    Energy Technology Data Exchange (ETDEWEB)

    Tansu, Nelson; Dierolf, Volkmar; Huang, Gensheng; Penn, Samson; Zhao, Hongping; Liu, Guangyu; Li, Xiaohang; Poplawsky, Jonathan

    2011-07-14

    The technology on the large overlap InGaN QWs developed in this program is currently implemented in commercial technology in enhancing the internal quantum efficiency in major LED industry in US and Asia. The scientific finding from this work supported by the DOE enabled the implementation of this step-like staggered quantum well in the commercial LEDs.

  8. The use of staggered scheme and an absorbing buffer zone for computational aeroacoustics

    Science.gov (United States)

    Nark, Douglas M.

    1995-01-01

    Various problems from those proposed for the Computational Aeroacoustics (CAA) workshop were studied using second and fourth order staggered spatial discretizations in conjunction with fourth order Runge-Kutta time integration. In addition, an absorbing buffer zone was used at the outflow boundaries. Promising results were obtained and provide a basis for application of these techniques to a wider variety of problems.

  9. Experimental study of induced staggered magnetic fields in dysprosium gallium garnet (DGG)

    International Nuclear Information System (INIS)

    Steiner, M.; Corliss, L.M.; Hastings, J.M.; Blume, M.; Giordano, N.; Wolf, W.P.

    1979-01-01

    Neutron diffraction techniques have been used to study induced staggered magnetic field effects in DGG. The application of a uniform magnetic field at temperatures much greater than the Neel temperature induces a significant amount of antiferromagnetic order. The temperature and field dependences of this effect are in good agreement with recent theoretical predicions

  10. Partial dynamical symmetry and odd-even staggering in deformed nuclei

    Directory of Open Access Journals (Sweden)

    Leviatan A.

    2015-01-01

    Full Text Available Partial dynamical symmetry (PDS is shown to be relevant for describing the odd-even staggering in the γ-band of 156Gd while retaining solvability and good SU(3 symmetry for the ground and β bands. Several classes of interacting boson model Hamiltonians with SU(3 PDS are surveyed.

  11. Remarks on the determination of the odd--even staggering parameter in the spectrum of cadmium

    International Nuclear Information System (INIS)

    Gerstenkorn, S.; Stroke, H.H.

    1976-01-01

    From an analysis of the isotope shifts in the Cd 3261, 4678, and 4416 A lines, it is pointed out that a precise determination of the odd--even staggering parameter is limited less by experimental error than by the lack of reliable knowledge of the specific mass effect

  12. A study of manufacturing tubes with nano/ultrafine grain structure by stagger spinning

    International Nuclear Information System (INIS)

    Xia, Qinxiang; Xiao, Gangfeng; Long, Hui; Cheng, Xiuquan; Yang, Baojian

    2014-01-01

    Highlights: • Proposing a method of manufacturing tubes with nano/ultrafine crystal. • Obtaining the refined ferritic grains with an size of 500 nm after stagger spinning. • Obtaining the equiaxial ferritic grains with an size of 600 nm after annealing. - Abstract: A new method of manufacturing tubes with nano/ultrafine grain structure by stagger spinning and recrystallization annealing is proposed in this study. Two methods of the stagger spinning process are developed, the corresponding macroforming quality, microstructural evolution and mechanical properties of the spun tubes made of ASTM 1020 steel are analysed. The results reveal that a good surface smoothness and an improved spin-formability of spun parts can be obtained by the process combining of 3-pass spinning followed by a 580 °C × 0.5 h static recrystallization and 2-pass spinning with a 580 °C × 1 h static recrystallization annealing under the severe thinning ratio of wall thickness reduction. The ferritic grains with an average initial size of 50 μm are refined to 500 nm after stagger spinning under the 87% thinning ratio of wall thickness reduction. The equiaxial ferritic grains with an average size of 600 nm are generated through re-nucleation and grain growth by subsequent recrystallization annealing at 580 °C for 1 h heat preservation. The tensile strength of spun tubes has been founded to be proportional to the reciprocal of layer spacing of pearlite (LSP), and the elongation is inversely proportional to the reciprocal of LSP. This study shows that the developed method of stagger power spinning has the potential to be used to manufacture bulk metal components with nano/ultrafine grain structure

  13. Beverage can stay-tabs: still a source for inadvertently ingested foreign bodies in children

    Energy Technology Data Exchange (ETDEWEB)

    Donnelly, Lane F. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, MLC 5031, Cincinnati, OH (United States); University of Cincinnati, College of Medicine, Departments of Radiology and Pediatrics, Cincinnati, OH (United States)

    2010-09-15

    In the 1970s in part to avoid inadvertent ingestion, the beverage-can industry changed can construction from pull-tabs to the stay-tabs (remain attached to can after opening) used today. Our purpose is to identify the number of inadvertent ingestions of beverage-can stay-tabs by children recognized at our institution. The medical information system of a children's hospital was searched with key terms to identify cases in which a witnessed or self-reported inadvertent ingestion of a beverage-can stay-tab resulted in a radiograph to rule out presence of a foreign body. Demographics, identification of stay-tab on radiographs, associated abnormalities, and patient management were reviewed. Nineteen cases of stay-tab ingestion were identified over 16 years. Mean age of ingesters was 8.5 years with the majority being teenagers and 15 (79%) >5 years of age. The stay-tab could be seen radiographically only in 4 (21%) cases - all with the stay-tab identified in the stomach. The identification of 19 children who inadvertently ingested beverage-can stay-tabs at a single children's hospital suggests that such ingestions still occur. Radiologists should be aware that stay-tabs are radiographically visible in the minority (21%) of cases. (orig.)

  14. Beverage can stay-tabs: still a source for inadvertently ingested foreign bodies in children

    International Nuclear Information System (INIS)

    Donnelly, Lane F.

    2010-01-01

    In the 1970s in part to avoid inadvertent ingestion, the beverage-can industry changed can construction from pull-tabs to the stay-tabs (remain attached to can after opening) used today. Our purpose is to identify the number of inadvertent ingestions of beverage-can stay-tabs by children recognized at our institution. The medical information system of a children's hospital was searched with key terms to identify cases in which a witnessed or self-reported inadvertent ingestion of a beverage-can stay-tab resulted in a radiograph to rule out presence of a foreign body. Demographics, identification of stay-tab on radiographs, associated abnormalities, and patient management were reviewed. Nineteen cases of stay-tab ingestion were identified over 16 years. Mean age of ingesters was 8.5 years with the majority being teenagers and 15 (79%) >5 years of age. The stay-tab could be seen radiographically only in 4 (21%) cases - all with the stay-tab identified in the stomach. The identification of 19 children who inadvertently ingested beverage-can stay-tabs at a single children's hospital suggests that such ingestions still occur. Radiologists should be aware that stay-tabs are radiographically visible in the minority (21%) of cases. (orig.)

  15. Vitamin K deficiency bleeding of the newborn

    Science.gov (United States)

    Vitamin K deficiency bleeding of the newborn (VKDB) is a bleeding disorder in babies. It most often develops shortly ... A lack of vitamin K may cause severe bleeding in newborn babies. Vitamin K plays an important role in blood clotting. Babies often have a ...

  16. Gastrointestinal Bleeding Secondary to Calciphylaxis

    Science.gov (United States)

    Gupta, Nancy; Haq, Khwaja F.; Mahajan, Sugandhi; Nagpal, Prashant; Doshi, Bijal

    2015-01-01

    Patient: Female, 66 Final Diagnosis: Calciphylaxis Symptoms: Gastrointesinal haemorrhage Medication: None Clinical Procedure: Hemodialysis • blood transfusions Specialty: Gastroenterology and Hepatology Objective: Rare disease Background: Calciphylaxis is associated with a high mortality that approaches 80%. The diagnosis is usually made when obvious skin lesions (painful violaceous mottling of the skin) are present. However, visceral involvement is rare. We present a case of calciphylaxis leading to lower gastrointestinal (GI) bleeding and rectal ulceration of the GI mucosa. Case Report: A 66-year-old woman with past medical history of diabetes mellitus, hypertension, end-stage renal disease (ESRD), recently diagnosed ovarian cancer, and on hemodialysis (HD) presented with painful black necrotic eschar on both legs. The radiograph of the legs demonstrated extensive calcification of the lower extremity arteries. The hospital course was complicated with lower GI bleeding. A CT scan of the abdomen revealed severe circumferential calcification of the abdominal aorta, celiac artery, and superior and inferior mesenteric arteries and their branches. Colonoscopy revealed severe rectal necrosis. She was deemed to be a poor surgical candidate due to comorbidities and presence of extensive vascular calcifications. Recurrent episodes of profuse GI bleeding were managed conservatively with blood transfusion as needed. Following her diagnosis of calciphylaxis, supplementation with vitamin D and calcium containing phosphate binders was stopped. She was started on daily hemodialysis with low calcium dialysate bath as well as intravenous sodium thiosulphate. The clinical condition of the patient deteriorated. The patient died secondary to multiorgan failure. Conclusions: Calciphylaxis leading to intestinal ischemia/perforation should be considered in the differential diagnosis in ESRD on HD presenting with abdominal pain or GI bleeding. PMID:26572938

  17. Antifibrinolytics for heavy menstrual bleeding.

    Science.gov (United States)

    Lethaby, A; Farquhar, C; Cooke, I

    2000-01-01

    Heavy menstrual bleeding (HMB) is an important cause of ill health in women. Medical therapy, with the avoidance of possibly unnecessary surgery, is an attractive treatment option. A wide variety of medications are available to reduce heavy menstrual bleeding but there is considerable variation in practice and uncertainty about the most appropriate therapy. Plasminogen activators are a group of enzymes that cause fibrinolysis (the dissolution of clots). An increase in the levels of plasminogen activators has been found in the endometrium of women with heavy menstrual bleeding compared to those with normal menstrual loss. Plasminogen activator inhibitors (antifibrinolytic agents) have therefore been promoted as a treatment for heavy menstrual bleeding. There has been a reluctance to prescribe tranexamic acid due to possible side effects of the drugs such as an increased risk of thrombogenic disease (deep venous thrombosis). Long term studies in Sweden, however, have shown that the rate of incidence of thrombosis in women treated with tranexamic acid is comparable with the spontaneous frequency of thrombosis in women. To determine the effectiveness of antifibrinolytics in achieving a reduction in heavy menstrual bleeding. All studies which might describe randomised controlled trials of antifibrinolytic therapy for the treatment of heavy menstrual bleeding were obtained by electronic searches of MEDLINE 1966-1997, EMBASE 1980-1997 and the Cochrane Library. Companies producing antifibrinolytics and experts within the field were contacted for reference lists and information on unpublished trials. Randomised controlled trials in women of reproductive age treated with antifibrinolytic agents versus placebo, no treatment or any other medical (non-surgical) therapy for regular heavy menstrual bleeding within either the primary, family planning or specialist clinic settings. Women with post menopausal bleeding, intermenstrual bleeding, iatrogenic or pathological causes of

  18. Testing of the Trim Tab Parametric Model in NASA Langley's Unitary Plan Wind Tunnel

    Science.gov (United States)

    Murphy, Kelly J.; Watkins, Anthony N.; Korzun, Ashley M.; Edquist, Karl T.

    2013-01-01

    In support of NASA's Entry, Descent, and Landing technology development efforts, testing of Langley's Trim Tab Parametric Models was conducted in Test Section 2 of NASA Langley's Unitary Plan Wind Tunnel. The objectives of these tests were to generate quantitative aerodynamic data and qualitative surface pressure data for experimental and computational validation and aerodynamic database development. Six component force-and-moment data were measured on 38 unique, blunt body trim tab configurations at Mach numbers of 2.5, 3.5, and 4.5, angles of attack from -4deg to +20deg, and angles of sideslip from 0deg to +8deg. Configuration parameters investigated in this study were forebody shape, tab area, tab cant angle, and tab aspect ratio. Pressure Sensitive Paint was used to provide qualitative surface pressure mapping for a subset of these flow and configuration variables. Over the range of parameters tested, the effects of varying tab area and tab cant angle were found to be much more significant than varying tab aspect ratio relative to key aerodynamic performance requirements. Qualitative surface pressure data supported the integrated aerodynamic data and provided information to aid in future analyses of localized phenomena for trim tab configurations.

  19. Radial and staggered treatment patterns to correct hyperopia using noncontact holmium:YAG laser thermal keratoplasty.

    Science.gov (United States)

    Vinciguerra, P; Kohnen, T; Azzolini, M; Radice, P; Epstein, D; Koch, D D

    1998-01-01

    To compare the effects of two treatment patterns in the correction of hyperopia by noncontact holmium:YAG laser thermal keratoplasty (LTK). Divisione Oculistica, Ospedale S. Gerardo, Monza, Italy. Using two treatment patterns, we performed noncontact LTK in one session in 16 eyes of 8 patients with isometropic hyperopic refractive errors; mean preoperative subjective cycloplegic refraction was +4.90 diopters (D) +/- 1.17 (SD). The treatment consisted of 24 spots in three concentric rings of eight spots each; ring diameters were 6.0, 7.0, and 8.0 mm, respectively. Each spot received seven pulses of laser energy at 30 mJ/pulse. We treated one eye of each patient with a radial pattern (the spots of the three rings aligned on the eight semimeridians) and the fellow eye with a staggered pattern (the spots of the contiguous rings at 22.5 degrees from each other). Follow-up at 1, 15, 30, 90, 180, and 360 days included subjective cycloplegic refraction, uncorrected (UCVA) and spectacle-corrected visual acuity (SCVA), computerized videokeratography (CVK), and Scheimpflug camera examination. One year postoperatively, the mean subjective cycloplegic refraction was +2.75 +/- 1.6 D in the eyes treated with the radial pattern and +3.40 +/- 1.6 D in those treated with the staggered pattern; the mean change in subjective cycloplegic refraction was 2.15 and 1.50 D, respectively. Mean UCVA improved by five lines in the radial group and by four lines in the staggered group. Mean SCVA returned to preoperative levels by day 15 in the radial group and at 1 year in the staggered group; at 1 year, SCVA improved by one line in the radial group and remained unchanged in the staggered group. No eye lost one or more lines of SCVA. Refractive astigmatism was essentially unchanged in both groups. Scheimpflug photography and CVK indicated larger and more uniform corrected zones in the radial group. Radial and staggered patterns effectively corrected low hyperopia, although both were subject to a

  20. Modeling seismic wave propagation using staggered-grid mimetic finite differences

    Directory of Open Access Journals (Sweden)

    Freysimar Solano-Feo

    2017-04-01

    Full Text Available Mimetic finite difference (MFD approximations of continuous gradient and divergence operators satisfy a discrete version of the Gauss-Divergence theorem on staggered grids. On the mimetic approximation of this integral conservation principle, an unique boundary flux operator is introduced that also intervenes on the discretization of a given boundary value problem (BVP. In this work, we present a second-order MFD scheme for seismic wave propagation on staggered grids that discretized free surface and absorbing boundary conditions (ABC with same accuracy order. This scheme is time explicit after coupling a central three-level finite difference (FD stencil for numerical integration. Here, we briefly discuss the convergence properties of this scheme and show its higher accuracy on a challenging test when compared to a traditional FD method. Preliminary applications to 2-D seismic scenarios are also presented and show the potential of the mimetic finite difference method.

  1. Skew information in the XY model with staggered Dzyaloshinskii-Moriya interaction

    Energy Technology Data Exchange (ETDEWEB)

    Qiu, Liang, E-mail: lqiu@cumt.edu.cn [School of Physics, China University of Mining and Technology, Xuzhou, Jiangsu 221116 (China); Quan, Dongxiao [State Key Laboratory of Integrated Services Networks, Xidian University, Xi' an, Shaanxi 710071 (China); Pan, Fei; Liu, Zhi [School of Physics, China University of Mining and Technology, Xuzhou, Jiangsu 221116 (China)

    2017-06-01

    We study the performance of the lower bound of skew information in the vicinity of transition point for the anisotropic spin-1/2 XY chain with staggered Dzyaloshinskii-Moriya interaction by use of quantum renormalization-group method. For a fixed value of the Dzyaloshinskii-Moriya interaction, there are two saturated values for the lower bound of skew information corresponding to the spin-fluid and Néel phases, respectively. The scaling exponent of the lower bound of skew information closely relates to the correlation length of the model and the Dzyaloshinskii-Moriya interaction shifts the factorization point. Our results show that the lower bound of skew information can be a good candidate to detect the critical point of XY spin chain with staggered Dzyaloshinskii-Moriya interaction.

  2. Investigation of writing error in staggered heated-dot magnetic recording systems

    Science.gov (United States)

    Tipcharoen, W.; Warisarn, C.; Tongsomporn, D.; Karns, D.; Kovintavewat, P.

    2017-05-01

    To achieve an ultra-high storage capacity, heated-dot magnetic recording (HDMR) has been proposed, which heats a bit-patterned medium before recording data. Generally, an error during the HDMR writing process comes from several sources; however, we only investigate the effects of staggered island arrangement, island size fluctuation caused by imperfect fabrication, and main pole position fluctuation. Simulation results demonstrate that a writing error can be minimized by using a staggered array (hexagonal lattice) instead of a square array. Under the effect of main pole position fluctuation, the writing error is higher than the system without main pole position fluctuation. Finally, we found that the error percentage can drop below 10% when the island size is 8.5 nm and the standard deviation of the island size is 1 nm in the absence of main pole jitter.

  3. Lower Gastrointestinal Bleeding in Children.

    Science.gov (United States)

    Sahn, Benjamin; Bitton, Samuel

    2016-01-01

    This article provides an overview of the evaluation and management of lower gastrointestinal bleeding (LGIB) in children. The common etiologies at different ages are reviewed. Conditions with endoscopic importance for diagnosis or therapy include solitary rectal ulcer syndrome, polyps, vascular lesions, and colonic inflammation and ulceration. Diagnostic modalities for identifying causes of LGIB in children include endoscopy and colonoscopy, cross-sectional and nuclear medicine imaging, video capsule endoscopy, and enteroscopy. Pre-endoscopic preparation and decision-making unique to pediatrics is highlighted. The authors conclude with a summary of current and emerging therapeutic hemostatic techniques that can be used in pediatric patients. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. [APPROACH TO PATIENTS WITH GASTROINTESTINAL BLEEDING].

    Science.gov (United States)

    Nikolić, M; Hanževački, M; Jurčić, P; Budimir, I; Ljubičić, N

    2015-11-01

    In the developed Western countries, despite the accumulation of knowledge about the causes and treatment of gastrointestinal bleeding, as well as the experience of gastroenterologists-endoscopists using sophisticated endoscopic devices, the number of hospitalizations and mortality rates has not declined as expected. The most likely explanations are the following: aging population, increased prevalence of alcoholic liver cirrhosis, gastroesophageal reflux disease and obesity, Helicobacter pylori antibiotic resistance, using dual anti-aggregation therapy, anticoagulants, and excessive use of nonsteroidal anti-inflammatory drugs. The aim of this paper is to show the incidence and the most common signs and symptoms of gastrointestinal bleeding. The aim is also to present initial clinical evaluation, diagnostic methods, the main causes of gastrointestinal bleeding, endoscopic hemostatic modalities and treatment of bleeding from the upper and lower gastrointestinal tract. Using the MEDLINE and Ovid databases, we searched the meta-analyses and systematic reviews published in English during the 2005-2015 period. Meta-analyses included results of randomized, double-blind studies on adults treated for gastrointestinal bleeding. Included were guidelines of the European and American Society of Gastroenterological Endoscopy, as well as recent expert work. In this review, we bring the state-of-the-art on gastrointestinal bleeding, new classification of gastrointestinal bleeding from the upper, mid and lower gut, controversy of nasogastric tube placement, use of prokinetic agents and inhibitor proton pumps in acute gastrointestinal bleeding from the upper tract, restrictive transfusion strategy, useful clinical stratification of the severity of bleeding, indications for hospitalization and outcome of using the clinical bleeding score, proper use of gastroprotection in patients at a high risk of peptic ulcer, the need of initial endoscopy, variceal assessment in newly diagnosed

  5. On the spectrum of the staggered Dirac operator at finite chemical potential

    International Nuclear Information System (INIS)

    Vink, J.C.; Nationaal Inst. voor Kernfysica en Hoge-Energiefysica

    1988-12-01

    The spectrum of the staggered Dirac operator in two-dimensional QEDF is investigated at finite chemical potential. In the quenced model, it is shown that lattice artefacts cause a spurious scattering of eigenvalues. This scattering disappears when lattice distance is taken to zero. In the unquenced model, a new approach is used to show that similar effects are absent. (author). 17 refs.; 6 figs

  6. Diffraction of love waves by two staggered perfectly weak half-planes

    International Nuclear Information System (INIS)

    Asghar, S.; Zaman, F.D.; Sajida Asghar

    1989-01-01

    Love wave travelling in a layer of uniform thickness overlying a half-space is assumed to be incident on two parallel but staggered perfectly weak half-planes lying in the upper layer. The diffracted fields is calculated using the modified Wiener-Hopf technique and contour integration method. The diffracted waves satisfy the dispersion relations appropriate to different regions formed by the perfectly weak half-planes

  7. Bottleneck congestion and distribution of work start times: The economics of staggered work hours revisited

    OpenAIRE

    Takayama, Yuki

    2014-01-01

    Since the seminal work of Henderson (1981), a number of studies examined the effect of staggered work hours by analyzing models of work start time choice that consider the trade-off between negative congestion externalities and positive production externalities. However, these studies described traffic congestion using flow congestion models. This study develops a model of work start time choice with bottleneck congestion and discloses the intrinsic properties of the model. To this end, this ...

  8. New 2D adaptive mesh refinement algorithm based on conservative finite-differences with staggered grid

    Science.gov (United States)

    Gerya, T.; Duretz, T.; May, D. A.

    2012-04-01

    We present new 2D adaptive mesh refinement (AMR) algorithm based on stress-conservative finite-differences formulated for non-uniform rectangular staggered grid. The refinement approach is based on a repetitive cell splitting organized via a quad-tree construction (every parent cell is split into 4 daughter cells of equal size). Irrespective of the level of resolution every cell has 5 staggered nodes (2 horizontal velocities, 2 vertical velocities and 1 pressure) for which respective governing equations, boundary conditions and interpolation equations are formulated. The connectivity of the grid is achieved via cross-indexing of grid cells and basic nodal points located in their corners: four corner nodes are indexed for every cell and up to 4 surrounding cells are indexed for every node. The accuracy of the approach depends critically on the formulation of the stencil used at the "hanging" velocity nodes located at the boundaries between different levels of resolution. Most accurate results are obtained for the scheme based on the volume flux balance across the resolution boundary combined with stress-based interpolation of velocity orthogonal to the boundary. We tested this new approach with a number of 2D variable viscosity analytical solutions. Our tests demonstrate that the adaptive staggered grid formulation has convergence properties similar to those obtained in case of a standard, non-adaptive staggered grid formulation. This convergence is also achieved when resolution boundary crosses sharp viscosity contrast interfaces. The convergence rates measured are found to be insensitive to scenarios when the transition in grid resolution crosses sharp viscosity contrast interfaces. We compared various grid refinement strategies based on distribution of different field variables such as viscosity, density and velocity. According to these tests the refinement allows for significant (0.5-1 order of magnitude) increase in the computational accuracy at the same

  9. A Simplified Method for Stationary Heat Transfer of a Hollow Core Concrete Slab Used for TABS

    DEFF Research Database (Denmark)

    Yu, Tao; Heiselberg, Per Kvols; Lei, Bo

    2014-01-01

    Thermally activated building systems (TABS) have been an energy efficient way to improve the indoor thermal comfort. Due to the complicated structure, heat transfer prediction for a hollow core concrete used for TABS is difficult. This paper proposes a simplified method using equivalent thermal...

  10. TABS Manual for the Temperament and Atypical Behavior Scale: Early Childhood Indicators of Developmental Dysfunction.

    Science.gov (United States)

    Neisworth, John T.; Bagnato, Stephen J.; Salvia, John; Hunt, Frances M.

    This manual describes the rationale, use, and validity of the Temperament and Atypical Behavior Scale (TABS), a norm-referenced measure of dysfunctional behavior appropriately used with infants and young children between the ages of 11 and 71 months. TABS is intended to identify children who are developing atypically or are at risk for atypical…

  11. Climate classification for the simulation of thermally activated building systems (TABS)

    DEFF Research Database (Denmark)

    Behrendt, Benjamin; Christensen, Jørgen Erik

    2013-01-01

    alternative (sustainable) energy sources that would otherwise be insufficient. The design of TABS is however challenging and most often requires a complete simulation of the building. The standard ISO 11855-4 (2011) suggests a simplified sizing method for TABS. The results however omit condensation risk...... entirely. The proposed climate classification should fill this gap by providing the missing data in a simple manner....

  12. Entropy Stable Staggered Grid Spectral Collocation for the Burgers' and Compressible Navier-Stokes Equations

    Science.gov (United States)

    Carpenter, Mark H.; Parsani, Matteo; Fisher, Travis C.; Nielsen, Eric J.

    2015-01-01

    Staggered grid, entropy stable discontinuous spectral collocation operators of any order are developed for Burgers' and the compressible Navier-Stokes equations on unstructured hexahedral elements. This generalization of previous entropy stable spectral collocation work [1, 2], extends the applicable set of points from tensor product, Legendre-Gauss-Lobatto (LGL) to a combination of tensor product Legendre-Gauss (LG) and LGL points. The new semi-discrete operators discretely conserve mass, momentum, energy and satisfy a mathematical entropy inequality for both Burgers' and the compressible Navier-Stokes equations in three spatial dimensions. They are valid for smooth as well as discontinuous flows. The staggered LG and conventional LGL point formulations are compared on several challenging test problems. The staggered LG operators are significantly more accurate, although more costly to implement. The LG and LGL operators exhibit similar robustness, as is demonstrated using test problems known to be problematic for operators that lack a nonlinearly stability proof for the compressible Navier-Stokes equations (e.g., discontinuous Galerkin, spectral difference, or flux reconstruction operators).

  13. Effects of acoustic ceiling units on the cooling performance of thermally activated building systems (TABS)

    DEFF Research Database (Denmark)

    Lacarte, Luis Marcos Domínguez; Rage, Niels; Kazanci, Ongun Berk

    2017-01-01

    removed by the TABS when 43% of the ceiling area was covered with free hanging horizontal sound absorbers at 300 mm (0.98 ft) from the active surface. This reduction was 23% for a ceiling coverage ratio of 60%. The decrease in heat absorbed by the TABS is less pronounced in the case of vertical sound...... absorbers for equivalent levels of sound absorption. A reduction of 12% of the heat removed by the TABS has been measured for vertical sound absorbers (equivalent sound absorption levels to 60% coverage ratio with horizontal sound absorbers). This reduction was of 13% for vertical sound absorbers...... the effects of two types of free hanging ceiling absorbers (horizontal and vertical) on the cooling performance of the TABS and the implications this has on the occupant thermal comfort. The measurements were carried out in a full-scale TABS test facility. The results show a reduction of 11% of the heat...

  14. TabSQL: a MySQL tool to facilitate mapping user data to public databases.

    Science.gov (United States)

    Xia, Xiao-Qin; McClelland, Michael; Wang, Yipeng

    2010-06-23

    With advances in high-throughput genomics and proteomics, it is challenging for biologists to deal with large data files and to map their data to annotations in public databases. We developed TabSQL, a MySQL-based application tool, for viewing, filtering and querying data files with large numbers of rows. TabSQL provides functions for downloading and installing table files from public databases including the Gene Ontology database (GO), the Ensembl databases, and genome databases from the UCSC genome bioinformatics site. Any other database that provides tab-delimited flat files can also be imported. The downloaded gene annotation tables can be queried together with users' data in TabSQL using either a graphic interface or command line. TabSQL allows queries across the user's data and public databases without programming. It is a convenient tool for biologists to annotate and enrich their data.

  15. Re: Penetration Behavior of Opposed Rows of Staggered Secondary Air Jets Depending on Jet Penetration Coefficient and Momentum Flux Ratio

    Science.gov (United States)

    Holdeman, James D.

    2016-01-01

    The purpose of this article is to explain why the extension of the previously published C = (S/Ho)sqrt(J) scaling for opposed rows of staggered jets wasn't directly successful in the study by Choi et al. (2016). It is not surprising that staggered jets from opposite sides do not pass each other at the expected C value, because Ho/D and sqrt(J) are much larger than the maximum in previous studies. These, and large x/D's, tend to suggest development of 2-dimensional flow. Although there are distinct optima for opposed rows of in-line jets, single-side injection, and opposed rows of staggered jets based on C, opposed rows of staggered jets provide as good or better mixing performance, at any C value, than opposed rows of in-line jets or jets from single-side injection.

  16. Management of bleeding gastroduodenal ulcers

    DEFF Research Database (Denmark)

    Laursen, Stig Borbjerg; Jørgensen, Henrik Stig; Schaffalitzky de Muckadell, Ove B

    2012-01-01

    Description: A multidisciplinary group of Danish experts developed this guideline on management of bleeding gastroduodenal ulcers. Sources of data included published studies up to March 2011. Quality of evidence and strength of recommendations have been graded. The guideline was approved by the D......Description: A multidisciplinary group of Danish experts developed this guideline on management of bleeding gastroduodenal ulcers. Sources of data included published studies up to March 2011. Quality of evidence and strength of recommendations have been graded. The guideline was approved...... by the Danish Society of Gastroenterology and Hepatology September 4, 2011. Recommendations: Recommendations emphasize the importance of early and efficient resuscitation. Endoscopy should generally be performed within 24 hours, reducing operation rate, rebleeding rate and duration of in-patient stay. When...... in achieving endoscopic hemostasis. Use of endoscopic monotherapy with epinephrine injection is not recommended. Intravenous high-dose proton pump inhibitor (PPI) therapy for 72 hours after successful endoscopic hemostasis is recommended as it decreases both rebleeding rate and mortality in patients with high...

  17. Gastric ulcer bleeding: diagnosis by computed tomography

    International Nuclear Information System (INIS)

    Voloudaki, Argyro; Tsagaraki, Kaliopi; Mouzas, John; Gourtsoyiannis, Nickolas

    1999-01-01

    A case of CT demonstration of a bleeding gastric ulcer is presented, in a patient with confusing clinical manifestations. Abdominal CT was performed without oral contrast medium administration, and showed extravasation of intravenous contrast into a gastric lumen distended with material of mixed attenuation. It is postulated that if radiopaque oral contrast had been given, peptic ulcer bleeding would probably have been masked. CT demonstration of gastric ulcer bleeding, may be of value in cases of differential diagnostic dilemmas

  18. Integral staggered point-matching method for millimeter-wave reflective diffraction gratings on electron cyclotron heating systems

    International Nuclear Information System (INIS)

    Xia, Donghui; Huang, Mei; Wang, Zhijiang; Zhang, Feng; Zhuang, Ge

    2016-01-01

    Highlights: • The integral staggered point-matching method for design of polarizers on the ECH systems is presented. • The availability of the integral staggered point-matching method is checked by numerical calculations. • Two polarizers are designed with the integral staggered point-matching method and the experimental results are given. - Abstract: The reflective diffraction gratings are widely used in the high power electron cyclotron heating systems for polarization strategy. This paper presents a method which we call “the integral staggered point-matching method” for design of reflective diffraction gratings. This method is based on the integral point-matching method. However, it effectively removes the convergence problems and tedious calculations of the integral point-matching method, making it easier to be used for a beginner. A code is developed based on this method. The calculation results of the integral staggered point-matching method are compared with the integral point-matching method, the coordinate transformation method and the low power measurement results. It indicates that the integral staggered point-matching method can be used as an optional method for the design of reflective diffraction gratings in electron cyclotron heating systems.

  19. Pseudo-spectral method using rotated staggered grid for elastic wave propagation in 3D arbitrary anisotropic media

    KAUST Repository

    Zou, Peng

    2017-05-10

    Staggering grid is a very effective way to reduce the Nyquist errors and to suppress the non-causal ringing artefacts in the pseudo-spectral solution of first-order elastic wave equations. However, the straightforward use of a staggered-grid pseudo-spectral method is problematic for simulating wave propagation when the anisotropy level is greater than orthorhombic or when the anisotropic symmetries are not aligned with the computational grids. Inspired by the idea of rotated staggered-grid finite-difference method, we propose a modified pseudo-spectral method for wave propagation in arbitrary anisotropic media. Compared with an existing remedy of staggered-grid pseudo-spectral method based on stiffness matrix decomposition and a possible alternative using the Lebedev grids, the rotated staggered-grid-based pseudo-spectral method possesses the best balance between the mitigation of artefacts and efficiency. A 2D example on a transversely isotropic model with tilted symmetry axis verifies its effectiveness to suppress the ringing artefacts. Two 3D examples of increasing anisotropy levels demonstrate that the rotated staggered-grid-based pseudo-spectral method can successfully simulate complex wavefields in such anisotropic formations.

  20. Integral staggered point-matching method for millimeter-wave reflective diffraction gratings on electron cyclotron heating systems

    Energy Technology Data Exchange (ETDEWEB)

    Xia, Donghui [State Key Laboratory of Advanced Electromagnetic Engineering and Technology, Huazhong University of Science and Technology, 430074 Wuhan (China); Huang, Mei [Southwestern Institute of Physics, 610041 Chengdu (China); Wang, Zhijiang, E-mail: wangzj@hust.edu.cn [State Key Laboratory of Advanced Electromagnetic Engineering and Technology, Huazhong University of Science and Technology, 430074 Wuhan (China); Zhang, Feng [Southwestern Institute of Physics, 610041 Chengdu (China); Zhuang, Ge [State Key Laboratory of Advanced Electromagnetic Engineering and Technology, Huazhong University of Science and Technology, 430074 Wuhan (China)

    2016-10-15

    Highlights: • The integral staggered point-matching method for design of polarizers on the ECH systems is presented. • The availability of the integral staggered point-matching method is checked by numerical calculations. • Two polarizers are designed with the integral staggered point-matching method and the experimental results are given. - Abstract: The reflective diffraction gratings are widely used in the high power electron cyclotron heating systems for polarization strategy. This paper presents a method which we call “the integral staggered point-matching method” for design of reflective diffraction gratings. This method is based on the integral point-matching method. However, it effectively removes the convergence problems and tedious calculations of the integral point-matching method, making it easier to be used for a beginner. A code is developed based on this method. The calculation results of the integral staggered point-matching method are compared with the integral point-matching method, the coordinate transformation method and the low power measurement results. It indicates that the integral staggered point-matching method can be used as an optional method for the design of reflective diffraction gratings in electron cyclotron heating systems.

  1. Management of acute gastric varices bleeding

    Directory of Open Access Journals (Sweden)

    Chen-Jung Chang

    2013-10-01

    Full Text Available Gastroesophageal varices bleeding is a major complication in patients with cirrhosis. Gastric varices (GVs occur in approximately 20% of patients with portal hypertension. However, GV bleeding develops in only 25% of patients with GV and requires more transfusion and has higher mortality than esophageal variceal (EV bleeding. The best strategy for managing acute GV bleeding is similar to that of acute EV bleeding, which involves airway protection, hemodynamic stabilization, and intensive care. Blood transfusion should be cautiously administered in order to avoid rebleeding. Vasoactive agents such as terlipressin or somatostatin should be used when GV bleeding is suspected. Routine use of prophylactic antibiotics reduces bacterial infection and lowers rebleeding rates. By administering endoscopic cyanoacrylate injection, the initial hemostasis rate achieved is at least 90% in most cases; the average mortality rate of GV bleeding is approximately 10–30% and the rebleeding rate is between 22% and 37%. Although endoscopic injection of cyanoacrylate is superior to sclerotherapy and band ligation, and has remained the treatment of choice for treating acute GV bleeding, the outcome of this treatment is still unsatisfactory. New treatment options, such as thrombin injection, transjugular intrahepatic portosystemic shunts, or balloon-occluded retrograde transvenous obliteration, have shown promising results for acute GV bleeding. However, randomized controlled trials are needed to compare the efficacy of these therapies with cyanoacrylate.

  2. [Gastrointestinal bleeding, NSAIDs, aspirin and anticoagulants].

    Science.gov (United States)

    Lanas, Ángel

    2014-09-01

    The studies presented at the recent American Congress of Gastroenterology in the field of non-variceal upper gastrointestinal bleeding (associated or not to NSAIDs or ASA use) have not been numerous but interesting. The key findings are: a) rabeprazole, the only PPI that had few studies in this field, is effective in the prevention of gastric ulcers; b) famotidine could also be effective in the prevention of complications by AAS; c) the new competitive inhibitors of the acid potassium pump are effective (as much as PPIs) on the recurrence of peptic ulcers by ASA; d) early endoscop (<8 h) in non-variceal upper gastrointestinal bleeding seems to offer no better results than those made in the first 24 h; e) endoscopic therapy in Forrest 1a ulcers does not obliterate the bleeding artery in 30% of cases and is the cause of bleeding recurrence; f) alternative therapies with glue or clotting products are being increasingly used in endoscopic therapy of gastrointestinal bleeding; g) liberal administration of blood in the GI bleeding is associated with poor prognosis; h) lesions of the small intestine are frequent cause of gastrointestinal bleeding when upper endoscopy shows no positive stigmata; and i) capsule endoscopy studies have high performance in gastrointestinal bleeding of obscure origin, if performed early in the first two days after the beginning of the bleeding episode. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  3. Serendipity in scintigraphic gastrointestinal bleeding studies

    International Nuclear Information System (INIS)

    Goergen, T.G.

    1983-01-01

    A retrospective review of 80 scintigraphic bleeding studies performed with Tc-99m sulfur colloid or Tc-99m labeled red blood cells showed five cases where there were abnormal findings not related to bleeding. In some cases, the abnormalities were initially confused with bleeding or could obscure an area of bleeding, while in other cases, the abnormalities represented additional clinical information. These included bone marrow replacement related to tumor and radiation therapy, hyperemia related to a uterine leiomyoma and a diverticular abscess, and a dilated abdominal aorta (aneurysm). Recognition of such abnormalities should prevent an erroneous diagnosis and the additional information may be of clinical value

  4. Serendipity in scintigraphic gastrointestinal bleeding studies

    Energy Technology Data Exchange (ETDEWEB)

    Goergen, T.G.

    1983-09-01

    A retrospective review of 80 scintigraphic bleeding studies performed with Tc-99m sulfur colloid or Tc-99m labeled red blood cells showed five cases where there were abnormal findings not related to bleeding. In some cases, the abnormalities were initially confused with bleeding or could obscure an area of bleeding, while in other cases, the abnormalities represented additional clinical information. These included bone marrow replacement related to tumor and radiation therapy, hyperemia related to a uterine leiomyoma and a diverticular abscess, and a dilated abdominal aorta (aneurysm). Recognition of such abnormalities should prevent an erroneous diagnosis and the additional information may be of clinical value.

  5. TAB3 involves in hepatic insulin resistance through activation of MAPK pathway.

    Science.gov (United States)

    Zhao, Yun; Tang, Zhuqi; Zhu, Xiaohui; Wang, Xueqin; Wang, Cuifang; Zhang, Wanlu; Xia, Nana; Wang, Suxin; Huang, Jieru; Cui, Shiwei

    2015-12-01

    Insulin resistance is often accompanied by chronic inflammatory responses. The mitogen-activated protein kinase (MAPK) pathway is rapidly activated in response to many inflammatory cytokines. But the functional role of MAPKs in palmitate-induced insulin resistance has yet to be clarified. In this study, we found that transforming growth factor β-activated kinase binding protein-3 (TAB3) was up-regulated in insulin resistance. Considering the relationship between transforming growth factor β-activated kinase (TAK1) and MAPK pathway, we assumed TAB3 involved in insulin resistance through activation of MAPK pathway. To certify this hypothesis, we knocked down TAB3 in palmitate treated HepG2 cells and detected subsequent biological responses. Importantly, TAB3 siRNA directly reversed insulin sensitivity by improving insulin signal transduction. Moreover, silencing of TAB3 could facilitate hepatic glucose uptake, reverse gluconeogenesis and improve ectopic fat accumulation. Meanwhile, we found that the positive effect of knocking down TAB3 was more significant when insulin resistance occurred. All these results indicate that TAB3 acts as a negative regulator in insulin resistance through activation of MAPK pathway. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. Massive rectal bleeding from colonic diverticulosis | Olokoba ...

    African Journals Online (AJOL)

    Objectives: This is to describe a case of colonic diverticulosis causing massive rectal bleeding in an elderly Nigerian man. Case report: We highlight a case of a 79 year old man who presented with massive rectal bleeding due to colonic diverticulosis from our centre. Colonoscopy identified multiple diverticula in the ...

  7. Gastrointestinal bleeding following NSAID ingestion in children

    African Journals Online (AJOL)

    presented with GI bleeding following ingestion of NSAID. Two female children ... users of NSAIDs [2]. The risk and the magnitude of. NSAID-induced GI injury in children are uncertain. Here, we report two cases of GI bleeding in children following NSAID use. .... Nonsteroidal anti-inflammatory drug induced gastrointestinal ...

  8. Rectal bleeding in children: endoscopic evaluation revisited

    NARCIS (Netherlands)

    de Ridder, Lissy; van Lingen, Anna V.; Taminiau, Jan A. J. M.; Benninga, Marc A.

    2007-01-01

    Objectives Rectal bleeding is an alarming event both for the child and parents. It is hypothesized that colonoscopy instead of sigmoidoscopy and adding esophago-gastro-duodenoscopy in case of accompanying complaints, improves the diagnostic accuracy in children with prolonged rectal bleeding. Study

  9. RESEARCH Endoscopic injection sclerotherapy for bleeding varices ...

    African Journals Online (AJOL)

    Portal hypertension due to intrahepatic disease or extrahepatic portal vein obstruction (EHPVO) is an important cause of upper gastro- intestinal bleeding in children. About 50% of children with EHPVO present with bleeding from oesophageal varices.1-3 Improvements in the management of children with intrahepatic ...

  10. Duodenal diverticular bleeding: an endoscopic challenge

    Directory of Open Access Journals (Sweden)

    Eduardo Valdivielso-Cortázar

    Full Text Available Duodenal diverticula are an uncommon cause of upper gastrointestinal bleeding. Until recently, it was primarily managed with surgery, but advances in the field of endoscopy have made management increasingly less invasive. We report a case of duodenal diverticular bleeding that was endoscopically managed, and review the literature about the various endoscopic therapies thus far described.

  11. Dysfunctional Uterine Bleeding (DUB) (For Teens)

    Science.gov (United States)

    ... Feelings Expert Answers Q&A Movies & More for Teens Teens site Sitio para adolescentes Body Mind Sexual Health ... English Español Abnormal Uterine Bleeding (AUB) KidsHealth / For Teens / Abnormal Uterine Bleeding (AUB) What's in this article? ...

  12. Massive rectal bleeding from colonic diverticulosis

    African Journals Online (AJOL)

    ABEOLUGBENGAS

    Objectives: This is to describe a case of colonic diverticulosis causing massive rectal bleeding in an elderly Nigerian man. ... also oozing blood. He was worked up, and had surgery for hemicolectomy due to massive blood loss following failure of initial conservative management. .... bleeding patterns observed in fifty cases.

  13. A simple spreadsheet-based, MIAME-supportive format for microarray data: MAGE-TAB

    Directory of Open Access Journals (Sweden)

    White Joseph

    2006-11-01

    Full Text Available Abstract Background Sharing of microarray data within the research community has been greatly facilitated by the development of the disclosure and communication standards MIAME and MAGE-ML by the MGED Society. However, the complexity of the MAGE-ML format has made its use impractical for laboratories lacking dedicated bioinformatics support. Results We propose a simple tab-delimited, spreadsheet-based format, MAGE-TAB, which will become a part of the MAGE microarray data standard and can be used for annotating and communicating microarray data in a MIAME compliant fashion. Conclusion MAGE-TAB will enable laboratories without bioinformatics experience or support to manage, exchange and submit well-annotated microarray data in a standard format using a spreadsheet. The MAGE-TAB format is self-contained, and does not require an understanding of MAGE-ML or XML.

  14. Transarterial embolization of acute intercostal artery bleeding

    Energy Technology Data Exchange (ETDEWEB)

    Bae, Jae Ik; Park, Auh Whan; Lee, Seon Joo [Inje University College of Medicine, Busan (Korea, Republic of); Ko, Gi Young; Yoon, Hyun Ki [University of Ulsan College of Medicine, Seoul (Korea, Republic of); Yoon, Chang Jin [Seoul National University Bundang Hospital, Seongnam (Korea, Republic of); Shin, Tae Beom [Donga University College of Medicine, Busan (Korea, Republic of); Kim, Young Hwan [Kyimyung University School of Medicine, Daegu (Korea, Republic of)

    2005-09-15

    To report our experiences of transarterial embolization for acute intercostal artery bleeding. A retrospectively analysis of the causes, clinical manifestations, angiographic findings and transarterial embolization technique in 8 patients with acute intercostal artery bleeding, with a review of the anatomical basis. The causes of intercostal artery bleeding were iatrogenic and traumatic in 88 and 12% of cases, respectively. Active bleeding from the collateral intercostal or posterior intercostal arteries was angiographically demonstrated in 75 and 25% of cases, respectively. Transarterial embolization successfully achieved hemostasis in all cases. However, two patient with hypovolemic shock expired due to a massive hemothorax, despite successful transarterial embolization. Intercostal access should be performed through the middle of the intercostal space to avoid injury to the collateral intercostal artery. Transarterial embolization is an effective method for the control of intercostal artery bleeding.

  15. EM reconstruction of dual isotope PET using staggered injections and prompt gamma positron emitters

    International Nuclear Information System (INIS)

    Andreyev, Andriy; Sitek, Arkadiusz; Celler, Anna

    2014-01-01

    Purpose: The aim of dual isotope positron emission tomography (DIPET) is to create two separate images of two coinjected PET radiotracers. DIPET shortens the duration of the study, reduces patient discomfort, and produces perfectly coregistered images compared to the case when two radiotracers would be imaged independently (sequential PET studies). Reconstruction of data from such simultaneous acquisition of two PET radiotracers is difficult because positron decay of any isotope creates only 511 keV photons; therefore, the isotopes cannot be differentiated based on the detected energy. Methods: Recently, the authors have proposed a DIPET technique that uses a combination of radiotracer A which is a pure positron emitter (such as 18 F or 11 C) and radiotracer B in which positron decay is accompanied by the emission of a high-energy (HE) prompt gamma (such as 38 K or 60 Cu). Events that are detected as triple coincidences of HE gammas with the corresponding two 511 keV photons allow the authors to identify the lines-of-response (LORs) of isotope B. These LORs are used to separate the two intertwined distributions, using a dedicated image reconstruction algorithm. In this work the authors propose a new version of the DIPET EM-based reconstruction algorithm that allows the authors to include an additional, independent estimate of radiotracer A distribution which may be obtained if radioisotopes are administered using a staggered injections method. In this work the method is tested on simple simulations of static PET acquisitions. Results: The authors’ experiments performed using Monte-Carlo simulations with static acquisitions demonstrate that the combined method provides better results (crosstalk errors decrease by up to 50%) than the positron-gamma DIPET method or staggered injections alone. Conclusions: The authors demonstrate that the authors’ new EM algorithm which combines information from triple coincidences with prompt gammas and staggered injections

  16. On the Quality of Velocity Interpolation Schemes for Marker-in-Cell Method and Staggered Grids

    Science.gov (United States)

    Pusok, Adina E.; Kaus, Boris J. P.; Popov, Anton A.

    2017-03-01

    The marker-in-cell method is generally considered a flexible and robust method to model the advection of heterogenous non-diffusive properties (i.e., rock type or composition) in geodynamic problems. In this method, Lagrangian points carrying compositional information are advected with the ambient velocity field on an Eulerian grid. However, velocity interpolation from grid points to marker locations is often performed without considering the divergence of the velocity field at the interpolated locations (i.e., non-conservative). Such interpolation schemes can induce non-physical clustering of markers when strong velocity gradients are present (Journal of Computational Physics 166:218-252, 2001) and this may, eventually, result in empty grid cells, a serious numerical violation of the marker-in-cell method. To remedy this at low computational costs, Jenny et al. (Journal of Computational Physics 166:218-252, 2001) and Meyer and Jenny (Proceedings in Applied Mathematics and Mechanics 4:466-467, 2004) proposed a simple, conservative velocity interpolation scheme for 2-D staggered grid, while Wang et al. (Geochemistry, Geophysics, Geosystems 16(6):2015-2023, 2015) extended the formulation to 3-D finite element methods. Here, we adapt this formulation for 3-D staggered grids (correction interpolation) and we report on the quality of various velocity interpolation methods for 2-D and 3-D staggered grids. We test the interpolation schemes in combination with different advection schemes on incompressible Stokes problems with strong velocity gradients, which are discretized using a finite difference method. Our results suggest that a conservative formulation reduces the dispersion and clustering of markers, minimizing the need of unphysical marker control in geodynamic models.

  17. Response of Maize Crop to Spatial Arrangement and Staggered Interseeding of Haricot Bean

    Directory of Open Access Journals (Sweden)

    Tamiru Hirpa

    2014-09-01

    Full Text Available Field studies conducted to determine the effects of intercrop row arrangements and staggered intercropping of haricot bean (Phaseolus vulgaris L. on the performances of maize (Zea mays L. crop at Hallaba and Taba areas in 2013 cropping season, southern Ethiopia, revealed that there were significant effects of cropping patterns and staggered interseeding of the legume component on growth and yield components of maize crop. Significant interaction of row arrangement × intercropping time of haricot bean was observed with respect to leaf area index (LAI of the maize crop. Increasing trends of LAI of maize crop were observed as interseeding of haricot bean was delayed for 3 weeks after maize (WAM that stabilized during the 6 WAM interseeding time. Maize stover production was significantly high at 1:2 row ratio and delaying of the undersowing haricot bean in the already established maize crop for 6 weeks, 10.94 tha-1 and 11.39 t ha-1, respectively. Maize grain yield showed a significant variation with respect to the staggered sowing of haricot bean, whereby the highest (3.99 t ha-1 being recorded when haricot bean intercropping was delayed for 21 days after maize planting. The data of this study revealed that the larger maize plant canopy providing larger photosynthetic area, attained when haricot bean interseeding was delayed, probably resulted in higher grain yield of maize. DOI: http://dx.doi.org/10.3126/ije.v3i3.11072 International Journal of Environment Vol.3(3 2014: 126-138

  18. EM reconstruction of dual isotope PET using staggered injections and prompt gamma positron emitters

    Science.gov (United States)

    Andreyev, Andriy; Sitek, Arkadiusz; Celler, Anna

    2014-01-01

    Purpose: The aim of dual isotope positron emission tomography (DIPET) is to create two separate images of two coinjected PET radiotracers. DIPET shortens the duration of the study, reduces patient discomfort, and produces perfectly coregistered images compared to the case when two radiotracers would be imaged independently (sequential PET studies). Reconstruction of data from such simultaneous acquisition of two PET radiotracers is difficult because positron decay of any isotope creates only 511 keV photons; therefore, the isotopes cannot be differentiated based on the detected energy. Methods: Recently, the authors have proposed a DIPET technique that uses a combination of radiotracer A which is a pure positron emitter (such as 18F or 11C) and radiotracer B in which positron decay is accompanied by the emission of a high-energy (HE) prompt gamma (such as 38K or 60Cu). Events that are detected as triple coincidences of HE gammas with the corresponding two 511 keV photons allow the authors to identify the lines-of-response (LORs) of isotope B. These LORs are used to separate the two intertwined distributions, using a dedicated image reconstruction algorithm. In this work the authors propose a new version of the DIPET EM-based reconstruction algorithm that allows the authors to include an additional, independent estimate of radiotracer A distribution which may be obtained if radioisotopes are administered using a staggered injections method. In this work the method is tested on simple simulations of static PET acquisitions. Results: The authors’ experiments performed using Monte-Carlo simulations with static acquisitions demonstrate that the combined method provides better results (crosstalk errors decrease by up to 50%) than the positron-gamma DIPET method or staggered injections alone. Conclusions: The authors demonstrate that the authors’ new EM algorithm which combines information from triple coincidences with prompt gammas and staggered injections improves

  19. Weak interaction matrix elements with staggered fermions. I: theory and a trial run

    International Nuclear Information System (INIS)

    Sharpe, S.R.; Patel, A.; Gupta, R.; Guralnik, G.; Kilsup, G.W.

    1986-08-01

    We present results of a preliminary study of the matrix elements of weak interaction operators using staggered fermions. We describe our method for transcribing the weak interaction Hamiltonian onto the lattice. This method preserves exact Ward Identities analogous to those of the continuum. The calculation uses operators involving 0, 1, 2, 3 and 4 gauge links. We present results for all these operators obtained on 8 3 x 16 lattices generated both with the Wilson action (β = 5.6) and an improved action

  20. Nucleon structure in the chiral regime with domain wall fermions on an improved staggered sea

    International Nuclear Information System (INIS)

    R.G. Edwards; G. Fleming; Ph. Hagler; J.W. Negele; K. Orginos; A.V. Pochinsky; D.B. Renner; D.G. Richards; W. Schroers

    2006-01-01

    Moments of unpolarized, helicity, and transversity distributions, electromagnetic form factors, and generalized form factors of the nucleon are presented from a preliminary analysis of lattice results using pion masses down to 359 MeV. The twist two matrix elements are calculated using a mixed action of domain wall valence quarks and asqtad staggered sea quarks and are renormalized perturbatively. Several observables are extrapolated to the physical limit using chiral perturbation theory. Results are compared with experimental moments of quark distributions and electromagnetic form factors and phenomenologically determined generalized form factors, and the implications on the transverse structure and spin content of the nucleon are discussed

  1. Aerodynamic drag of a staggered flat-oval finning tube banks at the small reynolds numbers

    Directory of Open Access Journals (Sweden)

    Максим Михайлович Вознюк

    2015-06-01

    Full Text Available Experimental investigations of aerodynamic drag of staggered bundles of flat-oval tubes with incomplete transversal fins in the range of Reynolds numbers 600 <  < 20000 are performed. New calculation correlations for determining of drag coefficients for 1<3000 are suggested, the impact of basic geometric and regime parameters on aerodynamic drag of bundles are determined. The received calculation depending is possible to use in developing of heat transfer surfaces for “dry” cooling towers and air cooling apparatus and economizers

  2. Calculation of cell face velocity of non-staggered grid system

    KAUST Repository

    Li, Wang

    2012-07-28

    In this paper, the cell face velocities in the discretization of the continuity equation, the momentum equation, and the scalar equation of a non-staggered grid system are calculated and discussed. Both the momentum interpolation and the linear interpolation are adopted to evaluate the coefficients in the discretized momentum and scalar equations. Their performances are compared. When the linear interpolation is used to calculate the coefficients, the mass residual term in the coefficients must be dropped to maintain the accuracy and convergence rate of the solution. © Shanghai University and Springer-Verlag Berlin Heidelberg 2012.

  3. Calculation of the Nucleon Axial Form Factor Using Staggered Lattice QCD

    Energy Technology Data Exchange (ETDEWEB)

    Meyer, Aaron S. [Fermilab; Hill, Richard J. [Perimeter Inst. Theor. Phys.; Kronfeld, Andreas S. [Fermilab; Li, Ruizi [Indiana U.; Simone, James N. [Fermilab

    2016-10-14

    The nucleon axial form factor is a dominant contribution to errors in neutrino oscillation studies. Lattice QCD calculations can help control theory errors by providing first-principles information on nucleon form factors. In these proceedings, we present preliminary results on a blinded calculation of $g_A$ and the axial form factor using HISQ staggered baryons with 2+1+1 flavors of sea quarks. Calculations are done using physical light quark masses and are absolutely normalized. We discuss fitting form factor data with the model-independent $z$ expansion parametrization.

  4. Endoscopic management of bleeding peptic ulcers

    International Nuclear Information System (INIS)

    Farooqi, J.I.; Farooqi, R.J.

    2001-01-01

    Peptic ulcers account for more than half of the cases of non variceal upper gastrointestinal (GI) bleeding and therefore, are the focus of most of the methods of endoscopic hemostasis. Surgical intervention is now largely reserved for patients in whom endoscopic hemostasis has failed. A variety of endoscopic techniques have been employed to stop bleeding and reduce the risk of rebleeding, with no major differences in outcome between these methods. These include injection therapy, fibrin injection, heater probe, mono polar electrocautery, bipolar electrocautery, lasers and mechanical hemo clipping. The most important factor in determining outcome after gastrointestinal bleeding is rebleeding or persistent bleeding. The endoscopic appearance of an ulcer, however, provides the most useful prognostic information for bleeding. Recurrent bleeding after initial endoscopic hemostasis occurs in 15-20% of patients with a bleeding peptic ulcer. The best approach to these patients remains controversial; the current options are repeat endoscopic therapy with the same or a different technique, emergency surgery or semi elective surgery after repeat endoscopic hemostasis. The combination of epinephrine injection with thermal coagulation may be more effective than epinephrine injection alone. Newer modalities such as fibrin injection or the application of hemo clips appear promising and comparative studies are awaited. (author)

  5. THROMBIN GENERATION AND BLEEDING IN HEMOPHILIA A

    Science.gov (United States)

    Brummel-Ziedins, Kathleen E.; Whelihan, Matthew F.; Gissel, Matthew; Mann, Kenneth G.; Rivard, Georges E.

    2012-01-01

    Introduction Hemophilia A displays phenotypic heterogeneity with respect to clinical severity. Aim To determine if tissue factor (TF)-initiated thrombin generation profiles in whole blood in the presence of corn trypsin inhibitor (CTI) are predictive of bleeding risk in hemophilia A. Methods We studied factor(F) VIII deficient individuals (11 mild, 4 moderate and 12 severe) with a well-characterized five-year bleeding history that included hemarthrosis, soft tissue hematoma and annual FVIII concentrate usage. This clinical information was used to generate a bleeding score. The bleeding scores (range 0–32) were separated into three groups (bleeding score groupings: 0, 0 and ≤9.6, >9.6), with the higher bleeding tendency having a higher score. Whole blood collected by phlebotomy and contact pathway suppressed by 100μg/mL CTI was stimulated to react by the addition of 5pM TF. Reactions were quenched at 20min by inhibitors. Thrombin generation, determined by ELISA for thrombin – antithrombin was evaluated in terms of clot time (CT), maximum level (MaxL) and maximum rate (MaxR) and compared to the bleeding score. Results Data are shown as the mean±SD. MaxL was significantly different (phemophilia A. PMID:19563500

  6. Causes of lower gastrointestinal bleeding on colonoscopy

    International Nuclear Information System (INIS)

    Rehman, A.U.; Gul, R.; Khursheed, L.; Hadayat, R.

    2017-01-01

    Background: Bleeding from anus is usually referred as rectal bleeding but actually rectal bleeding is defined as bleeding from lower colon or rectum, which means bleeding from a place distal to ligament of Treitz. This study was conducted to determine the frequency of different causes of rectal bleeding in patients at Ayub Teaching Hospital, Abbottabad. Methods: One hundred and seventy-five patients with evidence of rectal bleed, without gender discrimination were selected by non-probability convenient sampling from the out-patient department and general medical wards. Patients with suspected upper GI source of bleeding; acute infectious bloody diarrhoea and any coagulopathy were excluded from the study. All patients were subjected to fibre optic colonoscopy after preparation of the gut and findings were recorded. Where necessary, biopsy samples were also taken. Diagnosis was based on colonoscopic findings. Results: A total of 175 patients (92 males and 83 females) with mean age 35.81±9.18 years were part of the study. Colonoscopy showed abnormal findings in 150 (85.7%) patients. The commonest diagnosis was haemorrhoids, which was found in 39 (22.3%) patients. It was followed by inflammatory bowel disease (IBD) in 30 (17.1%) patients, solitary rectal ulcer in 13 (7.4%) patients and polyps in 25 (14.3%) patients. Other less frequent findings were non-specific inflammation and fungating growths in rectum. Conclusion: Haemorrhoids was the leading cause of bleeding per rectum in this study, followed by evidence of IBD while infrequent findings of polyps and diverticuli indicate that these are uncommon in this region. (author)

  7. Cas9-catalyzed DNA Cleavage Generates Staggered Ends: Evidence from Molecular Dynamics Simulations

    Science.gov (United States)

    Zuo, Zhicheng; Liu, Jin

    2016-11-01

    The CRISPR-associated endonuclease Cas9 from Streptococcus pyogenes (spCas9) along with a single guide RNA (sgRNA) has emerged as a versatile toolbox for genome editing. Despite recent advances in the mechanism studies on spCas9-sgRNA-mediated double-stranded DNA (dsDNA) recognition and cleavage, it is still unclear how the catalytic Mg2+ ions induce the conformation changes toward the catalytic active state. It also remains controversial whether Cas9 generates blunt-ended or staggered-ended breaks with overhangs in the DNA. To investigate these issues, here we performed the first all-atom molecular dynamics simulations of the spCas9-sgRNA-dsDNA system with and without Mg2+ bound. The simulation results showed that binding of two Mg2+ ions at the RuvC domain active site could lead to structurally and energetically favorable coordination ready for the non-target DNA strand cleavage. Importantly, we demonstrated with our simulations that Cas9-catalyzed DNA cleavage produces 1-bp staggered ends rather than generally assumed blunt ends.

  8. Parametric modeling and stagger angle optimization of an axial flow fan

    International Nuclear Information System (INIS)

    Li, M X; Zhang, C H; Liu, Y; Zheng, S Y

    2013-01-01

    Axial flow fans are widely used in every field of social production. Improving their efficiency is a sustained and urgent demand of domestic industry. The optimization of stagger angle is an important method to improve fan performance. Parametric modeling and calculation process automation are realized in this paper to improve optimization efficiency. Geometric modeling and mesh division are parameterized based on GAMBIT. Parameter setting and flow field calculation are completed in the batch mode of FLUENT. A control program is developed in Visual C++ to dominate the data exchange of mentioned software. It also extracts calculation results for optimization algorithm module (provided by Matlab) to generate directive optimization control parameters, which as feedback are transferred upwards to modeling module. The center line of the blade airfoil, based on CLARK y profile, is constructed by non-constant circulation and triangle discharge method. Stagger angles of six airfoil sections are optimized, to reduce the influence of inlet shock loss as well as gas leak in blade tip clearance and hub resistance at blade root. Finally an optimal solution is obtained, which meets the total pressure requirement under given conditions and improves total pressure efficiency by about 6%

  9. Parametric modeling and stagger angle optimization of an axial flow fan

    Science.gov (United States)

    Li, M. X.; Zhang, C. H.; Liu, Y.; Y Zheng, S.

    2013-12-01

    Axial flow fans are widely used in every field of social production. Improving their efficiency is a sustained and urgent demand of domestic industry. The optimization of stagger angle is an important method to improve fan performance. Parametric modeling and calculation process automation are realized in this paper to improve optimization efficiency. Geometric modeling and mesh division are parameterized based on GAMBIT. Parameter setting and flow field calculation are completed in the batch mode of FLUENT. A control program is developed in Visual C++ to dominate the data exchange of mentioned software. It also extracts calculation results for optimization algorithm module (provided by Matlab) to generate directive optimization control parameters, which as feedback are transferred upwards to modeling module. The center line of the blade airfoil, based on CLARK y profile, is constructed by non-constant circulation and triangle discharge method. Stagger angles of six airfoil sections are optimized, to reduce the influence of inlet shock loss as well as gas leak in blade tip clearance and hub resistance at blade root. Finally an optimal solution is obtained, which meets the total pressure requirement under given conditions and improves total pressure efficiency by about 6%.

  10. Effect of wall proximity of two staggered triangular cylinders on the transport process in a channel

    Directory of Open Access Journals (Sweden)

    Mousa Farhadi

    2016-09-01

    Full Text Available A numerical investigation has been carried out to analyze the heat transfer and the flow field around two isothermal triangular cylinders of equal size placed staggered in a horizontal plane channel with adiabatic walls. Computations have been carried out for Reynolds numbers (based on triangle width 100, 250, and 350, lateral gap ratios (d/B 0, 0.5, and 1, and longitudinal gap ratios (S/B 1, 2, 3 and 4. The effect of longitudinal and lateral gap between obstacles and proximity of channel walls is investigated. Results show that when obstacles are placed in close vicinity of the channel's wall (d/B = 1, vortex shedding disappears at the downstream of triangles at Re = 100 and 250 at all S/B, but for Re = 350 creating and disappearing of the vortex shedding depend on the longitudinal gap ratio (S/B. Proximity of obstacles has more effect on the second triangle than the first triangle especially from longitudinal gap ratio equals 2, so that with approaching the channel wall, the Nusselt number for the first triangle decreases, while for the second triangle a different behavior is seen. Staggered arrangement causes the Nusselt number of the second triangle to become greater than the first triangle.

  11. Experimental study of thermal–hydraulic performance of cam-shaped tube bundle with staggered arrangement

    International Nuclear Information System (INIS)

    Bayat, Hamidreza; Lavasani, Arash Mirabdolah; Maarefdoost, Taher

    2014-01-01

    Highlights: • Thermal–hydraulic performance of a non-circular tube bundle has been investigated experimentally. • Tubes were mounted in staggered arrangement with two longitudinal pitch ratios 1.5 and 2. • Drag coefficient and Nusselt number of tubes in second row was measured. • Friction factor of this tube bundle is lower than circular tube bundle. • Thermal–hydraulic performance of this tube bundle is greater than circular tube bundle. - Abstract: Flow and heat transfer from cam-shaped tube bank in staggered arrangement is studied experimentally. Tubes were located in test section of an open loop wind tunnel with two longitudinal pitch ratios 1.5 and 2. Reynolds number varies in range of 27,000 ⩽ Re D ⩽ 42,500 and tubes surface temperature is between 78 and 85 °C. Results show that both drag coefficient and Nusselt number depends on position of tube in tube bank and Reynolds number. Tubes in the first column have maximum value of drag coefficient, while its Nusselt number is minimum compared to other tubes in tube bank. Moreover, pressure drop from this tube bank is about 92–93% lower than circular tube bank and as a result thermal–hydraulic performance of this tube bank is about 6 times greater than circular tube bank

  12. Compressor bleed cooling fluid feed system

    Science.gov (United States)

    Donahoo, Eric E; Ross, Christopher W

    2014-11-25

    A compressor bleed cooling fluid feed system for a turbine engine for directing cooling fluids from a compressor to a turbine airfoil cooling system to supply cooling fluids to one or more airfoils of a rotor assembly is disclosed. The compressor bleed cooling fluid feed system may enable cooling fluids to be exhausted from a compressor exhaust plenum through a downstream compressor bleed collection chamber and into the turbine airfoil cooling system. As such, the suction created in the compressor exhaust plenum mitigates boundary layer growth along the inner surface while providing flow of cooling fluids to the turbine airfoils.

  13. HTLV-1 Tax-mediated TAK1 activation involves TAB2 adapter protein

    International Nuclear Information System (INIS)

    Yu Qingsheng; Minoda, Yasumasa; Yoshida, Ryoko; Yoshida, Hideyuki; Iha, Hidekatsu; Kobayashi, Takashi; Yoshimura, Akihiko; Takaesu, Giichi

    2008-01-01

    Human T cell leukemia virus type 1 (HTLV-1) Tax is an oncoprotein that plays a crucial role in the proliferation and transformation of HTLV-1-infected T lymphocytes. It has recently been reported that Tax activates a MAPKKK family, TAK1. However, the molecular mechanism of Tax-mediated TAK1 activation is not well understood. In this report, we investigated the role of TAK1-binding protein 2 (TAB2) in Tax-mediated TAK1 activation. We found that TAB2 physically interacts with Tax and augments Tax-induced NF-κB activity. Tax and TAB2 cooperatively activate TAK1 when they are coexpressed. Furthermore, TAK1 activation by Tax requires TAB2 binding as well as ubiquitination of Tax. We also found that the overexpression of TRAF2, 5, or 6 strongly induces Tax ubiquitination. These results suggest that TAB2 may be critically involved in Tax-mediated activation of TAK1 and that NF-κB-activating TRAF family proteins are potential cellular E3 ubiquitin ligases toward Tax

  14. Analysis of the influence of the interlayer staggered zone in the basalt of Jinsha River Basin on the main buildings

    Science.gov (United States)

    Guo, Qiaona; Huang, Jiangwei

    2018-02-01

    In this paper, the finite element software FEFLOW is used to simulate the seepage field of the interlayer staggered zone C2 in the basalt of Jinsha River Basin. The influence of the interlayer staggered zone C2 on the building is analyzed. Combined with the waterproof effect of current design scheme of anti-seepage curtain, the seepage field in the interlayer staggered zone C2 is discussed under different design schemes. The optimal design scheme of anti-seepage curtain is put forward. The results showed that the case four can effectively reduce the head and hydraulic gradient of underground powerhouse area, and improve the groundwater seepage field in the plant area.

  15. Energy Stability Analysis of Some Fully Discrete Numerical Schemes for Incompressible Navier–Stokes Equations on Staggered Grids

    KAUST Repository

    Chen, Huangxin

    2017-09-01

    In this paper we consider the energy stability estimates for some fully discrete schemes which both consider time and spatial discretizations for the incompressible Navier–Stokes equations. We focus on three kinds of fully discrete schemes, i.e., the linear implicit scheme for time discretization with the finite difference method (FDM) on staggered grids for spatial discretization, pressure-correction schemes for time discretization with the FDM on staggered grids for the solutions of the decoupled velocity and pressure equations, and pressure-stabilization schemes for time discretization with the FDM on staggered grids for the solutions of the decoupled velocity and pressure equations. The energy stability estimates are obtained for the above each fully discrete scheme. The upwind scheme is used in the discretization of the convection term which plays an important role in the design of unconditionally stable discrete schemes. Numerical results are given to verify the theoretical analysis.

  16. AL Amyloidosis Complicated by Persistent Oral Bleeding

    Directory of Open Access Journals (Sweden)

    Luiz Antonio Liarte Marconcini

    2015-01-01

    Full Text Available A case of amyloid light chain (AL amyloidosis is presented here with uncontrolled bleeding after a nonsurgical dental procedure, most likely multifactorial in nature, and consequently treated with a multidisciplinary approach.

  17. Gastrointestinal Bleeding: MedlinePlus Health Topic

    Science.gov (United States)

    ... peptic ulcers , tears or inflammation in the esophagus, diverticulosis and diverticulitis , ulcerative colitis and Crohn's disease , colonic ... PubMed (National Library of Medicine) Article: Small intestinal diverticulum with bleeding: Case report and literature review. Article: ...

  18. Fibrinogen concentrate for bleeding - a systematic review

    DEFF Research Database (Denmark)

    Lunde, J; Stensballe, J; Wikkelsø, A

    2014-01-01

    included a control group. Three out of 11 found a reduction in transfusion requirements while mortality was reduced in two and bleeding in one. In the available RCTs, which all have substantial shortcomings, we found a significant reduction in bleeding and transfusions requirements. However, data......Fibrinogen concentrate as part of treatment protocols increasingly draws attention. Fibrinogen substitution in cases of hypofibrinogenaemia has the potential to reduce bleeding, transfusion requirement and subsequently reduce morbidity and mortality. A systematic search for randomised controlled...... determined to be of high risk of bias and none reported a significant effect on mortality. Two RCTs found a significant reduction in bleeding and five RCTs found a significant reduction in transfusion requirements. The 23 non-randomised studies included a total of 2825 patients, but only 11 of 23 studies...

  19. CLSM bleed water reduction test results

    International Nuclear Information System (INIS)

    Langton, C.A.; Rajendran, N.

    1997-01-01

    Previous testing by BSRI/SRTC/Raytheon indicated that the CLSM specified for the Tank 20 closure generates about 6 gallons (23 liters) of bleed water per cubic yard of material (0.76 m3).1 This amount to about 10 percent of the total mixing water. HLWE requested that the CLSM mix be optimized to reduce bleed water while maintaining flow. Elimination of bleed water from the CLSM mix specified for High-Level Waste Tank Closure will result in waste minimization, time savings and cost savings. Over thirty mixes were formulated and evaluated at the on-site Raytheon Test Laboratory. Improved low bleed water CLSM mixes were identified. Results are documented in this report

  20. ISA-TAB-Nano: A Specification for Sharing Nanomaterial Research Data in Spreadsheet-based Format

    Science.gov (United States)

    2013-01-01

    Background and motivation The high-throughput genomics communities have been successfully using standardized spreadsheet-based formats to capture and share data within labs and among public repositories. The nanomedicine community has yet to adopt similar standards to share the diverse and multi-dimensional types of data (including metadata) pertaining to the description and characterization of nanomaterials. Owing to the lack of standardization in representing and sharing nanomaterial data, most of the data currently shared via publications and data resources are incomplete, poorly-integrated, and not suitable for meaningful interpretation and re-use of the data. Specifically, in its current state, data cannot be effectively utilized for the development of predictive models that will inform the rational design of nanomaterials. Results We have developed a specification called ISA-TAB-Nano, which comprises four spreadsheet-based file formats for representing and integrating various types of nanomaterial data. Three file formats (Investigation, Study, and Assay files) have been adapted from the established ISA-TAB specification; while the Material file format was developed de novo to more readily describe the complexity of nanomaterials and associated small molecules. In this paper, we have discussed the main features of each file format and how to use them for sharing nanomaterial descriptions and assay metadata. Conclusion The ISA-TAB-Nano file formats provide a general and flexible framework to record and integrate nanomaterial descriptions, assay data (metadata and endpoint measurements) and protocol information. Like ISA-TAB, ISA-TAB-Nano supports the use of ontology terms to promote standardized descriptions and to facilitate search and integration of the data. The ISA-TAB-Nano specification has been submitted as an ASTM work item to obtain community feedback and to provide a nanotechnology data-sharing standard for public development and adoption. PMID

  1. Management of patients with ulcer bleeding.

    Science.gov (United States)

    Laine, Loren; Jensen, Dennis M

    2012-03-01

    This guideline presents recommendations for the step-wise management of patients with overt upper gastrointestinal bleeding. Hemodynamic status is first assessed, and resuscitation initiated as needed. Patients are risk-stratified based on features such as hemodynamic status, comorbidities, age, and laboratory tests. Pre-endoscopic erythromycin is considered to increase diagnostic yield at first endoscopy. Pre-endoscopic proton pump inhibitor (PPI) may be considered to decrease the need for endoscopic therapy but does not improve clinical outcomes. Upper endoscopy is generally performed within 24h. The endoscopic features of ulcers direct further management. Patients with active bleeding or non-bleeding visible vessels receive endoscopic therapy (e.g., bipolar electrocoagulation, heater probe, sclerosant, clips) and those with an adherent clot may receive endoscopic therapy; these patients then receive intravenous PPI with a bolus followed by continuous infusion. Patients with flat spots or clean-based ulcers do not require endoscopic therapy or intensive PPI therapy. Recurrent bleeding after endoscopic therapy is treated with a second endoscopic treatment; if bleeding persists or recurs, treatment with surgery or interventional radiology is undertaken. Prevention of recurrent bleeding is based on the etiology of the bleeding ulcer. H. pylori is eradicated and after cure is documented anti-ulcer therapy is generally not given. Nonsteroidal anti-inflammatory drugs (NSAIDs) are stopped; if they must be resumed low-dose COX-2-selective NSAID plus PPI is used. Patients with established cardiovascular disease who require aspirin should start PPI and generally re-institute aspirin soon after bleeding ceases (within 7 days and ideally 1-3 days). Patients with idiopathic ulcers receive long-term anti-ulcer therapy.

  2. Engine bleed air reduction in DC-10

    Science.gov (United States)

    Newman, W. H.; Viele, M. R.

    1980-01-01

    An 0.8 percent fuel savings was achieved by a reduction in engine bleed air through the use of cabin air recirculation. The recirculation system was evaluated in revenue service on a DC-10. The cabin remained comfortable with reductions in cabin fresh air (engine bleed air) as much as 50 percent. Flight test verified the predicted fuel saving of 0.8 percent.

  3. Helping mothers survive bleeding after birth

    DEFF Research Database (Denmark)

    Nelissen, Ellen; Ersdal, Hege; Ostergaard, Doris

    2014-01-01

    OBJECTIVE: To evaluate "Helping Mothers Survive Bleeding After Birth" (HMS BAB) simulation-based training in a low-resource setting. DESIGN: Educational intervention study. SETTING: Rural referral hospital in Northern Tanzania. POPULATION: Clinicians, nurse-midwives, medical attendants, and ambul......OBJECTIVE: To evaluate "Helping Mothers Survive Bleeding After Birth" (HMS BAB) simulation-based training in a low-resource setting. DESIGN: Educational intervention study. SETTING: Rural referral hospital in Northern Tanzania. POPULATION: Clinicians, nurse-midwives, medical attendants...

  4. High‐order rotated staggered finite difference modeling of 3D elastic wave propagation in general anisotropic media

    KAUST Repository

    Chu, Chunlei

    2009-01-01

    We analyze the dispersion properties and stability conditions of the high‐order convolutional finite difference operators and compare them with the conventional finite difference schemes. We observe that the convolutional finite difference method has better dispersion properties and becomes more efficient than the conventional finite difference method with the increasing order of accuracy. This makes the high‐order convolutional operator a good choice for anisotropic elastic wave simulations on rotated staggered grids since its enhanced dispersion properties can help to suppress the numerical dispersion error that is inherent in the rotated staggered grid structure and its efficiency can help us tackle 3D problems cost‐effectively.

  5. Intervención para la deshabituación tabáquica

    OpenAIRE

    López Mantilla, Alexandra

    2014-01-01

    RESUMEN: INTRODUCCIÓN: El tabaquismo es una adicción crónica que produce gran dependencia. El mayor componente implicado en ello es la nicotina. El hábito tabáquico tiene muchas repercusiones sobre el sistema respiratorio, pero también afecta al resto del organismo. El 70% de los fumadores quieren dejar de serlo, pero solo el 70% lo consigue, debido al síndrome de abstinencia que se produce tras el abandono del hábito tabáquico. Son varias las estrategias que se han intentado utilizar para ay...

  6. Validation of a numerical model of acoustic ceiling combined with TABS

    DEFF Research Database (Denmark)

    Rage, Nils; Kazanci, Ongun Berk; Olesen, Bjarne W.

    2016-01-01

    in the heat flow from TABS; the difference between the numerical results and measurements is in the range of -6.9% to +5.2%. The second evaluates the impact on TABS cooling capacity coefficient and room temperatures. The simulated cases led to absolute differences +4.3% higher in average for the cooling...... Elements) developed to simulate partially covered suspended ceilings such as hanging sound absorbers. The tool is validated by numerically modelling a set of similar experiments carried out in full-scale by a previous study. For this, a total of 12 scenarios from two case studies have been modelled...

  7. Transcatheter emboilization therapy of massive colonic bleeding

    International Nuclear Information System (INIS)

    Shin, G. H.; Oh, J. H.; Yoon, Y.

    1996-01-01

    To evaulate the efficacy and safety of emergent superselective transcatheter embolization for controlling massive colonic bleeding. Six of the seven patients who had symptom of massive gastrointestinal bleeding underwent emergent transcatheter embolization for control of the bleeding. Gastrointestinal bleeding in these patients was originated from various colonic diseases: rectal cancer(n=1), proctitis(n=1), benign ulcer(n=1), mucosal injury by ventriculoperitoneal shunt(n=1), and unknown(n=2). All patients except one with rectal cancer were critically ill. Superselective embolization were done by using Gelfoam particles and/or coils. The vessels embolized were ileocolic artery(n=1). superior rectal artery(n=2), inferior rectal artery (n=1), and middle and inferior rectal arteries(n=1). Hemostasis was successful immediately in all patients. Two underwnet surgery due to recurrent bleeding developed 3 days after the procedure(n=1) or in associalion with underlying rectal cancer(n=1). On surgical specimen of two cases, there was no mucosal ischemic change. Transcatheter embolization is a safe and effective treatment of method for the control of massive colonic bleeding

  8. [Hysteroscopic polypectomy, treatment of abnormal uterine bleeding].

    Science.gov (United States)

    de Los Rios, P José F; López, R Claudia; Cifuentes, P Carolina; Angulo, C Mónica; Palacios-Barahona, Arlex U

    2015-07-01

    To evaluate the effectiveness of the hysteroscopic polypectomy in terms of the decrease of the abnormal uterine bleeding. A cross-sectional and analytical study was done with patients to whom a hysteroscopic polypectomy was done for treating the abnormal uterine bleeding, between January 2009 and December 2013. The response to the treatment was evaluated via a survey given to the patients about the behavior of the abnormal uterine bleeding after the procedure and about overall satisfaction. The results were obtained after a hysteroscopic polypectomy done to 128 patients and were as follows. The average time from the polypectomy applied until the survey was 30.5 months, with a standard deviation of 18 months. 67.2% of the patients reported decreased abnormal uterine bleeding and the 32.8% reported a persistence of symptoms. On average 82.8% of the. patients were satisfied with the treatment. Bivariate and multivariate analysis showed no association between the variables studied and no improvement of abnormal uterine bleeding after surgery (polypectomy). There were no complications. Hysteroscopic polypectomy is a safe surgical treatment, which decreases on two of three patients the abnormal uterine bleeding in the presence of endometrial polyps, with an acceptable level of satisfaction.

  9. Bleeding and starving: fasting and delayed refeeding after upper gastrointestinal bleeding.

    Science.gov (United States)

    Fonseca, Jorge; Meira, Tânia; Nunes, Ana; Santos, Carla Adriana

    2014-01-01

    Early refeeding after nonvariceal upper gastrointestinal bleeding is safe and reduces hospital stay/costs. The aim of this study was obtaining objective data on refeeding after nonvariceal upper gastrointestinal bleeding. From 1 year span records of nonvariceal upper gastrointestinal bleeding patients that underwent urgent endoscopy: clinical features; rockall score; endoscopic data, including severity of lesions and therapy; feeding related records of seven days: liquid diet prescription, first liquid intake, soft/solid diet prescription, first soft/solid intake. From 133 patients (84 men) Rockall classification was possible in 126: 76 score ≥5, 50 score gastrointestinal bleeding patients must be refed earlier, according to guidelines.

  10. Antifibrinolytics for heavy menstrual bleeding.

    Science.gov (United States)

    Bryant-Smith, Alison C; Lethaby, Anne; Farquhar, Cindy; Hickey, Martha

    2018-04-15

    Heavy menstrual bleeding (HMB) is an important physical and social problem for women. Oral treatment for HMB includes antifibrinolytic drugs, which are designed to reduce bleeding by inhibiting clot-dissolving enzymes in the endometrium.Historically, there has been some concern that using the antifibrinolytic tranexamic acid (TXA) for HMB may increase the risk of venous thromboembolic disease. This is an umbrella term for deep venous thrombosis (blood clots in the blood vessels in the legs) and pulmonary emboli (blood clots in the blood vessels in the lungs). To determine the effectiveness and safety of antifibrinolytic medications as a treatment for heavy menstrual bleeding. We searched the Cochrane Gynaecology and Fertility (CGF) Group trials register, CENTRAL, MEDLINE, Embase, PsycINFO and two trials registers in November 2017, together with reference checking and contact with study authors and experts in the field. We included randomized controlled trials (RCTs) comparing antifibrinolytic agents versus placebo, no treatment or other medical treatment in women of reproductive age with HMB. Twelve studies utilised TXA and one utilised a prodrug of TXA (Kabi). We used standard methodological procedures expected by Cochrane. The primary review outcomes were menstrual blood loss (MBL), improvement in HMB, and thromboembolic events. We included 13 RCTs (1312 participants analysed). The evidence was very low to moderate quality: the main limitations were risk of bias (associated with lack of blinding, and poor reporting of study methods), imprecision and inconsistency.Antifibrinolytics (TXA or Kabi) versus no treatment or placeboWhen compared with a placebo, antifibrinolytics were associated with reduced mean blood loss (MD -53.20 mL per cycle, 95% CI -62.70 to -43.70; I² = 8%; 4 RCTs, participants = 565; moderate-quality evidence) and higher rates of improvement (RR 3.34, 95% CI 1.84 to 6.09; 3 RCTS, participants = 271; moderate-quality evidence). This suggests that

  11. Hábitos tabágicos em alunos do 6.º ano de Medicina e medidas anti-tabágicas

    Directory of Open Access Journals (Sweden)

    André Borges

    2008-05-01

    Full Text Available Resumo: Objectivos: Estudar os hábitos tabágicos, caracterizar o conhecimento, aceitação de medidas anti-tabágicas e as expectativas em relação ao impacto destas na saúde pública em alunos do 6.º ano de Medicina, em Portugal.Material e métodos: Foi realizado um estudo descritivo transversal, cuja população alvo foram os alunos de Medicina do sexto ano, em Portugal. Foi utilizado um questionário auto-preenchido, anónimo, dispo-nibilizado numa página online, que divulgámos por correio electrónico. Para a análise de algumas variá-veis utilizamos tabelas de contingência e a prova do χ2, com nível de significância de 0,05.Resultados: Obtivemos 255 questionários válidos. A taxa de fumadores foi de 18,04%. O consumo de cigarros mais frequente foi entre 1-10 cigarros, sendo mais elevado entre os homens. A idade de início da maioria foi entre 13-18 anos, com as mulheres a co-meçarem mais tarde. Dos fumadores, 36,96% já fize-ram uma tentativa de cessação tabágica. A maioria dos inquiridos concorda com as medidas anti-tabágicas inquiridas e considera que irão diminuir o consumo e a morbimortalidade da população em geral. A formação sobre cessação tabágica foi considerada suficiente por 34,90%.Conclusões: Os resultados obtidos estão de acordo com as características da população em geral, nomea-damente quanto à prevalência de fumadores, idade de início do consumo de tabaco e elevada prevalência de mulheres fumadoras. As medidas anti-tabágicas parecem reunir consenso, segundo a nossa amostra, que também espera uma redução do consumo geral e individual, assim como da morbimortalidade.Rev Port Pneumol 2008; XIV (3: 379-390 Abstract: Objectives: To study the smoking habits of 6th year Portuguese medical students and assess their knowledge and acceptance of anti-smoking measures and how they felt these

  12. Hábitos tabágicos em alunos do 6.º ano de Medicina e medidas anti-tabágicas

    Directory of Open Access Journals (Sweden)

    André Borges

    2008-03-01

    Full Text Available Resumo: Objectivos: Estudar os hábitos tabágicos, caracterizar o conhecimento, a aceitação de medidas anti-tabágicas e as expectativas em relação ao impacto destas na saúde pública em alunos do 6.º ano de Medicina, em Portugal.Material e métodos: Foi realizado um estudo descritivo transversal, cuja população-alvo foram os alunos de Medicina do sexto ano em Portugal. Foi utilizado um questionário auto-preenchido, anónimo, disponibilizado numa página online, que divulgámos por correio electrónico. Para a análise de algumas variáveis, utilizámos tabelas de contingência e a prova do χ2, com nível de significância de 0,05.Resultados: Obtivemos 255 questionários válidos. A taxa de fumadores foi de 18,04%. O consumo de cigarros mais frequente foi entre 1-10, sendo mais elevado entre os homens. A idade de início da maioria foi entre 13-18 anos, com as mulheres a começarem mais tarde. Dos fumadores, 36,96% já fizeram uma tentativa de cessação tabágica. A maioria dos inquiridos concorda com as medidas anti-tabágicas inquiridas e considera que irão diminuir o consumo e a morbimortalidade da população em geral. A formação sobre cessação tabágica foi considerada suficiente por 34,90%.Conclusões: Os resultados obtidos estão de acordo com as características da população em geral, nomeadamente quanto à prevalência de fumadores, idade de início do consumo de tabaco e elevada prevalência de mulheres fumadoras. As medidas anti-tabágicas parecem reunir consenso, segundo a nossa amostra, que também espera uma redução do consumo geral e individual, assim como da morbimortalidade.Rev Port Pneumol 2007; XIV (2: 219-230 Abstract: Objectives: To study the smoking habits of 6th year Portuguese medical students and assess their knowledge and acceptance of anti-smoking measures and how they felt these would

  13. Shade distribution of commercial resin composites and color difference with shade guide tabs.

    Science.gov (United States)

    Park, Seung-Kook; Lee, Yong-Keun

    2007-10-01

    To determine the shade distribution of varied shades of contemporary resin composites, and to measure the color difference (deltaE*ab) between individual shades of resin composites and the nearest shade tabs, which showed the smallest color difference with each shade of resin composite, in the VITA shade guide. Eight light-curing resin composites, with a total of 41 shades, were studied. Color of specimens was measured on a reflection spectrophotometer over a white background. Ranges and distributions of CIE L*, C*ab, a* and b* values of each brand of resin composites were determined. Color difference between each shade of resin composites and each shade of the shade guide tabs were calculated, and the nearest shade guide tab was selected. The range of CIE L* value for eight brands of resin composites was 3.2-9.0, that of C*ab was 2.5-11.6, that of CIE a* value was 1.1-5.8, and that of CIE b* value was 5.9-11.5. Color differences (deltaE*ab) between each shade of resin composites and the nearest shade tab of the shade guide was 0.9-12.8.

  14. Muuga söeterminal töötab lubadeta / Urmas Tooming

    Index Scriptorium Estoniae

    Tooming, Urmas

    2005-01-01

    Kuigi keskkonnainspektsioon karistas Muuga söeterminalis tegutsevat AS-i Coal Terminal Operator välisõhu kaitse ja veeseaduse rikkumise eest kokku 33 000 krooni suuruse trahviga ja kohustas firmat lõpetama saasteainete keskkonda paiskamise, töötab kasutus- ja keskkonnalubadeta ettevõte edasi

  15. Towards corrections to the strong coupling limit of staggered lattice QCD

    CERN Document Server

    Fromm, Michael; Philipsen, Owe; de Forcrand, Philippe; Unger, Wolfgang; Miura, Kotaroh

    2011-01-01

    We report on the first steps of an ongoing project to add gauge observables and gauge corrections to the well-studied strong coupling limit of staggered lattice QCD, which has been shown earlier to be amenable to numerical simulations by the worm algorithm in the chiral limit and at finite density. Here we show how to evaluate the expectation value of the Polyakov loop in the framework of the strong coupling limit at finite temperature, allowing to study confinement properties along with those of chiral symmetry breaking. We find the Polyakov loop to rise smoothly, thus signalling deconfinement. The non-analytic nature of the chiral phase transition is reflected in the derivative of the Polyakov loop. We also discuss how to construct an effective theory for non-zero lattice coupling, which is valid to $O(\\beta)$.

  16. Field theory of a terahertz staggered double-grating arrays waveguide Cerenkov traveling wave amplifier

    Energy Technology Data Exchange (ETDEWEB)

    Xie, Wenqiu; He, Fangming [Institute of Electronics, Chinese Academy of Sciences, Beijing 100190 (China); University of Chinese Academy of Sciences, Beijing 100049 (China); Wang, Zicheng; Luo, Jirun; Zhao, Ding; Liu, Qinglun [Institute of Electronics, Chinese Academy of Sciences, Beijing 100190 (China)

    2014-04-15

    Based on a rectilinear sheet electron beam propagating through the tunnel of a staggered double-grating arrays waveguide (SDGAW) slow-wave structure (SWS), a three dimensional field theory for describing the modes and the beam-wave interaction is presented, in which the higher order terms inside the grooves are retained. The fields' distribution and the conductivity losses are also calculated utilizing the theoretical model. With the optimized parameters of the SWS and the electron beam, a 1 THz SDGAW Cerenkov traveling wave amplifier may obtain a moderate net gain (the peak gain is 12.7 dB/cm) and an ultra 3 dB wideband (0.19 THz) considering the serious Ohmic losses. The theoretical results have been compared with those calculated by 3D HFSS code and CST STUDIO particle-in-cell simulations.

  17. N{sub f}=1 QCD in external magnetic fields: staggered fermions

    Energy Technology Data Exchange (ETDEWEB)

    Cea, Paolo [INFN, Sezione di Bari, Via Amendola 173, I-70126 Bari (Italy); Dipartimento di Fisica dell’Università di Bari, Via Amendola 173, I-70126 Bari (Italy); Cosmai, Leonardo [INFN, Sezione di Bari, Via Amendola 173, I-70126 Bari (Italy)

    2015-12-10

    We investigate N{sub f}=1 QCD in external magnetic fields on the lattice. The background field is introduced by means of the so-called Schrödinger functional. We adopt standard staggered fermions with constant bare mass am=0.025 and magnetic fields with constant magnetic flux up to a{sup 2}eH≃2.3562. We find that the the deconfinement and chiral symmetry restoration temperatures do not depend on the strength of the applied magnetic field. Our method allow us to easily study the effects of the external magnetic fields on the QCD thermodynamics. We determine the influences of applied magnetic fields to the free energy, pressure, and equation of state of strongly interacting matter.

  18. Efficient gas-liquid contact using microfluidic membrane devices with staggered herringbone mixers.

    Science.gov (United States)

    Femmer, Tim; Eggersdorfer, Max L; Kuehne, Alexander J C; Wessling, Matthias

    2015-08-07

    We describe a novel membrane based gas-liquid-contacting device with increased mass transport and reduced pressure loss by combining a membrane with a staggered herringbone static mixer. Herringbone structures are imposed on the microfluidic channel geometry via soft lithography, acting as mixers which introduce secondary flows at the membrane interface. Such flows include Dean vortices and Taylor flows generating effective mixing while improving mass transport and preventing concentration polarization in microfluidic channels. Furthermore, our static herringbone mixer membranes effectively reduce pressure losses leading to devices with enhanced transfer properties for microfluidic gas-liquid contact. We investigate the red blood cell distribution to tailor our devices towards miniaturised extracorporeal membrane oxygenation and improved comfort of patients with lung insufficiencies.

  19. Constitutive Modelling in Thermomechanical Processes, Using The Control Volume Method on Staggered Grid

    DEFF Research Database (Denmark)

    Thorborg, Jesper

    -strain relation has been suggested. The intention of this method is to provide fast numerical results with reasonable accuracy in relation to the first order effects of the presented classical plasticity model. Application of the $J_2$ flow theory and the alternative method have shown some agreement...... of the method has been focused on high temperature processes such as casting and welding and the interest of using nonlinear constitutive stress-strain relations has grown to extend the applicability of the method. The work of implementing classical plasticity into the control volume formulation has been based...... on the $J_2$ flow theory describing an isotropic hardening material with a temperature dependent yield stress. This work has successfully been verified by comparing results to analytical solutions. Due to the comprehensive implementation in the staggered grid an alternative constitutive stress...

  20. An arbitrary-order staggered time integrator for the linear acoustic wave equation

    Science.gov (United States)

    Lee, Jaejoon; Park, Hyunseo; Park, Yoonseo; Shin, Changsoo

    2018-02-01

    We suggest a staggered time integrator whose order of accuracy can arbitrarily be extended to solve the linear acoustic wave equation. A strategy to select the appropriate order of accuracy is also proposed based on the error analysis that quantitatively predicts the truncation error of the numerical solution. This strategy not only reduces the computational cost several times, but also allows us to flexibly set the modelling parameters such as the time step length, grid interval and P-wave speed. It is demonstrated that the proposed method can almost eliminate temporal dispersive errors during long term simulations regardless of the heterogeneity of the media and time step lengths. The method can also be successfully applied to the source problem with an absorbing boundary condition, which is frequently encountered in the practical usage for the imaging algorithms or the inverse problems.

  1. Staggered-Grid Finite Difference Method with Variable-Order Accuracy for Porous Media

    Directory of Open Access Journals (Sweden)

    Jinghuai Gao

    2013-01-01

    Full Text Available The numerical modeling of wave field in porous media generally requires more computation time than that of acoustic or elastic media. Usually used finite difference methods adopt finite difference operators with fixed-order accuracy to calculate space derivatives for a heterogeneous medium. A finite difference scheme with variable-order accuracy for acoustic wave equation has been proposed to reduce the computation time. In this paper, we develop this scheme for wave equations in porous media based on dispersion relation with high-order staggered-grid finite difference (SFD method. High-order finite difference operators are adopted for low-velocity regions, and low-order finite difference operators are adopted for high-velocity regions. Dispersion analysis and modeling results demonstrate that the proposed SFD method can decrease computational costs without reducing accuracy.

  2. Stress analysis of three-dimensional roadway layout of stagger arrangement with field observation

    Science.gov (United States)

    Cui, Zimo; Chanda, Emmanuel; Zhao, Jingli; Wang, Zhihe

    2018-01-01

    Longwall top-coal caving (LTCC) has been a popular, more productive and cost-effective method for extracting thick (> 5 m) to ultra-thick coal seams in recent years. However, low-level recovery ratio of coal resources and top-coal loss above the supports at both ends of working face are long-term problems. Geological factors, such as large dip angle, soft rock, mining depth further complicate the problems. This paper proposes addressing this issue by adopting three-dimensional roadway layout of stagger arrangement (3-D RLSA). In this study, the first step was to analyse the stress environment surrounding head entry in the replacing working face based on the stress distribution characteristics at the triangular coal-pillar side in gob and the stress slip line field theory. In the second step, filed observation was conducted. Finally, an economic evaluation of the 3-D RLSA for extracting thick to ultra-thick seams was conducted.

  3. Surgical treatment of massive upper gastrointestinal bleeding in ...

    African Journals Online (AJOL)

    Acute upper gastrointestinal bleeding is a potentially life-threatening abdominal emergency condition. More immediately life-threatening is massive upper gastrointestinal bleeding resulting in cardiovascular compromise causing dizziness, syncope and shock. The causes of upper gastrointestinal bleeding include bleeding ...

  4. Predicting major bleeding in patients with noncardioembolic stroke on antiplatelets: S2TOP-BLEED.

    Science.gov (United States)

    Hilkens, Nina A; Algra, Ale; Diener, Hans-Christoph; Reitsma, Johannes B; Bath, Philip M; Csiba, Laszlo; Hacke, Werner; Kappelle, L Jaap; Koudstaal, Peter J; Leys, Didier; Mas, Jean-Louis; Sacco, Ralph L; Amarenco, Pierre; Sissani, Leila; Greving, Jacoba P

    2017-08-29

    To develop and externally validate a prediction model for major bleeding in patients with a TIA or ischemic stroke on antiplatelet agents. We combined individual patient data from 6 randomized clinical trials (CAPRIE, ESPS-2, MATCH, CHARISMA, ESPRIT, and PRoFESS) investigating antiplatelet therapy after TIA or ischemic stroke. Cox regression analyses stratified by trial were performed to study the association between predictors and major bleeding. A risk prediction model was derived and validated in the PERFORM trial. Performance was assessed with the c statistic and calibration plots. Major bleeding occurred in 1,530 of the 43,112 patients during 94,833 person-years of follow-up. The observed 3-year risk of major bleeding was 4.6% (95% confidence interval [CI] 4.4%-4.9%). Predictors were male sex, smoking, type of antiplatelet agents (aspirin-clopidogrel), outcome on modified Rankin Scale ≥3, prior stroke, high blood pressure, lower body mass index, elderly, Asian ethnicity, and diabetes (S 2 TOP-BLEED). The S 2 TOP-BLEED score had a c statistic of 0.63 (95% CI 0.60-0.64) and showed good calibration in the development data. Major bleeding risk ranged from 2% in patients aged 45-54 years without additional risk factors to more than 10% in patients aged 75-84 years with multiple risk factors. In external validation, the model had a c statistic of 0.61 (95% CI 0.59-0.63) and slightly underestimated major bleeding risk. The S 2 TOP-BLEED score can be used to estimate 3-year major bleeding risk in patients with a TIA or ischemic stroke who use antiplatelet agents, based on readily available characteristics. The discriminatory performance may be improved by identifying stronger predictors of major bleeding. © 2017 American Academy of Neurology.

  5. Cellular uptake of magnetite nanoparticles enhanced by NdFeB magnets in staggered arrangement

    Science.gov (United States)

    Lu, Yi-Ching; Chang, Fan-Yu; Tu, Shu-Ju; Chen, Jyh-Ping; Ma, Yunn-Hwa

    2017-04-01

    Magnetic force may greatly enhance uptake of magnetic nanoparticles (MNPs) by cultured cells; however, the effects of non-uniformity of magnetic field/ magnetic gradient on MNP internalization in culture has not been elucidated. Cellular uptake of polyacrylic acid coated-MNP by LN229 cells was measured with cylindrical NdFeB magnets arranged in a staggered pattern. The magnetic field generated by placing a magnet underneath (H-field) elicited a homogenous distribution of MNPs on the cells in culture; whereas the field without magnet underneath (L-field) resulted in MNP distribution along the edge of the wells. Cell-associated MNP (MNPcell) appeared to be magnetic field- and concentration-dependent. In H-field, MNPcell reached plateau within one hour of exposure to MNP with only one-min application of the magnetic force in the beginning of incubation; continuous presence of the magnet for 2 h did not further increase MNPcell, suggesting that magnetic force-induced uptake may be primarily contributed to enhanced MNP sedimentation. Although MNP distribution was much inhomogeneous in L-field, averaged MNPcell in the L-field may reach as high as 80% of that in H-field during 1-6 h incubation, suggesting high capacity of MNP internalization. In addition, no significant difference was observed in MNPcell analyzed by flow cytometry with the application of H-field of staggered plate vs. filled magnet plate. Therefore, biological variation may dominate MNP internalization even under relatively uniformed magnetic field; whereas non-uniformed magnetic field may serve as a model for tumor targeting with MNPs in vivo.

  6. A comparative study of Purkinje cells in two RORalpha gene mutant mice: staggerer and RORalpha(-/-).

    Science.gov (United States)

    Doulazmi, M; Frédéric, F; Capone, F; Becker-André, M; Delhaye-Bouchaud, N; Mariani, J

    2001-04-30

    The staggerer (Rora(sg/sg)) mutation is a deletion in the RORalpha gene, one member of a family of nuclear receptor genes related to the retinoic acid receptor. Recently Steinmayr et al. (Proc. Natl. Acad. Sci. USA 95 (1998) 3960) generated a RORalpha null-mutant mouse (Rora(-/-)) by using a targeting vector in which a beta-Gal gene replaces the second finger of the DNA-binding domain of RORalpha. The Rora(-/-) cerebellum is qualitatively a phenocopy of the Rora(sg/sg) one, but the two strains differ slightly in their motor skills. To address the question whether the morphological defects in the Rora(-/-) cerebellum are identical to the Rora(sg/sg) one, we compared number and size of Purkinje cells in both staggerer and RORalpha null-mutant mice, using calbindin (CaBP) immunohistochemistry and revelation of beta-Gal activity. Compared to control cerebella the Rora(sg/sg) cerebellum has 82% fewer CaBP-positive cells. In Rora(-/-) mouse, all the the beta-Gal-positive Purkinje cells also expressed CaBP, but the cerebellum contained 78% less CaBP-positive cells than control, a deficit not different from the one observed in Rora(sg/sg). We show similar mediolateral compartments in Purkinje cell number and cytological abnormality in Rora(sg/sg) and Rora(-/-) mice. These results provide quantitative support for the hypothesis that the cerebellar phenotype in the homozygous Rora(sg/sg) is due to the lack of function of the RORalpha gene.

  7. Investigation of analog/RF performance of staggered heterojunctions based nanowire tunneling field-effect transistors

    Science.gov (United States)

    Chakraborty, Avik; Sarkar, Angsuman

    2015-04-01

    In this paper, the analog/RF performance of an III-V semiconductor based staggered hetero-tunnel-junction (HETJ) n-type nanowire (NW) tunneling FET (n-TFET) is investigated, for the first time. The device performance figure-of-merits governing the analog/RF performance such as transconductance (gm), transconductance-to-drive current ratio (gm/IDS), output resistance (Rout), intrinsic gain and unity-gain cutoff frequency (fT) have been studied. The analog/RF performance parameters is compared between HETJ NW TFET and a homojunction (HJ) NW n-type TFET of similar dimensions. In addition to enhanced ION and subthreshold swing, a significant improvement in the analog/RF performance parameters obtained by the HETJ n-TFET over HJ counterpart for use in analog/mixed signal System-on-Chip (SoC) applications is reported. Moreover, the analog/RF performance parameters of a III-V based staggered HETJ NW TFET is also compared with a heterojunction (HETJ) NW n-type MOSFET having same material as HETJ n-TFET and equal dimension in order to provide a systematic comparison between HETJ-TFET and HETJ-MOSFET for use in analog/mixed-signal applications. The results reveal that HETJ n-TFET provides higher Rout and hence, a higher intrinsic gain, an improved gm/IDS ratio, and reasonable fT at lower values of gate-overdrive voltage as compared to the HETJ NW n-MOSFET.

  8. Individualized FAC on bottom tab subassemblies to minimize adhesive gap between emitter and optics

    Science.gov (United States)

    Sauer, Sebastian; Müller, Tobias; Haag, Sebastian; Beleke, Andreas; Zontar, Daniel; Baum, Christoph; Brecher, Christian

    2017-02-01

    High Power Diode Laser (HPDL) systems with short focal length fast-axis collimators (FAC) require submicron assembly precision. Conventional FAC-Lens assembly processes require adhesive gaps of 50 microns or more in order to compensate for component tolerances (e.g. deviation of back focal length) and previous assembly steps. In order to control volumetric shrinkage of fast-curing UV-adhesives shrinkage compensation is mandatory. The novel approach described in this paper aims to minimize the impact of volumetric shrinkage due to the adhesive gap between HPDL edge emitters and FAC-Lens. Firstly, the FAC is actively aligned to the edge emitter without adhesives or bottom tab. The relative position and orientation of FAC to emitter are measured and stored. Consecutively, an individual subassembly of FAC and bottom tab is assembled on Fraunhofer IPT's mounting station with a precision of +/-1 micron. Translational and lateral offsets can be compensated, so that a narrow and uniform glue gap for the consecutive bonding process of bottom tab to heatsink applies (Figure 4). Accordingly, FAC and bottom tab are mounted to the heatsink without major shrinkage compensation. Fraunhofer IPT's department assembly of optical systems and automation has made several publications regarding active alignment of FAC lenses [SPIE LASE 8241-12], volumetric shrinkage compensation [SPIE LASE 9730-28] and FAC on bottom tab assembly [SPIE LASE 9727-31] in automated production environments. The approach described in this paper combines these and is the logical continuation of that work towards higher quality of HPDLs.

  9. A Study of a Powder Coating Gun Near Field: Particle Flow in an Isothermal Staggered Concentric Air Jet

    Directory of Open Access Journals (Sweden)

    Graham Payne

    2014-07-01

    Full Text Available An experimental study of inert particle dispersion in an isothermal concentric air jet near field was conducted for cases of standard non-staggered and alternative staggered jet nozzles, each taken from a polymer powder flame deposition gun. The experimental work consisted of analysis of high speed digital images of the inert two phase isothermal jet flow, illuminated by a laser light sheet along and across the jet axis. The analysis of particle spread in the jet, represented by families of particle density distributions, clearly showed that the staggered nozzles resulted in a better-focused flow, with narrower distributions in the near field, and in the elimination of the recirculation zone that disrupted the particle flow in a non-staggered nozzle arrangement. In all cases, histograms of the cross-sectional particle area density were found to be approximately Gaussian. It was also found that there was a wide variation in the size and shape of the ground polymer particles used and these two characteristics caused a wide variation in the radial and axial velocities of the particles. Despite the differences between single-phase numerical simulations and experimental results, reported in Payne et al. [1], the introduction of particles into a numerical model produced satisfactory agreement with the particle velocities found experimentally.

  10. The sequential organ failure assessment (SOFA) score is an effective triage marker following staggered paracetamol (acetaminophen) overdose.

    Science.gov (United States)

    Craig, D G; Zafar, S; Reid, T W D J; Martin, K G; Davidson, J S; Hayes, P C; Simpson, K J

    2012-06-01

    The sequential organ failure assessment (SOFA) score is an effective triage marker following single time point paracetamol (acetaminophen) overdose, but has not been evaluated following staggered (multiple supratherapeutic doses over >8 h, resulting in cumulative dose of >4 g/day) overdoses. To evaluate the prognostic accuracy of the SOFA score following staggered paracetamol overdose. Time-course analysis of 50 staggered paracetamol overdoses admitted to a tertiary liver centre. Individual timed laboratory samples were correlated with corresponding clinical parameters and the daily SOFA scores were calculated. A total of 39/50 (78%) patients developed hepatic encephalopathy. The area under the SOFA receiver operator characteristic for death/liver transplantation was 87.4 (95% CI 73.2-95.7), 94.3 (95% CI 82.5-99.1), and 98.4 (95% CI 84.3-100.0) at 0, 24 and 48 h, respectively, postadmission. A SOFA score of paracetamol overdose, is associated with a good prognosis. Both the SOFA and APACHE II scores could improve triage of high-risk staggered paracetamol overdose patients. © 2012 Blackwell Publishing Ltd.

  11. Interventions for treating post-extraction bleeding.

    Science.gov (United States)

    Kumbargere Nagraj, Sumanth; Prashanti, Eachempati; Aggarwal, Himanshi; Lingappa, Ashok; Muthu, Murugan S; Kiran Kumar Krishanappa, Salian; Hassan, Haszelini

    2018-03-04

    Post-extraction bleeding (PEB) is a recognised, frequently encountered complication in dental practice, which is defined as bleeding that continues beyond 8 to 12 hours after dental extraction. The incidence of post-extraction bleeding varies from 0% to 26%. If post-extraction bleeding is not managed, complications can range from soft tissue haematomas to severe blood loss. Local causes of bleeding include soft tissue and bone bleeding. Systemic causes include platelet problems, coagulation disorders or excessive fibrinolysis, and inherited or acquired problems (medication induced). There is a wide array of techniques suggested for the treatment of post-extraction bleeding, which include interventions aimed at both local and systemic causes. This is an update of a review published in June 2016. To assess the effects of interventions for treating different types of post-extraction bleeding. Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 24 January 2018), the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library, 2017, Issue 12), MEDLINE Ovid (1946 to 24 January 2018), Embase Ovid (1 May 2015 to 24 January 2018) and CINAHL EBSCO (1937 to 24 January 2018). The US National Institutes of Health Trials Registry (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials. We searched the reference lists of relevant systematic reviews. We considered randomised controlled trials (RCTs) that evaluated any intervention for treating PEB, with male or female participants of any age, regardless of type of teeth (anterior or posterior, mandibular or maxillary). Trials could compare one type of intervention with another, with placebo, or with no treatment. Three pairs of review authors independently screened search records. We obtained full papers for potentially relevant trials. If data had been extracted

  12. Secondary electric power generation with minimum engine bleed

    Science.gov (United States)

    Tagge, G. E.

    1983-01-01

    Secondary electric power generation with minimum engine bleed is discussed. Present and future jet engine systems are compared. The role of auxiliary power units is evaluated. Details of secondary electric power generation systems with and without auxiliary power units are given. Advanced bleed systems are compared with minimum bleed systems. A cost model of ownership is given. The difference in the cost of ownership between a minimum bleed system and an advanced bleed system is given.

  13. Reliability measures in managing GI bleeding.

    Science.gov (United States)

    Sonnenberg, Amnon

    2012-06-01

    Multiple procedures and devices are used in a complex interplay to diagnose and treat GI bleeding. To model how a large variety of diagnostic and therapeutic components interact in the successful management of GI bleeding. The analysis uses the concept of reliability block diagrams from probability theory to model management outcome. Separate components of the management process are arranged in a serial or parallel fashion. If the outcome depends on the function of each component individually, such components are modeled to be arranged in series. If components complement each other and can mutually compensate for each of their failures, such components are arranged in a parallel fashion. General endoscopy practice. Patients with GI bleeding of unknown etiology. All available endoscopic and radiographic means to diagnose and treat GI bleeding. Process reliability in achieving hemostasis. Serial arrangements tend to reduce process reliability, whereas parallel arrangements increase it. Whenever possible, serial components should be bridged and complemented by additional alternative (parallel) routes of operation. Parallel components with low individual reliability can still contribute to overall process reliability as long as they function independently of other pre-existing alternatives. Probability of success associated with individual components is partly unknown. Modeling management of GI bleeding by a reliability block diagram provides a useful tool in assessing the impact of individual endoscopic techniques and administrative structures on the overall outcome. Copyright © 2012 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.

  14. [Update on non-variceal gastrointestinal bleeding].

    Science.gov (United States)

    Lanas, Ángel

    2013-10-01

    This article summarizes the main studies in the field of non-variceal gastrointestinal bleeding reported in the last American Congress of Gastroenterology (Digestive Disease Week) in 2013. Some of these studies have provided new knowledge and expertise in areas of uncertainty. In this context and among other findings, it has been reported that the administration of a proton pump inhibitor (PPI) prior to endoscopy or the early performance of endoscopy-within 6 hours of admission in patients with upper gastrointestinal bleeding (UGIB) (or colonoscopy within 24 hours in patients with lower gastrointestinal bleeding)-does not improve the prognosis of the event. It has also been reported that oral administration of a PPI after endoscopic hemostasis may produce a similar outcome to that of intravenously administered PPI in patients with upper gastrointestinal bleeding (UGIB). In the field of endoscopic therapy, the use of radiofrequency ablation for antral vascular ectasia is of interest. Regarding UGIB and nonsteroidal antiinflammatory drugs (NSAIDs), new data confirm the risk of cardiovascular events by stopping treatment with acetylsalicylic acid (ASA) after an episode of UGIB, the increased risk of UGIB when associating gastrotoxic drugs, and the need to identify both the gastrointestinal and cardiovascular risks of each NSAID and coxib when prescribing these agents. Finally, there is evidence that both environmental and genetic factors are involved in individual susceptibility to gastrointestinal bleeding. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  15. Staggered overdose pattern and delay to hospital presentation are associated with adverse outcomes following paracetamol-induced hepatotoxicity.

    Science.gov (United States)

    Craig, Darren G N; Bates, Caroline M; Davidson, Janice S; Martin, Kirsty G; Hayes, Peter C; Simpson, Kenneth J

    2012-02-01

    Paracetamol (acetaminophen) poisoning remains the major cause of severe acute hepatotoxicity in the UK. In this large single centre cohort study we examined the clinical impact of staggered overdoses and delayed presentation following paracetamol overdose. Between 1992 and 2008, 663 patients were admitted with paracetamol-induced severe liver injury, of whom 161 (24.3%) had taken a staggered overdose. Staggered overdose patients were significantly older and more likely to abuse alcohol than single time point overdose patients. Relief of pain (58.2%) was the commonest rationale for repeated supratherapeutic ingestion. Despite lower total ingested paracetamol doses and lower admission serum alanine aminotransferase concentrations, staggered overdose patients were more likely to be encephalopathic on admission, require renal replacement therapy or mechanical ventilation and had higher mortality rates compared with single time point overdoses (37.3% vs. 27.8%, P= 0.025), although this overdose pattern did not independently predict death. The King's College poor prognostic criteria had reduced sensitivity (77.6, 95% CI 70.8, 81.5) for this pattern of overdose. Of the 396/450 (88.0%) single time point overdoses in whom accurate timings could be obtained, 178 (44.9%) presented to medical services >24 h following overdose. Delayed presentation beyond 24 h post overdose was independently associated with death/liver transplantation (OR 2.25, 95% CI 1.23, 4.12, P= 0.009). Both delayed presentation and staggered overdose pattern are associated with adverse outcomes following paracetamol overdose. These patients are at increased risk of developing multi-organ failure and should be considered for early transfer to specialist liver centres. © 2011 The Authors. British Journal of Clinical Pharmacology © 2011 The British Pharmacological Society.

  16. Bleeding stomal varices in portal hypertension

    Directory of Open Access Journals (Sweden)

    Karen Tran-Harding, MD

    2018-04-01

    Full Text Available We report a case of a 50-year-old man with a history of liver cirrhosis and colon cancer post end colostomy presenting to the emergency department with stomal bleeding and passage of clots into the colostomy bag. The patient was treated with transjugular intrahepatic portosystemic shunt (TIPS and concomitant embolization of the stomal varices via the TIPS shunt using N-butyl cyanoacrylate mixed with ethiodol. Although stomal variceal bleeding is uncommon, this entity can have up to 40% mortality upon initial presentation, given the challenges in diagnosis and management. Currently, there are no established standard treatments for stomal variceal bleeding. In addition, to the best of our knowledge, there are no cases in the current literature in which treatment of this entity is performed with a combination of TIPS shunt placement and N-butyl cyanoacrylate variceal embolization. Keywords: Stomal varices, TIPS, Cirrhosis, Colon cancer, Embolization, NBCA

  17. Radiotherapy in benign uterine bleeding disorders

    International Nuclear Information System (INIS)

    Ryberg, M.; Pettersson, F.; Lundell, M.

    1989-01-01

    Radiotherapy was earlier a method of choice for treatment of benign bleeding disorders (metropathia), especially in woman of high surgical risk. During the period 1912 to 1977 933 women with benign bleeding disorders were treated at Radiumhemmet with intracavitary brachytherapy or external irradiation or a combination of both. The result with regard to cure of the uterine bleedings was good (48%). Hormonal withdrawal symptoms after treatment were noted in 45% of the patients. In the long term follow up an increased risk of cardiovascular death was found in women treated before menopause. Malignant tumours occurred in 107 cases versus 90.2 expected. The estimated ovarian dose of ionizing radiation varied from 3.5 Gy to 6.0 Gy for the three standard techniques. Two women gave birth to a healthy child 4 and 5 years after intracavitary radium treatment. The estimated absorbed dose to the ovaries in these two women were 1 Gy and 4 Gy, respectively

  18. Somatostatin analogues for acute bleeding oesophageal varices

    DEFF Research Database (Denmark)

    Gøtzsche, Peter C.; Hrobjartsson, A.

    2008-01-01

    BACKGROUND: Somatostatin and its derivatives are sometimes used for emergency treatment of bleeding oesophageal varices in patients with cirrhosis of the liver. OBJECTIVES: To study whether somatostatin or its analogues improve survival or reduce the need for blood transfusions in patients...... with bleeding oesophageal varices. SEARCH STRATEGY: PubMed and The Cochrane Library were searched (November 2007). Reference lists of publications, contacts with authors. SELECTION CRITERIA: All randomised trials comparing somatostatin or analogues with placebo or no treatment in patients suspected of acute...... or recent bleeding from oesophageal varices. DATA COLLECTION AND ANALYSIS: The outcome measures extracted were: mortality, blood transfusions, use of balloon tamponade, initial haemostasis and rebleeding. Intention-to-treat analyses including all randomised patients were conducted if possible; a random...

  19. Hemospray application in nonvariceal upper gastrointestinal bleeding

    DEFF Research Database (Denmark)

    Smith, Lyn A; Stanley, Adrian J; Bergman, Jacques J

    2013-01-01

    in combination with other hemostatic modalities at the endoscopists' discretion. RESULTS: Sixty-three patients (44 men, 19 women), median age 69 (range, 21 to 98) years with NVUGIB requiring endoscopic hemostasis were treated with TC-325. There were 30 patients with bleeding ulcers and 33 with other NVUGIB......BACKGROUND: Hemospray TM (TC-325) is a novel hemostatic agent licensed for use in nonvariceal upper gastrointestinal bleeding (NVUGIB) in Europe. GOALS: We present the operating characteristics and performance of TC-325 in the largest registry to date of patients presenting with NVUGIB in everyday...... pathology. Fifty-five (87%) were treated with TC-325 as monotherapy; 47 [85%; 95% confidence interval (CI), 76%-94%] of them achieved primary hemostasis, and rebleeding rate at 7 days was 15% (95% CI, 5%-25%). Primary hemostasis rate for TC-325 in patients with ulcer bleeds was 76% (95% CI, 59%-93%). Eight...

  20. Successful Management of Neobladder Variceal Bleeding

    Energy Technology Data Exchange (ETDEWEB)

    Atwal, Dinesh; Chatterjee, Kshitij, E-mail: kchatterjee@uams.edu [University of Arkansas for Medical Sciences, Department of Internal Medicine, Residency Program: Slot 634 (United States); Osborne, Scott [University of Arkansas for Medical Sciences, Division of Interventional Radiology, Department of Radiology (United States); Kakkera, Krishna; Deas, Steven [University of Arkansas for Medical Sciences, Department of Internal Medicine, Residency Program: Slot 634 (United States); Li, Ruizong [University of Arkansas for Medical Sciences, Division of Interventional Radiology, Department of Radiology (United States); Erbland, Marcia [University of Arkansas for Medical Sciences, Department of Internal Medicine, Residency Program: Slot 634 (United States)

    2016-10-15

    Hematuria from a neobladder can occur due to a variety of pathologies including tumors, stones, and fistulas. Variceal bleeding in a neobladder is a very rare condition with only one case reported in literature. We present a case of a patient with cirrhosis and portal hypertension and an ileocolic orthotopic neobladder presenting with hematuria. Computed tomographic angiography showed dilated varices around the neobladder which were successfully embolized. To the best of our knowledge, this is the first report case of variceal bleeding in a neobladder successfully managed with the combination of TIPS (transjugular intrahepatic portosystemic shunt) procedure and embolization.

  1. Endovascular management of acute bleeding arterioenteric fistulas

    DEFF Research Database (Denmark)

    Leonhardt, H.; Mellander, S.; Snygg, J.

    2008-01-01

    . All had massive persistent bleeding with hypotension despite volume substitution and transfusion by the time of endovascular management. Outcome after treatment of these patients was investigated for major procedure-related complications, recurrence, reintervention, morbidity, and mortality. Mean...... follow-up time was 3 months (range, 1-6 months). All massive bleeding was controlled by occlusive balloon catheters. Four fistulas were successfully sealed with stent-grafts, resulting in a technical success rate of 80%. One patient was circulatory stabilized by endovascular management but needed...

  2. Endovascular management of acute bleeding arterioenteric fistulas

    DEFF Research Database (Denmark)

    Leonhardt, H.; Mellander, S.; Snygg, J.

    2008-01-01

    follow-up time was 3 months (range, 1-6 months). All massive bleeding was controlled by occlusive balloon catheters. Four fistulas were successfully sealed with stent-grafts, resulting in a technical success rate of 80%. One patient was circulatory stabilized by endovascular management but needed...... reintervention. The in-hospital mortality was 20% and the 30-day mortality was 40%. The midterm outcome was poor, due to comorbidities or rebleeding, with a mortality of 80% within 6 months. In conclusion, endovascular repair is an efficient and safe method to stabilize patients with life-threatening bleeding...

  3. Numerical simulation of the effects of hanging sound absorbers on TABS cooling performance

    DEFF Research Database (Denmark)

    Rage, Nils; Kazanci, Ongun Berk; Olesen, Bjarne W.

    2016-01-01

    Recently there has been a considerable increase in the use of Thermally-Active Building Systems (TABS) in Europe as an energy-efficient and economical cooling and heating solution for buildings. However, this widespread solution requires large uncovered hard surfaces indoors, which can lead...... to a degradation of the room acoustic comfort. Therefore, challenges arise when this system has to be combined with acoustic requirements. Soffit-hanging sound absorbers embody a promising solution. This study focuses on quantifying their impact on the cooling performance of TABS, assessed by means of the cooling.......4% with a coverage of 80%. The presence of acoustic panels also affects the thermal comfort: the operative temperature in the room increases by 0.9°C in the former case and up to 1.6°C in the latter. Results also show that comfort ventilation supplied to the enclosure has a considerable influence on the thermal...

  4. Preformulation study of the vaccine candidate TAB9 against HIV-1.

    Science.gov (United States)

    Expósito Raya, Néstor; García Díaz, Alina; Carrazana López, Yamilka; Quintana Vazquez, Diógenes; Pichardo Díaz, Dagmara; Martínez de la Puente, Nieves; Duarte Cano, Carlos

    2002-10-01

    A preformulation study was performed for the evaluation of a vaccine candidate against HIV-1. Aluminium hydroxide was used in the preformulation. However, this adjuvant is not a good adsorbent for basic proteins since it is positively charged at a physiological pH. In the present study, we determined the adsorption of TAB9 (basic protein, pI: 11.3) by treating Alhydrogel with different ions. The immunogenicity of the vaccine candidate against HIV was also evaluated using three batches, 9801-A, 9802-A and 9803-A, and a placebo P-001. The evaluation was performed twice (0 and 9 months). Each batch was tested using groups of 10 mice that had a single inoculation. The results showed that the protein was totally adsorbed to the aluminium gel. Seroconvertion was attained in all analysed batches, indicating the potentiality of TAB9 as a vaccine candidate.

  5. Initial Development of a Combined PCM and TABS Solution for Heat Storage and Cooling

    DEFF Research Database (Denmark)

    Pomianowski, Michal Zbigniew; Heiselberg, Per; Jensen, Rasmus Lund

    2011-01-01

    This paper investigates heat storage and cooling concept that utilizes both phase change material (PCM) and a thermal active building system (TABS) implemented in a hollow core concrete deck element. PCMs are promising materials for improving the heat storage capacity of a building due...... to their significant thermal energy storage capabilities. The TABS has a potential for increasing the exploitation of the thermal mass of the building, which is rarely exposed for heat transfer.The main objective of this study is to optimize the location and amount of PCM in a hollow core deck in order to optimize...... heat storage capacity. A series of simulations were conducted using the COMSOL program to obtain knowledge regarding the dynamic heat storage capacity of the investigated hollow core deck element as a function of the amount and location of PCM. Furthermore, the dynamic heat storage capacity...

  6. Scintigraphic pattern of small bowel bleeding

    International Nuclear Information System (INIS)

    Anshu Rajnish Sharma; Charan, S.; Silva, I.

    2004-01-01

    Introduction: Small intestine is the longest part of gastrointestinal tract. Intra-luminal haemorrhage occurring anywhere in its long and tortuous course is difficult to trace. It is relatively inaccessible to endoscopic evaluation. Upper GI endoscopy can see only up to distal duodenum, whereas colonoscope can view maximum of 30 centimeters of terminal ileum after negotiating the scope through ileo-caecal valve. Hence, localization of bleeding source from small bowel remains a difficult clinical problem. This group of patients can be evaluated with scintigraphy for localizing the site of bleeding before undergoing either angiography or surgery. To our best of knowledge, there is no study, which has utilized scintigraphy for evaluation of small bowel bleed exclusively. The present study has been designed to know the efficacy of 99mTc-RBC scintigraphy in detecting small bowel bleed and to know whether it can differentiate between jejunal and ileal bleeding ? Materials and methods: Thirteen patients presenting with lower gastrointestinal bleeding (malena) were enrolled for the study. In all cases, upper GI endoscopy (UGIE) was unremarkable. Colonoscopic examination was either negative or suspected bleeding occurring proximal to ileo-caecal valve. Thus, in these patients, it is presumed clinically that bleeding is originating from small bowel. Barium meal follow through (BMFT) studies, however, could not delineate any etiological lesion in these patients. There were 8 men and 5 women (mean age 48 years). All patients were anemic (Hb- 6 gm%) and mean 3 units of blood were transfused.These patients were subjected to Tc-99m labeled red blood cells scintigraphy (15 mci, in-vivo method) for localization of source of bleeding. The scintiscan was acquired in two phases. A first pass phase acquired at a rate of 2 seconds per frame for 60 seconds followed by acquisition of static abdominal images (500 K, 256 x 256 matrix) at 5 minutes intervals up to 90 minutes on LFOV gamma

  7. Prospective analysis of delayed colorectal post-polypectomy bleeding.

    Science.gov (United States)

    Park, Soo-Kyung; Seo, Jeong Yeon; Lee, Min-Gu; Yang, Hyo-Joon; Jung, Yoon Suk; Choi, Kyu Yong; Kim, Hungdai; Kim, Hyung Ook; Jung, Kyung Uk; Chun, Ho-Kyung; Park, Dong Il

    2018-01-17

    Although post-polypectomy bleeding is the most frequent complication after colonoscopic polypectomy, only few studies have investigated the incidence of bleeding prospectively. The aim of this study was to investigate the incidence of delayed post-polypectomy bleeding and its associated risk factors prospectively. Patients who underwent colonoscopic polypectomy at Kangbuk Samsung Hospital from January 2013 to December 2014 were prospectively enrolled in this study. Trained nurses contacted patients via telephone 7 and 30 days after polypectomy and completed a standardized questionnaire regarding the development of bleeding. Delayed post-polypectomy bleeding was categorized as minor or major and early or late bleeding. Major delayed bleeding was defined as a > 2-g/dL drop in the hemoglobin level, requiring hospitalization for control of bleeding or blood transfusion; late delayed bleeding was defined as bleeding occurring later than 24 h after polypectomy. A total of 8175 colonoscopic polypectomies were performed in 3887 patients. Overall, 133 (3.4%) patients developed delayed post-polypectomy bleeding. Among them, 90 (2.3%) and 43 (1.1%) patients developed minor and major delayed bleeding, respectively, and 39 (1.0%) patients developed late delayed bleeding. In the polyp-based multivariate analysis, young age ( 10 mm (OR 2.45; 95% CI 1.38-4.36) were significant risk factors for major delayed bleeding, while young age (< 50 years; OR 2.6; 95% CI 1.35-5.12) and immediate bleeding (OR 3.3; 95% CI 1.49-7.30) were significant risk factors for late delayed bleeding. Young age, aspirin use, polyp size, and immediate bleeding were found to be independent risk factors for delayed post-polypectomy bleeding.

  8. Cellular uptake of magnetite nanoparticles enhanced by NdFeB magnets in staggered arrangement

    Energy Technology Data Exchange (ETDEWEB)

    Lu, Yi-Ching; Chang, Fan-Yu [Department of Physiology and Pharmacology & Healthy Aging Research Center, Guishan, Taoyuan City 33302, Taiwan, ROC (China); Tu, Shu-Ju [Department of Medical Imaging and Radiological Sciences, Chang Gung University, Guishan, Taoyuan City 33302, Taiwan, ROC (China); Chen, Jyh-Ping [Department of Chemical and Materials Engineering, Chang Gung University, Guishan, Taoyuan City 33302, Taiwan, ROC (China); Ma, Yunn-Hwa, E-mail: yhma@mail.cgu.edu.tw [Department of Physiology and Pharmacology & Healthy Aging Research Center, Guishan, Taoyuan City 33302, Taiwan, ROC (China); Department of Neurology, Chang Gung Memorial Hospital, Guishan, Taoyuan City 33305, Taiwan, ROC (China)

    2017-04-01

    Magnetic force may greatly enhance uptake of magnetic nanoparticles (MNPs) by cultured cells; however, the effects of non-uniformity of magnetic field/ magnetic gradient on MNP internalization in culture has not been elucidated. Cellular uptake of polyacrylic acid coated-MNP by LN229 cells was measured with cylindrical NdFeB magnets arranged in a staggered pattern. The magnetic field generated by placing a magnet underneath (H-field) elicited a homogenous distribution of MNPs on the cells in culture; whereas the field without magnet underneath (L-field) resulted in MNP distribution along the edge of the wells. Cell-associated MNP (MNP{sub cell}) appeared to be magnetic field- and concentration-dependent. In H-field, MNP{sub cell} reached plateau within one hour of exposure to MNP with only one-min application of the magnetic force in the beginning of incubation; continuous presence of the magnet for 2 h did not further increase MNP{sub cell}, suggesting that magnetic force-induced uptake may be primarily contributed to enhanced MNP sedimentation. Although MNP distribution was much inhomogeneous in L-field, averaged MNP{sub cell} in the L-field may reach as high as 80% of that in H-field during 1–6 h incubation, suggesting high capacity of MNP internalization. In addition, no significant difference was observed in MNP{sub cell} analyzed by flow cytometry with the application of H-field of staggered plate vs. filled magnet plate. Therefore, biological variation may dominate MNP internalization even under relatively uniformed magnetic field; whereas non-uniformed magnetic field may serve as a model for tumor targeting with MNPs in vivo. - Graphical abstract: Averaged MNP uptake by glioma cells in the low and non-uniformed magnetic field reached as high as 80% of that in uniformed magnetic field, which is probably due to both heterogeneous distributions of MNPs in the non-uniformed magnetic field and high capacity of the MNP uptake by these cells. - Highlights:

  9. An effective method for smoothing the staggered dose distribution of multi-leaf collimator field edge

    International Nuclear Information System (INIS)

    Hwang, I.-M.; Lin, S.-Y.; Lee, M.-S.; Wang, C.-J.; Chuang, K.-S.; Ding, H.-J.

    2002-01-01

    Purpose: To smooth the staggered dose distribution that occurs in stepped leaves defined by a multi-leaf collimator (MLC). Materials and methods: The MLC Shaper program controlled the stepped leaves, which were shifted in a traveling range, the pattern of shift was from the position of out-bound to in-bound with a one-segment (cross-bound), three-segment, and five-segment shifts. Film was placed at a depth of 1.5 cm and irradiated with the same irradiation dose used for the cerrobend block experiment. Four field edges with the MLC defining at 15 deg., 30 deg., 45 deg., 60 deg. angels relative to the jaw edge were performed, respectively, in this study. For the field edge defined by the multi-segment technique, the amplitude of the isodose lines for 50% isodose line and both the 80% and 20% isodose lines were measured. The effective penumbra widths with 90-10% and 80-20% distances for different irradiations were determined at four field edges with the MLC defining at 15 deg., 30 deg., 45 deg., 60 deg. angels relative to the jaw edge. Results: Use of the five-segment technique for multi-leaf collimation at the 60 deg. angle field edge smoothes each isodose line into an effectively straight line, similar to the pattern achieved using a cerrobend block. The separation of these lines is also important. The 80-20% effective penumbra width with five-segment techniques (8.23 mm) at 60 deg. angle relative to the jaw edge is little wider (1.9 times) than the penumbra of cerrobend block field edge (4.23 mm). We also found that the 90-10% effective penumbra width with five-segment techniques (12.68 mm) at 60 deg. angle relative to the jaw edge is little wider (1.28 times) than the penumbra of cerrobend block field edge (9.89 mm). Conclusion: The multi-segment technique is effective in smoothing the MLC staggered field edge. The effective penumbra width with more segment techniques at larger degree angles relative to the field edge is little wider than the penumbra for a

  10. Simulated performance of the Thermo Active Building System (TABS) with respect to the provided thermal comfort and primary energy use

    DEFF Research Database (Denmark)

    Kolarik, Jakub; Olesen, Bjarne W.; Toftum, Jørn

    2009-01-01

    The central module of an office building conditioned by a Thermo Active Building System (TABS) coupled with constant volume ventilation was evaluated by means of dynamic computer simulations. Additionally, the same building model was simulated with a conventional all air VAV ventilation system...... for comparison. The results showed that with the moderate climate, the TABS decreased the primary energy use by about 16% as compared with the VAV. With hot-humid climate, the portion of the primary energy saved by TABS was ca. 50% even with the supply air dehumidification taken into account. The TABS working...

  11. Comparing L*a*b* color coordinates for natural teeth shades and corresponding shade tabs using a spectrophotometer.

    Science.gov (United States)

    Hassel, Alexander J; Doz, Priv; Nitschke, Ina; Rammelsberg, Peter

    2009-01-01

    It was investigated whether L*a*b* values for teeth as well as shade tabs for one 3D-Master shade were similar to one another. Teeth were measured using Vita Easyshade and L*a*b* values and the closest 3D shade was then recorded. The shade-guide tabs were also measured using the same device. 3D-Master shades yielded different L*a*b* values for the teeth than for the tabs. L* and a* values, especially, were systematically different. Therefore, Easyshade L*a*b* values for teeth and tabs could not be directly compared.

  12. The Multifactorial Nature of Thromboembolic and Bleeding ...

    African Journals Online (AJOL)

    Background: Thromboembolic and bleeding complications are the main causes of morbidity and mortality in patients with mechanical heart valves1. The risk factors for these complications in Tanzania have not been established. Methods: A retrospective cohort study was conducted among patients with mechanical heart ...

  13. Dysfunctional uterine bleedings of a climacteric period

    International Nuclear Information System (INIS)

    Prilepskaya, V.N.

    1993-01-01

    Climacteric period of some women is complicated by dysfunctional uterine bleedings (DUB). Bearing in mind the fact that DUBS are caused by disorder of estrin rhysmic secretion, the paper presents the methods of differential diagnostics for investigations into functional disorders in the hypothalamus -hypophysis - ovaries - uterus system. The preference is given to roentgenologic and radioimmunologic diagnostic methods

  14. Systemic causes of heavy menstrual bleeding

    NARCIS (Netherlands)

    Verschueren, Sophie

    2017-01-01

    Heavy menstrual bleeding (HMB) is a common problem in fertile women. In addition to local factors, such as a polyp or a uterine fibroid, systemic causes may lead to HMB. These systemic causes are discussed in this thesis. For years, women with HMB were tested underlying thyroid disorder, but our

  15. Thromboembolic and Bleeding Complications among Patients with ...

    African Journals Online (AJOL)

    Objective: This study was conducted to determine the incidence of thromboembolic and bleeding complications among patients with mechanical heart valves operated from 1990 to 2003 attending the Muhimbili National Hospital. Study design: This was a retrospective cohort study conducted at the cardiac, anticoagulation ...

  16. RESEARCH Endoscopic injection sclerotherapy for bleeding varices ...

    African Journals Online (AJOL)

    RESEARCH. 884 November 2012, Vol. 102, No. 11 SAMJ. Endoscopic injection sclerotherapy for bleeding varices in children with intrahepatic and extrahepatic portal venous ... Progress has been made in developing newer endoscopic techniques ... a sclerosant, usually 0.5 - 0.75 ml per injection, at multiple (up to.

  17. Massive rectal bleeding from colonic diverticulosis

    African Journals Online (AJOL)

    ABEOLUGBENGAS

    barium enema studies have indicated increasing world prevalence ... Other diagnostic modalities include barium enema, computerised ... This is in contrast to the findings in our patient when colonoscopy was carried out, in which the diverticula were more at the descending colon-left sided, and were found to be bleeding.

  18. An unusual cause of lower gastrointestinal bleeding: ' '

    African Journals Online (AJOL)

    Summary. This is an unusual case report of a 60-year-old man who presented with massive rectal bleeding due to angiomatous formation. ' He was also found to be cirrhosis and to have an ectopic left kidney in the ... attribuable a la formation angiomateuse. On a decouvert qu' ... challenging experience to the treating team.

  19. Management of Acute Bleeding Per Rectum

    Directory of Open Access Journals (Sweden)

    Benita K.T. Tan

    2004-01-01

    Conclusion: Perianal conditions contributed to the majority of acute patient admissions. Colonic causes of bleeding were less common and were most stable. There were differences in the frequencies of aetiologies in our population compared to Western populations. Understanding the common pathologies and outcomes guides the management of our patients.

  20. Endometrial biopsy findings in postmenopausal bleeding

    International Nuclear Information System (INIS)

    Sarfraz, T.; Tariq, H.

    2007-01-01

    To study endometrial histopathology in women presenting with postmenopausal bleeding. A two-year study from January 2003 to December 2004 of 100 cases of postmenopausal bleeding was conducted at Combined Military Hospital, Sialkot. The histopathology of endometrial biopsy specimens was done to find out the causes of postmenopausal bleeding in these ladies. All these 100 patients had confirmed menopause and the average age was 55 years and above. The most common histopathological diagnosis was senile endometrial atrophy (27%), followed by simple cystic hyperplasia in (17%). Three cases of simple cystic hyperplasia had coexistent ovarian tumors. Glandular hyperplasia without atypia was seen in 6% and with atypia in 4%. Other causes were endometritis (13%), endometrial polyps (8%), proliferative phase endometrium (6%) and secretary phase endometrium (5%). Endometrial carcinoma was seen in (6%) cases, (8%) biopsy specimens were non-representative. Although senile endometrial atrophy was most commonly found in these ladies but a significant percentage of endometrial hyperplasia and endometrial cancer implies the need for investigating all cases of postmenopausal bleeding. Bimanual examination and pelvic ultrasonography should be combined with endometrial sampling so that rare pelvic pathologies may not be missed. (author)

  1. Continued bleeding following acute intracerebral hemorrhage

    NARCIS (Netherlands)

    Brouwers, H.B.

    2014-01-01

    In this Ph.D. thesis, ‘Continued bleeding following acute intracerebral hemorrhage’, we have discussed the background literature, risk factors, and underlying biology of hematoma expansion, as well as the clinical applicability of the CT angiography (CTA) 'spot sign' as an imaging marker of this

  2. First trimester bleeding and maternal cardiovascular morbidity

    DEFF Research Database (Denmark)

    Lykke, Jacob A; Langhoff-Roos, Jens

    2012-01-01

    First trimester bleeding without miscarriage is a risk factor for complications later in the pregnancy, such as preterm delivery. Also, first trimester miscarriage has been linked to subsequent maternal ischemic heart disease. We investigated the link between maternal cardiovascular disease prior...

  3. Managing Chemotherapy Side Effects: Bleeding Problems

    Science.gov (United States)

    ... nurse: 1. What problems should I call you about? 2. How long should I wait for the bleeding to stop before I call you or go to the emergency room? 3. Is it okay to drink beer, wine, or other drinks with alcohol? Yes No, don’ ...

  4. Medical treatment for heavy menstrual bleeding

    Directory of Open Access Journals (Sweden)

    Yi-Jen Chen

    2015-10-01

    Full Text Available Heavy menstrual bleeding, or menorrhagia, is subjectively defined as a “complaint of a large amount of bleeding during menstrual cycles that occurs over several consecutive cycles” and is objectively defined as menstrual blood loss of more than 80 mL per cycle that is associated with an anemia status (defined as a hemoglobin level of <10 g/dL. During their reproductive age, more than 30% of women will complain of or experience a heavy amount of bleeding, which leads to a debilitating health outcome, including significantly reduced health-related quality of life, and a considerable economic burden on the health care system. Although surgical treatment might be the most important definite treatment, especially hysterectomy for those women who have finished bearing children, the uterus is still regarded as the regulator and controller of important physiological functions, a sexual organ, a source of energy and vitality, and a maintainer of youth and attractiveness. This has resulted in a modern trend in which women may reconsider the possibility of organ preservation. For women who wish to retain the uterus, medical treatment may be one of the best alternatives. In this review, recent trends in the management of women with heavy menstrual bleeding are discussed.

  5. Risk Factors for Post-TAVI Bleeding According to the VARC-2 Bleeding Definition and Effect of the Bleeding on Short-Term Mortality: A Meta-analysis.

    Science.gov (United States)

    Wang, Jiayang; Yu, Wenyuan; Jin, Qi; Li, Yaqiong; Liu, Nan; Hou, Xiaotong; Yu, Yang

    2017-04-01

    In this study we investigated the effect of post-transcatheter aortic valve implantation (TAVI) bleeding (per Valve Academic Research Consortium-2 [VARC-2] bleeding criteria) on 30-day postoperative mortality and examined the correlation between pre- or intraoperative variables and bleeding. Multiple electronic literature databases were searched using predefined criteria, with bleeding defined per Valve Academic Research Consortium-2 criteria. A total of 10 eligible articles with 3602 patients were included in the meta-analysis. The meta-analysis revealed that post-TAVI bleeding was associated with a 323% increase in 30-day postoperative mortality (odds risk [OR]; 4.23, 95% confidence interval [CI], 2.80-6.40; P Risk Evaluation (EuroSCORE), aortic valve area, mean pressure gradient, left ventricular ejection fraction, preoperative hemoglobin and platelet levels, and study design had no significant effects on the results of the meta-analysis. Post-TAVI bleeding, in particular, major bleeding/life-threatening bleeding, increased 30-day postoperative mortality. Transapical access was a significant bleeding risk factor. Preexisting AF independently correlated with TAVI-associated bleeding, likely because of AF-related anticoagulation. Recognition of the importance and determinants of post-TAVI bleeding should lead to strategies to improve outcomes. Copyright © 2016 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  6. THERMOELECTRIC SEMICONDUCTOR DEVICE FOR CAUTERY OF BLEEDING

    Directory of Open Access Journals (Sweden)

    Denis V. Yevdulov

    2017-01-01

    Full Text Available Abstract. Objectives The aim of the work is to study the possibilities for using a semiconductor device to cauterise bleeding by means of cooling (cryocautery. Method The study is based on methods for approximate modeling of heat exchange processes. Results The construction of a device for cauterisation of bleeding, the actuating element of which consists of a thermoelectric battery operating in cooling mode at the time of blood flow cautery and in heating mode when removing the device from the damaged area, is considered. A model of a device, realised on the basis of the solution of the problem of solidification of a viscous liquid by the method of L.S. Leibenson, is proposed, taking into account the electro- and thermo-physical characteristics of the thermoelectric battery cold source. As a result of the numerical experiment, the dependence of the duration of the ice crust formation on tissues 1 mm thick (which corresponds to the cauterisation of bleeding is obtained on the value of the supply current of the thermoelectric battery. With increasing current, the duration of the ice crust formation is reduced; this can be of the order of 160 s at 5 A. It was demonstrated that the selection of thermoelectric battery parameters and current should be guided by medical norms and standards in order to avoid frostbite in the tissues adjacent to the bleeding zone. Conclusion The special design of thermoelectric device provides an effective technical means for cauterising bleeding by freezing (cryocautery, providing high intensity of cooling, shortenened thrombus formation duration, and eliminating painful sensations when removing the device from a damaged area. 

  7. Endovascular Management of Acute Bleeding Arterioenteric Fistulas

    International Nuclear Information System (INIS)

    Leonhardt, Henrik; Mellander, Stefan; Snygg, Johan; Loenn, Lars

    2008-01-01

    The objective of this study was to review the outcome of endovascular transcatheter repair of emergent arterioenteric fistulas. Cases of abdominal arterioenteric fistulas (defined as a fistula between a major artery and the small intestine or colon, thus not the esophagus or stomach), diagnosed over the 3-year period between December 2002 and December 2005 at our institution, were retrospectively reviewed. Five patients with severe enteric bleeding underwent angiography and endovascular repair. Four presented primary arterioenteric fistulas, and one presented a secondary aortoenteric fistula. All had massive persistent bleeding with hypotension despite volume substitution and transfusion by the time of endovascular management. Outcome after treatment of these patients was investigated for major procedure-related complications, recurrence, reintervention, morbidity, and mortality. Mean follow-up time was 3 months (range, 1-6 months). All massive bleeding was controlled by occlusive balloon catheters. Four fistulas were successfully sealed with stent-grafts, resulting in a technical success rate of 80%. One patient was circulatory stabilized by endovascular management but needed immediate further open surgery. There were no procedure-related major complications. Mean hospital stay after the initial endovascular intervention was 19 days. Rebleeding occurred in four patients (80%) after a free interval of 2 weeks or longer. During the follow-up period three patients needed reintervention. The in-hospital mortality was 20% and the 30-day mortality was 40%. The midterm outcome was poor, due to comorbidities or rebleeding, with a mortality of 80% within 6 months. In conclusion, endovascular repair is an efficient and safe method to stabilize patients with life-threatening bleeding arterioenteric fistulas in the emergent episode. However, in this group of patients with severe comorbidities, the risk of rebleeding is high and further intervention must be considered

  8. A Study of a Powder Coating Gun near Field: A Case of Staggered Concentric Jet Flow

    Directory of Open Access Journals (Sweden)

    Edward Grandmaison

    2013-11-01

    Full Text Available This paper examines, experimentally and numerically, an isothermal coaxial air jet, created by an innovative nozzle design for an air propane torch, used for the thermal deposition of polymers. This design includes staggering the origins of the central and annular jets and creating an annular air jet with an inward radial velocity component. The experimental work used a Pitot tube to measure axial velocity on the jet centerline and in the fully developed flow. The static gauge pressure in the near field was also measured and found to be positive, an unexpected result. The numerical work used Gambit and Fluent. An extensive grid sensitivity study was conducted and it was found that results from a relatively coarse mesh were substantially the same as results from a mesh with almost 11 times the number of control volumes. A thorough evaluation of all of the RANS models in Fluent 6.3.26 found that the flow fields they calculated showed at most partial agreement with the experimental results. The greatest difference between numerical and experimental results was the incorrect prediction by all RANS models of a recirculation zone in the near field on the jet axis. Experimental work showed it did not exist.

  9. The interference between two flat plates normal to a stream in staggered arrangement, 1

    International Nuclear Information System (INIS)

    Hirano, Kimitaka; Kawashima, Akira; Ohsako, Hideyuki.

    1983-01-01

    The clarification of the mutual interference characteristics between the bodies with sharp corners, such as flat plates and rectangular prisms placed perpendicularly to flow, is a fundamental and important problem. But it has not yet been sufficiently clarified. In flat plates, the points of breaking away do not move, a large breaking away region is in the wake, and the thickness is very thin in the direction of main flow. Moreover, a moment arises around the center of flat plates. In this study, a new parameter expressing the influence of channel walls on a single flat plate in the measuring part of two-dimensional wind tunnel experiment was proposed. The change of steady drag coefficient and Strouhal number corresponding to the series and parallel arrangements of two plates was clarified, and the patterns of the mutual interference were classified by using the results of visualizing flow in a circulation tank together. By the experimental results in the widely changed staggered arrangements, the isodrag contour diagram and isomoment contour diagram were drawn, and the general characteristics of mutual interference related to steady drag and moment were clarified. The experimental setup and method and the results are reported. (Kako, I.)

  10. Natural convection heat transfer for a staggered array of heated, horizontal cylinders within a rectangular enclosure

    Energy Technology Data Exchange (ETDEWEB)

    Triplett, C.E.

    1996-12-01

    This thesis presents the results of an experimental investigation of natural convection heat transfer in a staggered array of heated cylinders, oriented horizontally within a rectangular enclosure. The main purpose of this research was to extend the knowledge of heat transfer within enclosed bundles of spent nuclear fuel rods sealed within a shipping or storage container. This research extends Canaan`s investigation of an aligned array of heated cylinders that thermally simulated a boiling water reactor (BWR) spent fuel assembly sealed within a shipping or storage cask. The results are presented in terms of piecewise Nusselt-Rayleigh number correlations of the form Nu = C(Ra){sup n}, where C and n are constants. Correlations are presented both for individual rods within the array and for the array as a whole. The correlations are based only on the convective component of the heat transfer. The radiative component was calculated with a finite-element code that used measured surface temperatures, rod array geometry, and measured surface emissivities as inputs. The correlation results are compared to Canaan`s aligned array results and to other studies of natural convection in horizontal tube arrays.

  11. Natural convection heat transfer for a staggered array of heated, horizontal cylinders within a rectangular enclosure

    International Nuclear Information System (INIS)

    Triplett, C.E.

    1996-12-01

    This thesis presents the results of an experimental investigation of natural convection heat transfer in a staggered array of heated cylinders, oriented horizontally within a rectangular enclosure. The main purpose of this research was to extend the knowledge of heat transfer within enclosed bundles of spent nuclear fuel rods sealed within a shipping or storage container. This research extends Canaan's investigation of an aligned array of heated cylinders that thermally simulated a boiling water reactor (BWR) spent fuel assembly sealed within a shipping or storage cask. The results are presented in terms of piecewise Nusselt-Rayleigh number correlations of the form Nu = C(Ra) n , where C and n are constants. Correlations are presented both for individual rods within the array and for the array as a whole. The correlations are based only on the convective component of the heat transfer. The radiative component was calculated with a finite-element code that used measured surface temperatures, rod array geometry, and measured surface emissivities as inputs. The correlation results are compared to Canaan's aligned array results and to other studies of natural convection in horizontal tube arrays

  12. Development of Non-staggered, SMAC numerical scheme for a two-fluid model

    International Nuclear Information System (INIS)

    Yoon, H. Y.; Jeong, Jae Jun

    2007-06-01

    The SMAC(Simplified Marker And Cell) method, along with the SIMPLE, has long been used efficiently for the computational fluid dynamics. Usually, the majority of the applications are single phase compressible or incompressible fluids, and the numerical methods are to be modified to implement the following items for the analysis of two-phase flows. - Non-staggered grid for the analysis of a complex geometry - Application of the two-phase models - Coupling of the energy conservation equations - Two-phase flows with phase change. In this report, the SMAC Method is reviewed and extended to compressible two-phase flows with phase change. A pilot code CUPID-M is developed using the proposed numerical method. A set of verification calculations are carried out for th CUPID-M. At first, isothermal air-water flow is simulated to verify the numerical method against two-phase flow flow problems. Next, the two-phase flows with phase change are calculated using CUPID-M and the results are compared to that of CUPID-I, which is based on the coupled ICE method. The calculation time is shorter with CUPID-M than with CUPID-I, while the calculations are unstable with CUPID-M for the rapid phase change problems. Thus, CUPID-M and CUPID-I can be used as an user input considering the application problems

  13. An analytical solution for contact resistance of staggered organic field-effect transistors

    Science.gov (United States)

    Karimi-Alavijeh, Hamidreza; Katebi-Jahromi, Alireza

    2017-03-01

    We have developed analytical models for bias dependent contact resistance (RC) and output characteristics of staggered organic field-effect transistors (OFETS) based on a bulk resistance-approximated and mobility-modified current-crowding method. Numerical evaluations of RC and its resistive components show that the bias dependency of the bulk resistance is negligible. Consequently, the properties of the active layer interfaces determine RC and its characteristics. Effective parameters include a normally constant charge injection barrier at the organic-metal interface (Eb) and a gate induced surface carrier-concentration (PS0) at the organic-insulator boundary. The energy barrier pertains to the fabrication process, and its related resistance (rc) can be determined as the fitting parameter of the theoretical model. However, PS0 is strongly gate bias dependent and the results of the numerical model indicate that the resulting component (rch) is dominant and has a considerable effect on RC and its characteristics. More importantly, PS0 as the key parameter of the contact resistance is analytically expressible and by using a proposed mobility-modified current-crowding model, the contact resistance can be analytically formulated. Accordingly, the output characteristics of the OFETs in the triode region can be also analytically modeled using the developed relation of RC.

  14. Large odd-even staggering in the very light platinum isotopes from laser spectroscopy

    CERN Document Server

    Le Blanc, F; Cabaret, L A; Crawford, J E; Duong, H T; Genevey, J; Girod, M; Huber, G; Krieg, M; Lee, J K P; Lettry, Jacques; Lunney, M D; Obert, J; Oms, J; Peru, S; Putaux, J C; Roussière, B; Sauvage, J; Sebastian, V; Zemlyanoi, S G

    1998-01-01

    Laser spectroscopy measurements have been carried out on very neutron-deficient platinum isotopes with the COMPLIS experimental set-up on line with the ISOLDE-Booster facility. For the first time, Hg alpha -decay was exploited to extend the very light platinum chain. Using the 5d/sup 9/6s /sup 3/D/sub 3/ to 5d/sup 9/6p /sup 3/P /sub 2/ optical transition, hyperfine spectra of /sup 182,181,180,179,178/Pt and /sup 183/Pt/sup m/ were recorded for the first time. The variation of the mean square charge radius between these nuclei, the magnetic moments of the odd isotopes and the quadrupole moment of /sup 183/Pt/sup m/ were thus measured. A large deformation change between /sup 183/Pt/sup 9/ and /sup 183/Pt/sup m/, an odd-even staggering of the charge radius and a deformation drop from A=179 are clearly observed. All these results are discussed and compared with microscopic theoretical predictions using Hartree-Fock- Bogolyubov calculations using the Gogny force. (20 refs).

  15. The Effect of First-Step Techniques from the Staggered Stance in American Football

    DEFF Research Database (Denmark)

    Knudsen, Nikolas Sten; Andersen, Thomas Bull

    2017-01-01

    The purpose of this study was to evaluate 3 different starting techniques from the staggered stance with regards to sprint time, reaction time, linear impulse and power. 11 male amateur American football players volunteered to participate in a testing session consisting of twelve 5 m sprints, 4...... in each technique (normal (NORM), backwards false step (BFS) and forwards false step (FFS)) in random order. Sprint starts were performed on force plates to investigate ground reaction forces, reaction time and total sprint time. Analysis showed significant differences in sprint times, with NORM (1.......77±0.10 s) being faster than FFS (1.81±0.12 s) and BFS (2.01±0.13 s), and FFS being faster than BFS, although no differences were found in reaction time. In terms of mean force and power, NORM (331.1±39.2N, 542.2±72.3W) and FFS (320.8±43.2N, 550.9±81.4W) were significantly larger than BFS (256.9±36.2N, 443...

  16. Performance Analysis and Modeling of a Tubular Staggered-Tooth Transverse-Flux PM Linear Machine

    Directory of Open Access Journals (Sweden)

    Shaohong Zhu

    2016-03-01

    Full Text Available This paper investigates the performance analysis and mathematical modeling of a staggered-tooth transverse-flux permanent magnet linear synchronous machine (STTF-PMLSM, which is characterized by simple structure and low flux leakage. Firstly, the structure advantages and operation principle of the STTF-PMLSM are introduced, and a simplified one phase model is established to investigate the performance of the machine in order to save the computation time. Then, the electromagnetic characteristics, including no-load flux linkage, electromotive force (EMF, inductance, detent force and thrust force, are simulated and analyzed in detail. After that, the theoretical analysis of the detent force, thrust force, and power factor are carried out. And the theoretical analysis results are validated with 3-D finite-element method (FEM. Finally, an improved mathematical model of the machine based on d-q rotating coordinate system is proposed, in which inductance harmonics and coupling between d- and q-axis inductance is considered. The results from the proposed mathematical model are in accordance with the results from 3-D FEM, which proves the validity and effectiveness of the proposed mathematical model. This provides a powerful foundation for the control of the machine.

  17. Dave Eggers's a heartbreaking work of staggering genius: memoir as a "pain-relief device".

    Science.gov (United States)

    Miller, Elise

    2011-10-01

    Dave Eggers's memoir is an important addition to the tradition of autobiography in America, and offers significant contributions to our understanding of creativity, sublimation, and the psychology of the memoir-writing process. A Heartbreaking Work of Staggering Genius is really two books--an autobiographical narrative about unbearable suffering, and a book of psychoanalytic commentary on the challenges of writing a memoir about catastrophic loss and trauma. The main narrative suggests the psychological resilience it takes to contain unbearable suffering. The metanarrative renders transparent the mind of someone who is both remembering his losses and constantly reflecting upon the process of writing about them. Eggers's identification with authorship, rather than bereavement or traumatization, may have played an important role in containing his affect and his sense of self when the heartbreaking events were originally unfolding. But a price is paid when a son uses his art to construct a new identity as an author--unconscious conflicts, primitive affect, anxieties about failing, as well as guilt about succeeding--consequences often missed by readers. Heartbreaking is a palimpsest, a story about story-telling superimposed on tales of death and survival, but its messages will be missed unless all its parts are preserved when being read or studied.

  18. Exploration of the horizontally staggered light guides for high concentration CPV applications.

    Science.gov (United States)

    Selimoglu, Ozgur; Turan, Rasit

    2012-08-13

    The material and processing costs are still the major drawbacks of the c-Si based photovoltaic (PV) technology. The wafer cost comprises up to 35-40% of the total module cost. New approaches and system designs are needed in order to reduce the share of the wafer cost in photovoltaic energy systems. Here we explore the horizontally staggered light guide solar optics for use in Concentrated Photovoltaic (CPV) applications. This optical system comprises a lens array system coupled to a horizontal light guide which directs the incoming light beam to its edge. We have designed and simulated this system using a commercial ray tracing software (Zemax). The system is more compact, thinner and more robust compared to the conventional CPV systems. Concentration levels as high as 1000x can easily be reached when the system is properly designed. With such a high concentration level, a good acceptance angle of + -1 degree is still be conserved. The analysis of the system reveals that the total optical efficiency of the system could be as high as %94.4 without any anti-reflection (AR) coating. Optical losses can be reduced by just accommodating a single layer AR coating on the initial lens array leading to a %96.5 optical efficiency. Thermal behavior of high concentration linear concentrator is also discussed and compared with a conventional point focus CPV system.

  19. Chiral phase transition of three flavor QCD with nonzero magnetic field using standard staggered fermions

    Science.gov (United States)

    Tomiya, Akio; Ding, Heng-Tong; Mukherjee, Swagato; Schmidt, Christian; Wang, Xiao-Dan

    2018-03-01

    Lattice simulations for (2+1)-flavor QCD with external magnetic field demon-strated that the quark mass is one of the important parameters responsible for the (inverse) magnetic catalysis. We discuss the dependences of chiral condensates and susceptibilities, the Polyakov loop on the magnetic field and quark mass in three degenerate flavor QCD. The lattice simulations are performed using standard staggered fermions and the plaquette action with spatial sizes Nσ = 16 and 24 and a fixed temporal size Nτ = 4. The value of the quark masses are chosen such that the system undergoes a first order chiral phase transition and crossover with zero magnetic field. We find that in light mass regime, the quark chiral condensate undergoes magnetic catalysis in the whole temperature region and the phase transition tend to become stronger as the magnetic field increases. In crossover regime, deconfinement transition temperature is shifted by the magnetic field when quark mass ma is less than 0:4. The lattice cutoff effects are also discussed.

  20. Ginsparg-Wilson pions scattering in a sea of staggered quarks

    International Nuclear Information System (INIS)

    Chen, J.-W.; O'Connell, Donal; Van de Water, Ruth; Walker-Loud, Andre

    2006-01-01

    We calculate isospin 2 pion-pion scattering in chiral perturbation theory for a partially quenched, mixed action theory with Ginsparg-Wilson valence quarks and staggered sea quarks. We point out that for some scattering channels, the power-law volume dependence of two-pion states in nonunitary theories such as partially quenched or mixed action QCD is identical to that of QCD. Thus one can extract infinite-volume scattering parameters from mixed action simulations. We then determine the scattering length for both 2 and 2+1 sea quarks in the isospin limit. The scattering length, when expressed in terms of the pion mass and the decay constant measured on the lattice, has no contributions from mixed valence-sea mesons, thus it does not depend upon the parameter, C Mix , that appears in the chiral Lagrangian of the mixed theory. In addition, the contributions which nominally arise from operators appearing in the mixed action O(a 2 m q ) Lagrangian exactly cancel when the scattering length is written in this form. This is in contrast to the scattering length expressed in terms of the bare parameters of the chiral Lagrangian, which explicitly exhibits all the sicknesses and lattice spacing dependence allowed by a partially quenched mixed action theory. These results hold for both 2 and 2+1 flavors of sea quarks

  1. Animal physiology and genetic aspects of ryegrass staggers in grazing sheep.

    Science.gov (United States)

    Morris, C A; Wheeler, T T; Henderson, H V; Towers, N R; Phua, S H

    2017-07-01

    Ryegrass staggers (RGS) is a metabolic disease of herbivores, caused by the ingestion of perennial ryegrass (Lolium perenne L.) containing a fungal endophyte (Neotyphodium lolii) which produces a tremorgenic toxin, lolitrem B. RGS has a major economic impact for agriculture in New Zealand as well as internationally. Management of RGS in grazing sheep can be problematic, and there is an incomplete knowledge of the interaction between the toxin and the grazing animal. This review is focused on recent advances in understanding the molecular physiology of RGS in the affected animal as well as the influence of animal genetics on the degree of susceptibility to RGS. Investigations to date suggest that the primary target for toxin is the large conductance, calcium-activated, potassium (BK) channel, resulting in disruption of neuromuscular junction signalling. Genetic investigation has established the existence of genes influencing resistance to RGS, however their identity has not been confirmed and their impact has not been established. Studies to date suggest that a multi-gene selection approach will be necessary in order to develop an effective selection tool for use in the agricultural industries.

  2. Nuclear shape staggering in very neutron deficient Hg isotopes detected by laser spectroscopy

    International Nuclear Information System (INIS)

    Dabkiewicz, P.; Duke, C.; Fischer, H.; Kuehl, T.; Kluge, H.-J.

    1978-01-01

    The isotope shift in the lambda = 2537 A line of the even isotopes 206 Hg, 190 Hg, 188 Hg, 186 Hg, 184 Hg as well as of the I = 13/2 isomers of 191 Hg, 189 Hg, 187 Hg, 185 Hg has been measured by use of a tunable dye laser at the on-line masseparator ISOLDE at CERN. The resulting delta 2 > values follow the line, extrapolated from the chain 205 Hg- 187 Hg which is known to have spherical nuclear shape at the heavy end changing smoothly to slight oblate deformation for the lighter isotopes. Previous measurements of the I = 1/2 groundstates of 181 Hg. 183 Hg and 185 Hg revealed a sharp shape transition to strong deformation. Combined with the new results the following effects can be proved for the first time from the model-independent quantity delta 2 >: 1) the existence of odd even-shape staggering, 2) the coexistence of very different shapes in one and the same nucleus as manifested by the huge isomer shift in 185 Hg, 3) the absence of mixing of the different shapes. (author)

  3. Simulating dam-break over an erodible embankment using SWE-Exner model and semi-implicit staggered scheme

    Science.gov (United States)

    Ambara, M. D.; Gunawan, P. H.

    2018-03-01

    The impact of a dam-break wave on an erodible embankment with a steep slope has been studied recently using both experimental and numerical approaches. In this paper, the semi-implicit staggered scheme for approximating the shallow water-Exner model will be elaborated to describe the erodible sediment on a steep slope. This scheme is known as a robust scheme to approximate shallow water-Exner model. The results are shown in a good agreement with the experimental data. The comparisons of numerical results with data experiment using slopes Φ = 59.04 and Φ = 41.42 by coefficient of Grass formula Ag = 2 × 10‑5 and Ag = 10‑5 respectively are found the closest results to the experiment. This paper can be seen as the additional validation of semi-implicit staggered scheme in the paper of Gunawan, et al (2015).

  4. Tight-binding electrons on triangular and kagome lattices under staggered modulated magnetic fields: quantum Hall effects and Hofstadter butterflies

    Energy Technology Data Exchange (ETDEWEB)

    Li Juan; Wang Yifei; Gong Changde, E-mail: yfwang_nju@hotmail.com [Center for Statistical and Theoretical Condensed Matter Physics, and Department of Physics, Zhejiang Normal University, Jinhua 321004 (China)

    2011-04-20

    We consider the tight-binding models of electrons on a two-dimensional triangular lattice and kagome lattice under staggered modulated magnetic fields. Such fields have two components: a uniform-flux part with strength {phi}, and a staggered-flux part with strength {Delta}{phi}. Various properties of the Hall conductances and Hofstadter butterflies are studied. When {phi} is fixed, variation of {Delta}{phi} leads to the quantum Hall transitions and Chern numbers of Landau subbands being redistributed between neighboring pairs. The energy spectra with nonzero {Delta}{phi}s have similar fractal structures but quite different energy gaps compared with the original Hofstadter butterflies of {Delta}{phi} = 0. Moreover, the fan-like structure of Landau levels in the low magnetic field region is also modified appreciably by {Delta}{phi}.

  5. Systematic review: tranexamic acid for upper gastrointestinal bleeding

    DEFF Research Database (Denmark)

    Klingenberg, S.L.; Langholz, S.E.; Gluud, Lise Lotte

    2008-01-01

    BACKGROUND: Tranexamic acid may reduce upper gastrointestinal bleeding and stabilize patients before endoscopic treatments. AIM: To review randomized trials on tranexamic acid for upper gastrointestinal bleeding. METHODS: Manual and electronic searches of The Cochrane Library, MEDLINE, EMBASE and...

  6. 14 CFR 23.1109 - Turbocharger bleed air system.

    Science.gov (United States)

    2010-01-01

    ... Induction System § 23.1109 Turbocharger bleed air system. The following applies to turbocharged bleed air... vapors following any probable failure or malfunction of the engine exhaust, hydraulic, fuel, or oil...

  7. Bleeding in cancer patients and its treatment: a review.

    Science.gov (United States)

    Johnstone, Candice; Rich, Shayna E

    2017-12-18

    Bleeding is a common problem in cancer patients, related to local tumor invasion, tumor angiogenesis, systemic effects of the cancer, or anti-cancer treatments. Existing bleeds can also be exacerbated by medications such as bevacizumab, nonsteroidal anti-inflammatory drugs (NSAIDs), and anticoagulants. Patients may develop acute catastrophic bleeding, episodic major bleeding, or low-volume oozing. Bleeding may present as bruising, petechiae, epistaxis, hemoptysis, hematemesis, hematochezia, melena, hematuria, or vaginal bleeding. Therapeutic intervention for bleeding should start by establishing goals of care, and treatment choice should be guided by life expectancy and quality of life. Careful thought should be given to discontinuation of medications and reversal of anticoagulation. Interventions to stop or slow bleeding may include systemic agents or transfusion of blood products. Noninvasive local treatment options include applied pressure, dressings, packing, and radiation therapy. Invasive local treatments include percutaneous embolization, endoscopic procedures, and surgical treatment.

  8. Breast cancer recurrence after reoperation for surgical bleeding

    DEFF Research Database (Denmark)

    Pedersen, Rikke Nørgaard; Bhaskaran, K; Heide-Jørgensen, U

    2017-01-01

    BACKGROUND: Bleeding activates platelets that can bind tumour cells, potentially promoting metastatic growth in patients with cancer. This study investigated whether reoperation for postoperative bleeding is associated with breast cancer recurrence. METHODS: Using the Danish Breast Cancer Group d...

  9. Postprandial effects of consuming a staggered meal on gut peptide and glycemic responses in obese women and men.

    Science.gov (United States)

    Griffith, Lisa; Haddad, Ella H; Tonstad, Serena

    2016-01-01

    Eating slowly by staggering a meal may reduce energy intake. Our aim was to examine the effect of eating a portion of beans 15min before the rest of the meal, on gastrointestinal (GI) peptides, glucose and insulin concentrations and subsequent energy intake in obese adults. This was a randomised crossover design study with 28 obese subjects. Participants consumed a standardised breakfast on test days followed by test meals: (1) control meal containing 86g (0.5 cup) of beans, and (2) staggered meal in which 86g (0.5 cup) of beans were consumed 15min before the rest of the meal. Blood obtained prior to and at 30, 60, and 120min following the meals was analysed for acylated ghrelin, unacylated ghrelin, glucagon-like peptide-1 (GLP-1), peptide YY, oxyntomodulin, glucose and insulin. Feelings of hunger and satiety were assessed using analog visual scales. Energy intake following the test meal was obtained by computer assisted dietary recalls. Mixed model statistical analysis of data showed time effects for unacylated ghrelin, GLP-1, glucose, insulin, hunger and fullness, however, meal effects were not shown for any of the parameters. GLP-1 area under the curve from baseline to 120min (AUC0-120) decreased by 19% (P=0.024) and that of glucose increased by 7% (P=0.046) following the staggered compared to the control bean meal. Energy intake subsequent to the test meals did not differ between treatments. In conclusion, lengthening meal times by staggering eating did not benefit hormonal, metabolic or appetite control in obese individuals. Copyright © 2015 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

  10. PARACIUDADES. Rompiendo tabúes en búsqueda de una renovación urbana.

    OpenAIRE

    Carlos Medellín

    2015-01-01

    ¿Qué pasaría si los pensamientos y anhelos de los ciudadanos comenzaran a ser expresados libremente y, de este modo, permitir que todos seamos atraídos o convertidos en atracción, rompiendo los tabúes sobre la forma de abordar al extraño y al desconocido? ¿Qué pasaría si los ciudadanos tuviésemos acceso a una superficie reactiva al aire libre, pero que opera bajo nuestro propio control? El objetivo de esta iniciativa es utilizar y explorar la ciudad de otra manera al hacer evidente lo q...

  11. JIGSAW-GEO (1.0): locally orthogonal staggered unstructured grid generation for general circulation modelling on the sphere

    Science.gov (United States)

    Engwirda, Darren

    2017-06-01

    An algorithm for the generation of non-uniform, locally orthogonal staggered unstructured spheroidal grids is described. This technique is designed to generate very high-quality staggered Voronoi-Delaunay meshes appropriate for general circulation modelling on the sphere, including applications to atmospheric simulation, ocean-modelling and numerical weather prediction. Using a recently developed Frontal-Delaunay refinement technique, a method for the construction of high-quality unstructured spheroidal Delaunay triangulations is introduced. A locally orthogonal polygonal grid, derived from the associated Voronoi diagram, is computed as the staggered dual. It is shown that use of the Frontal-Delaunay refinement technique allows for the generation of very high-quality unstructured triangulations, satisfying a priori bounds on element size and shape. Grid quality is further improved through the application of hill-climbing-type optimisation techniques. Overall, the algorithm is shown to produce grids with very high element quality and smooth grading characteristics, while imposing relatively low computational expense. A selection of uniform and non-uniform spheroidal grids appropriate for high-resolution, multi-scale general circulation modelling are presented. These grids are shown to satisfy the geometric constraints associated with contemporary unstructured C-grid-type finite-volume models, including the Model for Prediction Across Scales (MPAS-O). The use of user-defined mesh-spacing functions to generate smoothly graded, non-uniform grids for multi-resolution-type studies is discussed in detail.

  12. Development of multi dimensional analysis code for containment safety and performance based on staggered semi-implicit finite volume method

    International Nuclear Information System (INIS)

    Hong, Soon Joon; Hwang, Su Hyun; Han, Tae Young; Lee, Byung Chul; Byun, Choong Sup

    2009-01-01

    A solver of 3-dimensional thermal hydraulic analysis code for a large building having multi rooms such as reactor containment was developed based on 2-phase and 3-field conservation equations. Three fields mean gas, continuous liquid, and dispersed drop. Gas field includes steam, air and hydrogen. Gas motion equation and state equation also considered. Homogeneous and equilibrium conditions were assumed for gas motion equation. Source terms related with phase change were explicitly expressed for the implicit scheme. Resultantly, total 17 independent equations were setup, and total 17 primitive unknowns were identified. Numerical scheme followed the FVM (Finite Volume Method) based on staggered orthogonal structured grid and semi-implicit method. Staggered grid system produces staggered numerical cells of a scalar cell and a vector cell. The porosity method was adopted for easy handling the complex structures inside a computational cell. Such porosity method has been known to be very effective in reducing mesh numbers and acquiring accurate results in spite of fewer meshes. In the actual programming C++ language of OOP (Object Oriented Programming) was used. The code developed by OOP has the features such as the information hiding, encapsulation, modularity and inheritance. These can offer code developers the more explicit and clearer development method. Classes were designed. Cell and Face, and Volume and Component are the bases of the largest Class, System. Class Solver was designed in order to run the solver. Sample runs showed physically reasonable results. The foundation of code was setup through a series of numerical development. (author)

  13. Entropy Stable Staggered Grid Discontinuous Spectral Collocation Methods of any Order for the Compressible Navier--Stokes Equations

    KAUST Repository

    Parsani, Matteo

    2016-10-04

    Staggered grid, entropy stable discontinuous spectral collocation operators of any order are developed for the compressible Euler and Navier--Stokes equations on unstructured hexahedral elements. This generalization of previous entropy stable spectral collocation work [M. H. Carpenter, T. C. Fisher, E. J. Nielsen, and S. H. Frankel, SIAM J. Sci. Comput., 36 (2014), pp. B835--B867, M. Parsani, M. H. Carpenter, and E. J. Nielsen, J. Comput. Phys., 292 (2015), pp. 88--113], extends the applicable set of points from tensor product, Legendre--Gauss--Lobatto (LGL), to a combination of tensor product Legendre--Gauss (LG) and LGL points. The new semidiscrete operators discretely conserve mass, momentum, energy, and satisfy a mathematical entropy inequality for the compressible Navier--Stokes equations in three spatial dimensions. They are valid for smooth as well as discontinuous flows. The staggered LG and conventional LGL point formulations are compared on several challenging test problems. The staggered LG operators are significantly more accurate, although more costly from a theoretical point of view. The LG and LGL operators exhibit similar robustness, as is demonstrated using test problems known to be problematic for operators that lack a nonlinear stability proof for the compressible Navier--Stokes equations (e.g., discontinuous Galerkin, spectral difference, or flux reconstruction operators).

  14. 14 CFR 23.1111 - Turbine engine bleed air system.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Turbine engine bleed air system. 23.1111... Induction System § 23.1111 Turbine engine bleed air system. For turbine engine bleed air systems, the following apply: (a) No hazard may result if duct rupture or failure occurs anywhere between the engine port...

  15. Colonoscopic examination of rectal bleeding in children: A report of ...

    African Journals Online (AJOL)

    Rectal bleeding in children is a frightening and cause of great concern, and of parental anxiety. In this report, we present the value of colonoscopy to unravel the diagnostic conundrum often associated with rectal bleeding in children. Key words: Children, colonoscopy, juvenile polyps, rectal bleeding ...

  16. Leech as a cause of abnormal vaginal bleeding: Presentation of ...

    African Journals Online (AJOL)

    Leech bites are a recognized cause of bleeding from any human orifice upon exposure to water which is infested with leeches. A high level of suspicion is necessary to make the diagnosis and institute cost-effective definitive treatment for leech bite induced bleeding including vaginal bleeding as has been revealed by the ...

  17. No increased systemic fibrinolysis in women with heavy menstrual bleeding

    NARCIS (Netherlands)

    Wiewel-Verschueren, S.; Knol, H. M.; Lisman, T.; Bogchelman, D. H.; Kluin-Nelemans, J. C.; van der Zee, A.G.J.; Mulder, A.B.; Meijer, K.

    BackgroundBleeding disorders have been recognized as important etiologic or contributory factors in women with heavy menstrual bleeding. Fibrinolysis in the endometrium plays a role in heavy menstrual bleeding. It is unknown whether increased systemic fibrinolysis might also increase the risk of

  18. Small intestinal diverticulum with bleeding: Case report and literature review.

    Science.gov (United States)

    Zhao, Lifang; Lu, Wei; Sun, Yinping; Liang, Junrong; Feng, Shanshan; Shi, Yongquan; Wu, Qiong; Wang, Jianhong; Wu, Kaichun

    2018-03-01

    Small intestinal diverticulum with bleeding is an important reason for obscure gastrointestinal bleeding (OGB) , in addition to tumor and vascular diseases. Small intestinal diverticulum with bleeding is difficult to detect by barium meal and angiographic methods and has been regarded as an important cause of obscure gastrointestinal tract bleeding in adolescents. Because of its complicated etiology and non-specific clinical manifestations, it is relatively difficult to detect small intestinal diverticulum with bleeding, especially in patients with a large amount of bleeding and hemodynamic instability. This retrospective study collects clinical statistics of 19 patients admitted to our hospital from January 2010 to December 2016. Patients who had small intestinal diverticulum patients with bleeding were included in this study. Patients who were taking anticoagulants were excluded DIAGNOSES:: Small intestinal diverticulum patients with bleeding. This retrospective study describes the clinical features of patients with small intestinal diverticulum whose main symptom was gastrointestinal bleeding and analyze the literature on this topic, with particular reference to the clinical characteristics, pathological features, and choice of examination methods. Small intestinal diverticulum with bleeding is a common cause of obscure gastrointestinal bleeding, but it is difficult to detect using normal examination methods. For patients with repeated gastrointestinal bleeding and no positive results found on gastroscopy and colonoscopy, endoscopy of the small intestine and CTE with contrast can be considered as a diagnostic modality.

  19. Helping mothers survive bleeding after birth

    DEFF Research Database (Denmark)

    Nelissen, Ellen; Ersdal, Hege; Ostergaard, Doris

    2014-01-01

    OBJECTIVE: To evaluate "Helping Mothers Survive Bleeding After Birth" (HMS BAB) simulation-based training in a low-resource setting. DESIGN: Educational intervention study. SETTING: Rural referral hospital in Northern Tanzania. POPULATION: Clinicians, nurse-midwives, medical attendants, and ambul......OBJECTIVE: To evaluate "Helping Mothers Survive Bleeding After Birth" (HMS BAB) simulation-based training in a low-resource setting. DESIGN: Educational intervention study. SETTING: Rural referral hospital in Northern Tanzania. POPULATION: Clinicians, nurse-midwives, medical attendants...... low (3% pass rate for basic delivery and management of postpartum hemorrhage). CONCLUSIONS: The HMS BAB simulation-based training has potential to contribute to education of health care providers. We recommend a full day of training and validation of the facilitators to improve the training....

  20. Treatment and prognosis in peptic ulcer bleeding.

    Science.gov (United States)

    Laursen, Stig Borbjerg

    2014-01-01

    Peptic ulcer bleeding is a frequent cause of admission. Despite several advances in treatment the 30-day mortality seems unchanged at a level around 11%. Use of risk scoring systems is shown to be advantageous in the primary assessment of patients presenting with symptoms of peptic ulcer bleeding. Studies performed outside Denmark have demonstrated that use of risk scoring systems facilitates identification of low-risk patients suitable for outpatient management. Nevertheless, these systems have not been implemented for routine use in Denmark. This is mainly explained by concerns about the external validity due to considerable inter-country variation in patients' characteristics. In recent years, transcatheter arterial embolization (TAE) has become increasingly used for achievement of hemostasis in patients with peptic ulcer bleeding not responding to endoscopic therapy. As rebleeding is associated with poor outcome TAE could, in theory, also be beneficial as a supplementary treatment in patients with ulcer bleeding responding to endoscopic therapy. This has not been examined previously. Several studies have concluded that peptic ulcer bleeding is associated with excess long-term mortality. These findings are, however, questioned as the studies were based on life-table analysis, unmatched control groups, or did not perform adequate adjustment for comorbidity. Treatment with blood transfusion is, among patients undergoing cardiac bypass surgery, shown to increase the long-term mortality. Despite frequent use of blood transfusion in treatment of peptic ulcer bleeding a possible adverse effect of on long-term survival has not been examined in these patients. The aims of the present thesis were: 1. To examine which risk scoring system is best at predicting need of hospital-based intervention, rebleeding, and mortality in patients presenting with upper gastrointestinal bleeding (Study I) 2. To evaluate if supplementary transcatheter arterial embolization (STAE) after

  1. [Bleeding gastric inflammatory fibroid polyp (Vanek's tumor)].

    Science.gov (United States)

    Guţu, E; Ghidirim, Gh; Mişin, I; Iakovleva, Iraida; Vozian, M

    2010-01-01

    Inflammatory fibroid polyp's (IFP) or Vanek tumor of the gastrointestinal tract represents a relatively unusual entity. IFP is an extremely rare cause of upper gastrointestinal bleeding. We report herein a case of a 30-year-old woman who had a gastric IFP complicated by gastrointestinal bleeding and obstructive symptoms. The lesion was mistaken on endoscopic, radiologic examination and in the operating room for a gastrointestinal stromal tumor (GIST). Preoperative endoscopic examination revealed a protruding oval-shaped submucosal lesion (approximately 7 cm in size) of the gastric antrum, with ulceration of the mucosal surface. Multiple endoscopic biopsies were negative for neoplastic changes. Barium meal study disclosed a large tumor in the prepyloric area of the stomach. Presumptive preoperative diagnosis was GIST. Subtotal Bilroth II gastrectomy en bloc with the mass and lymphadenectomy was performed. Surprisingly, the final histological diagnosis was IFP. Postoperative course was uneventful and no recurrences were observed during 4 years follow-up. With reference to case report, the etiology, diagnosis and treatment strategy of IFP will be discussed. This case highlights an unusual presentation of IFP. Although bleeding may represent a rare complication due IFP, it should be considered in the differential diagnosis of upper gastrointestinal hemorrhage of uncertain etiology.

  2. Treatment Modalities in Adolescents Who present With Heavy Menstrual Bleeding.

    Science.gov (United States)

    Alaqzam, Tasneem S; Stanley, Angela C; Simpson, Pippa M; Flood, Veronica H; Menon, Seema

    2018-03-07

    This study sought to determine the relationship of bleeding disorders to iron deficiency anemia. Additionally, this study was undertaken to examine all current treatment modalities used in a menorrhagia clinic with respect to heavy menstrual bleeding management to identify the most effective options for menstrual management in the setting of an underlying bleeding disorder. DESIGN, SETTING, PARTICIPANT, INTERVENTION, AND MAIN OUTCOME MEASURES: Retrospective chart review of adolescent <21 years with heavy menstrual bleeding attending a multidisciplinary hematology-adolescent gynecology clinic. Information included demographics, bleeding diathesis, hematologic parameters, treatment, and the diagnosis was extracted from each chart. Subjects were grouped into two categories based on the diagnosis of a bleeding disorder. Hemoglobin level, iron deficiency anemia, and need for transfusion were compared between a bleeding disorder and no bleeding disorder group. Subjects were grouped into categories depending on hormonal modality and treatment success of the groups were compared. 73 subjects tested for a bleeding disorder. Of the subjects completing testing, 34 (46%) were diagnosed with a bleeding disorders. 39 (54%) subjects had heavy menstrual bleeding due to other causes. There was no significant difference in hemoglobin between those with and without a bleeding disorder. Iron deficiency anemia was significantly higher in subjects without bleeding disorder. When comparing hormone therapy success, the levonorgestrel IUD (LNG-IUD) (89%) had the highest rate of menstrual suppression followed by norethindrone acetate 5-10mg/day (83%), and the transdermal patch (80%). All subjects using both tranexamic acid and hormonal therapy had 100% achievement of menstrual suppression. A high frequency of bleeding disorder was found in those tested. Subjects with a bleeding disorder were less likely to present with severe anemia requiring blood transfusion and less likely to have iron

  3. Research of heat transfer of staggered horizontal bundles of finned tubes at free air convection

    Science.gov (United States)

    Novozhilova, A. V.; Maryna, Z. G.; Samorodov, A. V.; Lvov, E. A.

    2017-11-01

    The study of free-convective processes is important because of the cooling problem in many machines and systems, where other ways of cooling are impossible or impractical. Natural convective processes are common in the steam turbine air condensers of electric power plants located within the city limits, in dry cooling towers of circulating water systems, in condensers cooled by air and water, in radiators cooling oil of power electric transformers, in emergency cooling systems of nuclear reactors, in solar power, as well as in air-cooling of power semiconductor energy converters. All this makes actual the synthesis of the results of theoretical and experimental research of free convection for heat exchangers with finned tube bundles. The results of the study of free-convection heat transfer for two-, three- and four-row staggered horizontal bundles of industrial bimetallic finned tubes with finning factor of 16.8 and equilateral tubes arrangement are presented. Cross and diagonal steps in the bundles are the same: 58; 61; 64; 70; 76; 86; 100 mm, which corresponds to the relative steps: 1.042; 1.096; 1.152; 1.258; 1.366; 1.545; 1.797. These steps are standardized for air coolers. An equation for calculating the free-convection heat transfer, taking into account the influence of geometrical parameters in the range of Rayleigh number from 30,000 to 350,000 with an average deviation of ± 4.8%, has been obtained. The relationship presented in the article allows designing a wide range of air coolers for various applications, working in the free convection modes.

  4. Comparing Bleeding Risk Assessment Focused on Modifiable Risk Factors Only Versus Validated Bleeding Risk Scores in Atrial Fibrillation

    DEFF Research Database (Denmark)

    Guo, Yutao; Zhu, Hang; Chen, Yundai

    2018-01-01

    predictive ability for major bleeding (c-index 0.63, 95% confidence interval 0.56-0.69) and intracranial hemorrhage (0.72, 0.65-0.79) but nonsignificantly (and poorly) predicted extracranial bleeding (0.55, 0.54-0.56; P = .361). The HAS-BLED score was superior to predict bleeding events compared...

  5. Bleeding risk in 'real world' patients with atrial fibrillation: comparison of two established bleeding prediction schemes in a nationwide cohort

    DEFF Research Database (Denmark)

    Olesen, J B; Lip, G Y H; Hansen, P R

    2011-01-01

    Oral anticoagulation (OAC) in patients with atrial fibrillation (AF) is a double-edged sword, because it decreases the risk of stroke at the cost of an increased risk of bleeding. We compared the performance of a new bleeding prediction scheme, HAS-BLED, with an older bleeding prediction scheme...

  6. Jejunal Diverticula Causing Unusual Massive Lower Gastrointestinal Bleeding

    Directory of Open Access Journals (Sweden)

    Chiong-Hee Wong

    2008-09-01

    Full Text Available Jejunal diverticula are rare and difficult to diagnose. They are often asymptomatic, but they may infrequently cause serious acute complications, such as diverticulitis with or without perforation, volvulus, intussusception, or hemorrhage. Hemorrhage of jejunal diverticula usually presents as lower gastrointestinal bleeding. Diverticula with bleeding may be associated with some anticoagulants, antiplatelets or nonsteroidal antiinflammatory agents in the elderly. In our case, upper gastroscopy and colonoscopy could not easily disclose the bleeding. Selective mesenteric angiography is the gold standard for diagnosis of active and fatal bleeding. The management of a bleeding jejunal diverticulum is surgical resection of the involved segment of jejunum.

  7. [ENDOSCOPIC INJECTION TREATMENT OF BLEEDING PEPTIC ULCER

    Science.gov (United States)

    Díaz, Freddy; Contardo, Carlos; Román, Rossana; Eduardo, Vesco; Dávalos, Milagros; Velásquez, Hermes; Soriano, César; Espejo, Hernán

    1997-01-01

    BACKGROUND: Objectives were two. (1) to determine theefficiency of the endoscopic injection therapy (EIT) in patients suffering from bleeding caused by peptic ulcer disease with high risk of recurrence, and (2) to recognize clinical and endoscopical risk factors that influence recurrence of hemorrhage and mortality from this pathology. METHODS: This is a retrospective study that included 121 patients, who were admitted by a unit specialized in managing gastrointestinal hemorrhage owing to peptic ulcer with active bleeding or non-bleeding visible vessel, and who underwent EIT with epinephrine between March, 1994 and February, 1996.RESULTS: Initial success was achieved in 119 patients who underwent EIT (99,1%). Bleeding persisted in one patient (0,9%), and in another one, EIT was not sucessful because of inaccessible location. Definite hemostasis was achieved in 93 patients (77,5%) and there was recurrence in 28 cases (23,5%). Twenty-six patients underwent surgical therapy (21,5%). The univariable analysis showed that hemorrhage recurrence was related to the presence of shock (p = 0,002), hematemesis (p = 0,2), age over 60 (p = 0,009), number of blood units transfused (p = 0,00000) and ulcer diameter larger than 2 cm (p = 0,018). The global mortality in our patients was of 10%, and surgical mortality was of 34,6%. Factors significantly related to mortality were hemorrhage recurrence (p = 0,000003), presence of concomitant disease (p = 0,05), and presence of gastric ulcer (p = 0,021), in addition to age (over 60), presence of shock and ulcer diameter larger than 2 cm (p = 0,05).CONCLUSION: EIT is a valuable procedure for the treatment of hemorrhage caused by peptic ulcer with high risk of recurrence (active hemorrhage or visible vessel), with a definite hemostasis of 77,5%. The presence of shock, hematemesis, age over 60, transfusion requirements of more than 3 blood units, and ulcer diameter of more than 2 cm are factors that increase the probability of hemorrhage

  8. Influence of surface layer removal of shade guide tabs on the measured color by spectrophotometer and spectroradiometer.

    Science.gov (United States)

    Kim, Jin-Cheol; Yu, Bin; Lee, Yong-Keun

    2008-12-01

    To determine the changes in color parameters of Vitapan 3D-Master shade guide tabs by a spectrophotometer (SP) or a spectroradiometer (SR), and by the removal of the surface layer of the tabs that was performed to make a flat measuring surface for the SP color measurement. Color of the shade tabs was measured before and after removing the surface layer of the tabs using SP and SR. Correlations between the color parameters between the original (OR) and the surface layer removed (RM) tabs and between the SP and the SR measurements were determined (alpha=0.05). Based on SP, the lightness, chroma, CIE a* and b* values measured after the surface layer removal were higher than those of the original tabs except a few cases. Based on SR, the chroma and CIE a* and b* values measured after surface layer removal were higher than those of the original tabs except a few cases; however, in case of the lightness, the changes varied by the shade designation. Type of instrument influenced the changes in color parameters based on paired t-test (pspectrophotometer or a spectroradiometer, measurement protocols should be specified because color difference by the surface layer removal and the instrument was high.

  9. Risk factors for severity and recurrence of colonic diverticular bleeding

    Directory of Open Access Journals (Sweden)

    Joaquim Natércia

    Full Text Available Background: Colonic diverticular bleeding is the most common cause of lower gastrointestinal bleeding. Risk factors related to severity and repeated bleeding episodes are not completely clearly defined. Objective: To characterize a Portuguese population hospitalized due to colonic diverticular bleeding and to identify the clinical predictors related to bleeding severity and rebleeding. Methods: Retrospective analysis of all hospitalized patients diagnosed with colonic diverticular bleeding from January 2008 to December 2013 at our institution. The main outcomes evaluated were bleeding severity, defined as any transfusion support requirements and/or signs of hemodynamic shock, and 1-year recurrence rate. Results: Seventy-four patients were included, with a mean age of 75.7 ± 9.5 years; the majority were male (62.2%. Thirty-six patients (48.6% met the criteria for severe bleeding; four independent risk factors for severe diverticular bleeding were identified: low hemoglobin level at admission (≤ 11 g/dL; OR 18.8, older age (≥ 75 years; OR 4.7, bilateral diverticular location (OR 14.2 and chronic kidney disease (OR 5.6. The 1-year recurrence rate was 12.9%. We did not identify any independent risk factor for bleeding recurrence in this population. Conclusion: In this series, nearly half of the patients hospitalized with diverticular bleeding presented with severe bleeding. Patients with low hemoglobin levels, older age, bilateral diverticular location and chronic kidney disease had a significantly increased risk for severe diverticular bleeding. In addition, a small number of patients rebled within the first year after the index episode, although we could not identify independent risk factors associated with the recurrence of diverticular bleeding.

  10. Optimized Size and Tab Width in Partial Solar Cell Modules including Shingled Designs

    Directory of Open Access Journals (Sweden)

    Julius Roeth

    2017-01-01

    Full Text Available Cell-to-module loss (CTM loss is defined by optical and electrical losses. Using partial solar cells can reduce ohmic losses. Today, some manufactures use halved cells even if they have to employ extra effort for sorting, placing, and soldering the solar cells. In this work, the advantage of partial solar cells is described. An LTSpice simulation is used to quantify the reduced ohmic loss and the resulting efficiency gain for differently separated solar cells. This efficiency gain is compared with the whole module area caused by the tab and cell areas. The additional gain due to the backsheet reflection is added afterwards. It can be pointed out that the use of half cells is a technical optimal application while not using shingled modules.

  11. Field test of a thermal active building system (tabs) in an office building in Denmark

    DEFF Research Database (Denmark)

    Raimondo, Daniela; Olesen, Bjarne W.; Corgnati, Stefano P.

    2013-01-01

    An increasing attention has been addressed in the last years to the assessment, at the same time, of energy performances and indoor environmental quality in buildings. Focusing on thermal comfort recent international standards as ISOEN7730 and EN15251 introduce criteria for using categories...... in the indoor environmental assessment of a building. At the same time, also use of low temperature heating and high temperature cooling systems in non-residential buildings has increased, due to the energy efficiency and the economical cooling and heating performance of tins kind of plants. This paper presents...... an experimental study in an office building in Denmark where cooling in summer is provided by thermally activated building systems (TABS). Indoor climate quality evaluation, cooling system performance and energy consumption for a specific room were analyzed with different levels of internal gains. The experiments...

  12. 3D Staggered-Grid Finite-Difference Simulation of Acoustic Waves in Turbulent Moving Media

    Science.gov (United States)

    Symons, N. P.; Aldridge, D. F.; Marlin, D.; Wilson, D. K.; Sullivan, P.; Ostashev, V.

    2003-12-01

    Acoustic wave propagation in a three-dimensional heterogeneous moving atmosphere is accurately simulated with a numerical algorithm recently developed under the DOD Common High Performance Computing Software Support Initiative (CHSSI). Sound waves within such a dynamic environment are mathematically described by a set of four, coupled, first-order partial differential equations governing small-amplitude fluctuations in pressure and particle velocity. The system is rigorously derived from fundamental principles of continuum mechanics, ideal-fluid constitutive relations, and reasonable assumptions that the ambient atmospheric motion is adiabatic and divergence-free. An explicit, time-domain, finite-difference (FD) numerical scheme is used to solve the system for both pressure and particle velocity wavefields. The atmosphere is characterized by 3D gridded models of sound speed, mass density, and the three components of the wind velocity vector. Dependent variables are stored on staggered spatial and temporal grids, and centered FD operators possess 2nd-order and 4th-order space/time accuracy. Accurate sound wave simulation is achieved provided grid intervals are chosen appropriately. The gridding must be fine enough to reduce numerical dispersion artifacts to an acceptable level and maintain stability. The algorithm is designed to execute on parallel computational platforms by utilizing a spatial domain-decomposition strategy. Currently, the algorithm has been validated on four different computational platforms, and parallel scalability of approximately 85% has been demonstrated. Comparisons with analytic solutions for uniform and vertically stratified wind models indicate that the FD algorithm generates accurate results with either a vanishing pressure or vanishing vertical-particle velocity boundary condition. Simulations are performed using a kinematic turbulence wind profile developed with the quasi-wavelet method. In addition, preliminary results are presented

  13. Surface Adsorption of Oppositely Charged SDS:C(12)TAB Mixtures and the Relation to Foam Film Formation and Stability.

    Science.gov (United States)

    Fauser, Heiko; Uhlig, Martin; Miller, Reinhard; von Klitzing, Regine

    2015-10-08

    The complexation, surface adsorption, and foam film stabiliztation of the oppositely charged surfactants, sodium dodecyl sulfate (SDS) and dodecyl trimethylammonium bromide (C12TAB), is analyzed. The SDS:C12TAB mixing ratio is systematically varied to investigate whether the adsorption of equimolar or irregular catanionic surfactant complexes, and thus a variation in surface charge (i.e., surface excess of either SDS or C12TAB), governs foam film properties. Surface tension measurements indicate that SDS and C12TAB interact electrostatically in order to form stoichometric catanionic surfactant complexes and enhance surface adsorption. On the other hand it can be demonstrated that the SDS:C12TAB mixing ratio and, thus, a change in surface charge and composition plays a decisive role in foam film stabilization. The present study demonstrates that varying the mixing ratio between SDS and C12TAB offers a tool for tailoring surface composition and foam film properties, which are therefore not exclusively mediated by the presence of equimolar catanionic surfactant complexes. The SDS:C12TAB net amount and mixing ratio determine the type, stability, and thinning behavior of the corresponding foam film. These observations indicate the formation of a mixed surface layer, composed of the catanionic surfactant species surrounded by either free SDS or C12TAB molecules in excess. Furthermore, a systematic variation in CBF-NBF transition kinetics is rationalized on the basis of a microscopic phase transition within the foam films. Fundamental knowlegde gained from this research gives insight into the surface adsorption and foam film formation of catanionic surfactant mixtures. The study helps researchers to understand basic mechanisms of foam film stabilization and to use resources more efficiently.

  14. An Unusual Case of Gastrointestinal Bleeding

    Directory of Open Access Journals (Sweden)

    Kristin N. Fiorino

    2011-01-01

    Full Text Available A 10-year-old boy presented with a 3-day history of worsening abdominal pain, fever, emesis and melena. Abdominal ultrasound revealed a right upper quadrant mass that was confirmed by computed tomography angiogram (CTA, which showed an 8 cm well-defined retroperitoneal vascular mass. 123Iodine metaiodobenzylguanidine (123MIBG scan indicated uptake only in the abdominal mass. Subsequent biopsy revealed a paraganglioma that was treated with chemotherapy. This case represents an unusual presentation of a paraganglioma associated with gastrointestinal (GI bleeding and highlights the utility of CTA and 123MIBG in evaluation and treatment.

  15. An unusual case of gastrointestinal bleeding.

    Science.gov (United States)

    Fiorino, Kristin N; Lestini, Brian; Nichols, Kim E; Anupindi, Sudha A; Maqbool, Asim

    2011-01-01

    A 10-year-old boy presented with a 3-day history of worsening abdominal pain, fever, emesis and melena. Abdominal ultrasound revealed a right upper quadrant mass that was confirmed by computed tomography angiogram (CTA), which showed an 8 cm well-defined retroperitoneal vascular mass. (123)Iodine metaiodobenzylguanidine ((123)MIBG) scan indicated uptake only in the abdominal mass. Subsequent biopsy revealed a paraganglioma that was treated with chemotherapy. This case represents an unusual presentation of a paraganglioma associated with gastrointestinal (GI) bleeding and highlights the utility of CTA and (123)MIBG in evaluation and treatment.

  16. An Unusual Case of Gastrointestinal Bleeding

    Science.gov (United States)

    Fiorino, Kristin N.; Lestini, Brian; Nichols, Kim E.; Anupindi, Sudha A.; Maqbool, Asim

    2011-01-01

    A 10-year-old boy presented with a 3-day history of worsening abdominal pain, fever, emesis and melena. Abdominal ultrasound revealed a right upper quadrant mass that was confirmed by computed tomography angiogram (CTA), which showed an 8 cm well-defined retroperitoneal vascular mass. 123Iodine metaiodobenzylguanidine (123MIBG) scan indicated uptake only in the abdominal mass. Subsequent biopsy revealed a paraganglioma that was treated with chemotherapy. This case represents an unusual presentation of a paraganglioma associated with gastrointestinal (GI) bleeding and highlights the utility of CTA and 123MIBG in evaluation and treatment. PMID:22606522

  17. Endoscopic hemostasis state of the art - Nonvariceal bleeding.

    Science.gov (United States)

    Goelder, Stefan Karl; Brueckner, Juliane; Messmann, Helmut

    2016-02-25

    New endoscopic techniques for hemostasis in nonvariceal bleeding were introduced and known methods further improved. Hemospray and Endoclot are two new compounds for topical treatment of bleeding. Initial studies in this area have shown a good hemostatic effect, especially in active large scale oozing bleeding, e.g., tumor bleedings. For further evaluation larger prospective studies comparing the substanced with other methods of endoscopic hemostasis are needed. For localized active arterial bleeding primary injection therapy in the area of ​​bleeding as well as in the four adjacent quadrants offers a good method to reduce bleeding activity. The injection is technically easy to learn and practicable. After bleeding activity is reduced the bleeding source can be localized more clearly for clip application. Today many different through-the-scope (TTS) clips are available. The ability to close and reopen a clip can aid towards good positioning at the bleeding site. Even more important is the rotatability of a clip before application. Often multiple TTS clips are required for secure closure of a bleeding vessel. One model has the ability to use three clips in series without changing the applicator. Severe arterial bleeding from vessels larger than 2 mm is often unmanageable with these conventional methods. Here is the over-the-scope-clip system another newly available method. It is similar to the ligation of esophageal varices and involves aspiration of tissue into a transparent cap before closure of the clip. Thus a greater vascular occlusion pressure can be achieved and larger vessels can be treated endoscopically. Patients with severe arterial bleeding from the upper gastrointestinal tract have a very high rate of recurrence after initial endoscopic treatment. These patients should always be managed in an interdisciplinary team of interventional radiologist and surgeons.

  18. Dual-mixed finite elements for the three-field Stokes model as a finite volume method on staggered grids

    KAUST Repository

    Kou, Jisheng

    2017-06-09

    In this paper, a new three-field weak formulation for Stokes problems is developed, and from this, a dual-mixed finite element method is proposed on a rectangular mesh. In the proposed mixed methods, the components of stress tensor are approximated by piecewise constant functions or Q1 functions, while the velocity and pressure are discretized by the lowest-order Raviart-Thomas element and the piecewise constant functions, respectively. Using quadrature rules, we demonstrate that this scheme can be reduced into a finite volume method on staggered grid, which is extensively used in computational fluid mechanics and engineering.

  19. Heat transfer of a staggered fining flat-oval tube banks in cross flow at the small Reynolds number

    Directory of Open Access Journals (Sweden)

    Максим Михайлович Вознюк

    2015-05-01

    Full Text Available Experimental investigations of heat transfer of staggered bundles of flat-oval tubes with incomplete transversal finning in the range of Reynolds numbers 500 < <20000 are performed. New calculation correlations for determining of heat transfer coefficients for 1<3000 are suggested, the impact of basic geometric and regime parameters on intensity of external heat transfer are determined. The received calculation depending is possible to use in developing of heat transfer surfaces for “dry” cooling towers and air cooling apparatuses

  20. Effects of Front-Loading and Stagger Angle on Endwall Losses of High Lift Low Pressure Turbine Vanes

    Science.gov (United States)

    2012-09-01

    length scale at z/H = 0.20 ………….… 131 Fig. E.1 Traverse arrangement to enable 3D movement inside the wind tunnel …..… 132 Fig. E.2 Diagram of in...2 ] USAF = United States Air Force 2D = two-dimensional 3D = three-dimensional 1 EFFECTS OF FRONT-LOADING AND STAGGER ANGLE ON ENDWALL...within the wakes. I used Druck LPM 5481 pressure transducers, calibrated using a Ruska 7250LP laboratory standard (the reported accuracy is within

  1. Predicting major bleeding in patients with noncardioembolic stroke on antiplatelets: S2TOP-BLEED

    NARCIS (Netherlands)

    Hilkens, Nina A.; Algra, Ale; Diener, Hans-Christoph; Reitsma, Johannes B.; Bath, Philip M.; Csiba, Laszlo; Hacke, Werner; Kappelle, L. Jaap; Koudstaal, Peter J.; Leys, Didier; Mas, Jean-Louis; Sacco, Ralph L.; Amarenco, Pierre; Sissani, Leila; Greving, Jacoba P.; Gent, M.; Beaumont, D.; Blanchard, J.; Bousser, M. G.; Coffman, J.; Easton, J. D.; Hampton, J. R.; Harker, L. A.; Janzon, L.; Kusmierek, Jje; Panak, E.; Roberts, R. S.; Shannon, S.; Sicurella, J.; Tognoni, G.; Topol, E. J.; Verstraete, M.; Warlow, C.; Blard, J. M.; Capildeo, R.; Diener, H. C.; Ersmark, B.; Escartin, A.; Ferro, J.; Galvin, R.; Hogenhuis, Lah; Laterre, C.; Provincial, L.; Rinne, U. K.; Bovim, G.; Lowenthal, A.; Bogousslavsky, J.; Brass, L.; Cimminiello, C.; Csiba, L.; Kaste, M.; Leys, D.; Matias-Guiu, J.; Rupprecht, H. J.; Berger, P. B.; Bhatt, D. L.; Black, H. R.; Boden, W. E.; Cacoub, P.; Cohen, E. A.; Creager, M. A.; Flather, M. D.; Fox, Kaa; Hacke, W.; Haffner, S. M.; Hamm, C. W.; Hankey, G. J.; Johnston, S. C.; Mak, K. H.; Mas, J. L.; Montalescot, G.; Pearson, T. A.; Steg, P. G.; Steinhubl, S. R.; Weber, M. A.; Aichner, F.; Algra, A.; Chamorro, A.; Chen, Cplh; de Schryver, Ellm; Ferro, J. M.; van Gijn, J.; Hertzberger, L. I.; Koudstaal, P. J.; Ricci, S.; Ringelstein, E. B.; Vanhooren, G.; Venables, G. S.; Albers, G.; Bath, P.; Bornstein, N.; Chan, B.; Chen, S.-T.; Cunha, L.; Dahlöf, B.; DeKeyser, J.; Donnan, G.; Estol, C.; Gorelick, P.; Lu, C.; Pais, P.; Roberts, R.; Sacco, R.; Skvortsova, V.; Teal, P.; Toni, D.; Weber, M.; Yoon, B. W.; Yusuf, S.; Amarenco, P.; Bousser, M.-G.; Fisher, M.; Ford, I.; Fox, K. M.; Hennerici, M. G.; Mattle, H. P.; Rothwell, P.; Sissani, L.; Labreuche, J.; Steg, G.; Vicaut, E.

    2017-01-01

    To develop and externally validate a prediction model for major bleeding in patients with a TIA or ischemic stroke on antiplatelet agents. We combined individual patient data from 6 randomized clinical trials (CAPRIE, ESPS-2, MATCH, CHARISMA, ESPRIT, and PRoFESS) investigating antiplatelet therapy

  2. Otorrhagia bleeding due to leech bite

    Directory of Open Access Journals (Sweden)

    Narges Askari

    2012-01-01

    Full Text Available Leeches are blood-sucking hermaphroditic parasites that attach to vertebrate hosts, bite through the skin, and suck out blood. When leeches feed, they secrete an anticoagulant (hirudin, which helps them get a full meal of blood. This is the first report of leech removal from external auditory canal. Previous leech involvement cases were explained in nasopharynx, larynx, pharynx, eye, and gastrointestinal tract. Prominent sign of all cases was active bleeding from the leech attachment site; that stopped with leech removal. A 24-year-old man was presented to Al-Zahra hospital with left otorrhagia and otalgia from 2 days ago. After suction of ear a small soft foreign body was seen in the external ear near the tympanic membrane, then the ear filled with glycerine phenice, the patient explained decreased movement of foreign body. Four hours later the bloody discharge stopped and otalgia decreased. After suction of clots, a leech was extruded from external auditory canal by alligator. Leech infestation is a rare cause of otorrhagia and should be suspected in the endemic region in all of unusual bleeding; it can be diagnosed and treated by exact inspection and removal.

  3. Enteral alimentation and gastrointestinal bleeding in mechanically ventilated patients.

    Science.gov (United States)

    Pingleton, S K; Hadzima, S K

    1983-01-01

    The incidence of upper gastrointestinal (GI) bleeding in mechanically ventilated ICU patients receiving enteral alimentation was reviewed and compared to bleeding occurring in ventilated patients receiving prophylactic antacids or cimetidine. Of 250 patients admitted to our ICU during a 1-yr time period, 43 ventilated patients were studied. Patients in each group were comparable with respect to age, respiratory diagnosis, number of GI hemorrhage risk factors, and number of ventilator, ICU, and hospital days. Twenty-one patients had evidence of GI bleeding. Fourteen of 20 patients receiving antacids and 7 of 9 patients receiving cimetidine had evidence of GI bleeding. No bleeding occurred in 14 patients receiving enteral alimentation. Complications of enteral alimentation were few and none required discontinuation of enteral alimentation. Our preliminary data suggest the role of enteral alimentation in critically ill patients may include not only protection against malnutrition but also protection against GI bleeding.

  4. Abnormal Uterine Bleeding: American College of Nurse-Midwives.

    Science.gov (United States)

    2016-07-01

    Variations in uterine bleeding, termed abnormal uterine bleeding, occur commonly among women and often are physiologic in nature with no significant consequences. However, abnormal uterine bleeding can cause significant distress to women or may signify an underlying pathologic condition. Most women experience variations in menstrual and perimenstrual bleeding in their lifetimes; therefore, the ability of the midwife to differentiate between normal and abnormal bleeding is a key diagnostic skill. A comprehensive history and use of the PALM-COEIN classification system will provide clear guidelines for clinical management, evidence-based treatment, and an individualized plan of care. The purpose of this Clinical Bulletin is to define and describe classifications of abnormal uterine bleeding, review updated terminology, and identify methods of assessment and treatment using a woman-centered approach. © 2016 by the American College of Nurse-Midwives.

  5. Use of heparin in the investigation of obscure gastrointestinal bleeding

    International Nuclear Information System (INIS)

    Mernagh, J.R.; O'Donovan, N.; Somers, S.; Gill, G.; Sridhar, S.

    2001-01-01

    To determine if the administration of heparin improves the predictive value of angiography in the investigation of obscure gastrointestinal (GI) bleeding. 18 patients with a history of chronic GI bleeding were investigated with angiography. For 6 patients, the cause of GI bleeding was established with angiography; the 12 patients who had negative results were given heparin for 24 h and were reassessed with angiography. After heparin administration, the source of GI bleeding was determined with angiography for 6 of the remaining 12 patients. Thus, heparinization increased diagnostic yield from 33% (6 of 18) to 67% (12 of 18). No significant complications, such as uncontrolled GI bleeding, occurred. Heparinization improves the diagnostic yield of angiography when obscure GI bleeding is being investigated. (author)

  6. New Trends in Acute Management of Colonic Diverticular Bleeding

    OpenAIRE

    Cirocchi, Roberto; Grassi, Veronica; Cavaliere, Davide; Renzi, Claudio; Tabola, Renata; Poli, Giulia; Avenia, Stefano; Farinella, Eleonora; Arezzo, Alberto; Vettoretto, Nereo; D?Andrea, Vito; Binda, Gian Andrea; Fingerhut, Abe

    2015-01-01

    Abstract Colonic diverticular disease is the most common cause of lower gastrointestinal bleeding. In the past, this condition was usually managed with urgent colectomy. Recently, the development of endoscopy and interventional radiology has led to a change in the management of colonic diverticular bleeding. The aim of this systematic review is to define the best treatment for colonic diverticular bleeding. A systematic bibliographic research was performed on the online databases for studies ...

  7. New Trends in Acute Management of Colonic Diverticular Bleeding

    Science.gov (United States)

    Cirocchi, Roberto; Grassi, Veronica; Cavaliere, Davide; Renzi, Claudio; Tabola, Renata; Poli, Giulia; Avenia, Stefano; Farinella, Eleonora; Arezzo, Alberto; Vettoretto, Nereo; D’Andrea, Vito; Binda, Gian Andrea; Fingerhut, Abe

    2015-01-01

    Abstract Colonic diverticular disease is the most common cause of lower gastrointestinal bleeding. In the past, this condition was usually managed with urgent colectomy. Recently, the development of endoscopy and interventional radiology has led to a change in the management of colonic diverticular bleeding. The aim of this systematic review is to define the best treatment for colonic diverticular bleeding. A systematic bibliographic research was performed on the online databases for studies (randomized controlled trials [RCTs], observational trials, case series, and case reports) published between 2005 and 2014, concerning patients admitted with a diagnosis of diverticular bleeding according to the PRISMA methodology. The outcomes of interest were: diagnosis of diverticulosis as source of bleeding; incidence of self-limiting diverticular bleeding; management of non self-limiting bleeding (endoscopy, angiography, surgery); and recurrent diverticular bleeding. Fourteen studies were retrieved for analysis. No RCTs were found. Eleven non-randomized clinical controlled trials (NRCCTs) were included in this systematic review. In all studies, the definitive diagnosis of diverticular bleeding was always made by urgent colonoscopy. The colonic diverticular bleeding stopped spontaneously in over 80% of the patients, but a re-bleeding was not rare. Recently, interventional endoscopy and angiography became the first-line approach, thus relegating emergency colectomy to patients presenting with hemodynamic instability or as a second-line treatment after failure or complications of hemostasis with less invasive treatments. Colonoscopy is effective to diagnose diverticular bleeding. Nowadays, interventional endoscopy and angiographic treatment have gained a leading role and colectomy should only be entertained in case of failure of the former. PMID:26554768

  8. Predictive factors of recurrent bleeding in Mallory-Weiss syndrome.

    Science.gov (United States)

    Kim, Jae Woo; Kim, Hyun Soo; Byun, Jong Won; Won, Chan Sik; Jee, Myeong Gwan; Park, Yong Soon; Baik, Soon Koo; Kwon, Sang Ok; Lee, Dong Ki

    2005-12-01

    Although the majority of patients with Mallory-Weiss syndrome (MWS) have a benign course, MWS patients with recurrent bleeding have an unfavorable outcome and require intensive care. Therefore, this study was carried out to identify the risk factors for recurrent bleeding in MWS patients. The medical records of patients with MWS between January 1999 and December 2003, were reviewed retrospectively. Demographics, initial clinical and laboratory parameters, and endoscopic findings of the patients with and without recurrent bleeding were compared and the potential risk factors predicting recurrent bleeding in MWS were evaluated. A total of one hundred and fifty-nine patients (22 women, 137 men, mean age 48.1 years old) were enrolled in the study. Recurrent bleeding was observed in 17 patients (10.7%). Those patients with recurrent bleeding showed higher frequency for the presence of shock at initial manifestation, combined liver cirrhosis and endoscopic findings of active bleeding, lower hemoglobin level and platelet count, higher amount of transfusions and epinephrine-mixed fluid injections, and longer hospital stay than those patients without recurrent bleeding. Significant risk factors predicting the recurrent bleeding in MWS were the presence of shock at initial manifestation (OR 3.71, 95% CI 1.07-14.90) and the evidence of active bleeding on endoscopic examination (OR 9.89, 95% CI 1.88-51.98) on multivariate analysis. Intensive care with close monitoring is required for the patients with shock on initial manifestation or with evidence of active bleeding on endoscopic examinations since these are independent risk factors predicting the recurrent bleeding in MWS patients.

  9. Dependência tabágica, assertividade e alexitimia em doentes cardíacos

    Directory of Open Access Journals (Sweden)

    Vânia Rocha

    2010-08-01

    Full Text Available O tabagismo é uma das principais causas evitáveis de morte, aumentando acentuadamente o risco de infarto do miocárdio. Este último está associado a certas variáveis psicossociais relacionadas com o tabagismo, nomeadamente a alexitimia e a falta de assertividade. O objetivo do presente artigo foi caracterizar os dois tipos de dependência tabágica (fisiológica e comportamental, a assertividade e a alexitimia, e avaliar a relação das variáveis entre si, em 30 doentes homens internados com infarto. Foram aplicados o Teste de Fagerström, o Questionário de Glover-Nilsson, a Escala de "Rathus" e a TAS-20. Os resultados indicam que a alexitimia encontra-se relacionada com a dependência comportamental e com a assertividade, sugerindo que os sujeitos menos assertivos e com dificuldade em gerir afetos negativos e situações de estresse, podem recorrer ao tabagismo como mecanismo de enfrentamento. Nas intervenções voltadas à interrupção do hábito de fumar em doentes infartados deve-se enfatizar as competências sociais e de regulação emocional.

  10. Shade variance in ceramic restoration and shade tab: An in vitro study

    Directory of Open Access Journals (Sweden)

    Pannaikadu Somasundaram Prabu

    2012-01-01

    Full Text Available Background: In clinical practice aesthetics for any restoration needs to consider the parameters of surface form, translucency and colour.To achieve ideal aesthetics the colour replication process for dental porcelain is the most important step which comprises of a shade selection phase followed by shade duplication. Materials and Methods: The ceramic brands Vita VMK95 (classic and Ivoclar classic V were used for comparison with Vita classic shade tab guide shades A2 and B2. The samples were made of specific shape, size, and were of the recommended dimensions from investing self-cure acrylic strips to casted NiCr specimens Objective. The objective of this study was to quantify the results in CIE AE units system for the colour differences between the Vita shade guide colours and two commercial porcelains for metal ceramic crowns. Results: The results indicated that the porcelains do not match the shade guides to which they are compared and shade variations exist between different lots of porcelain from the same and different manufacturer. Conclusion: Problems identified that porcelains do not match the shade guides to which they are compared and shade variations exist between different lots of porcelain from the same and different manufacturer

  11. SANS method study of surfactant mixture system TX-100+C16TAB in heavy water solutions

    Science.gov (United States)

    Rajewska, A.; Islamov, A. Kh; Bakeeva, R. F.

    2017-05-01

    The mixture system of two classic surfactants cationic and non-ionic - C16TAB (hexadecyltrimethylammonium bromide)+TX-100(p-(1,1,3,3-tetramethyl) poly(oxyethylene) in heavy water solutions was investigated at temperatures 30o, 50o, 70o for compositions 1:1, 2:1, 3:1 by the small-angle neutron scattering(SANS) method on spectrometer (‘YuMO’) at the IBR-2 pulsed neutron source at FLNP, JINR in Dubna (Russia). Measurements have covered Q range from 7x10-3 to 0.4 Å-1. The SANS measurements of aqueous solutions of nonionic / cationic surfactants have shown that the mixed micelles are formed [1-2]. From the measured dependence of the scattered intensity on the scattering angle, we derived the size, shape of micelles, aggregation number at various compositions and temperatures. The size of mixed micelle is a weak function of the mixing ratio between the two components.

  12. CERVICAL ECTOPIC PREGNANCY WITH MASSIVE BLEEDING: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Slavcho Tomov

    2015-05-01

    Full Text Available A 29-year-old patient with cervical ectopic pregnancy (CEP presented as "suspected" cervical mass, and irregular vaginal bleeding was directed to a gynecologic oncologist for consultation. During the examination a massive bleeding occurred. After an unsuccessful attempt to stop the bleeding with a balloon catheter and vaginal tamponade, a total abdominal hysterectomy was performed. The predisposing factors, the differential diagnostic possibilities and the clinical approaches in CEP are discussed. Total abdominal hysterectomy is the procedure of choice for treatment of cervical pregnancy under conditions of urgency and life-threatening bleeding.

  13. Recent Update of Embolization of Upper Gastrointestinal Tract Bleeding

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Ji Hoon [Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of)

    2012-02-15

    Nonvariceal upper gastrointestinal (UGI) bleeding is a frequent complication with significant morbidity and mortality. Although endoscopic hemostasis remains the initial treatment modality, severe bleeding despite endoscopic management occurs in 5-10% of patients, necessitating surgery or interventional embolotherapy. Endovascular embolotherapy is now considered the first-line therapy for massive UGI bleeding that is refractory to endoscopic management. Interventional radiologists need to be familiar with the choice of embolic materials, technical aspects of embolotherapy, and the factors affecting the favorable or unfavorable outcomes after embolotherapy for UGI bleeding.

  14. Transcatheter arterial embolization in gastric cancer patients with acute bleeding

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hyun Joo; Shin, Ji Hoon; Yoon, Hyun-Ki; Ko, Gi-Young; Gwon, Dong-Il; Song, Ho-Young; Sung, Kyu-Bo [University of Ulsan College of Medicine, Department of Radiology and Research Institute of Radiology, Seoul (Korea)

    2009-04-15

    The safety and clinical effectiveness of transcatheter arterial embolization for bleeding associated with unresectable gastric cancer was evaluated. Twenty-three patients with bleeding from unresectable gastric cancer underwent transcatheter arterial embolization. Of the 23 patients, eight showed signs of active bleeding, such as contrast extravasation or pseudoaneurysm, seven showed only tumor staining, and the remaining eight patients showed negative angiographic findings. All embolization procedures were successful without procedure-related complications. In all eight active bleeding patients, immediate hemostasis was achieved. The overall clinical success rate was 52% (12/23). Recurrent bleeding within 1 month occurred in one (8%) in 12 patients with initial clinical success. One patient showed partial splenic infarction after embolization of the splenic artery for active bleeding from the short gastric artery. Overall 30-day mortality rate was 43% (10/23). The median overall survival period was 38 days. In patients with bleeding from unresectable gastric cancer, transcatheter arterial embolization was found to be safe and effective for achieving immediate hemostasis for active bleeding. Although the clinical success rate was not high, the recurrent bleeding rate was low at 1 month post procedure. (orig.)

  15. Incidence and Management of Bleeding Complications Following Percutaneous Radiologic Gastrostomy

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Nieun; Shin, Ji Hoon; Ko, Gi Young; Yoon, Hyun Ki; Gwon, Dong Il; Kim, Jin Hyoung; Sung, Kyu Bo [Asan Medical Center, Ulsan University College of Medicine, Seoul (Korea, Republic of)

    2012-03-15

    Upper gastrointestinal (GI) bleeding is a serious complication that sometimes occurs after percutaneous radiologic gastrostomy (PRG). We evaluated the incidence of bleeding complications after a PRG and its management including transcatheter arterial embolization (TAE). We retrospectively reviewed 574 patients who underwent PRG in our institution between 2000 and 2010. Eight patients (1.4%) had symptoms or signs of upper GI bleeding after PRG. The initial presentation was hematemesis (n = 3), melena (n = 2), hematochezia (n = 2) and bloody drainage through the gastrostomy tube (n = 1). The time interval between PRG placement and detection of bleeding ranged from immediately after to 3 days later (mean: 28 hours). The mean decrease in hemoglobin concentration was 3.69 g/dL (range, 0.9 to 6.8 g/dL). In three patients, bleeding was controlled by transfusion (n = 2) or compression of the gastrostomy site (n = 1). The remaining five patients underwent an angiography because bleeding could not be controlled by transfusion only. In one patient, the bleeding focus was not evident on angiography or endoscopy, and wedge resection including the tube insertion site was performed for hemostasis. The other four patients underwent prophylactic (n = 1) or therapeutic (n = 3) TAEs. In three patients, successful hemostasis was achieved by TAE, whereas the remaining one patient underwent exploration due to persistent bleeding despite TAE. We observed an incidence of upper GI bleeding complicating the PRG of 1.4%. TAE following conservative management appears to be safe and effective for hemostasis.

  16. Low hemoglobin levels are associated with upper gastrointestinal bleeding.

    Science.gov (United States)

    Tomizawa, Minoru; Shinozaki, Fuminobu; Hasegawa, Rumiko; Shirai, Yoshinori; Motoyoshi, Yasufumi; Sugiyama, Takao; Yamamoto, Shigenori; Ishige, Naoki

    2016-09-01

    Upper gastrointestinal (GI) bleeding can be fatal. Blood test variables were reviewed in search of threshold values to detect the presence of occult upper GI bleeding. The records of 1,023 patients who underwent endoscopy at the National Hospital Organization Shimoshizu Hospital from October 2014, to September 2015, were retrospectively reviewed. Of those, 95 had upper GI bleeding. One-way analysis of variance was applied to blood test variables comparing patients with and without upper GI bleeding. Logistic regression analysis was applied to detect the association of blood test parameters with upper GI bleeding, and receiver-operator characteristics were applied to establish threshold values. White blood cell count (WBC), platelet (Plt) count, and blood urea nitrogen (BUN) levels were higher, and hemoglobin (Hb) and albumin (Alb) levels were lower in patients with upper GI bleeding. Logistic regression analysis showed that low Hb was significantly associated with upper GI bleeding and a Hb value of 10.8 g/dl was established as the threshold for the diagnosis. In patients with upper GI bleeding, WBC, Plt count, and BUN levels were higher and Hb and Alb levels were reduced. Hb at 10.8 g/dl was established as a threshold value to detect upper GI bleeding.

  17. [Dutch College of General Practitioners' practice guideline on 'Vaginal bleeding'].

    Science.gov (United States)

    de Vries, Corlien J H; Meijer, Loes J; Janssen, C A H Ineke; Burgers, Jako S; Opstelten, Wim

    2015-01-01

    The revised Dutch College of General Practitioners' practice guideline on 'Vaginal bleeding' provides recommendations for abnormal bleeding in women in the reproduction phase of life and for post-menopausal bleeding. This guideline is closely attuned to the guideline on 'Heavy menstrual bleeding' of the Dutch Society of Obstetrics and Gynaecology. Transvaginal sonography is not reliable for excluding endometrial carcinoma in women with abnormal vaginal bleeding treated with tamoxifen. The choice of medical treatment is determined in consultation with the patient. The following factors are assessed: severity and bother, long-term need for contraception, preference for cycle control, desire to have a child, pain during menstruation, comorbidity and use of medication. Treatment options are nonhormonal (NSAIDs, or tranexamic acid) or hormonal (a levonorgestrel-releasing intrauterine system, or combined oral contraceptive). In women of reproductive age, referral is indicated if medical treatment is not effective. Other indications are intracavitary abnormalities diagnosed by transvaginal sonography, tamoxifen use, persistent contact bleeding, and suspicion of coagulation disorders. Indications for referral for post-menopausal bleeding include: sonographic endometrial thickness > 4 mm, abnormal cervical cytology, tamoxifen use, irregular bleeding during use of hormone therapy for vasomotor symptoms and persistent or recurrent bleeding, regardless of endometrial thickness.

  18. Abnormal Bleeding during Menopause Hormone Therapy: Insights for Clinical Management

    Directory of Open Access Journals (Sweden)

    Sebastião Freitas De Medeiros

    2013-01-01

    Full Text Available Objective Our objective was to review the involved mechanisms and propose actions for controlling/treating abnormal uterine bleeding during climacteric hormone therapy. Methods A systemic search of the databases SciELO, MEDLINE, and Pubmed was performed for identifying relevant publications on normal endometrial bleeding, abnormal uterine bleeding, and hormone therapy bleeding. Results Before starting hormone therapy, it is essential to exclude any abnormal organic condition, identify women at higher risk for bleeding, and adapt the regimen to suit eachwoman's characteristics. Abnormal bleeding with progesterone/progestogen only, combined sequential, or combined continuous regimens may be corrected by changing the progestogen, adjusting the progestogen or estrogen/progestogen doses, or even switching the initial regimen to other formulation. Conclusion To diminish the occurrence of abnormal bleeding during hormone therapy (HT, it is important to tailor the regimen to the needs of individual women and identify those with higher risk of bleeding. The use of new agents as adjuvant therapies for decreasing abnormal bleeding in women on HT awaits future studies.

  19. Three-dimensional viscoelastic time-domain finite-difference seismic modelling using the staggered Adams-Bashforth time integrator

    Science.gov (United States)

    Bohlen, Thomas; Wittkamp, Florian

    2016-03-01

    We analyse the performance of a higher order accurate staggered viscoelastic time-domain finite-difference method, in which the staggered Adams-Bashforth (ABS) third-order and fourth-order accurate time integrators are used for temporal discretization. ABS is a multistep method that uses previously calculated wavefields to increase the order of accuracy in time. The analysis shows that the numerical dispersion is much lower than that of the widely used second-order leapfrog method. Numerical dissipation is introduced by the ABS method which is significantly smaller for fourth-order than third-order accuracy. In 1-D and 3-D simulation experiments, we verify the convincing improvements of simulation accuracy of the fourth-order ABS method. In a realistic elastic 3-D scenario, the computing time reduces by a factor of approximately 2.4, whereas the memory requirements increase by approximately a factor of 2.2. The ABS method thus provides an alternative strategy to increase the simulation accuracy in time by investing computer memory instead of computing time.

  20. Joint Interference Alignment and Power Allocation for K-User Multicell MIMO Channel through Staggered Antenna Switching.

    Science.gov (United States)

    Selvaprabhu, Poongundran; Chinnadurai, Sunil; Sarker, Md Abdul Latif; Lee, Moon Ho

    2018-01-28

    In this paper, we characterise the joint interference alignment (IA) and power allocation strategies for a K -user multicell multiple-input multiple-output (MIMO) Gaussian interference channel. We consider a MIMO interference channel with blind-IA through staggered antenna switching on the receiver. We explore the power allocation and feasibility condition for cooperative cell-edge (CE) mobile users (MUs) by assuming that the channel state information is unknown. The new insight behind the transmission strategy of the proposed scheme is premeditated (randomly generated transmission strategy) and partial cooperative CE MUs, where the transmitter is equipped with a conventional antenna, the receiver is equipped with a reconfigurable multimode antenna (staggered antenna switching pattern), and the receiver switches between preset T modes. Our proposed scheme assists and aligns the desired signals and interference signals to cancel the common interference signals because the received signal must have a corresponding independent signal subspace. The capacity for a K -user multicell MIMO Gaussian interference channel with reconfigurable multimode antennas is completely characterised. Furthermore, we show that the proposed K -user multicell MIMO scheduling and K -user L -cell CEUs partial cooperation algorithms elaborate the generalisation of K -user IA and power allocation strategies. The numerical results demonstrate that the proposed intercell interference scheme with partial-cooperative CE MUs achieves better capacity and signal-to-interference plus noise ratio (SINR) performance compared to noncooperative CE MUs and without intercell interference schemes.

  1. Joint Interference Alignment and Power Allocation for K-User Multicell MIMO Channel through Staggered Antenna Switching

    Directory of Open Access Journals (Sweden)

    Poongundran Selvaprabhu

    2018-01-01

    Full Text Available In this paper, we characterise the joint interference alignment (IA and power allocation strategies for a K-user multicell multiple-input multiple-output (MIMO Gaussian interference channel. We consider a MIMO interference channel with blind-IA through staggered antenna switching on the receiver. We explore the power allocation and feasibility condition for cooperative cell-edge (CE mobile users (MUs by assuming that the channel state information is unknown. The new insight behind the transmission strategy of the proposed scheme is premeditated (randomly generated transmission strategy and partial cooperative CE MUs, where the transmitter is equipped with a conventional antenna, the receiver is equipped with a reconfigurable multimode antenna (staggered antenna switching pattern, and the receiver switches between preset T modes. Our proposed scheme assists and aligns the desired signals and interference signals to cancel the common interference signals because the received signal must have a corresponding independent signal subspace. The capacity for a K-user multicell MIMO Gaussian interference channel with reconfigurable multimode antennas is completely characterised. Furthermore, we show that the proposed K-user multicell MIMO scheduling and K-user L-cell CEUs partial cooperation algorithms elaborate the generalisation of K-user IA and power allocation strategies. The numerical results demonstrate that the proposed intercell interference scheme with partial-cooperative CE MUs achieves better capacity and signal-to-interference plus noise ratio (SINR performance compared to noncooperative CE MUs and without intercell interference schemes.

  2. Risk-based decision making for staggered bioterrorist attacks : resource allocation and risk reduction in "reload" scenarios.

    Energy Technology Data Exchange (ETDEWEB)

    Lemaster, Michelle Nicole; Gay, David M. (Sandia National Laboratories, Albuquerque, NM); Ehlen, Mark Andrew (Sandia National Laboratories, Albuquerque, NM); Boggs, Paul T.; Ray, Jaideep

    2009-10-01

    Staggered bioterrorist attacks with aerosolized pathogens on population centers present a formidable challenge to resource allocation and response planning. The response and planning will commence immediately after the detection of the first attack and with no or little information of the second attack. In this report, we outline a method by which resource allocation may be performed. It involves probabilistic reconstruction of the bioterrorist attack from partial observations of the outbreak, followed by an optimization-under-uncertainty approach to perform resource allocations. We consider both single-site and time-staggered multi-site attacks (i.e., a reload scenario) under conditions when resources (personnel and equipment which are difficult to gather and transport) are insufficient. Both communicable (plague) and non-communicable diseases (anthrax) are addressed, and we also consider cases when the data, the time-series of people reporting with symptoms, are confounded with a reporting delay. We demonstrate how our approach develops allocations profiles that have the potential to reduce the probability of an extremely adverse outcome in exchange for a more certain, but less adverse outcome. We explore the effect of placing limits on daily allocations. Further, since our method is data-driven, the resource allocation progressively improves as more data becomes available.

  3. SBP-SAT finite difference discretization of acoustic wave equations on staggered block-wise uniform grids

    KAUST Repository

    Gao, Longfei

    2018-02-16

    We consider the numerical simulation of the acoustic wave equations arising from seismic applications, for which staggered grid finite difference methods are popular choices due to their simplicity and efficiency. We relax the uniform grid restriction on finite difference methods and allow the grids to be block-wise uniform with nonconforming interfaces. In doing so, variations in the wave speeds of the subterranean media can be accounted for more efficiently. Staggered grid finite difference operators satisfying the summation-by-parts (SBP) property are devised to approximate the spatial derivatives appearing in the acoustic wave equation. These operators are applied within each block independently. The coupling between blocks is achieved through simultaneous approximation terms (SATs), which impose the interface condition weakly, i.e., by penalty. Ratio of the grid spacing of neighboring blocks is allowed to be rational number, for which specially designed interpolation formulas are presented. These interpolation formulas constitute key pieces of the simultaneous approximation terms. The overall discretization is shown to be energy-conserving and examined on test cases of both theoretical and practical interests, delivering accurate and stable simulation results.

  4. An experimental study on the effect of wind load around tall towers of square and hexagonal shapes in staggered form

    Science.gov (United States)

    Anwar, Proma; Islam, Md. Quamrul; Ali, Mohammad

    2017-06-01

    In this research work an experiment is conducted to observe the effect of wind load around square and hexagonal shaped cylinders in staggered form. The experiment is performed in an open circuit wind tunnel at a Reynolds number of 4.23×104 based on the face width of the cylinder across the flow direction. The flow velocity has been kept uniform at 14.3 m/s throughout the experiment. The test is conducted for single cylinders first and then in staggered form. The cylinders are rotated to create different angles of attack and the angles are chosen at a definite interval. The static pressure readings are taken at different locations of the cylinder by inclined multi-manometers. From the surface static pressure readings pressure coefficients, drag coefficients and lift coefficients are calculated using numerical integration method. These results will surely help engineers to design buildings more stable against wind load. All the results are expressed in non-dimensional form, so that they can be applied for prototype structures.

  5. Comparison of Two Major Perioperative Bleeding Scores for Cardiac Surgery Trials: Universal Definition of Perioperative Bleeding in Cardiac Surgery and European Coronary Artery Bypass Grafting Bleeding Severity Grade.

    Science.gov (United States)

    Bartoszko, Justyna; Wijeysundera, Duminda N; Karkouti, Keyvan; Callum, Jeannie; Rao, Vivek; Crowther, Mark; Grocott, Hilary P; Pinto, Ruxandra; Scales, Damon C; Achen, Blaine; Brar, Sukhpal; Morrison, Doug; Wong, David; Bussières, Jean S; de Waal, Tonya; Harle, Christopher; de Médicis, Étienne; McAdams, Charles; Syed, Summer; Tran, Diem; Waters, Terry

    2018-03-15

    Research into major bleeding during cardiac surgery is challenging due to variability in how it is scored. Two consensus-based clinical scores for major bleeding: the Universal definition of perioperative bleeding and the European Coronary Artery Bypass Graft (E-CABG) bleeding severity grade, were compared in this substudy of the Transfusion Avoidance in Cardiac Surgery (TACS) trial. As part of TACS, 7,402 patients underwent cardiac surgery at 12 hospitals from 2014 to 2015. We examined content validity by comparing scored items, construct validity by examining associations with redo and complex procedures, and criterion validity by examining 28-day in-hospital mortality risk across bleeding severity categories. Hierarchical logistic regression models were constructed that incorporated important predictors and categories of bleeding. E-CABG and Universal scores were correlated (Spearman ρ = 0.78, P model discrimination based on predictors of perioperative mortality increased with additional inclusion of the Universal score (c-statistic increase from 0.83 to 0.91) or E-CABG (c-statistic increase from 0.83 to 0.92). When other major postoperative complications were added to these models, the association between Universal or E-CABG bleeding with mortality remained. Although each offers different advantages, both the Universal score and E-CABG performed well in the validity assessments, supporting their use as outcome measures in clinical trials.

  6. Bleeding Time, Volume of Shed Blood Collected at the Bleeding Time Site, and the Peripheral Venous Hematocrit.

    Science.gov (United States)

    1995-01-10

    Journal of Obstetrics and Gynaecology 1991;98:327-328. 20. Bain B, Forster T. A sex difference in the bleeding time. 21. Smith PS, Baglini R, Meissner GF...Description of a method for determining the bleeding time and coagulation time and report of three cases of hemorrhagic disease relieved by...OFFICE OF NAVAL RESEARCH CONTRACT N00014-88-C-0118 CONTRACT N00014-94-C-0149 TECHNICAL REPORT 95-01 BLEEDING TIME, VOLUME OF SHED BLOOD

  7. Do statins protect against upper gastrointestinal bleeding?

    DEFF Research Database (Denmark)

    Gulmez, Sinem Ezgi; Lassen, Annmarie Touborg; Aalykke, Claus

    2009-01-01

    AIMS: Recently, an apparent protective effect of statins against upper gastrointestinal bleeding (UGB) was postulated in a post hoc analysis of a randomized trial. We aimed to evaluate the effect of statin use on acute nonvariceal UGB alone or in combinations with low-dose aspirin and other...... antithrombotic drugs. METHODS: A population-based case-control study was conducted in the County of Funen, Denmark. Cases (n = 3652) were all subjects with a first discharge diagnosis of serious UGB from a hospital during the period 1995 to 2006. Age- and gender-matched controls (10 for each case) (n = 36 502...... significant protective effect was observed for concurrent users of low-dose aspirin [OR 0.43 (0.18-1.05)]. CONCLUSION: Statins do not prevent UGB, except possibly in users of low-dose aspirin....

  8. ENDOSCOPIC DIAGNOSIS AND TREATMENT OF UPPER GASTROINTESTINAL BLEEDING

    Directory of Open Access Journals (Sweden)

    Daniela Benedeto-Stojanov

    2015-06-01

    Full Text Available Upper gastrointestinal bleeding (UGB is a common medical emergency problem with significant morbidity and mortality. The aim of this paper is to establish the incidence of upper gastrointestinal bleeding in relation to sex and age, determine the prevalence of bleeding lesions and perform analysis of bleeding peptic ulcer in relation to the location, age, gender, Forrest classification and the need for endoscopic hemostasis. Thе prospective study included 70 patients with UGB, 42 men and 28 women, mean age 68.64±13.66 years. The diagnosis of bleeding lesions was made exclusively by means of esophagogastroduodenoscopy. Forrest classification was used in the evaluation of the activity of bleeding ulcers of the stomach and duodenum. The largest number of bleeding patients was of male sex (60%. Bleeding most commonly occurred in patients older than 60 years (84.29%. Statistically, female patients were significantly older than patients of male gender (p=0.001. The most common cause of bleeding was peptic ulcer (65.71%. The average age of patients with gastric ulcer was 70.57±15.68 years, with a duodenal ulcer 63.78±16.70 years. In the duodenum, Forrest Ib, IIa and IIb ulcers were usually confirmed, whereas Forrest IIc ulcers were identified in the stomach. Endoscopic hemostasis was required in 55.56% of patients with duodenal and in 23.81% of patients with gastric ulcer. The incidence of UGB is higher in men and it increases with age. The most common cause of bleeding is ulcer disease. Patients with gastric ulcer are older than patients with duodenal ulcer, while both gastric and duodenal ulcers are found in the oldest patients. Duodenal ulcers cause serious bleeding and more often require endoscopic hemostasis.

  9. Isospin transport phenomena and odd-even staggering in 84Kr+112,124Sn collisions at 35 AMeV

    Directory of Open Access Journals (Sweden)

    Piantelli S.

    2015-01-01

    Full Text Available Experimental results concerning isospin transport phenomena and odd-even staggering in Z and N distributions are presented. Data refer to 84Kr+112,124Sn collisions at 35AMeV and they were collected with a high resolution FAZIA telescope, able to isotopically resolve ions up to Z ∼ 20. Evidences of isospin diffusion and drift obtained from the /Z behaviour of the detected fragments are discussed. The odd-even staggering both in Z and N is compared with experimental data available in literature, finding that it shows a common trend in different reaction types.

  10. Isospin transport phenomena and odd-even staggering in 84Kr+112,124Sn collisions at 35 AMeV

    Science.gov (United States)

    Piantelli, S.; Casini, G.; Maurenzig, P. R.; Olmi, A.; Barlini, S.; Bini, M.; Carboni, S.; Pasquali, G.; Poggi, G.; Stefanini, A. A.; Valdré, S.; Bougault, R.; Bonnet, E.; Borderie, B.; Chbihi, A.; Frankland, J. D.; Gruyer, D.; Lopez, O.; Le Neindre, N.; Parlog, M.; Rivet, M.-F.; Vient, E.; Rosato, E.; Spadaccini, G.; Vigilante, M.; Bruno, M.; Marchi, T.; Morelli, L.; Cinausero, M.; Degerlier, M.; Gramegna, F.; Kozik, T.; Twarog, T.; Alba, R.; Maiolino, C.; Santonocito, D.

    2015-04-01

    Experimental results concerning isospin transport phenomena and odd-even staggering in Z and N distributions are presented. Data refer to 84Kr+112,124Sn collisions at 35AMeV and they were collected with a high resolution FAZIA telescope, able to isotopically resolve ions up to Z ˜ 20. Evidences of isospin diffusion and drift obtained from the /Z behaviour of the detected fragments are discussed. The odd-even staggering both in Z and N is compared with experimental data available in literature, finding that it shows a common trend in different reaction types.

  11. Society Influencing Science: The role of the Transdisciplinary Advisory Board (TAB) of the European Joint Programming Initiative on Climate.

    Science.gov (United States)

    Noone, K. J.; Manderscheid, P.; Monfray, P.

    2017-12-01

    It is becoming increasingly apparent that the separation between science and the rest of society is not helping us find solutions to "wicked" problems like climate change or achieving the Sustainable Development Goals. It is clear that a broader approach to research is necessary - one that includes stakeholders in the research process itself. What is unclear is how best to do this. The Transdisciplinary Advisory Board (TAB) of the European Joint Programming Initiative on Climate (JPI Climate) is an example of scientists and stakeholders working together to frame climate research and move the results of scientific research into decision support. JPI Climate is a consortium of 12 European countries (with partners from nine more countries) and is a major funding channel and forum for climate research in Europe. The TAB has an equal number of stakeholders and researchers from 10 different European countries, has an even gender balance, and its members have widely differing backgrounds. The TAB provides input and advice to the governing board of JPI Climate, and influences both the strategic planning for this funding initiative as well as specific calls for proposals issued through the consortium. In addition to its advisory role, the TAB explores the transdisciplinary process itself, expanding the boundaries of how stakeholders and science can interact positively. The TAB is a two-way mechanism through which stakeholders can help improve research and science can help improve society. We will give examples of the spectrum of how the TAB provides mutual influence between stakeholders and science - from helping to draft 10-year research strategies to helping advance the uptake of climate research into the private and policy sectors.

  12. Challenges in the Management of Bleeding Disorders in Nigeria

    African Journals Online (AJOL)

    2018-04-04

    Apr 4, 2018 ... Background: Bleeding disorders (BDs) are characterized by abnormal bleeding for which effective management requires a combination of skill, workforce, diagnostic facilities, and adequate therapeutic options. Objectives: The objectives of this study were to determine the capacity of Nigerian hematologists ...

  13. The efficacy of endoscopic therapy in bleeding peptic ulcer patients ...

    African Journals Online (AJOL)

    Background. Endotherapy is the primary modality for the control of bleeding from peptic ulceration. Objective. To assess the efficacy of endoscopic intervention for high-risk bleeding peptic ulcer disease and to benchmark our surgical and mortality rates. Methods. Two hundred and twenty-seven patients with peptic

  14. Coffee grounds emesis: not just an upper GI bleed.

    Science.gov (United States)

    Bou-Abdallah, Jad Z; Murthy, Uma K; Mehta, Nilish; Prasad, Heramba N; Kaul, Vivek

    2012-07-01

    Acute upper gastrointestinal (UGI) bleeding manifests as hematemesis, melena, or hematochezia. Initial management is identical, irrespective of nasogastric (NG) aspirate results. Current practice includes early upper endoscopy. Significantly fewer high-risk bleeding lesions are found on endoscopy in patients with coffee grounds vs. bloody NG aspirates. We present a case series to illustrate that patients with coffee grounds emesis (CGE) often have other unsuspected illnesses that may be overlooked due to preoccupation with the GI bleed. A retrospective chart review of a series of 6 patients presenting with CGE and admitted for upper GI bleeding was performed. All 6 patients were hemodynamically stable at admission. NG lavage showed coffee grounds that cleared easily. None of the patients required blood transfusions during their hospital stay. Endoscopy in 3 of 6 patients failed to find any significant UGI lesions or stigmata of recent bleed. Although patients were admitted for UGI bleeding, the more significant associated diagnoses included acute myocardial infarction, urosepsis, small bowel obstruction, bilateral pulmonary emboli, and acute renal failure. Hemodynamically stable patients presenting with coffee grounds NG aspirate and no fall in hemoglobin/hematocrit should be evaluated for other non-GI bleeding-related conditions even as the GI bleed is being managed. Copyright © 2012 Elsevier Inc. All rights reserved.

  15. Leech as a cause of abnormal vaginal bleeding: Presentation of ...

    African Journals Online (AJOL)

    days, menstrual cycle of 80ml. Rather than this specific figures, however, abnormal uterine bleeding should be defined in terms of deviation from an individual patient's established menstrual pattern1,2. Leech bite as a cause pf abnormal vaginal bleeding has been reported in ...

  16. Pattern recognition in menstrual bleeding diaries by statistical cluster analysis

    Directory of Open Access Journals (Sweden)

    Wessel Jens

    2009-07-01

    Full Text Available Abstract Background The aim of this paper is to empirically identify a treatment-independent statistical method to describe clinically relevant bleeding patterns by using bleeding diaries of clinical studies on various sex hormone containing drugs. Methods We used the four cluster analysis methods single, average and complete linkage as well as the method of Ward for the pattern recognition in menstrual bleeding diaries. The optimal number of clusters was determined using the semi-partial R2, the cubic cluster criterion, the pseudo-F- and the pseudo-t2-statistic. Finally, the interpretability of the results from a gynecological point of view was assessed. Results The method of Ward yielded distinct clusters of the bleeding diaries. The other methods successively chained the observations into one cluster. The optimal number of distinctive bleeding patterns was six. We found two desirable and four undesirable bleeding patterns. Cyclic and non cyclic bleeding patterns were well separated. Conclusion Using this cluster analysis with the method of Ward medications and devices having an impact on bleeding can be easily compared and categorized.

  17. First-trimester vaginal bleeding and complications later in pregnancy

    DEFF Research Database (Denmark)

    Lykke, Jacob Alexander; Dideriksen, Katrine Lehrmann; Lidegaard, Øjvind

    2010-01-01

    To evaluate the association of first-trimester bleeding without miscarriage and complications later in the first pregnancy as well as in the next pregnancy.......To evaluate the association of first-trimester bleeding without miscarriage and complications later in the first pregnancy as well as in the next pregnancy....

  18. Increased accuracy in heparin and protamine administration decreases bleeding

    DEFF Research Database (Denmark)

    Runge, Marx; Møller, Christian H; Steinbrüchel, Daniel A

    2009-01-01

    Three to 5 percent of the patients undergoing cardiac surgery are reoperated because of bleeding. When a surgical cause can be excluded, heparin/protamine mismatch may be considered. Insufficient reversal of heparin and overdosing of protamine may cause postoperative bleeding. The purpose...

  19. Endoscopic injection sclerotherapy for bleeding varices in children ...

    African Journals Online (AJOL)

    Endoscopic injection sclerotherapy for bleeding varices in children with intrahepatic and extrahepatic portal venous obstruction: Benefit of injection tract embolisation. ... In a previous study at our institution, sclerotherapy was associated with a high re-bleeding rate and oesophageal ulceration. Embolisation of the injection ...

  20. 14 CFR 33.66 - Bleed air system.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Bleed air system. 33.66 Section 33.66 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS STANDARDS: AIRCRAFT ENGINES Design and Construction; Turbine Aircraft Engines § 33.66 Bleed air system. The...

  1. Recombinant activated factor VII for uncontrolled bleeding postcardiac surgery

    Directory of Open Access Journals (Sweden)

    Aly Makram Habib

    2016-10-01

    Conclusion: In this analysis, rFVIIa succefully reduced the chest tube bleeding and blood products transfused during severe post cardiac surgical bleeding. However, safety of rFVIIa remains unclear. Prospective controlled trials are still needed to confirm the role of rFVIIa.

  2. [Prophylaxis for stress ulcer bleeding in the intensive care unit].

    Science.gov (United States)

    Avendaño-Reyes, J M; Jaramillo-Ramírez, H

    2014-01-01

    The critically ill patient can develop gastric erosions and, on occasion, stress ulcers with severe gastrointestinal bleeding that can be fatal. The purpose of this review was to provide current information on the pathophysiology, risk factors, and prophylaxis of digestive tract bleeding from stress ulcers in the intensive care unit. We identified articles through a PubMed search, covering the years 1970 to 2013. The most relevant articles were selected using the search phrases "stress ulcer", "stress ulcer bleeding prophylaxis", and "stress-related mucosal bleeding" in combination with "intensive care unit". The incidence of clinically significant bleeding has decreased dramatically since 1980. The most important risk factors are respiratory failure and coagulopathy. Proton pump inhibitors (PPIs) or H2 receptor antagonists (H2RAs) are used in stress ulcer bleeding prophylaxis. Both drugs have been shown to be superior to placebo in reducing the risk for gastrointestinal bleeding and PPIs are at least as effective as H2RAs. Early enteral feeding has been shown to reduce the risk for stress ulcer bleeding, albeit in retrospective studies. Admittance to the intensive care unit in itself does not justify prophylaxis. PPIs are at least as effective as H2RAs. We should individualize the treatment of each patient in the intensive care unit, determining risk and evaluating the need to begin prophylaxis. Copyright © 2014 Asociación Mexicana de Gastroenterología. Published by Masson Doyma México S.A. All rights reserved.

  3. Aetiology of Upper Gastrointestinal Bleeding in North-Eastern Nigeria

    African Journals Online (AJOL)

    Oesophageal varices were the most frequent cause of bleeding (45.3%) followed by non-ulcer peptic acid disease (23.7%) and peptic ulcer disease (16.9%). Gastric cancer and Mallory-Weiss syndrome were rare with each accounting for 1.9% of the cases. In 11 (10.4%) patients no source of bleeding could be identified.

  4. Packing of Renal Fossa: Useful Technique for Intractable Bleeding ...

    African Journals Online (AJOL)

    There is no documented study to indicate the role of prolonged packing of renal fossa (24 to 48 hours) to control bleeding in life threating haemorrhage following open pyelolithotomy without compromise in the renal functions. On the contrary emergency nephrectomy was performed for intractable bleeding during renal stone ...

  5. Histopathological findings of Post-Menopausal bleeding in ...

    African Journals Online (AJOL)

    Background: Postmenopausal bleeding is an alarming sign that may be associated with uterine malignancy. In recent years about 60% of women with post menopausal bleeding are said to have no organic cause in developed countries. There is no data concerning about this issue in Ethiopia. Objective: To determine ...

  6. Prediction models in women with postmenopausal bleeding: a systematic review

    NARCIS (Netherlands)

    van Hanegem, Nehalennia; Breijer, Maria C.; Opmeer, Brent C.; Mol, Ben W. J.; Timmermans, Anne

    2012-01-01

    Postmenopausal bleeding is associated with an elevated risk of having endometrial cancer. The aim of this review is to give an overview of existing prediction models on endometrial cancer in women with postmenopausal bleeding. In a systematic search of the literature, we identified nine prognostic

  7. Clinical approach to a patient with abnormal uterine bleeding

    African Journals Online (AJOL)

    bleeding, type, appearance, duration, cyclicity and associated ... Clinical approach. In all cases where the main complaint is that of excessive menstrual bleeding, an immediate differentiation must be made between acute severe blood loss and chronic excessive ... management rules can be implemented. In such patients ...

  8. Gastrointestinal bleeding in patients with hereditary hemorrhagic telangiectasia

    DEFF Research Database (Denmark)

    Kjeldsen, A D; Kjeldsen, J

    2000-01-01

    Gastrointestinal bleeding occurs in a number of patients with hereditary hemorrhagic telangiectasia (HHT) and may lead to a high transfusion need. The aim of this study was to estimate the occurrence and severity of gastrointestinal bleeding in a geographically well defined HHT population....

  9. Bleeding gastrointestinal stromal tumour of the stomach complicated ...

    African Journals Online (AJOL)

    Inferior vena cava filter insertion was not possible due to non-availability. Coexistence of DVT needing anticoagulation and bleeding gastric GIST requiring urgent resection presented a management dilemna. Despite the risk, the patient was taken for an emergency tumor resection primarily to stop the bleeding and facilitate ...

  10. Value of Adjusted Blood Requirement Index in determining failure to control bleed in patients with variceal bleeding.

    Science.gov (United States)

    Abid, Shahab; Khalid, Abdullah B; Awan, Safia; Shah, Hasnain A; Hamid, Saeed; Jafri, Wasim

    2015-03-01

    Variceal bleeding is a serious complication in patients with cirrhosis. Among the criteria that were proposed in Baveno conferences, the Adjusted Blood Requirement Index (ABRI) has not been validated prospectively in clinical practice. We therefore aim to evaluate the measurement of ABRI as a marker of failure to control bleeding and to evaluate the consistency of ABRI in relation to other criteria of failure to control variceal bleeding. All patients with variceal bleeding who presented to Aga Khan University Hospital from January 2010 to December 2012 who were administered transfusion of packed red blood cells were included after obtaining informed consent. All patients were managed as per the standard protocol with intravenous terlipressin along with band ligation and injection of cyanoacrylate in cases of esophageal and fundal varices, respectively. Hemoglobin and hematocrit were measured every 6 h for 48 h and then every 12 h until 5 days of index bleed in each patient. Packed cells were transfused if hemoglobin decreased below 8 g/dl. The number of blood units transfused, change in hemoglobin values, and ABRI were calculated after each unit of blood transfusion till 120 h. In patients in whom bleed could not be controlled, an ABRI value of 0.75 or more was compared with other Baveno IV-based parameters that define failure to control variceal bleeding. During the study period, 137 eligible patients with variceal bleed were admitted. The mean age of the patients was 52±12 years. The majority of patients (50.4%) were in Child-Pugh class B, followed by 38% in Child-Pugh class C. According to the Baveno IV criteria, overall failure to control acute variceal bleeding occurred in 52 (37.9%) patients. Excluding ABRI, failure to control bleeding was found in 22/137 (16%) patients, whereas ABRI-based criteria showed that in 34/137 (24.8%) patients, bleeding could not be controlled. There were only four (2.9%) patients with variceal bleeding in whom ABRI and

  11. Alternative Treatment for Bleeding Peristomal Varices: Percutaneous Parastomal Embolization

    Energy Technology Data Exchange (ETDEWEB)

    Pabon-Ramos, Waleska M., E-mail: waly.pr@duke.edu [Duke University Hospital, Department of Radiology (United States); Niemeyer, Matthew M. [Washington University Medical Center, Mallinckrodt Institute of Radiology (United States); Dasika, Narasimham L., E-mail: narasimh@med.umich.edu [University of Michigan Health System, Department of Radiology (United States)

    2013-10-15

    Purpose: To describe how peristomal varices can be successfully embolized via a percutaneous parastomal approach. Methods: The medical records of patients who underwent this procedure between December 1, 2000, and May 31, 2008, were retrospectively reviewed. Procedural details were recorded. Median fluoroscopy time and bleeding-free interval were calculated. Results: Seven patients underwent eight parastomal embolizations. The technical success rate was 88 % (one failure). All embolizations were performed with coils combined with a sclerosant, another embolizing agent, or both. Of the seven successful parastomal embolizations, there were three cases of recurrent bleeding; the median time to rebleeding was 45 days (range 26-313 days). The remaining four patients did not develop recurrent bleeding during the follow-up period; their median bleeding-free interval was 131 days (range 40-659 days). Conclusion: This case review demonstrated that percutaneous parastomal embolization is a feasible technique to treat bleeding peristomal varices.

  12. PARACIUDADES. Rompiendo tabúes en búsqueda de una renovación urbana.

    Directory of Open Access Journals (Sweden)

    Carlos Medellín

    2015-07-01

    Full Text Available ¿Qué pasaría si los pensamientos y anhelos de los ciudadanos comenzaran a ser expresados libremente y, de este modo, permitir que todos seamos atraídos o convertidos en atracción, rompiendo los tabúes sobre la forma de abordar al extraño y al desconocido? ¿Qué pasaría si los ciudadanos tuviésemos acceso a una superficie reactiva al aire libre, pero que opera bajo nuestro propio control? El objetivo de esta iniciativa es utilizar y explorar la ciudad de otra manera al hacer evidente lo que se busca o anhela para, así, redefinir la fisiología urbana descubriendo y exponiendo su geografía de deseos. Los flujos de datos digitales y las posibilidades de interacción social online han aumentado gracias a las oportunidades que ofrece la web. Esto caracteriza a las dinámicas contemporáneas responsables de crear “realidades” urbanas. Es una manera rápida, en tiempo real y flujo constante, de información; un instrumento que podría potenciar el cambio y la comprensión de diversos fenómenos de una forma más eficiente y real. Por lo general, los ejercicios de geografía y cartografía se basan en hechos “tangibles”; sin embargo, hoy en día generamos una gran cantidad de información mientras usamos-navegamos los espacios urbanos. Esta información dibuja un mapa diferente, que nos permite ver más allá de los límites preestablecidos políticamente. En este caso, la información digital se combina con la observación clásica del paisaje, para así obtener una imagen más exacta de la ciudad.

  13. Bleeding disorders in the tribe: result of consanguineous in breeding

    Directory of Open Access Journals (Sweden)

    Borhany Munira

    2010-09-01

    Full Text Available Abstract Objective To determine the frequency and clinical features of bleeding disorders in the tribe as a result of consanguineous marriages. Design Cross Sectional Study Introduction Countries in which consanguinity is a normal practice, these rare autosomal recessive disorders run in close families and tribes. Here we describe a family, living in village Ali Murad Chandio, District Badin, labeled as haemophilia. Patients & Methods Our team visited the village & developed the pedigree of the whole extended family, up to seven generations. Performa was filled by incorporating patients, family history of bleeding, signs & symptoms, and bleeding from any site. From them 144 individuals were screened with CBC, bleeding time, platelet aggregation studies & RiCoF. While for PT, APTT, VWF assay and Factor VIII assay, samples were kept frozen at -70 degrees C until tested. Results The family tree of the seven generations comprises of 533 individuals, 63 subjects died over a period of 20 years and 470 were alive. Out of all those 144 subjects were selected on the basis of the bleeding history. Among them 98(68.1% were diagnosed to have a bleeding disorder; 44.9% patients were male and 55.1% patients were female. Median age of all the patients was 20.81, range (4 months- 80 yrs. The results of bleeding have shown that majority had gum bleeding, epistaxis and menorrhagia. Most common bleeding disorder was Von Willebrand disease and Platelet functional disorders. Conclusion Consanguineous marriages keep all the beneficial and adversely affecting recessive genes within the family; in homozygous states. These genes express themselves and result in life threatening diseases. Awareness, education & genetic counseling will be needed to prevent the spread of such common occurrence of these bleeding disorders in the community.

  14. Does painless rectal bleeding equate to a colonic polyp?

    Science.gov (United States)

    Campbell, Alison Morag; Sugarman, Ian

    2017-11-01

    It is often stated that if a patient presents with 'painless rectal bleeding' then a rectal polyp is the probable diagnosis. The aim of this study is to review our experience of children undergoing endoscopy to assess if the above statement is correct. The senior author keeps a prospective database of every child undergoing flexible sigmoidoscopy or colonoscopy. As part of this database, the symptoms and signs that the patient presents with, specifically abdominal pain, diarrhoea, mucous per rectum and rectal bleeding, are recorded. These results have been analysed specifically to assess whether the opening statement is correct. Between 2000 and 2014, a total of 401 children have undergone flexible sigmoidoscopy (21) or colonoscopy (380) to investigate rectal bleeding. Of these 401 patients, 42 (10.5%) had at least one polyp. Four polyps (9%) occurred in 159 patients with no rectal bleeding during the study period. The remaining 42 polyps (91%) were identified in patients with rectal bleeding. Of these 42 polyps, painless rectal bleeding was the only symptom in 24 (57%). However, 123 patients were endoscoped with painless rectal bleeding alone, giving a polyp rate of 19.5% for this symptom. The polyp pickup rate was increased to 28% if rectal bleeding and mucous per rectum were present; however, only 25 patients had this clinical history. We confirm that the most common symptom of rectal polyps is painless rectal bleeding. However, only one in five patients with this clinical history has a rectal polyp at endoscopy. The polyp pickup rate at endoscopy is greater (28%) when a history of both rectal bleeding and mucous per rectumispresent. This information can be used to counsel parents preoperatively. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  15. [High risk factors of upper gastrointestinal bleeding after neurosurgical procedures].

    Science.gov (United States)

    Zheng, Kang; Wu, Gang; Cheng, Neng-neng; Yao, Cheng-jun; Zhou, Liang-fu

    2005-12-21

    To analyze high risk factors of postoperative upper gastrointestinal (GI) bleeding after neurosurgery so as to give guidance for prevention of GI bleeding. A questionnaire was developed to investigate the medical records of 1500 patients who were hospitalized and underwent neurosurgical operations in 1997. Logistic regression analysis was made. 1430 valid questionnaires were obtained. Postoperative upper GI bleeding occurred in 75 patients (5.24%). The incidence of upper GI bleeding were 6.64% (54/813) in the male patients and 3.40% (21/617) in the female persons (P = 0.007); 9.88% (41/415) in those aged > 50 and 3.35% in those aged hematoma, intraventricular hemorrhage, subdural hematoma, and extradural hematoma were 15.7%, 10.0%, 6.00%, and 2.94% respectively (P = 0.02). The incidence of upper GI bleeding of the patients with tumors of fourth ventricle of cerebrum, brainstem, cerebral hemisphere, and sellar hypothalamus were 15.79% (3/19), 7.89%, 5.71%, and 3.74% respectively. In the emergent cases, the incidence of upper GI bleeding was higher in those with hypertension. The incidence of upper GI bleeding was 5.46% in the patients undergoing adrenocortical hormone treatment, significantly higher than that in those who did not receive such treatment (2.13%). Patients who are at high risk of developing postoperative upper GI bleeding including that: age greater than 50 years; male; Glasgow Coma Score less than 10 pre and post operation; The lesion was located in brain stem and forth ventricle; Hypertensive cerebral hemorrhage; Intracerebral and intraventricular hemorrhagic brain trauma; Postoperative pneumonia, brain edema, encephalic high pressure, pyogenic infection of the central nervous system and other postoperative complications. The mortality of patients with postoperative upper GI bleeding was evidently higher than that of the patients without postoperative upper GI bleeding.

  16. The prevalence of underlying bleeding disorders in patients with heavy menstrual bleeding with and without gynecologic abnormalities

    NARCIS (Netherlands)

    Knol, H. Marieke; Mulder, Andre; Bogchelman, Dick H.; Kluin-Nelemans, Hanneke C.; van der Zee, Ate G. J.; Meijer, Karina

    OBJECTIVE: The purpose of this study was to assess the prevalence of underlying bleeding disorders in women with heavy menstrual bleeding (HMB) with and without gynecologic abnormalities. STUDY DESIGN: We performed a single-center prospective cohort study of 112 consecutive patients who were

  17. The analysis of the causes of uterine bleeding occurred after cesarean section and the evaluation of interventional therapy for bleeding

    International Nuclear Information System (INIS)

    Hu Peng; Li Yuwei; Li Yunhui; Luo Bin; Wen Wen; Yang Bo

    2011-01-01

    Objective: to analyze the causes of uterine hemorrhage occurred after cesarean section and to investigate the value of angiography and transcatheter artery embolization (TAE) in the diagnosis and treatment of postpartum hemorrhage after cesarean section. Methods: During the period from Jan. 2001 to Dec. 2011, a total of 65 cases suffering from uterine bleeding after cesarean section had underwent uterine arteriography to clarify the diagnosis, which was followed by transcatheter uterine artery embolization (TUAE). The clinical data, the causes of bleeding and the angiographic features were retrospectively analyzed. Results: The causes of uterine bleeding after cesarean section included uterine artery pseudoaneurysm (n=26), uterine atony (n=18), placental factors (n=11), gestational hypertension (n=8), coexisting uterine fibroids (n=1) and uterine bleeding of unknown reason (n=1). Uterine artery angiography revealed contrast extravasation in all patients except one patient. The angiographic findings confirmed the diagnosis of uterine artery bleeding after cesarean section. The bleeding stopped after TUAE, and the patients were in stable condition. No serious complications occurred. Conclusion: Pseudoaneurysm is the primary cause of postpartum uterine hemorrhage after cesarean section. Transcatheter uterine artery angiography can promptly and reliably determine the causes of bleeding, and, at the same time, embolization therapy can be carried out to effectively stop the bleeding. (authors)

  18. Staggered-grid finite-difference acoustic modeling with the Time-Domain Atmospheric Acoustic Propagation Suite (TDAAPS).

    Energy Technology Data Exchange (ETDEWEB)

    Aldridge, David Franklin; Collier, Sandra L. (U.S. Army Research Laboratory); Marlin, David H. (U.S. Army Research Laboratory); Ostashev, Vladimir E. (NOAA/Environmental Technology Laboratory); Symons, Neill Phillip; Wilson, D. Keith (U.S. Army Cold Regions Research Engineering Lab.)

    2005-05-01

    This document is intended to serve as a users guide for the time-domain atmospheric acoustic propagation suite (TDAAPS) program developed as part of the Department of Defense High-Performance Modernization Office (HPCMP) Common High-Performance Computing Scalable Software Initiative (CHSSI). TDAAPS performs staggered-grid finite-difference modeling of the acoustic velocity-pressure system with the incorporation of spatially inhomogeneous winds. Wherever practical the control structure of the codes are written in C++ using an object oriented design. Sections of code where a large number of calculations are required are written in C or F77 in order to enable better compiler optimization of these sections. The TDAAPS program conforms to a UNIX style calling interface. Most of the actions of the codes are controlled by adding flags to the invoking command line. This document presents a large number of examples and provides new users with the necessary background to perform acoustic modeling with TDAAPS.

  19. Experimental study on the dynamic performance of a novel system combining natural ventilation with diffuse ceiling inlet and TABS

    DEFF Research Database (Denmark)

    Yu, Tao; Heiselberg, Per Kvols; Lei, Bo

    2016-01-01

    Highlights • Dynamic experiments are performed to study energy performance of a new HVAC system. • Designed control strategies show good utilization of natural ventilation cooling. • TABS work well with the diffuse ceiling in the dynamic measurements. • No local thermal comfort problem is found...

  20. Using Exploratory and Confirmatory Factor Analysis to Measure Construct Validity of the Traits, Aptitudes, and Behaviors Scale (TABS)

    Science.gov (United States)

    Besnoy, Kevin D.; Dantzler, John; Besnoy, Lisa R.; Byrne, Caitlin

    2016-01-01

    This study evaluated the construct validity of the Traits, Aptitudes, and Behaviors Scale (TABS). Data for this study were collected from two separate school districts across three different academic years in the Southeastern United States. Of the total sample (N = 2,330), 64.6% of the children were identified as African American, 29.0% as…

  1. Investigating the iatrogenic effects of repeated suicidal ideation screening on suicidal and depression symptoms: A staggered sequential study.

    Science.gov (United States)

    Hom, Melanie A; Stanley, Ian H; Rogers, Megan L; Gallyer, Austin J; Dougherty, Sean P; Davis, Lisa; Joiner, Thomas E

    2018-02-21

    Research suggests that screening for suicidality does not have iatrogenic effects; however, less is known regarding the impact of repeatedly screening for suicidal ideation among individuals with varying levels of exposure to these screenings. This staggered sequential study evaluated whether suicidal ideation severity increases with repeated screening for suicidal ideation and depression symptoms. Undergraduates (N = 207) were recruited at one of four time points (baseline [n = 37], 1 month later [n = 61], 4 months later [n = 55], and 12 months later [n = 54]) to complete the self-report Beck Depression Inventory (BDI). Participants completed the BDI at the time point at which they were recruited and all subsequent study time points. Non-parametric tests were employed to compare suicidal ideation severity (BDI Item 9) and depression symptom severity (BDI total score): (1) within each group across time points and (2) within each time point across groups. Suicidal ideation severity did not significantly differ within any group across time points, and for two groups, depression symptom severity decreased over time. For analyses between groups, suicidal ideation and depression symptom scores were, at times, significantly lower during subsequent BDI completion time points. This study utilized a relatively small sample size and participants of low clinical severity. Findings align with prior research indicating that suicidality screening is not iatrogenic. This study also expanded upon previous studies by leveraging a staggered sequential design to compare suicidal ideation and depression symptom severity among individuals with varying exposure to suicidal ideation screenings. Copyright © 2018 Elsevier B.V. All rights reserved.

  2. Giant bleeding renal angiomyolipoma: diagnosis and management

    International Nuclear Information System (INIS)

    Ashebu, S.D.; Elshebiny, Y.H.; Dahniya, M.H.; Varro, J.; Al-khawari, H.

    2002-01-01

    A case of a giant bleeding renal angiomyolipoma is presented. The patient was a 40-year-old Egyptian male with no clinical or radiological evidence of tuberous sclerosis. The radiological features and management, including the role of angiography are briefly discussed and the medical reviews on this subject are briefly considered. There was no fever. He had a history of renal calculi. Physical examination revealed a mass in the right loin. His haemoglobin was 9.9 g/dL, blood pressure 110/70 and pulse 96 b.p.m. Routine biochemical investigations were normal. A plain radiograph of the abdomen suggested a right upper pole renal mass. Intravenous urography (IVU) confirmed a large space-occupying lesion. Ultrasonography (US) discovered mixed echogenicity but predominantly echogenic. A few hours after admission, the patient's blood pressure and haematocrit dropped. Plain and contrast enhanced CT (CECT) performed after resuscitation with three units of blood revealed a huge, heterogeneously enhancing and very vascular right renal tumour, with multiple small pseudoaneurysms. The tumour was predominantly of fat density, with soft tissue components and extended beyond the kidney into the perinephric space. The appearance was typical of an angiomyolipoma (AML). Small AML were demonstrated in the left kidney. Copyright (2002) Blackwell Science Pty Ltd

  3. Wireless capsule endoscopy: perspectives beyond gastrointestinal bleeding.

    Science.gov (United States)

    Redondo-Cerezo, Eduardo; Sánchez-Capilla, Antonio Damián; De La Torre-Rubio, Paloma; De Teresa, Javier

    2014-11-14

    Wireless capsule endoscopy (CE) is a technology developed for the endoscopic exploration of the small bowel. The first capsule model was approved by the Food and Drug Administration in 2001, and its first and essential indication was occult gastrointestinal (GI) bleeding. Over subsequent years, this technology has been refined to provide superior resolution, increased battery life, and capabilities to view different parts of the GI tract. Indeed, cases for which CE proved useful have increased significantly over the last few years, with new indications for the small bowel and technical improvements that have expanded its use to other parts of the GI tract, including the esophagus and colon. The main challenges in the development of CE are new devices with the ability to provide therapy, air inflation for a better vision of the small bowel, biopsy sampling systems attached to the capsule and the possibility to guide and move the capsule with an external motion control. In this article we review the current and new indications of CE, and the evolving technological changes shaping this technology, which has a promising potential in the coming future of gastroenterology.

  4. Agonist-induced platelet reactivity correlates with bleeding in haemato-oncological patients

    NARCIS (Netherlands)

    Batman, B.; van Bladel, E. R.; van Hamersveld, M.; Pasker-De Jong, Pieternel C M; Korporaal, S. J.A.; Urbanus, R. T.; Roest, M.; Boven, Leonie A; Fijnheer, R.

    2017-01-01

    Background and objective: Prophylactic platelet transfusions are administered to prevent bleeding in haemato-oncological patients. However, bleeding still occurs, despite these transfusions. This practice is costly and not without risk. Better predictors of bleeding are needed, and flow cytometric

  5. Severity and Features of Epistaxis in Children with a Mucocutaneous Bleeding Disorder

    NARCIS (Netherlands)

    Stokhuijzen, Eva; Segbefia, Catherine I.; Biss, Tina T.; Clark, Dewi S.; James, Paula D.; Riddel, Jim; Blanchette, Victor S.; Rand, Margaret L.

    2018-01-01

    Objective To use standardized bleeding questionnaires to compare the severity and patterns of epistaxis in children with a mucocutaneous bleeding disorder and control children. Study design The epistaxis sections of the Pediatric Bleeding Questionnaire (PBQ) administered to pediatric patients with

  6. Towards the development of a fully coupled arterial-venous 1D model: suitability of using a 1D finite volume method with staggered spatial discretization

    CSIR Research Space (South Africa)

    Bogaers, Alfred EJ

    2012-07-01

    Full Text Available In this paper we outline the development of a 1D finite volume model to solve for blood flow through the arterial system. The model is based on a staggered spatial discretization which leads to a stable solution scheme. This scheme can accurately...

  7. 49 CFR Figure 1 to Subpart B of... - Example of Location and Staggering of Emergency Window Exits-§ 238.113

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Example of Location and Staggering of Emergency Window Exits-§ 238.113 1 Figure 1 to Subpart B of Part 238 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION, DEPARTMENT OF TRANSPORTATION PASSENGER EQUIPMENT...

  8. 49 CFR Figure 2 to Subpart B of... - Example of a Multi-Level Car Complying with Window Location and Staggering Requirements-§§ 238...

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Example of a Multi-Level Car Complying with Window Location and Staggering Requirements-§§ 238.113 and 238.114 2 Figure 2 to Subpart B of Part 238 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION...

  9. 29 CFR Appendix H to Subpart R of... - Double Connections: Illustration of a Clipped End Connection and a Staggered Connection: Non...

    Science.gov (United States)

    2010-07-01

    ... Connection and a Staggered Connection: Non-Mandatory Guidelines for Complying With § 1926.756(c)(1) H Appendix H to Subpart R of Part 1926 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY... CONSTRUCTION Steel Erection Pt. 1926, Subpt. R, App. H Appendix H to Subpart R of Part 1926—Double Connections...

  10. Management of dysfunctional uterine bleeding based on endometrial thickness

    Directory of Open Access Journals (Sweden)

    Ozgul Muneyyirci-Delale

    2010-09-01

    Full Text Available Ozgul Muneyyirci-Delale1,2, Anuja Gupta1,2, Cynthia Abraham1, Ashadeep Chandrareddy1, Charles H Bowers Jr2, Jed B Cutler2Departments of Obstetrics and Gynecology, 1SUNY Downstate Medical Center, 2Kings County Hospital Center, Brooklyn, New York, USAObjective: To manage patients with dysfunctional uterine bleeding (DUB according to endometrial thickness.Methods: A retrospective chart review of 49 patients who reported 8 or more days of bleeding was performed. They were then divided into three groups based on endometrial thickness (mm: less than 6, 6–11, and greater than 11. These three groups were treated with combined oral contraceptive pills (OCP, conjugated estrogen plus progesterone and megestrol respectively. Patients given megestrol also underwent endometrial biopsy before treatment. Patients recorded the degree of bleeding each day for one month after starting treatment.Results: Mean endometrial thickness in the combined OCPs, conjugated estrogen plus progesterone and megestrol groups were 4, 8 and 14 mm, respectively. Combined OCPs decreased bleeding from 46 to 8 days (P < 0.05, n = 8. Conjugated estrogen plus progesterone decreased the number of days of bleeding from a mean of 41 to 9 (P < 0.01, n = 16. Megestrol decreased bleeding from 54 to 3 days (P < 0.001, n = 25. 52% of patients given megestrol had endometrial hyperplasia.Conclusion: These results support the effectiveness of treating patients with DUB according to endometrial thickness.Keywords: DUB, abnormal uterine bleeding, endometrium, hyperplasia, megestrol acetate

  11. [Management of intractable epistaxis and bleeding points localization].

    Science.gov (United States)

    Yang, Da-Zhang; Cheng, Jing-Ning; Han, Jun; Shu, Ping; Zhang, Hua

    2005-05-01

    To investigate the common nasal bleeding points and the management of intractable epistaxis. The bleeding points and its correlation with age distribution, surgical techniques as well as its effects were studied retrospectively in 92 patients, in whom the bleeding points were not found by routine nasal endoscopy and the hemorrhage was not controlled with standard nasal packing. The bleeding points were found in the following different sites: superior wall of inferior nasal meatus (56.5%, 52/92), olfactory cleft of nasal septum (27.2%, 25/92), posterosuperior wall of middle nasal meatus (8.7%, 8/92) and uncertain (7.6%, 7/92). The results showed that the bleeding points had correlation with age. Epistaxis was well controlled by electrocoagulation in 83 cases, gelfoam packing in 8 cases, and transcatheter maxillary artery embolization in 1 case. There were no complications during a followed-up for 1 - 3 months after management. Among the 92 cases, the numbers of treatment needed to stop bleeding were 82 cases (89.1%) after 1 time of treatment, 9 cases (9.8%) after 2 times and in one case (1.1%) after 4 times. Endoscopy combined with displacement of the middle and inferior turbinate gives good visualization and direct management of the deeply-sited bleeding points, which were difficult in localization. The combined method provides an effective and safe way to control intractable epistaxis.

  12. Bleeding related to etonogestrel subdermal implant in a US population.

    Science.gov (United States)

    Casey, Petra M; Long, Margaret E; Marnach, Mary L; Bury, Jessica E

    2011-05-01

    The etonogestrel subdermal implant received US Food and Drug Administration approval in 2006. Menstrual changes represent a common reason why recipients of this implant request early implant removal. Retrospective review of medical records of 155 patients with placement of this implant at Mayo Clinic in Rochester, Minnesota, and medical literature review. In 151 patients (97.4%), this implant was placed for contraception. Sixty-four patients (41.3%) contacted a health care provider about implant-related issues after insertion, including 39 (25.2%) for abnormal bleeding. Mean body mass index (BMI) was 28.5, higher than prior studies of implant-related bleeding. Implant removal rate was 25.2% (mean interval, 9.8 months), with 14.8% requesting removal for bleeding changes. No insertion or postinsertion complications or contraceptive failures were found. Age, race, BMI, parity, prior contraception method, and postpartum and breastfeeding status did not predict bleeding or removal for bleeding risk. Removal rates were higher for amenorrhea, occasional spotting or bleeding, and regular menses than for prolonged or continuous bleeding. Copyright © 2011 Elsevier Inc. All rights reserved.

  13. Acquired Inhibitors: A Special Case of Bleeding in Older Adults

    Directory of Open Access Journals (Sweden)

    Richard G. Stefanacci

    2012-01-01

    Full Text Available This literature review is intended to familiarize physicians and healthcare providers of older adults with the potential causes of acute bleeding in older adults and to review diagnostic approaches that can produce prompt identification of acute bleeding and facilitate timely treatment. Adverse events from anticoagulant treatment and nonsteroidal anti-inflammatory drug (NSAID and aspirin use and abuse are among the most common causes of bleeding in older adults. Diagnoses infrequently considered—mild congenital hemophilia, acquired hemophilia, von Willebrand disease, and platelet dysfunction—can contribute to acute bleeding in older adults. The approach to management of bleeding varies. Management of acute bleeding in older adults can be challenging because these patients often have chronic comorbidity and have been prescribed long-term concomitant medications that can complicate diagnosis and treatment. Prompt recognition of acquired hemophilia, referral to an expert hematologist, and timely initiation of treatment could improve outcome in older patients who experience bleeding episodes resulting from this condition.

  14. Importance of histopathological examination of endometrium in Dysfunctional Uterine Bleeding.

    Directory of Open Access Journals (Sweden)

    Dr. Yaminee Rana

    2017-12-01

    Full Text Available Introduction: Abnormal uterine bleeding is a common condition affecting women of reproductive age that has significant social and economic impact. Dysfunctional uterine bleeding (DUB is defined as abnormal uterine bleeding in the absence of organic disease. Dysfunctional uterine bleeding is one of the most commonly encountered gynaecological problems. Objectives: This study is done to evaluate the histopathological pattern of the endometrial biopsies of patients with dysfunctional uterine bleeding and its correlation with clinical data. Methods: The present prospective study included evaluation of 208 cases of dysfunctional uterine bleeding in the Department of Pathology, B. J. Medical College, Ahmedabad over a period of 10 months, from January 2017 to October 2017. Women presenting with abnormal uterine bleeding were included in the study. Those women in which bleeding is secondary to systemic causes, organic causes and due to cervical and vaginal causes were excluded. The specimens were processed, embedded and cut into sections of 3-4 microns. The histopathological patterns were studied. Results: Age distribution varied from 18 years to 70 years, majority of the patients were between 21 to 30 years. Among the cases of DUB, proliferative phase accounted for 66.3% and secretory phase accounted for 21.3%. 18 cases (8.6% of atrophic endometrium, four cases (1.9% of irregular shedding and two cases of luteal phase insufficiency were received. Conclusion: Dysfunctional uterine bleeding is a common and debilitating condition in women of reproductive age. Endometrial biopsy could be effectively used as the first diagnostic step in DUB and thus ensures correct management.

  15. Therapeutic Options for Patients Bleeding with Peptic Ulcers

    Directory of Open Access Journals (Sweden)

    ABR Thomson

    1994-01-01

    Full Text Available It is likely that the best outcome for the patient with an acute upper gastrointestinal bleed (GIB includes early diagnosis: for a bleeding lesion with a high risk of rebleeding, in an older patient with systolic h.ypotension or in a person with multiple medical problems. Early therapeutic endoscopy with meticulous control of intragastric pH will Likely achieve the best outcome. The ideal pH criterion to stop bleeding or to prevent recurrence is unknown. An algorithm is presented to guide the clinical management of patients with GIB, and to focus on important questi.ons for future therapeutic studies.

  16. Gastrointestinal bleeding secondary to ulcer in duodenal diverticulosis

    International Nuclear Information System (INIS)

    Banos Madrid, Ramon; Alberca de las Parras, Fernando; Vargas Acosta, Angel and others

    2006-01-01

    The reasons more frequent of high gastrointestinal bleeding are the peptic gastric and duodenal, followed by acute erosion and the varicose veins in oesophagus and stomachs. The diverticulosis of the small bowel is a very rare reason of gastrointestinal bleeding, must considerate in patients with bleeding without evident reason in oesophagus and stomach the habitual is to diagnose this entity of occidental form in the course of endoscopic procedures, radiological of surgical. The complications associated with the diverticulosis duodenal are rare; it justifies supporting a not surgical attitude at first

  17. Gastrointestinal bleeding secondary to ulcer in duodenal diverticulosis

    International Nuclear Information System (INIS)

    Ramon Banos Madrid; Fernando Alberca de las Parras; Angel Vargas Acosta and others

    2006-01-01

    The reasons more frequent of high gastrointestinal bleeding are the peptic gastric and duodenal, followed by acute erosions and the varicose veins in oesophagus and stomach. The diverticulosis of the small bowel is a very rare reason of gastrointestinal bleeding, must considerate in patients with bleeding without evident reason in oesophagus and stomach, the habitual is to diagnose this entity of accidental form in the course of endoscopic procedures, radiological or surgical. The complications associated with the diverticulosis duodenal are rare; it justifies supporting a not surgical attitude at first

  18. Risk of bleeding related to antithrombotic treatment in cardiovascular disease

    DEFF Research Database (Denmark)

    Sørensen, Rikke; Olesen, Jonas B; Charlot, Mette

    2012-01-01

    Antithrombotic therapy is a cornerstone of treatment in patients with cardiovascular disease with bleeding being the most feared complication. This review describes the risk of bleeding related to different combinations of antithrombotic drugs used for cardiovascular disease: acute coronary...... syndrome (ACS), atrial fibrillation (AF), cerebrovascular (CVD) and peripheral arterial disease (PAD). Different risk assessment schemes and bleeding definitions are compared. The HAS-BLED risk score is recommended in patients with AF and in ACS patients with AF. In patients with ACS with or without...

  19. Gastrointestinal bleeding from supraduodenal artery with aberrant origin

    Directory of Open Access Journals (Sweden)

    Qiong Han, MD, PhD

    2017-09-01

    Full Text Available Angiography and endovascular embolization play an important role in controlling acute arterial upper gastrointestinal hemorrhage, particularly when endoscopic intervention fails to do so. In our case, the patient presented with recurrent life-threatening bleed in spite of multiple prior endoscopic interventions and gastroduodenal artery embolization. Our teaching points focus on the role of angiography in acute upper gastrointestinal bleed and when to conduct empiric embolization, while reviewing the supraduodenal artery as an atypical but important potential culprit for refractory upper gastrointestinal bleed.

  20. Transvaginal Ultrasound for the Diagnosis of Abnormal Uterine Bleeding.

    Science.gov (United States)

    Wheeler, Karen C; Goldstein, Steven R

    2017-03-01

    Transvaginal ultrasound is the first-line imaging test for the evaluation of abnormal uterine bleeding in both premenopausal and postmenopausal women. Transvaginal ultrasound can be used to diagnose structural causes of abnormal bleeding such as polyps, adenomyosis, leiomyomas, hyperplasia, and malignancy, and can also be beneficial in making the diagnosis of ovulatory dysfunction. Traditional 2-dimensional imaging is often enhanced by the addition of 3-dimension imaging with coronal reconstruction and saline infusion sonohysterography. In this article we discuss specific ultrasound findings and technical considerations useful in the diagnosis of abnormal uterine bleeding.

  1. Predicting Major Bleeding in Ischemic Stroke Patients With Atrial Fibrillation.

    Science.gov (United States)

    Hilkens, Nina A; Algra, Ale; Greving, Jacoba P

    2017-11-01

    Performance of risk scores for major bleeding in patients with atrial fibrillation and a previous transient ischemic attack or ischemic stroke is not well established. We aimed to validate risk scores for major bleeding in patients with atrial fibrillation treated with oral anticoagulants after cerebral ischemia and explore the net benefit of oral anticoagulants among bleeding risk categories. We analyzed 3623 patients with a history of transient ischemic attack or stroke included in the RE-LY trial (Randomized Evaluation of Long-Term Anticoagulation Therapy). We assessed performance of HEMORR 2 HAGES (hepatic or renal disease, ethanol abuse, malignancy, older age, reduced platelet count or function, hypertension [uncontrolled], anemia, genetic factors, excessive fall risk, and stroke), Shireman, HAS-BLED (hypertension, abnormal renal/liver function, stroke, bleeding history or predisposition, labile international normalized ratio, elderly, drugs/alcohol concomitantly), ATRIA (Anticoagulation and Risk Factors in Atrial Fibrillation), and ORBIT scores (older age, reduced haemoglobin/haematocrit/history of anaemia, bleeding history, insufficient kidney function, and treatment with antiplatelet) with C statistics and calibration plots. Net benefit of oral anticoagulants was explored by comparing risk reduction in ischemic stroke with risk increase in major bleedings on warfarin. During 6922 person-years of follow-up, 266 patients experienced a major bleed (3.8 per 100 person-years). C statistics ranged from 0.62 (Shireman) to 0.67 (ATRIA). Calibration was poor for ATRIA and moderate for other models. The reduction in recurrent ischemic strokes on warfarin was larger than the increase in major bleeding risk, irrespective of bleeding risk category. Performance of prediction models for major bleeding in patients with cerebral ischemia and atrial fibrillation is modest but comparable with performance in patients with only atrial fibrillation. Bleeding risk scores cannot

  2. Clival chordoma manifesting as nasal bleeding. A case report

    Energy Technology Data Exchange (ETDEWEB)

    Kitai, Ryuhei; Yoshida, Kazuhiko; Kubota, Toshihiko; Sato, Kazufumi; Handa, Yuji; Kasahara, Kazuma [University of Fukui, Department of Neurosurgery, Fukui (Japan); Nakajima, Hirofumi [Tsuruga Municipal Hospital, Department of Neurosurgery, Fukui (Japan)

    2005-05-01

    Chordoma is a rare cartilaginous tumor, for which bleeding presentation is unusual. We report a case of rare hemorrhaged clival chordoma, which was diagnosed correctly by magnetic resonance imaging. A 32-year-old man presented with nasal bleeding. The tumor was totally removed via a trans-sphenoidal approach, from which the surgical specimen confirmed chordoma. Epistaxis seemed to be caused by the spreading of the intratumoral hemorrhage into the sphenoid sinus. This case demonstrates the importance of an exact differential diagnostic evaluation, including chordoma, by use of modern imaging techniques for nasal bleeding. (orig.)

  3. Clival chordoma manifesting as nasal bleeding. A case report

    International Nuclear Information System (INIS)

    Kitai, Ryuhei; Yoshida, Kazuhiko; Kubota, Toshihiko; Sato, Kazufumi; Handa, Yuji; Kasahara, Kazuma; Nakajima, Hirofumi

    2005-01-01

    Chordoma is a rare cartilaginous tumor, for which bleeding presentation is unusual. We report a case of rare hemorrhaged clival chordoma, which was diagnosed correctly by magnetic resonance imaging. A 32-year-old man presented with nasal bleeding. The tumor was totally removed via a trans-sphenoidal approach, from which the surgical specimen confirmed chordoma. Epistaxis seemed to be caused by the spreading of the intratumoral hemorrhage into the sphenoid sinus. This case demonstrates the importance of an exact differential diagnostic evaluation, including chordoma, by use of modern imaging techniques for nasal bleeding. (orig.)

  4. Desmopressin acetate (DDAVP) for preventing and treating acute bleeds during pregnancy in women with congenital bleeding disorders.

    Science.gov (United States)

    Karanth, Laxminarayan; Barua, Ankur; Kanagasabai, Sachchithanantham; Nair, Sreekumar

    2015-09-09

    Congenital bleeding disorders can cause obstetric haemorrhage during pregnancy, labour and following delivery. Desmopressin acetate is found to be an effective drug which can reduce the risk of haemorrhage and can also stop bleeding in certain congenital bleeding disorders. Its use in pregnancy has been controversial. Hence beneficial and adverse effects of desmopressin acetate in these groups of pregnant women should be evaluated.This is an update of a Cochrane review first published in 2013. To determine the efficacy of desmopressin acetate in preventing and treating acute bleeds during pregnancy in women with congenital bleeding disorders. We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group's Coaguopathies Trials Register comprising references identified from comprehensive electronic database searches and handsearches of relevant and abstract books of conferences proceedings. We also searched for any randomised controlled trials in a registry of ongoing trials and the reference lists of relevant articles and reviews.Date of most recent search: 18 June 2015. Randomised and quasi-randomised controlled trials investigating the efficacy of desmopressin acetate versus tranexamic acid or factor VIII or rFactor VII or fresh frozen plasma in preventing and treating congenital bleeding disorders during pregnancy were eligible. No trials matching the selection criteria were eligible for inclusion. No trials matching the selection criteria were eligible for inclusion. The review did not identify any randomised controlled trials investigating the relative effectiveness of desmopressin acetate for bleeding during pregnancy in women with congenital bleeding disorders. In the absence of high quality evidence, clinicians need to use their clinical judgement and lower level evidence (e.g. from observational trials) to decide whether or not to treat women with congenital bleeding disorders with desmopressin acetate.Given the ethical considerations, future

  5. Abnormal Uterine Bleeding including coagulopathies and other menstrual disorders.

    Science.gov (United States)

    Deligeoroglou, Efthimios; Karountzos, Vasileios

    2018-04-01

    Abnormal Uterine Bleeding (AUB) is a frequent cause of visits to the emergency department and a major reason for concern among adolescents and their families. The most common cause of AUB, in otherwise healthy adolescents, is ovulatory dysfunction, although 5-36% of adolescents who present with heavy menstrual bleeding, have an underlying bleeding disorder (BD). The most common form of BDs is von Willebrand Disease, reflecting 13% of adolescents with AUB. Management of AUB depends on the underlying etiology, the bleeding severity, as well as the need for hospitalization. Treatment of adolescents with an underlying coagulopathy depends on the severity of the BD, while therapeutic interventions are summarized in supportive measures, hormonal treatments (e.g. Combined Oral Contraceptives), non-hormonal treatments (e.g. tranexamic acid and desmopressin), surgical options (e.g. dilatation & curettage) and treatment options in specific conditions. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. Hormone Replacement Therapy: Can It Cause Vaginal Bleeding?

    Science.gov (United States)

    Hormone replacement therapy: Can it cause vaginal bleeding? I'm taking hormone therapy for menopause symptoms, and my monthly ... mayoclinic.org/diseases-conditions/menopause/expert-answers/hormone-replacement-therapy/FAQ-20058499 . Mayo Clinic Footer Legal Conditions ...

  7. Predictive factors for intraoperative excessive bleeding in Graves’ disease

    Directory of Open Access Journals (Sweden)

    Kosho Yamanouchi

    2015-01-01

    Conclusion: A huge goiter presented as a predictive factor for excessive bleeding during surgery for Graves’ disease, and preparation for blood transfusion should be considered in cases where thyroids weigh more than 200 g.

  8. Management of bleeding and leakage after pancreatic surgery

    NARCIS (Netherlands)

    de Castro, S. M. M.; Busch, O. R. C.; Gouma, D. J.

    2004-01-01

    Pancreatic surgery has advanced considerably during the past decades. Recent studies report reduced morbidity rates and virtually no mortality after resection. However, postoperative complications are still a formidable menace. In this chapter we discuss the management of postoperative bleeding and

  9. Anode reactive bleed and injector shift control strategy

    Science.gov (United States)

    Cai, Jun [Rochester, NY; Chowdhury, Akbar [Pittsford, NY; Lerner, Seth E [Honeoye Falls, NY; Marley, William S [Rush, NY; Savage, David R [Rochester, NY; Leary, James K [Rochester, NY

    2012-01-03

    A system and method for correcting a large fuel cell voltage spread for a split sub-stack fuel cell system. The system includes a hydrogen source that provides hydrogen to each split sub-stack and bleed valves for bleeding the anode side of the sub-stacks. The system also includes a voltage measuring device for measuring the voltage of each cell in the split sub-stacks. The system provides two levels for correcting a large stack voltage spread problem. The first level includes sending fresh hydrogen to the weak sub-stack well before a normal reactive bleed would occur, and the second level includes sending fresh hydrogen to the weak sub-stack and opening the bleed valve of the other sub-stack when the cell voltage spread is close to stack failure.

  10. Risk of bleeding related to antithrombotic treatment in cardiovascular disease

    DEFF Research Database (Denmark)

    Sørensen, Rikke; Olesen, Jonas B; Charlot, Mette

    2012-01-01

    syndrome (ACS), atrial fibrillation (AF), cerebrovascular (CVD) and peripheral arterial disease (PAD). Different risk assessment schemes and bleeding definitions are compared. The HAS-BLED risk score is recommended in patients with AF and in ACS patients with AF. In patients with ACS with or without......Antithrombotic therapy is a cornerstone of treatment in patients with cardiovascular disease with bleeding being the most feared complication. This review describes the risk of bleeding related to different combinations of antithrombotic drugs used for cardiovascular disease: acute coronary...... a stent dual antiplatelet therapy with a P2Y12 receptor antagonist and acetylsalicylic acid (ASA) is recommended for 12 months, preferable with prasugrel or ticagrelor unless there is an additional indication of warfarin or increased risk of bleeding. In patients with AF, warfarin is recommended...

  11. Pregnancy Complications: Bleeding and Spotting from the Vagina

    Science.gov (United States)

    ... miscarry have bleeding or spotting before the miscarriage. Ectopic pregnancy. This is when a fertilized egg implants itself ... of the uterus and begins to grow. An ectopic pregnancy cannot result in the birth of a baby. ...

  12. A rare cause of recurrent gastrointestinal bleeding: mesenteric hemangioma

    Directory of Open Access Journals (Sweden)

    Zeytunlu Murat

    2009-01-01

    Full Text Available Abstract Lower gastrointestinal hemorrhage accounts for approximately 20% of gastrointestinal hemorrhage. The most common causes of lower gastrointestinal hemorrhage in adults are diverticular disease, inflammatory bowel disease, benign anorectal diseases, intestinal neoplasias, coagulopathies and arterio-venous malformations. Hemangiomas of gastrointestinal tract are rare. Mesenteric hemangiomas are also extremely rare. We present a 25-year-old female who was admitted to the emergency room with recurrent lower gastrointestinal bleeding. An intraluminal bleeding mass inside the small intestinal segment was detected during explorative laparotomy as the cause of the recurrent lower gastrointestinal bleeding. After partial resection of small bowel segment, the histopathologic examination revealed a cavernous hemagioma of mesenteric origin. Although rare, gastrointestinal hemangioma should be thought in differential diagnosis as a cause of recurrent lower gastrointestinal bleeding.

  13. Evaluation and Management of Adolescents with Abnormal Uterine Bleeding.

    Science.gov (United States)

    Mullins, Tanya L Kowalczyk; Miller, Rachel J; Mullins, Eric S

    2015-09-01

    The International Federation of Gynecology and Obstetrics and the American Congress of Obstetricians and Gynecologists support the use of new terminology for abnormal uterine bleeding (AUB) to consistently categorize AUB by etiology. The term AUB can be further classified as AUB/heavy menstrual bleeding (HMB) (replacing the term "menorrhagia") or AUB/intermenstrual bleeding (replacing the term "metrorrhagia"). Although many cases of AUB in adolescent women are attributable to immaturity of the hypothalamic-pituitary-ovarian axis, underlying bleeding disorders should be considered in women with AUB/HMB. This article reviews the new terminology for AUB, discusses important relevant features of history and examination, presents the laboratory evaluation of HMB, and describes hormonal (oral contraceptive pills, progestin-only methods, long-acting reversible contraceptives including intrauterine systems), hematologic (tranexamic acid and desmopressin), and surgical management options for AUB/HMB. Copyright 2015, SLACK Incorporated.

  14. Saliency-Based Bleeding Localization for Wireless Capsule Endoscopy Diagnosis

    Directory of Open Access Journals (Sweden)

    Hongda Chen

    2017-01-01

    Full Text Available Stomach bleeding is a kind of gastrointestinal disease which can be diagnosed noninvasively by wireless capsule endoscopy (WCE. However, it requires much time for physicians to scan large amount of WCE images. Alternatively, computer-assisted bleeding localization systems are developed where color, edge, and intensity features are defined to distinguish lesions from normal tissues. This paper proposes a saliency-based localization system where three saliency maps are computed: phase congruency-based edge saliency map derived from Log-Gabor filter bands, intensity histogram-guided intensity saliency map, and red proportion-based saliency map. Fusing the three maps together, the proposed system can detect bleeding regions by thresholding the fused saliency map. Results demonstrate the accuracy of 98.97% for our system to mark bleeding regions.

  15. Transarterial embolization for management of severe postcoital bleeding

    Directory of Open Access Journals (Sweden)

    Armen Eskandari

    2016-08-01

    Full Text Available Objectives: Postcoital bleeding is an uncommon cause of gynecologic hemorrhage; however, it can be severe in a majority of cases necessitating surgical management. Methods: We report a case of severe postcoital bleeding in a young woman requiring blood transfusion. Results: Hemostasis was achieved using subselective embolization of cervical artery by metallic coils. Conclusion: Our case demonstrates a minimally invasive treatment for control of non-obstetric hemorrhage.

  16. Appendicular bleeding: an excepcional cause of lower hemorrhage

    Directory of Open Access Journals (Sweden)

    Marta Magaz-Martínez

    Full Text Available Chronic complications of acute appendicitis managed in a conservative manner are not frequent. We present a case of acute lower gastrointestinal hemorrhage in a young patient with a previous acute appendicitis without surgical intervention. The colonoscopy detected an appendicular bleeding which was surgically treated. The anatomopathological diagnosis was granulomatous appendicitis. The clinical evolution of the patient was favorable without bleeding recurrence. Appendicular hemorrhage can be an unusual complication -however potentially severe- of acute appendicitis not treated surgically.

  17. Practical Approach to Endoscopic Management for Bleeding Gastric Varices

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Young Suk [Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of)

    2012-02-15

    Bleeding from gastric varices is generally more severe than bleeding from esophageal varices, although it occurs less frequently. Recently, new endoscopic treatment options and interventional radiological procedures have broadened the therapeutic armamentarium for gastric varices. This review provides an overview of the classification and pathophysiology of gastric varices, an introduction to current endoscopic and interventional radiological management options for gastric varices, and details of a practical approach to endoscopic variceal obturation using N-butyl-2-cyanoacrylate.

  18. Abnormal uterine bleeding in reproductive-aged women.

    Science.gov (United States)

    Matthews, Michelle L

    2015-03-01

    Abnormal uterine bleeding is a common medical condition with several causes. The International Federation of Gynecology and Obstetrics published guidelines in 2011 to develop universally accepted nomenclature and a classification system. In addition, the American College of Obstetrics and Gynecology recently updated recommendations on evaluation of abnormal uterine bleeding and indications for endometrial biopsies. This article reviews both medical and surgical treatments, including meta-analysis reviews of the most effective treatment options. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. Fibrinogen concentrates for bleeding trauma patients: what is the evidence?

    DEFF Research Database (Denmark)

    Meyer, Martin; Ostrowski, S R; Windeløv, N A

    2011-01-01

    A balanced transfusion of red blood cells, fresh frozen plasma and platelets are recommended for massively bleeding trauma patients. Fibrinogen concentrates could potentially lessen or replace the need for fresh frozen plasma and/or platelet transfusions.......A balanced transfusion of red blood cells, fresh frozen plasma and platelets are recommended for massively bleeding trauma patients. Fibrinogen concentrates could potentially lessen or replace the need for fresh frozen plasma and/or platelet transfusions....

  20. Analysis of Brand Personality on Customer Loyalty (Case Study Tablet Computer: Apple Ipad and Samsung Galaxy Tab)

    OpenAIRE

    Andu, Risca A.

    2013-01-01

    Brand personality is a potential marketing strategy to increase the customer loyalty towards the particular brand. Many customers will choose products with a brand that suitable with their personality. It also applies to tablet computer customers. The objectives of this research are to describe the effect of brand personality on customer loyalty in purchasing Apple Ipad and Samsung Galaxy Tab. This research also will analyze the difference in customer loyalty based on brand personality betwee...

  1. Bleeding disorders in dental practice: A diagnostic overview

    Directory of Open Access Journals (Sweden)

    Abhirup Goswami

    2014-01-01

    Full Text Available Dental health care workers are increasingly called upon to provide quality dental care to individuals whose bleeding and clotting mechanisms have been altered by inherited or acquired diseases. This provides an opportunity for the dentist who is trained in the recognition of oral and systemic signs of altered hemostasis to assist in the diagnosis of the underlying condition. A number of dental procedures result in the risk of bleeding that can have serious consequences, such as severe hemorrhage or possibly death, for the patient with a bleeding disorder. Oral care providers must be aware of the impact of bleeding disorders on the management of their patients. These disorders must be recognized from history, clinical examinations, and laboratory investigations, if indicated, prior to surgical procedures including those in dental surgery to prevent bleeding related complications. Safe dental care may require consultation with the patient′s physician, systemic management, and dental treatment modifications. The purpose of this article is how to identify these patients with bleeding disorders.

  2. Transvaginal sonography in abnormal uterine bleeding and correlation to hysteroscopy

    International Nuclear Information System (INIS)

    Saeed, S.; Shah, S.; Ali, H.; Khan, S.; Ehsan, N.; Ahmed, S.Z.

    2017-01-01

    To correlate results of Transvaginal sonography with those of hysteroscopy and biopsy in abnormal uterine bleeding to estimate the accuracy and analytical values of non-invasive transvaginal sonography in abnormal uterine bleeding. Methodology: This cross-sectional Study was carried out at BMCH, Quetta, Balochistan, Pakistan from March 2013 to February 2014 and included 200 patients of abnormal uterine bleeding. Exclusion criteria were pregnancy, virginity, local bleeding of perineal or vaginal origin. Hysteroscopy and biopsy and Transvaginal Ultrasound (TVS) were performed in all. Result: The most common type of bleeding was found to be menorrhagia in 39% while the least common type was postmenopausal bleeding in 9%. Mean endometrial thickness was 11.64 mm and it was noted that at less than 14mm thickness no serious pathology was found. Sensitivity of TVS for endometrial hyperplasia was found to be 66.66% while specificity was 100%. Positive analytical value was 100% while negative value was 100%. Overall sensitivity calculated for TVS was 94.44%, specificity 98.55%, PPV was 81.93% and NPV 98.55%. Conclusion: Sensitivity and specificity of TVS were lower than hysteroscopy and biopsy but the difference was not significant. TVS can be used as first line investigation while hysteroscopy and biopsy may be left for cases of high risk or in those cases where some positive findings could be found on TVS. (author)

  3. Congenital portosystemic shunts with and without gastrointestinal bleeding - case series

    Energy Technology Data Exchange (ETDEWEB)

    Gong, Ying; Chen, Jun; Chen, Qi; Ji, Min; Pa, Mier; Qiao, Zhongwei [Children' s Hospital of Fudan University, Department of Radiology, Shanghai (China); Zhu, Hui [Fudan University Shanghai Cancer Center, Department of Radiology, Shanghai (China); Zheng, Shan [Children' s Hospital of Fudan University, Department of Surgery, Shanghai (China)

    2015-12-15

    The clinical presentation of congenital portosystemic shunt is variable and gastrointestinal bleeding is an uncommon presentation. To describe the imaging features of congenital portosystemic shunt as it presented in 11 children with (n = 6) and without gastrointestinal bleeding (n = 5). We performed a retrospective study on a clinical and imaging dataset of 11 children diagnosed with congenital portosystemic shunt. A total of 11 children with congenital portosystemic shunt were included in this study, 7 with extrahepatic portosystemic shunts and 4 with intrahepatic portosystemic shunts. Six patients with gastrointestinal bleeding had an extrahepatic portosystemic shunt, and the imaging results showed that the shunts originated from the splenomesenteric junction (n = 5) or splenic vein (n = 1) and connected to the internal iliac vein. Among the five cases of congenital portosystemic shunt without gastrointestinal bleeding, one case was an extrahepatic portosystemic shunt and the other four were intrahepatic portosystemic shunts. Most congenital portosystemic shunt patients with gastrointestinal bleeding had a shunt that drained portal blood into the iliac vein via an inferior mesenteric vein. This type of shunt was uncommon, but the concomitant rate of gastrointestinal bleeding with this type of shunt was high. (orig.)

  4. Evaluation and management of abnormal uterine bleeding in premenopausal women.

    Science.gov (United States)

    Sweet, Mary Gayle; Schmidt-Dalton, Tarin A; Weiss, Patrice M; Madsen, Keith P

    2012-01-01

    Up to 14 percent of women experience irregular or excessively heavy menstrual bleeding. This abnormal uterine bleeding generally can be divided into anovulatory and ovulatory patterns. Chronic anovulation can lead to irregular bleeding, prolonged unopposed estrogen stimulation of the endometrium, and increased risk of endometrial cancer. Causes include polycystic ovary syndrome, uncontrolled diabetes mellitus, thyroid dysfunction, hyperprolactinemia, and use of antipsychotics or antiepileptics. Women 35 years or older with recurrent anovulation, women younger than 35 years with risk factors for endometrial cancer, and women with excessive bleeding unresponsive to medical therapy should undergo endometrial biopsy. Treatment with combination oral contraceptives or progestins may regulate menstrual cycles. Histologic findings of hyperplasia without atypia may be treated with cyclic or continuous progestin. Women who have hyperplasia with atypia or adenocarcinoma should be referred to a gynecologist or gynecologic oncologist, respectively. Ovulatory abnormal uterine bleeding, or menorrhagia, may be caused by thyroid dysfunction, coagulation defects (most commonly von Willebrand disease), endometrial polyps, and submucosal fibroids. Transvaginal ultrasonography or saline infusion sonohysterography may be used to evaluate menorrhagia. The levonorgestrel-releasing intrauterine system is an effective treatment for menorrhagia. Oral progesterone for 21 days per month and nonsteroidal anti-inflammatory drugs are also effective. Tranexamic acid is approved by the U.S. Food and Drug Administration for the treatment of ovulatory bleeding, but is expensive. When clear structural causes are identified or medical management is ineffective, polypectomy, fibroidectomy, uterine artery embolization, and endometrial ablation may be considered. Hysterectomy is the most definitive treatment.

  5. Transcatheter embolization for treatment of acute lower gastrointestinal bleeding

    International Nuclear Information System (INIS)

    Uflacker, R.

    1987-01-01

    Treatment of lower gastrointestinal bleeding was attempted in 13 patients by selective embolization of branches of the mesenteric arteries with Gelfoam. Bleeding was adequately controlled in 11 patients with active bleeding during the examination. One patient improved after embolization but bleeding recurred within 24 hours and in another patient the catheterization was unsuccessful. Five patients with diverticular hemorrhage were embolized in the right colic artery four times, and once in the middle colic artery. Three patients had embolization of the ileocolic artery because of hemorrhage from cecal angiodysplasia, post appendectomy, and leukemia infiltration. Three patients had the superior hemorrhoidal artery embolized because of bleeding from unspecific proctitis, infiltration of the rectum from a carcinoma of the bladder, and transendoscopic polypectomy. One patient was septic and bled from jejunal ulcers. Ischemic changes with infarction of the large bowel developed in two patients and were treated by partial semi-elective colectomy, three and four days after embolization. Four other patients developed pain and fever after embolization. Transcatheter embolization of branches of mesenteric arteries in an effective way to control acute lower gastrointestinal bleeding, but still has a significant rate of complications that must be seriously weighed against the advantages of operation. (orig.)

  6. Statin prescribing for people with severe mental illnesses: a staggered cohort study of 'real-world' impacts.

    Science.gov (United States)

    Blackburn, R; Osborn, D; Walters, K; Falcaro, M; Nazareth, I; Petersen, I

    2017-03-07

    To estimate the 'real-world effectiveness of statins for primary prevention of cardiovascular disease (CVD) and for lipid modification in people with severe mental illnesses (SMI), including schizophrenia and bipolar disorder. Series of staggered cohorts. We estimated the effect of statin prescribing on CVD outcomes using a multivariable Poisson regression model or linear regression for cholesterol outcomes. 587 general practice (GP) surgeries across the UK reporting data to The Health Improvement Network. All permanently registered GP patients aged 40-84 years between 2002 and 2012 who had a diagnosis of SMI. Exclusion criteria were pre-existing CVD, statin-contraindicating conditions or a statin prescription within the 24 months prior to the study start. One or more statin prescriptions during a 24-month 'baseline' period (vs no statin prescription during the same period). The primary outcome was combined first myocardial infarction and stroke. All-cause mortality and total cholesterol concentration were secondary outcomes. We identified 2944 statin users and 42 886 statin non-users across the staggered cohorts. Statin prescribing was not associated with significant reduction in CVD events (incident rate ratio 0.89; 95% CI 0.68 to 1.15) or all-cause mortality (0.89; 95% CI 0.78 to 1.02). Statin prescribing was, however, associated with statistically significant reductions in total cholesterol of 1.2 mmol/L (95% CI 1.1 to 1.3) for up to 2 years after adjusting for differences in baseline characteristics. On average, total cholesterol decreased from 6.3 to 4.6 in statin users and 5.4 to 5.3 mmol/L in non-users. We found that statin prescribing to people with SMI in UK primary care was effective for lipid modification but not CVD events. The latter finding may reflect insufficient power to detect a smaller effect size than that observed in randomised controlled trials of statins in people without SMI. Published by the BMJ Publishing Group Limited. For

  7. Prognostic variables in patients with cirrhosis and oesophageal varices without prior bleeding

    DEFF Research Database (Denmark)

    Møller, S; Bendtsen, F; Christensen, E

    1994-01-01

    As identification of patients at risk of bleeding or death is essential for prophylaxis, we determined the prognostic influence of various patient characteristics on the risk of bleeding and death. Fifty-five patients with cirrhosis and oesophageal varices without previous bleeding were included...... a significant relation with an increased risk of bleeding or death: high plasma volume (p varices (p

  8. Fasting for haemostasis in children with gastrointestinal bleeding.

    Science.gov (United States)

    Luo, Shuang-Hong; Guo, Qin; Liu, Guan J; Wan, Chaomin

    2016-05-19

    Gastrointestinal bleeding refers to loss of blood from any site of the digestive tract. In paediatric clinical practice, it is usually a complaint of children attending the emergency department as a symptom of diseases such as ulcers, gastric or oesophageal varices, gastritis, Mallory-Weiss tears, anorectal fissures, allergic colitis, infectious colitis, intussusception, Henoch-Schonlein purpura, and Meckel's diverticulum; it also occurs with high incidence in critically ill children hospitalised in intensive care units and is caused by stress-induced gastropathy. No matter what the cause of gastrointestinal bleeding, fasting is believed to be necessary due to the fear that eating may affect haemostasis or aggravate bleeding. To assess the effects and safety of fasting for haemostasis in gastrointestinal bleeding in children. We searched EBM Reviews - the Cochrane Central Register of Controlled Trials (CENTRAL) (May 2016), Ovid MEDLINE(R) (1946 to 3 May 2016), EMBASE (1980 to 2016 Week 18), Chinese Biomedical Database (CBM) (1978 to 3 May 2016), China National Knowledge Infrastructure (CNKI) (1979 to 3 May 2016), VIP Database (1989 to 4 May 2016) and Wanfang Data (1990 to 4 May 2016). We used no restrictions on language or study setting and limited searches in CNKI and Wanfang Data to the medical field. Randomised controlled trials (RCTs) or quasi-RCTs in children with gastrointestinal bleeding that compared fasting with feeding. Two review authors independently screened the literature search results, and there were no disagreements. We identified no RCTs or quasi-RCTs that compared the effects and safety of fasting with feeding for haemostasis in children with gastrointestinal bleeding. No study fulfilled the criteria for considering studies for our review. There is currently no information available from RCTs or quasi-RCTs to support or refute the use of fasting for haemostasis in children with gastrointestinal bleeding.

  9. A novel semi-quantitative method for measuring tissue bleeding.

    Science.gov (United States)

    Vukcevic, G; Volarevic, V; Raicevic, S; Tanaskovic, I; Milicic, B; Vulovic, T; Arsenijevic, S

    2014-03-01

    In this study, we describe a new semi-quantitative method for measuring the extent of bleeding in pathohistological tissue samples. To test our novel method, we recruited 120 female patients in their first trimester of pregnancy and divided them into three groups of 40. Group I was the control group, in which no dilation was applied. Group II was an experimental group, in which dilation was performed using classical mechanical dilators. Group III was also an experimental group, in which dilation was performed using a hydraulic dilator. Tissue samples were taken from the patients' cervical canals using a Novak's probe via energetic single-step curettage prior to any dilation in Group I and after dilation in Groups II and III. After the tissue samples were prepared, light microscopy was used to obtain microphotographs at 100x magnification. The surfaces affected by bleeding were measured in the microphotographs using the Autodesk AutoCAD 2009 program and its "polylines" function. The lines were used to mark the area around the entire sample (marked A) and to create "polyline" areas around each bleeding area on the sample (marked B). The percentage of the total area affected by bleeding was calculated using the formula: N = Bt x 100 / At where N is the percentage (%) of the tissue sample surface affected by bleeding, At (A total) is the sum of the surfaces of all of the tissue samples and Bt (B total) is the sum of all the surfaces affected by bleeding in all of the tissue samples. This novel semi-quantitative method utilizes the Autodesk AutoCAD 2009 program, which is simple to use and widely available, thereby offering a new, objective and precise approach to estimate the extent of bleeding in tissue samples.

  10. Periodically fully developed laminar flow and heat transfer in a two-dimensional horizontal channel with staggered fins

    Directory of Open Access Journals (Sweden)

    Turgut Oğuz

    2017-01-01

    Full Text Available The 2-D periodically fully developed laminar forced convection fluid flow and heat transfer characteristics in a horizontal channel with staggered fins are investigated numerically under constant wall heat flux boundary condition. Study is performed using ANSYS Fluent 6.3.26 which uses finite volume method. Air (Pr @ 0.7 and Freon-12 (Pr @ 3.5 are used as working fluids. Effects of Reynolds number, Prandtl number, fin height, and distances between two fins on heat transfer and friction factor are examined. Results are given in the form of non-dimensional average Nusselt number and average Darcy friction factor as a function of Reynolds number for different fin distances and Prandtl numbers. The velocity and temperature profiles are also obtained. It is seen that as the fin distance increases, behavior approaches the finless channel, as expected. Also, thermal enhancement factors are given graphically for working fluids. It is seen that heat transfer dominates the friction as both the distance between two fins and Prandtl number increase. It is also seen that fins having blockage ratio of 0.10 in 2-D periodically fully developed laminar flow is not advantageous in comparison to smooth channel without fins.

  11. Interim analysis based on the weighted log-rank test for delayed treatment effects under staggered patient entry.

    Science.gov (United States)

    Yoshida, Mizuki; Matsuyama, Yutaka

    2016-01-01

    Fleming and Harrington's G(ρ,γ) class of weighted log-rank tests is appropriate for detecting delayed treatment effects such as those seen in cancer vaccines. A conditional power (CP) and an alpha spending function (ASF) approach are useful for interim analyses that are conducted with the aim of early termination due to futility and efficacy, respectively. However, calculation of the CP and the total Type I error probability are often not considered for delayed effects under the staggered patient entry. In this article, we first propose methods for calculating the CP analytically based on the weighted log-rank test. We compared the performances of the proposed methods with two other methods (i.e., usual log-rank test and optimal one) under the delayed alternatives. Our simulations demonstrated that the CP based on the weighted log-rank test was more powerful than that of the usual log-rank test and was comparable to the CP based on the optimal log-rank test. Second, we quantitatively evaluated the degree to which the Type I error probability was inflated when an ASF approach with forced independent increments assumption was applied to the weighted log-rank test. The proposed method will provide valuable tools in the decision-making stage of the interim analysis.

  12. Localizing gene regulation reveals a staggered wood decay mechanism for the brown rot fungus Postia placenta

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Jiwei; Presley, Gerald N.; Hammel, Kenneth E.; Ryu, Jae-San; Menke, Jon R.; Figueroa, Melania; Hu, Dehong; Orr, Galya; Schilling, Jonathan S.

    2016-09-12

    The fungi that cause brown rot of wood are essential contributors to biomass recycling in forest ecosystems. Their highly efficient cellulolytic systems, which may have practical applications, apparently depend on a combination of two mechanisms: nonselective oxidation of the lignocellulose by reactive oxygen species (ROS) coupled with hydrolysis of the polysaccharide components by a limited set of glycoside hydrolases (GHs). Since the production of strongly oxidizing ROS appears incompatible with the operation of GHs, it has been proposed that the fungi regulate ROS production by maintaining concentration gradients of the chelated metal ions they use to generate extracellular oxidants. However, calculations have indicated that this protective mechanism is physically infeasible. We examined a different hypothesis, that expression of ROS and GH components is temporally staggered by brown rot fungi in wood. We sectioned thin wafers of spruce and aspen that had been colonized directionally by Postia placenta and measured expression of relevant genes and some of the encoded enzymes, thus using the spatial distribution of fungal hyphae to resolve a fine-scale temporal sequence. Hierarchical clustering of gene expression for eight oxidoreductases thought to have a role in ROS production and of eight GHs revealed a zone of oxidoreductase upregulation at the hyphal front that persisted about 48 h before upregulation of the GHs. Additional evidence for differential expression was provided by localization of endoglucanase, xylanase, mannanase, and laccase activities in the colonized wood. Our results support a two-step mechanism for brown rot, in which substrate oxidation precedes enzymatic hydrolysis.

  13. What is the recurrence rate of postmenopausal bleeding in women who have a thin endometrium during a first episode of postmenopausal bleeding?

    NARCIS (Netherlands)

    van Doorn, H. C.; Timmermans, A.; Opmeer, B. C.; Kruitwagen, R. F. M. P.; Dijkhuizen, F. P. H. L. J.; Kooi, G. S.; van de Weijer, P. H. M.; Mol, B. W. J.

    2008-01-01

    Objective. To determine the incidence and significance of recurrent postmenopausal bleeding among women diagnosed with an endometrial thickness <= 4 mm after a first episode of postmenopausal bleeding. Methods. Consecutive patients not using hormone replacement therapy (HRT) presenting with a first

  14. What is the recurrence rate of postmenopausal bleeding in women who have a thin endometrium during a first episode of postmenopausal bleeding?

    NARCIS (Netherlands)

    Doorn, H.C. van; Timmermans, A.; Opmeer, B.C.; Kruitwagen, R.F.P.M.; Dijkhuizen, F.P.; Kooi, G.S.; Weijer, P.H.M. van de; Mol, B.W.; Dupomeb, F.

    2008-01-01

    OBJECTIVE: To determine the incidence and significance of recurrent postmenopausal bleeding among women diagnosed with an endometrial thickness < or =4 mm after a first episode of postmenopausal bleeding. METHODS: Consecutive patients not using hormone replacement therapy (HRT) presenting with a

  15. Analysis and Optimization of a Novel 2-D Magnet Array with Gaps and Staggers for a Moving-Magnet Planar Motor

    Science.gov (United States)

    Chen, Xuedong; Zeng, Lizhan

    2018-01-01

    This paper presents a novel 2-D magnet array with gaps and staggers, which is especially suitable for magnetically levitated planar motor with moving magnets. The magnetic flux density distribution is derived by Fourier analysis and superposition. The influences of gaps and staggers on high-order harmonics and flux density were analyzed, and the optimized design is presented. Compared with the other improved structures based on traditional Halbach magnet arrays, the proposed design has the lowest high-order harmonics percentage, and the characteristics of flux density meet the demand of high acceleration in horizontal directions. It is also lightweight and easy to manufacture. The proposed magnet array was built, and the calculation results have been verified with experiment. PMID:29300323

  16. Management and outcome of bleeding pseudoaneurysm associated with chronic pancreatitis

    Directory of Open Access Journals (Sweden)

    Jan Yi-Yin

    2006-01-01

    Full Text Available Abstract Background A bleeding pseudoaneurysm in patients with chronic pancreatitis is a rare and potentially lethal complication. Optimal treatment of bleeding peripancreatic pseudoaneurysm remains controversial. This study reports on experience at Chang Gung Memorial Hospital (CGMH in managing of bleeding pseudoaneurysms associated with chronic pancreatitis. Methods The medical records of 9 patients (8 males and 1 female; age range, 28 – 71 years; median, 36 years with bleeding pseudoaneurysms associated with chronic pancreatitis treated at CGMH between Aug. 1992 and Sep. 2004 were retrospectively reviewed. Alcohol abuse (n = 7;78% was the predominant predisposing factor. Diagnoses of bleeding pseudoaneurysms were based on angiographic (7/7, computed tomographic (4/7, ultrasound (2/5, and surgical (2/2 findings. Whether surgery or angiographic embolization was performed was primarily based on patient clinical condition. Median follow-up was 38 months (range, 4 – 87 months. Results Abdominal computed tomography revealed bleeding pseudoaneurysms in 4 of 7 patients (57%. Angiography determined correct diagnosis in 7 patients (7/7, 100%. The splenic artery was involved in 5 cases, the pancreaticoduodenal artery in 2, the gastroduodenal artery in 1, and the middle colic artery in 1. Initial treatment was emergency (n = 4 or elective (n = 3 surgery in 7 patients and arterial embolization in 2. Rebleeding was detected after initial treatment in 3 patients. Overall, 5 arterial embolizations and 9 surgical interventions were performed; the respective rates of success of these treatments were 20% (1/5 and 89% (8/9. Five patients developed pseudocysts before treatment (n = 3 or following intervention (n = 2. Pseudocyst formation was identified in 2 of the 3 rebleeding patients. Five patients underwent surgical treatment for associated pseudocysts and bleeding did not recur. One patient died from angiography-related complications. Overall mortality

  17. Bleed water testing program for controlled low strength material

    International Nuclear Information System (INIS)

    Langton, C.A.

    1996-01-01

    Bleed water measurements for two Controlled Low Strength Material (CLSM) mixes were conducted to provide engineering data for the Tank 20F closure activities. CLSM Mix 1 contained 150 pounds of cement per cubic yard whereas CLSM Mix 2 contained 50 pounds per cub yard. SRS currently used CLSM Mix 2 for various applications. Bleed water percentages and generation rates were measured along with flow and compressive strength. This information will be used to select a mix design for the Tank 20F closure activities and to establish the engineering requirements, such as, lift height, time required between lifts and quantity of bleed water to be removed from the tank during the placement activities. Mix 1 is recommended for placement within Tank 20F because it has better flow characteristics, less segregation, lower percentage of bleed water and slightly higher strength. Optimization of Mix 1 was beyond the scope of this study. However, further testing of thickening additives, such as clays (bentonite), sodium silicate or fine silicas maybe useful for decreasing or eliminating bleed water

  18. Computed tomography angiography in patients with active gastrointestinal bleeding

    International Nuclear Information System (INIS)

    Reis, Fatima Regina Silva; D'Ippolito, Giuseppe

    2015-01-01

    Gastrointestinal bleeding represents a common medical emergency, with considerable morbidity and mortality rates, and a prompt diagnosis is essential for a better prognosis. In such a context, endoscopy is the main diagnostic tool; however, in cases where the gastrointestinal hemorrhage is massive, the exact bleeding site might go undetected. In addition, a trained professional is not always present to perform the procedure. In an emergency setting, optical colonoscopy presents limitations connected with the absence of bowel preparation, so most of the small bowel cannot be assessed. Scintigraphy cannot accurately demonstrate the anatomic location of the bleeding and is not available at emergency settings. The use of capsule endoscopy is inappropriate in the acute setting, particularly in the emergency department at night, and is a highly expensive method. Digital angiography, despite its high sensitivity, is invasive, presents catheterization-related risks, in addition to its low availability at emergency settings. On the other hand, computed tomography angiography is fast, widely available and minimally invasive, emerging as a promising method in the diagnostic algorithm of these patients, being capable of determining the location and cause of bleeding with high accuracy. Based on a critical literature review and on their own experience, the authors propose a computed tomography angiography protocol to assess the patient with gastrointestinal bleeding. (author)

  19. Computed tomography angiography in patients with active gastrointestinal bleeding

    Energy Technology Data Exchange (ETDEWEB)

    Reis, Fatima Regina Silva; D' Ippolito, Giuseppe, E-mail: fatima.rsreis@gmail.com [Universidade Federal de Sao Paulo (EPM/UNIFESP), Sao Paulo, SP (Brazil). Escola Paulista de Medicina; Cardia, P.P. [Hospital Vera Cruz, Campinas, SP (Brazil)

    2015-11-15

    Gastrointestinal bleeding represents a common medical emergency, with considerable morbidity and mortality rates, and a prompt diagnosis is essential for a better prognosis. In such a context, endoscopy is the main diagnostic tool; however, in cases where the gastrointestinal hemorrhage is massive, the exact bleeding site might go undetected. In addition, a trained professional is not always present to perform the procedure. In an emergency setting, optical colonoscopy presents limitations connected with the absence of bowel preparation, so most of the small bowel cannot be assessed. Scintigraphy cannot accurately demonstrate the anatomic location of the bleeding and is not available at emergency settings. The use of capsule endoscopy is inappropriate in the acute setting, particularly in the emergency department at night, and is a highly expensive method. Digital angiography, despite its high sensitivity, is invasive, presents catheterization-related risks, in addition to its low availability at emergency settings. On the other hand, computed tomography angiography is fast, widely available and minimally invasive, emerging as a promising method in the diagnostic algorithm of these patients, being capable of determining the location and cause of bleeding with high accuracy. Based on a critical literature review and on their own experience, the authors propose a computed tomography angiography protocol to assess the patient with gastrointestinal bleeding. (author)

  20. Portable semiconductor laser system to stop internal bleeding

    Science.gov (United States)

    Rediker, Robert H.; Durville, Frederic M.; Cho, George; Boll, James H.

    1995-03-01

    One significant cause of death during a sever trauma (gun wound or stab wound) is internal bleeding. A semiconductor diode laser system has been used in in vitro studies of cauterizing veins and arteries to stop bleeding. The conditions of laparoscopic surgery, including bleeding conditions (blood flow and pressure), are simulated. Results have been obtained both with and without using a hemostat (e.g., forceps) to temporarily stop the bleeding prior to the cautery. With the hemostat and a fiber-coupled 810-nm laser, blood vessels of up to 5 mm diameter were cauterized with an 8 W output from the fiber. Great cautions must be used in extrapolating from these in vitro results, since the exact conditions of bleeding in a living being are impossible to exactly reproduce in a laboratory in-vitro experiment. In a living being, when blood flow stops the cessation of nourishment to the vessels results in irreversible physiological changes. Also, the blood itself is different from blood in a living being because an anti-clotting agent (heparin) was added in order to inhibit the blood's natural tendency to coagulate.

  1. Histopathological pattern of abnormal uterine bleeding in endometrial biopsies.

    Science.gov (United States)

    Vaidya, S; Lakhey, M; Vaidya, S; Sharma, P K; Hirachand, S; Lama, S; KC, S

    2013-03-01

    Abnormal uterine bleeding is a common presenting complaint in gyanecology out patient department. Histopathological evaluation of the endometrial samples plays a significant role in the diagnosis of abnormal uterine bleeding. This study was carried out to determine the histopathological pattern of the endometrium in women of various age groups presenting with abnormal uterine bleeding. Endometrial biopsies and curettings of patients presenting with abnormal uterine bleeding was retrospectively studied. A total of 403 endometrial biopsies and curettings were analyzed. The age of the patients ranged from 18 to 70 years. Normal cyclical endometrium was seen in 165 (40.94%) cases, followed by 54 (13.40%) cases of disordered proliferative endometrium and 44 (10.92%) cases of hyperplasia. Malignancy was seen in 10 (2.48%) cases. Hyperplasia and malignancy were more common in the perimenopausal and postmenopausal age groups. Histopathological examination of endometrial biopsies and curettings in patients presenting with abnormal uterine bleeding showed a wide spectrum of changes ranging from normal endometrium to malignancy. Endometrial evaluation is specially recommended in women of perimenopausal and postmenopausal age groups presenting with AUB, to rule out a possibility of any preneoplastic condition or malignancy.

  2. DSA diagnosis and interventional management of postoperative bleeding

    International Nuclear Information System (INIS)

    Li Yuwei; Zhang Fuqiang; Li Yunhui; Yuan Liang; Si Guangyan; Liu Lili

    2009-01-01

    Objective: To discuss the clinical application of DSA and interventional management in diagnosing and treating the bleeding after surgery. Methods: The clinical data and the interventional management of 14 patients with DSA-proved postoperative bleeding, encountered during the period of Aug. 2005-Jan. 2008, were retrospectively analyzed. The surgeries included subtotal gastrectomy (n=4), pancreatoduodenectomy (n=3), cesarean section (n=2), nephrolithotomy (n=3), heminephrectomy (n=1), internal hemorrhoidectomy (n=1). Results: Seventeen arterial bleeding sites were demonstrated, including gastroduodenal (n=2), left gastric (n=4), phrenic (n=1), short gastric (n=1), superior mesenteric (n=2), renal (n=4), uterine (n=2) and internal pudendal (n=1) artery. The diagnosis was confirmed with DSA in all 14 patients, of which embolization was successfully carried out in 13 in one session (92.8%). The remaining one case had to be operated again to stop the bleeding because of the failure of the superselective catheterization. No serious complications, such as organ necrosis or visceral dysfunction, occurred. Conclusion: As a safe, minimally-invasive and effective technique, DSA and interventional management are very helpful in diagnosing and treating the bleeding after surgery. (authors)

  3. Mortality in high-risk patients with bleeding Mallory-Weiss syndrome is similar to that of peptic ulcer bleeding. Results of a prospective database study.

    Science.gov (United States)

    Ljubičić, Neven; Budimir, Ivan; Pavić, Tajana; Bišćanin, Alen; Puljiz, Zeljko; Bratanić, Andre; Troskot, Branko; Zekanović, Dražen

    2014-04-01

    The aim of this study was to identify the predictive factors influencing mortality in patients with bleeding Mallory-Weiss syndrome in comparison with peptic ulcer bleeding. Between January 2005 and December 2009, 281 patients with endoscopically confirmed Mallory-Weiss syndrome and 1530 patients with peptic ulcer bleeding were consecutively evaluated. The 30-day mortality and clinical outcome were related to the patients' demographic data, endoscopic, and clinical characteristics. The one-year cumulative incidence for bleeding Mallory-Weiss syndrome was 7.3 cases/100,000 people and for peptic ulcer bleeding 40.4 cases/100,000 people. The age-standardized incidence for both bleeding Mallory-Weiss syndrome and peptic ulcer bleeding remained unchanged during the observational five-year period. The majority of patients with bleeding Mallory-Weiss syndrome were male patients with significant overall comorbidities (ASA class 3-4). Overall 30-day mortality rate was 5.3% for patients with bleeding Mallory-Weiss syndrome and 4.6% for patients with peptic ulcer bleeding (p = 0.578). In both patients with bleeding Mallory-Weiss syndrome and peptic ulcer bleeding, mortality was significantly higher in patients over 65 years of age and those with significant overall comorbidities (ASA class 3-4). The incidence of bleeding Mallory-Weiss syndrome and peptic ulcer bleeding has not changed over a five-year observational period. The overall 30-day mortality was almost equal for both bleeding Mallory-Weiss syndrome and peptic ulcer bleeding and was positively correlated to older age and underlying comorbid illnesses.

  4. Procarcinogenic effects of cyclosporine A are mediated through the activation of TAK1/TAB1 signaling pathway

    Energy Technology Data Exchange (ETDEWEB)

    Xu, Jianmin; Walsh, Stephanie B.; Verney, Zoe M. [Department of Dermatology, University of Alabama at Birmingham, AL 35294 (United States); Kopelovich, Levy [Division of Cancer Prevention, National Cancer Institute, Bethesda, MD (United States); Elmets, Craig A. [Department of Dermatology, University of Alabama at Birmingham, AL 35294 (United States); Skin Diseases Research Center, University of Alabama at Birmingham, AL 35294 (United States); Athar, Mohammad, E-mail: mathar@uab.edu [Department of Dermatology, University of Alabama at Birmingham, AL 35294 (United States); Skin Diseases Research Center, University of Alabama at Birmingham, AL 35294 (United States)

    2011-05-13

    Research highlights: {yields} Organ transplant recipients are highly susceptible to early skin cancer development. {yields} CsA-mediated TGFB1-dependent TAK1/TAB1 signaling augments invasive tumor growth. {yields} CsA enhances accumulation of upstream kinases, ZMP, AMPK and IRAK to activate TAK1. {yields} TAK1 mediates enhanced proliferation and reduced apoptosis via CsA-dependent NF{kappa}B. -- Abstract: Cyclosporine A (CsA) is an immunosuppressive drug commonly used for maintaining chronic immune suppression in organ transplant recipients. It is known that patients receiving CsA manifest increased growth of aggressive non-melanoma skin cancers. However, the underlying mechanism by which CsA augments tumor growth is not fully understood. Here, we show that CsA augments the growth of A431 epidermoid carcinoma xenograft tumors by activating tumor growth factor {beta}-activated kinase1 (TAK1). The activation of TAK1 by CsA occurs at multiple levels by kinases ZMP, AMPK and IRAK. TAK1 forms heterodimeric complexes with TAK binding protein 1 and 2 (TAB1/TAB2) which in term activate nuclear factor {kappa}B (NF{kappa}B) and p38 MAP kinase. Transcriptional activation of NF{kappa}B is evidenced by IKK{beta}-mediated phosphorylation-dependent degradation of I{kappa}B and consequent nuclear translocation of p65. This also leads to enhancement in the expression of its transcriptional target genes cyclin D1, Bcl2 and COX-2. Similarly, activation of p38 leads to enhanced inflammation-related signaling shown by increased phosphorylation of MAPKAPK2 and which in turn phosphorylates its substrate HSP27. Activation of both NF{kappa}B and p38 MAP kinase provide mitogenic stimuli to augment the growth of SCCs.

  5. Energy Performance of a Novel System Combining Natural Ventilation with Diffuse Ceiling Inlet and Thermally Activated Building Systems (TABS)

    DEFF Research Database (Denmark)

    Yu, Tao

    . Both steady-state and dynamic measurements are carried out in the experimental chamber to investigate the energy performance of the system and the thermal comfort in the test room. Overall, this integrated system has high energy saving potential without any compromise of thermal comfort even in extreme...... and thermally activated building systems (TABS) for cooling and ventilation in future Danish office buildings. The new solution would have the special potential of using natural ventilation all year round even in the extremely cold seasons without any draught risk. The main focuses of this study are the energy...

  6. Theoretical investigation of GaAsBi/GaAsN tunneling field-effect transistors with type-II staggered tunneling junction

    Science.gov (United States)

    Wang, Yibo; Liu, Yan; Han, Genquan; Wang, Hongjuan; Zhang, Chunfu; Zhang, Jincheng; Hao, Yue

    2017-06-01

    We investigate GaAsBi/GaAsN system for the design of type-II staggered hetero tunneling field-effect transistor (hetero-TFET). Strain-symmetrized GaAsBi/GaAsN with effective lattice match to GaAs exhibits a type-II band lineup, and the effective bandgap EG,eff at interface is significantly reduced with the incorporation of Bi and N elements. The band-to-band tunneling (BTBT) rate and drive current of GaAsBi/GaAsN hetero-TFETs are boosted due to the utilizing of the type-II staggered tunneling junction with the reduced EG,eff. Numerical simulation shows that the drive current and subthreshold swing (SS) characteristics of GaAsBi/GaAsN hetero-TFETs are remarkably improved by increasing Bi and N compositions. The dilute content GaAs0.85Bi0.15/GaAs0.92N0.08 staggered hetero-nTFET achieves 7.8 and 550 times higher ION compared to InAs and In0.53Ga0.47As homo-TFETs, respectively, at the supply voltage of 0.3 V. GaAsBi/GaAsN heterostructure is a potential candidate for high performance TFET.

  7. A Study of the Transient Response of Duct Junctions: Measurements and Gas-Dynamic Modeling with a Staggered Mesh Finite Volume Approach

    Directory of Open Access Journals (Sweden)

    Antonio J. Torregrosa

    2017-05-01

    Full Text Available Duct junctions play a major role in the operation and design of most piping systems. The objective of this paper is to establish the potential of a staggered mesh finite volume model as a way to improve the description of the effect of simple duct junctions on an otherwise one-dimensional flow system, such as the intake or exhaust of an internal combustion engine. Specific experiments have been performed in which different junctions have been characterized as a multi-port, and that have provided precise and reliable results on the propagation of pressure pulses across junctions. The results obtained have been compared to simulations performed with a staggered mesh finite volume method with different flux limiters and different meshes and, as a reference, have also been compared with the results of a more conventional pressure loss-based model. The results indicate that the staggered mesh finite volume model provides a closer description of wave dynamics, even if further work is needed to establish the optimal calculation settings.

  8. A Priori Estimates of Solution of a Homogeneous Boundary Value Problem for Parabolic Type Equations by the Discontinuous Galerkin Method on Staggered Grids

    Directory of Open Access Journals (Sweden)

    Ruslan V. Zhalnin

    2017-12-01

    Full Text Available Introduction: In this paper, we present a priori error analysis of the solution of a homogeneous boundary value problem for a second-order differential equation by the discontinuous Galerkin method on staggered grids. Materials and Methods: This study is based on the unified hp-version error analysis of local discontinuous Galerkin method proposed by Castillo et al. [Optimal a priori error estimates for the hp-version of the local discontinuous Galerkin method for convection-diffusion problems, 2002]. The purpose of this paper is to present a new approach to the error analysis of the solution of parabolic equations by the discontinuous Galerkin method on staggered grids. Results: We suggest that approximation errors depend on the characteristic size of the cells and the degree of polynomials used in the basis functions. The necessary lemmas are formulated for the problem solution. The complete proof of the lemmas formulated is carried out. We formulated and proved a theorem, in which a priori error estimates are given for solving parabolic equations using the discontinuous Galerkin method on staggered grids Discussion and Conclusions: The obtained results are consistent with similar studies of other authors and complement them. Further work on this topic involves the study of diffusion-type equations of order higher than the first and the production of a posteriori error estimates.

  9. Bleeding Jejunal Diverticulosis in a Patient with Myasthenia Gravis

    Directory of Open Access Journals (Sweden)

    I. Zuber-Jerger

    2008-01-01

    Full Text Available A seventy-year-old male presented with severe myasthenia gravis and an episode of obscure bleeding. There was a history of gastric ulcer leading to Billroth II surgery twenty-five years ago. Upper endoscopy revealed no pathology. Colonoscopy showed a few solitary diverticula and traces of old blood in the terminal ileum. Capsule endoscopy pictured red smear in the upper jejunum. Diverticula were seen as well. Suspecting bleeding jejunal diverticulosis double balloon enteroscopy was performed. The complete jejunal ascending loop and about 100 cm of the jejunum through the descending jejunal loop could be inspected. Large diverticula with fecoliths were found in both loops. Bleeding had ceased. The patient was discharged to neurology for optimizing therapy for myasthenia gravis.

  10. No impact of fish oil supplements on bleeding risk

    DEFF Research Database (Denmark)

    Begtrup, Katrine Munk; Krag, Andreas Engel; Hvas, Anne-Mette

    2017-01-01

    Abstract Introduction: Fish oil supplementation may inhibit platelet aggregation and can potentially increase the risk of bleeding. The aim of the present systematic review was to evaluate the effect of fish oil supplements on haemostasis and bleeding risk, and to provide recommendations on whether...... it is necessary to discontinue fish oil supplementation prior to surgery. Methods: Studies were identified through PubMed and Embase searches and by reviewing the reference lists of the included papers. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used. Included...... of the included studies were randomised controlled trials or included a control group. Overall, fish oil supplements reduced platelet aggregation in healthy subjects. Fish oil exposure in surgical patients did not increase bleeding or blood transfusions either during or after surgery. Conclusion: Fish oil...

  11. Complex endoscopic treatment of acute gastrointestinal bleeding of ulcer origin

    Directory of Open Access Journals (Sweden)

    V. V. Izbitsky

    2013-06-01

    Full Text Available Gastrointestinal bleeding (GIB is determined in 20-30% of patients with peptic ulcer disease. Acute gastrointestinal bleeding is on the first place as the main cause of deaths from peptic ulcer ahead of the other complications. Rebleeding occurs in 30-38% of patients. Materials and Methods For getting of the objective endoscopic picture in patients with bleeding gastroduodenal ulcers we used the classification of J.A. Forrest in our study: Type I - active bleeding: • I a - pulsating jet; • I b - stream. Type II - signs of recent bleeding: • II a - visible (non-bleeding visible vessel; • II b - fixed thrombus - a clot; • II c - flat black spot (black bottom ulcers. Type III - ulcer with a clean (white down. Integrated endoscopic hemostasis included: irrigation of ulcer defect and area around it with 3% hydrogen peroxide solution in a volume of 10 - 30ml; Injection of 2-4 mL of diluted epinephrine (1:10000 for hemostasis; use of Argon plasma coagulation. Results and Discussion Integrated endoscopic stop of bleeding was performed in 57 patients who were examined and treated at the Department of Surgery from 2006 to 2012. In 16 patients bleeding was caused by gastric ulcer. Gastric ulcer type I localization according to classification (HD Johnson, 1965 was determined in 9 patients, type II - in 2 patients, type III – in 5 patients. In 31 patients bleeding was caused by duodenal peptic ulcer, in 4 patients - erosive gastritis, 1 - erosive esophagitis, and in 5 patients - gastroenteroanastomosis area peptic ulcer. Final hemostasis was achieved in 55 (96.5% patients. In 50 (87.7% patients it was sufficient to conduct a single session of complex endoscopic treatment. In 5 (8.8% patients – it was done two times. In 2 (3.5% cases operation was performed due to the recurrent bleeding. The source of major bleeding in these patients was: chronic, duodenal ulcer penetrating into the head of the pancreas in one case complicated by subcompensated

  12. Computed tomography diagnosis of active bleeding into the thyroid gland.

    Science.gov (United States)

    Veverková, Lucia; Bakaj-Zbrožková, Lenka; Hallamová, Lucie; Heřman, Miroslav

    2013-10-01

    Fine-needle biopsy of the thyroid gland is the most common interventional procedure used to diagnose thyroid diseases. Serious complications are rare in this procedure. They comprise an infection with abscess formation and hemorrhage. To date, only a few case reports have described an ultrasound diagnosis of active bleeding into the thyroid gland. We established such a diagnosis using computed tomography (CT). A 74-year-old woman presented to the emergency department of our hospital with complications after fine-needle biopsy of the thyroid gland. Ultrasound revealed a large hematoma surrounding the gland. A subsequent CT scan confirmed the presence of hematoma and, moreover, showed active bleeding. This finding prompted rapid surgical intervention. CT has the capability to show active bleeding into the thyroid gland.

  13. Reduced bleed air extraction for DC-10 cabin air conditioning

    Science.gov (United States)

    Newman, W. H.; Viele, M. R.; Hrach, F. J.

    1980-01-01

    It is noted that a significant fuel savings can be achieved by reducing bleed air used for cabin air conditioning. Air in the cabin can be recirculated to maintain comfortable ventilation rates but the quality of the air tends to decrease due to entrainment of smoke and odors. Attention is given to a development system designed and fabricated under the NASA Engine Component Improvement Program to define the recirculation limit for the DC-10. It is shown that with the system, a wide range of bleed air reductions and recirculation rates is possible. A goal of 0.8% fuel savings has been achieved which results from a 50% reduction in bleed extraction from the engine.

  14. Effects of Aglumin on the rectal bleeding following radiotherapy

    International Nuclear Information System (INIS)

    Yamashita, Michitaka; Tanaka, Motoshi; Yoshimura, Osamu; Matsubayashi, Shigeru

    1978-01-01

    Aglumin was administered to 20 cases which had rectal bleeding following radiotherapy. The results were as follows. Rectal bleeding decreased in 16 of 20 cases (80%): remarkably effective, 15%; effective, 25%; slightly effective, 40%. Bleeding time decreased in 11 cases (55%). Rumpel-Leede test gave remarkable improvement in 10 of 14 cases which had been abnormal (71.4%). Platelet increased in 18 of 20 cases (90%). Liver function test and peripheral blood findings showed no remarkable changes. No side effects such as intestinal disturbance etc were noted. In the series of symptomatic treatment for rectal disturbance resulting from radiotherapy, this drug had considerable effect of hemostasis. It was concluded that this drug is useful in combined use with other antiphlogistics, analgesic, and hematinic etc. (Ueda, J.)

  15. PALM-COEIN Nomenclature for Abnormal Uterine Bleeding.

    Science.gov (United States)

    Deneris, Angela

    2016-05-01

    Approximately 30% of women will experience abnormal uterine bleeding (AUB) during their life time. Previous terms defining AUB have been confusing and imprecisely applied. As a consequence, both clinical management and research on this common problem have been negatively impacted. In 2011, the International Federation of Gynecology and Obstetrics (FIGO) Menstrual Disorders Group (FMDG) published PALM-COEIN, a new classification system for abnormal bleeding in the reproductive years. Terms such as menorrhagia, menometrorrhagia, metrorrhagia, dysfunctional uterine bleeding, polymenorrhea, oligomenorrhea, and uterine hemorrhage are no longer recommended. The PALM-COEIN system was developed to standardize nomenclature to describe the etiology and severity of AUB. A brief description of the PALM-COEIN nomenclature is presented as well as treatment options for each etiology. Clinicians will frequently encounter women with AUB and should report findings utilizing the PALM-COEIN system. © 2016 by the American College of Nurse-Midwives.

  16. What to do when she's bleeding through: the recognition, evaluation, and management of abnormal uterine bleeding in adolescents.

    Science.gov (United States)

    Bennett, Alyssa R; Gray, Susan H

    2014-08-01

    This article reviews the current understanding and management of abnormal uterine bleeding (AUB) in adolescents. The readers will learn a practical approach to the evaluation and treatment of mild-to-severe uterine bleeding. In 2011, a new classification system was proposed to standardize the terminology used to describe AUB. This system is based on the pattern and etiology of bleeding and has been adopted by other organizations. The term dysfunctional uterine bleeding has been replaced by AUB. The negative effect of AUB on adolescents' quality of life is now well established. The levonorgestrel-releasing intrauterine system is considered a first-line treatment for heavy menstrual bleeding and should be considered, especially in those adolescents who may also need contraception. AUB is a common adolescent complaint that can vary from mild to life-threatening if not recognized and treated promptly. This article reviews the appropriate assessment and management of AUB and proposes a practical algorithm that can be used in an office or hospital setting.

  17. The timing of neovascularization in fingertip replantation by external bleeding.

    Science.gov (United States)

    Han, Seung-Kyu; Chung, Heung-Soo; Kim, Woo-Kyung

    2002-09-15

    To overcome venous congestion in fingertip replantation with no venous anastomosis, the authors have used a salvage procedure that consists of continuous external bleeding through a stab incision on the paraungual area and dripping a heparinized saline solution at the incision site to maintain external bleeding. Because this method requires continuous bleeding for a certain period of time, it may be a great burden on the patient; therefore, it is most important to minimize the duration of bleeding. Many authors have studied the timing of the new venous channel formation of the flap. However, to our knowledge, a study on fingertip replantations has not yet been performed. From June of 1985 to November of 1999, the authors performed fingertip replantations on 144 fingers of 137 patients using our salvage procedure at Korea University Guro Hospital. Among the 144 fingers, 101 fingers of 96 patients were successfully transplanted, including those with partial necrosis. The authors reviewed the medical records of these 101 fingers retrospectively; they compared and analyzed the necessary duration of external bleeding according to sex, age, level of injury, cause of amputation, and the type of injury. The average period of the salvage procedure was 7.6 days. Regarding age, the shortest period (5.5 days) was required for patients younger than 10 years. On the basis of the types of injuries, the duration of bleeding was shortest for the guillotine injury group (5.9 days) compared with crush (8.2 days) or avulsion (8.0 days) injuries. Sex and level of injury did not make much difference in the duration of the procedure.

  18. Neurosurgical management in children with bleeding diathesis: auditing neurological outcome.

    Science.gov (United States)

    Zakaria, Zaitun; Kaliaperumal, Chandrasekaran; Crimmins, Darach; Caird, John

    2018-01-01

    OBJECTIVE The aim of this study was to assess the outcome of neurosurgical treatment in children with bleeding diathesis and also to evaluate the current management plan applied in the authors' service. METHODS The authors retrospectively analyzed all cases in which neurosurgical procedures were performed in pediatric patients presenting with intracranial hematoma due to an underlying bleeding tendency over a 5-year period at their institution. They evaluated the patients' neurological symptoms from the initial referral, hematological abnormalities, surgical treatment, neurological outcome, and scores on the Pediatric Glasgow Outcome Scale-Extended (GOS-E Peds) obtained 1 year after the last operation. RESULTS Five patients with a bleeding diathesis who underwent surgery for intracranial hematoma were identified; the diagnosis was hemophilia A in 3 cases, idiopathic thrombocytopenic purpura in 1 case, and severe aplastic anemia in 1 case. Intracerebral hematoma (ICH) (n = 4) and acute subdural hematoma (n = 1) were confirmed on radiological investigations. In 2 of the 4 patients with ICH, the diagnosis of bleeding diathesis was made for the first time on presentation. Four patients (all male) were younger than 2 years; the patient with severe aplastic anemia and spontaneous ICH was 15 years old and female. The duration of symptoms varied from 24 hours to 5 days. Neurological examination at 1 year's follow-up showed complete recovery (GOS-E Peds score of 1) in 3 cases and mild weakness (GOS-E Peds score of 2) in 2 cases. CONCLUSIONS Neurosurgical management of patients with bleeding diathesis should be carried out in a tertiary-care setting with multidisciplinary team management, including members with expertise in neuroimaging and hematology, in addition to neurosurgery. Early diagnosis and prompt treatment of a bleeding diathesis is crucial for full neurological recovery.

  19. Therapeutic and Diagnostic Tactics for Bleedings from Esophagogastric Varices

    Directory of Open Access Journals (Sweden)

    F. G. Nazyrov

    2010-01-01

    Full Text Available Objective: to elaborate therapeutic and diagnostic tactics for bleedings from esophagogastric varices (EGV in an intensive care unit (ICU. Subjects and methods: The experience in treating 102 patients with profuse bleeding from EGV, admitted to the ICU, Acad. V. Vakhidov Republican Specialized Center of Surgery, in 2000—2008, was summarized. Results. The findings show that just less than 40% of the patients with hepatic cirrhosis are admitted for the clinical manifestations of active bleeding from EGV, the latter being profuse in 17.6%. These indicate that the noticeable admission preponderance of patients with first-degree blood loss and the low proportion of those with critical third-degree blood loss are noteworthy. Retrospective analysis demonstrated that hemostasis was achieved in 97 (95.1% patients, by applying solely conservative measures using a Blakemore tube (in both variants of its use. After removal of the Blakemore tube, stable hemostasis retained in 88.9% of the patients with bleedings from the veins of the middle third of the esophagus, in 71.8% of cases of those from its lower third and only in 24.1% of the patients with those from the cardiac stomach. Conclusion. According to the results of the study, we propose the therapeutic and diagnostic tactics for patients with profuse bleedings from EGV, which involve the use of a Blakemore tube and a complex of conservative measures with traditional hemostatic therapy, the administration of portal pressure-reducing agents to prevent or treat hepatic failure. Key words: bleeding, esophagogastric varices, hepatic failure, intensive therapy.

  20. Mifepristone-induced abortion and vaginal bleeding in subsequent pregnancy.

    Science.gov (United States)

    Liang, Hong; Gao, Er-sheng; Chen, Ai-min; Luo, Lin; Cheng, Yi-min; Yuan, Wei

    2011-12-01

    The aim of this study is to explore the effect of first-trimester mifepristone-induced abortion on vaginal bleeding in subsequent pregnancy. This observational cohort study was conducted during 1998-2001 at antenatal clinics in Beijing, Chengdu, and Shanghai, China. The study enrolled 4,931 women with one previous mifepristone-induced abortion, 4,925 women with no history of induced abortion, and 4,800 women with one previous surgical abortion and followed them through pregnancy and childbirth. The rates of vaginal bleeding in pregnant women with a history of medical abortion, no abortion, and surgical abortion were 16.5%, 13.9%, and 17.3%, respectively. The women with medical abortion had a higher risk (adjusted relative risk (aRR)=1.17, 95% confidence interval (CI): 1.07, 1.29) of vaginal bleeding compared with those with no abortion but similar risk to prior surgical abortion. When the correlation between medical abortion and vaginal bleeding was examined by period, increased risk was observed only in the early period (abortion and no abortion showed that the observed risks increased particularly in those with abortion at gestational age ≤ 7 weeks (aRR=1.33, 95% CI: 1.18, 1.49), those followed by a postabortion curettage (aRR=1.58, 95% CI: 1.37, 1.84) or complications (aRR=1.99, 95% CI: 1.67, 2.37). There was no difference between women with medical abortion and women with surgical abortion in the occurrence of vaginal bleeding for either period. One previous mifepristone-induced abortion increased the risk of vaginal bleeding in early gestation period of subsequent pregnancy compared with no abortion, especially if abortion occurred before 7 weeks of gestation and was followed by a curettage or complications. Copyright © 2011 Elsevier Inc. All rights reserved.

  1. Emergency management of lower gastrointestinal bleed in children.

    Science.gov (United States)

    Balachandran, Binesh; Singhi, Sunit

    2013-03-01

    Lower gastro intestinal bleed (LGIB) is defined as any bleeding that occurs distal to the ligament of Treitz (situated at the duodeno jejunal junction). It constitutes the chief complaint of about 0.3 % of children presenting to the pediatric emergency department(ED). Among Indian children the most common causes are colitis and polyps. In most of the cases of LGIB the bleeding is small and self limiting, but conditions like Meckel's diverticulum often presents with life threatening bleeds. The approach in ED should include in order of priority-assessment and maintenance of hemodynamic stability, confirmation of LGIB and then to attempt for specific diagnoses and their management. This is achieved with help of rapid cardiopulmonary assessment, focused history and examination. The management of all serious hemodynamically significant bleeds includes, rapid IV access, volume replacement with normal saline 20 ml/kg, blood sampling (for cross matching, hematocrit, platelet, coagulogram and liver function tests), Inj. Vit K 5-10 mg IV, acid suppression with H2 antagonists/PPI and nasogastric lavage to rule out upper gastrointestinal bleed. Continuous ongoing monitoring of vital signs is important after stabilization. In ill looking infant, infectious colitis, Necrotizing enterocolitis (NEC), Hirschsprung enterocolitis and volvulus and in older infants and children, intussusceptions, typhoid fever, volvulus should be looked for. Proctosigmoidoscopy remains the first investigation to be done and reveals majority of etiology. Multidetector CT scan, Tc 99 m RBC scan, angiography and Push enteroscopy are the further investigation choices according to the clinical condition of the child. Intra operative enteroscopy is reserved for refractory cases with an obscure etiology.

  2. Laser tabbed die: A repairable, high-speed die-interconnection technology. 1994 LDRD final report 93-SR-089

    Energy Technology Data Exchange (ETDEWEB)

    Malba, V.; Bernhardt, A.F.

    1995-09-01

    A unique technology for multichip module production is presented. The technology, called Laser Tabbed Die (L-TAB), consists of a method for forming surface-mount-type {open_quotes}gull wing{close_quotes} interconnects on bare dice. The dice are temporarily bonded to a sacrificial substrate which has a polymer thin film coated onto it. The gull wings are formed on the side of the die with a direct-write laser patterning process which allows vertical as well as horizontal image formation. Using the laser patterning system, trenches are formed in a positive electrodeposited photoresist (EDPR) which is plated onto a metal seed layer, allowing copper to be electroplated through the resultant mask. After stripping the resist and the metal seed layer, the polymer film on the substrate is dissolved, releasing the chip with the {open_quotes}gull wings{close_quotes} intact. The chips are then bonded onto a circuit board or permanent substrate with solder or conductive adhesive.

  3. An unusual case of vaginal myoma presenting with postmenopausal bleeding.

    Directory of Open Access Journals (Sweden)

    Lajya Devi Goyal

    2013-06-01

    Full Text Available Vaginal leiomyomas are uncommon benign tumour with variable clinical presentation. These tumours arise most commonly from anterior vaginal wall. We report a case of 50-year old postmenopausal woman who presented with urinary retention, profuse vaginal bleeding and mass protruding into vagina. Local examination revealed a pedunculated mass attached to the posterior vaginal wall with vascular stalk one cm below the cervix. Mass was hanging outside vulva and vascular pedicle was profusely bleeding. The pedicle was ligated and tumour was excised. Subsequent histopathology revealed a vaginal myoma.

  4. Prolonged bleeding on the neck in leech therapy: Case report

    Directory of Open Access Journals (Sweden)

    Atakan Savrun

    2015-12-01

    Full Text Available Superficial skin bleeding can usually be stopped by applying short-time compression, unless the patient suffers from coagulation disorders or uses anticoagulant. Because of the anticoagulant component of leech saliva, a leech bite may cause long-time bleeding, which cannot be stopped via compression. In this study, the case of a patient who applied leech therapy on her neck for the treatment of migraine has been presented. [Arch Clin Exp Surg 2015; 4(4.000: 234-237

  5. Systematic review: tranexamic acid for upper gastrointestinal bleeding

    DEFF Research Database (Denmark)

    Klingenberg, S.L.; Langholz, S.E.; Gluud, Lise Lotte

    2008-01-01

    BACKGROUND: Tranexamic acid may reduce upper gastrointestinal bleeding and stabilize patients before endoscopic treatments. AIM: To review randomized trials on tranexamic acid for upper gastrointestinal bleeding. METHODS: Manual and electronic searches of The Cochrane Library, MEDLINE, EMBASE...... were unclearly reported. Data from three of the included trials suggested that tranexamic acid did not significantly increase the risk of thromboembolic disease. CONCLUSIONS: The present review suggests that tranexamic acid may reduce all-cause mortality. However, because of limitations in the internal...... and external validity of included trials, additional evidence is needed before treatment recommendations can be made Udgivelsesdato: 2008/5...

  6. Premenopausal abnormal uterine bleeding and risk of endometrial cancer.

    Science.gov (United States)

    Pennant, M E; Mehta, R; Moody, P; Hackett, G; Prentice, A; Sharp, S J; Lakshman, R

    2017-02-01

    Endometrial biopsies are undertaken in premenopausal women with abnormal uterine bleeding but the risk of endometrial cancer or atypical hyperplasia is unclear. To conduct a systematic literature review to establish the risk of endometrial cancer and atypical hyperplasia in premenopausal women with abnormal uterine bleeding. Search of PubMed, Embase and the Cochrane Library from database inception to August 2015. Studies reporting rates of endometrial cancer and/or atypical hyperplasia in women with premenopausal abnormal uterine bleeding. Data were independently extracted by two reviewers and cross-checked. For each outcome, the risk and a 95% CI were estimated using logistic regression with robust standard errors to account for clustering by study. Sixty-five articles contributed to the analysis. Risk of endometrial cancer was 0.33% (95% CI 0.23-0.48%, n = 29 059; 97 cases) and risk of endometrial cancer or atypical hyperplasia was 1.31% (95% CI 0.96-1.80, n = 15 772; 207 cases). Risk of endometrial cancer was lower in women with heavy menstrual bleeding (HMB) (0.11%, 95% CI 0.04-0.32%, n = 8352; 9 cases) compared with inter-menstrual bleeding (IMB) (0.52%, 95% CI 0.23-1.16%, n = 3109; 14 cases). Of five studies reporting the rate of atypical hyperplasia in women with HMB, none identified any cases. The risk of endometrial cancer or atypical hyperplasia in premenopausal women with abnormal uterine bleeding is low. Premenopausal women with abnormal uterine bleeding should first undergo conventional medical management. Where this fails, the presence of IMB and older age may be indicators for further investigation. Further research into the risks associated with age and the cumulative risk of co-morbidities is needed. Contrary to practice, premenopausal women with heavy periods or inter-menstrual bleeding rarely require biopsy. © 2016 The Authors BJOG An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd on behalf of Royal

  7. A simple and universal ligation mediated fusion of genes based on hetero-staggered PCR for generating immunodominant chimeric proteins.

    Science.gov (United States)

    Reddy, Prakash K; Ramlal, Shylaja; Sripathy, Murali H; Batra, Harshvardhan

    2012-11-01

    We developed a simple T4 DNA ligase mediated strategy for inframe splicing of two or more cohesive genes generated by hetero-staggered PCR and directionally cloning the spliced product bearing sticky overhangs in to a correspondingly cut vector. For this, two pairs of primers are used in two different parallel PCRs, for generation of each cohesive gene product. We exemplified this strategy by splicing two major super-antigen genes of Staphylococcus aureus, namely, staphylococcal enterotoxin A (sea), and toxic shock syndrome toxin (tsst-1) followed by its directional cloning into pre-digested pRSET A vector. The fusion gene encoding chimeric recombinant SEA-TSST protein (32kDa) was expressed in E. coli BL21(DE3) host strain. The recombinant chimeric protein retained the antigenicity of both toxins as observed by the strong immunoreactivity with commercial antibodies against both SEA and TSST-1 toxin components by Western blot analysis. We observed that the present method for gene splicing with cohesive ends is simple since it does not require elaborate standardization and a single fusion product is obtained consistently during nested PCR with forward primer of first gene and reverse primer of second gene. For comparison, we fused the same genes using splicing by overlap extension PCR (SOE-PCR) and consistently obtained DNA smearing and multiple non-specific bands even after several rounds of PCRs from gel excised product. Moreover, the newly described method requires only two to six complimentary sticky ends between the genes to be spliced, in contrast to long stretch of overlapping nucleotides in case of SOE-PCR. Copyright © 2012 Elsevier B.V. All rights reserved.

  8. A Study on the Uncertainty of Flow-Induced Vibration in a Cross Flow over Staggered Tubes

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ji-Su; Park, Jong-Woon [Dongguk univ, Gyeong Ju (Korea, Republic of); Choi, Hyeon-Kyeong [HanNam University, Daejeon (Korea, Republic of)

    2015-05-15

    Cross-flow in many support columns of very high temperature reactor (VHTR) lower plenum would have FIV issues under high speed flow jetting from the core. For a group of multiple circular cylinders subjected to a cross-flow, three types of potential vibration mechanisms may exist: (1) Vortex-induced vibration (VIV), (2) Fluid-elastic vibration (FEV) and (3) Turbulence-induced vibration (TIV). Kevalahan studied the free vibration of circular cylinders in a tightly packed periodic square inline array of cylinders. Pandey et al. studied the flue gas flow distribution in the Low Temperature Super Heater (LTSH) tube bundles situated in second pass of a utility boiler and the phenomenon of flow induced vibration. Nakamura et al. studied flow instability of cylinder arrays resembling U-bend tubes in steam generators. The FIV evaluation is usually performed with computational fluid dynamic (CFD) analysis to obtain unknown frequency of oscillation of the multiple objects under turbulent flow and thus the uncertainty residing in the turbulence model used should be quantified. In this paper, potential FIV uncertainty arising from the turbulence phenomena are evaluated for a typical cross flow through staggered tube bundles resembling the VHTR lower plenum support columns. Flow induced vibration (FIV) is one of the important mechanical and fatigue issues in nuclear systems. Especially, cross-flow in many support structures of VHTR lower plenum would have FIV issues under highly turbulent jet flows from the core. The results show that the effect of turbulence parameters on FIV is not negligible and the uncertainty is 5 to 10%. Present method can be applied to future FIV evaluations of nuclear systems. More extensive studies on flow induced vibration in a plant scale by using more rigorous computational methods are under way.

  9. Rectal Dieulafoy Lesions: A Rare Etiology of Chronic Lower Gastrointestinal Bleeding

    Directory of Open Access Journals (Sweden)

    Ugur Dogan

    2014-01-01

    Full Text Available Dieulafoy lesion is rarely seen, yet it can be life-threatening. This lesion makes up to 1-2% of gastrointestinal bleedings and must definitely be considered in gastrointestinal bleedings whose source cannot be identified. In this case study, the 75-year-old woman was suffering from active, fresh, and massive rectal bleeding. Colonoscopy was applied in order to find out the source of bleeding. In the typical endoscopic appearance of the lesion a single round mucosal defect in the rectum and arterial bleeding were observed. To procure hemostasis, epinephrine was injected into the lesion and the bleeding vein was sutured.

  10. Anaesthesia care for emergency endoscopy for peptic ulcer bleeding

    DEFF Research Database (Denmark)

    Duch, Patricia; Haahr, Camilla; Møller, Morten Hylander

    2016-01-01

    OBJECTIVE: Currently, no standard approach exists to the level of monitoring or presence of staff with anaesthetic expertise required during emergency esophago-gastro-duodenoscopy (EGD) for peptic ulcer bleeding (PUB). We assess the association between anaesthesia care and mortality. We further...

  11. Duodenal Diverticulum Co-Existing with a Bleeding Duodenal Ulcer ...

    African Journals Online (AJOL)

    Background: Duodenal diverticula are characterized by the presence of sac-like mucosal herniations through weak points in the duodenal wall. Duodenal diverticula co-existing with a bleeding duodenal ulcer is rare. Objective: The objective of this case report is to illustrate an uncommon case of two duodenal diverticula ...

  12. Embolotherapy using N-butyl cyanoacrylate for abdominal wall bleeding

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Young Ho; Koh, Young Hwan; Han, Dae Hee; Kim, Ji Hoon; Cha, Joo Hee; Lee, Eun Hye; Song, Chi Sung [Seoul National University Boramae Hospital, Seoul (Korea, Republic of)

    2008-05-15

    We describe our experience with the use of N-butyl cyanoacrylate (NBCA) embolization of abdominal wall bleeding and we evaluate the clinical effectiveness of the procedure. Embolization was performed in nine patients with abdominal wall bleeding. The sites of embolization were the left first lumbar (n = 1), left second lumbar (n = 1), right inferior epigastric (n 2), left inferior epigastric (n = 3), right circumflex iliac (n = 1), and left circumflex iliac artery (n = 1). A coil was used with NBCA in one patient due to difficulty in selecting only a bleeding focus and anticipated reflux. NBCA was mixed with Lipiodol at the ratio of 1:1 to 1:4. Blood pressure and heart rate were measured before and after the embolization procedure, and the serial hemoglobin and hematocrit levels and transfusion requirements were reviewed to evaluate hemostasis and rebleeding. Hemostasis was obtained in six out of the nine patients and technical success was achieved in all patients. There were no procedure-related complications. Four out of the nine patients died due to rebleeding of a subarachnoid hemorrhage (n = 1), multiorgan failure (n = 1), and hepatic failure (n =2) that occurred two to nine days after the embolization procedure. One patient had rebleeding. The five surviving patients had no rebleeding, and the patients continue to visit the clinical on an outpatient basis. NBCA embolization is a clinically safe procedure and is effective for abdominal wall bleeding.

  13. Predictors of post operative bleeding and blood transfusion in ...

    African Journals Online (AJOL)

    blood requirements. Objective: To evaluate the impact of some perioperative predictors of post-operative bleeding, and blood transfusion after heart surgery and offer suggestions on preventive measures. Design and Methods: A prospective analytical study. The perioperative factors studied were haemoglobin level, ...

  14. Colorectal polyps: an important cause of rectal bleeding.

    OpenAIRE

    Perisic, V N

    1987-01-01

    Seventy one children with rectal bleeding were examined by total fibreoptic colonoscopy. Large bowel polyps were found in 45; 27 (60%) had solitary rectal polyps. Altogether, 83% of resected polyps were juvenile. No complication of colonoscopic polypectomy occurred. New polyps reoccurred in four (9%) treated children.

  15. Kleinke's "Bleeding Edge" sees utility role for providers.

    Science.gov (United States)

    Johnson, D E

    1998-10-01

    Hospitals will evolve into units of health care delivery systems that will eventually resemble utilities, like water and the telephone, according to a new book. Donald E.L. Johnson reviews Bleeding Edge: The Business View of Health Care in the New Century, by J.D. Kleinke, and discusses the strategic implications of Kleinke's predictions.

  16. Prophylactic Dosing of Vitamin K to Prevent Bleeding

    NARCIS (Netherlands)

    Witt, Mauri; Kvist, Nina; Jorgensen, Marianne Horby; Hulscher, Jan B.F.; Verkade, Henkjan J.

    BACKGROUND AND OBJECTIVES: Based on a high incidence of Vitamin K deficiency bleeding (VKDB) in breastfed infants with thus far unrecognized cholestasis, such as biliary atresia (BA), the Dutch regimen to prevent VKDB in breastfed infants was changed from a daily oral dosage of 25 mu g to 150 mu g

  17. Oral contraception and menstrual bleeding during treatment of venous thromboembolism

    DEFF Research Database (Denmark)

    Klok, F A; Schreiber, K; Stach, K

    2017-01-01

    INTRODUCTION: The optimal management of oral contraception and menstrual bleeding during treatment of venous thromboembolism (VTE) is largely unknown. We aimed to elicit expert opinion and compare that to current practice as assessed by a world-wide international web-based survey among physicians...

  18. Attitude of Nigerian women to abnormal menstrual bleeding from ...

    African Journals Online (AJOL)

    Background: Depot Medroxyprogesterone acetate (DMPA) and Norethisterone Enanthate (Net-En) are frequently used progestogen-only injectable contraceptives in many developing countries including Nigeria. Their use is often complicated by abnormal and unpredictable menstrual bleeding patterns. This has often been ...

  19. Abnormal Uterine Bleeding: Current Classification and Clinical Management.

    Science.gov (United States)

    Bacon, Janice L

    2017-06-01

    Abnormal uterine bleeding is now classified and categorized according to the International Federation of Gynecology and Obstetrics classification system: PALM-COEIN. This applies to nongravid women during their reproductive years and allows more clear designation of causes, thus aiding clinical care and future research. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Challenges in the management of bleeding disorders in Nigeria ...

    African Journals Online (AJOL)

    Only 39.1% centers had factor concentrates available. Conclusion: Facilities required for diagnosing and treating BD are significantly deficient in most centers in Nigeria. Funding to provide facility and training is required to improve on this inadequacy. Keywords: Bleeding, hemophilia, thrombocytopenia, whole blood ...

  1. Management of Adult Jehovah's Witness Patients with Acute Bleeding

    NARCIS (Netherlands)

    Berend, Kenrick; Levi, Marcel

    2009-01-01

    Because of the firm refusal of transfusion of blood and blood components by Jehovah's Witnesses, the management of Jehovah's Witness patients with severe bleeding is often complicated by medical, ethical, and legal concerns. Because of a rapidly growing and worldwide membership, physicians working

  2. Upper GI bleeding among neonates admitted to Mulago Hospital ...

    African Journals Online (AJOL)

    These conditions are risk factors for upper GI bleeding (UGIB) in sick neonates. UGIB is associated with poor neonatal outcomes such as prolonged hospitalisation and poor weight gain. The magnitude of UGIB and its contribution to neonatal morbidity has not been described in most low income countries. Objective: To ...

  3. Risk stratification in upper gastrointestinal bleeding; prediction, prevention and prognosis

    NARCIS (Netherlands)

    de Groot, N.L.

    2013-01-01

    In the first part of this thesis we developed a novel prediction score for predicting upper gastrointestinal (GI) bleeding in both NSAID and low-dose aspirin users. Both for NSAIDs and low-dose aspirin use risk scores were developed by identifying the five most dominant predictors. The risk of upper

  4. Profiling lifetime episodes of upper gastrointestinal bleeding among ...

    African Journals Online (AJOL)

    Profiling lifetime episodes of upper gastrointestinal bleeding among patients from rural Sub-Saharan Africa where schistosoma mansoni is endemic. ... female sex, history of blood transfusion, abdominal collaterals, esophageal varices, pattern x periportal fibrosis, anemia, and thrombocytopenia) significantly associated ...

  5. Localization and Treatment of Small and Large Bowel Bleeding

    Directory of Open Access Journals (Sweden)

    Richard H Hunt

    1992-01-01

    Full Text Available Bleeding from the small or large bowel may present a diagnostic dilemma for the clinician, requiring careful consideration and multidisciplinary consultation before the problem is located. Careful selection of the appropriate investigations in the most logical order is important to minimize delay to diagnosis, inconvenience, discomfort and risk to the patient and costs to health care delivery.

  6. A sensitive venous bleeding model in haemophilia A mice

    DEFF Research Database (Denmark)

    Pastoft, Anne Engedahl; Lykkesfeldt, Jens; Ezban, M.

    2012-01-01

    for evaluation of pro-coagulant compounds for treatment of haemophilia. Interestingly, the vena saphena model proved to be sensitive towards FVIII in plasma levels that approach the levels preventing bleeding in haemophilia patients, and may, thus, in particular be valuable for testing of new long...

  7. Oral misoprostol in the prevention of uterine bleeding after surgical ...

    African Journals Online (AJOL)

    2013-03-13

    Mar 13, 2013 ... Oral misoprostol in the prevention of uterine bleeding after surgical evacuation of first trimester abortion: A comparative study of three uterotonic agents. TM Aramide, AK Olusegun1, AC Akinfolarin2, DF Oriola. Department of Obstetrics and Gynaecology, LAUTECH Teaching Hospital, Ogbomoso, Oyo State, ...

  8. Bleeding in children with cancer | Dippenaar | Continuing Medical ...

    African Journals Online (AJOL)

    Before the success story of leukaemia treatment started in the 1950s, many patients succumbed to the disease because of severe haemorrhage. A bleeding tendency is one of the hallmarks of haematological malignancies such as leukaemia, since together with anaemia and an increased susceptibility to infection it ...

  9. The role of acid suppressants in upper gastrointestinal ulcer bleeding

    NARCIS (Netherlands)

    van Leerdam, M. E.; Rauws, E. A.

    2001-01-01

    Re-bleeding and mortality remain significant in peptic ulcer haemorrhage despite the widespread use of endoscopic therapy. The acidic gastric environment interferes with coagulation. In vitro studies show that an intragastric pH of above 6 results in normal blood coagulation and platelet function.

  10. Endocrine carcinoma of the pancreatic tail exhibiting gastric variceal bleeding

    Directory of Open Access Journals (Sweden)

    Si-Yuan Wu

    2014-01-01

    Full Text Available Nonfunctional endocrine carcinoma of the pancreas is uncommon. Without excess hormone secretion, it is clinically silent until the enlarging or metastatic tumor causes compressive symptoms. Epigastric pain, dyspepsia, jaundice, and abdominal mass are the usual symptoms, whereas upper gastrointestinal (GI bleeding is rare. Here, we describe the case of a 24-year-old man with the chief complaint of hematemesis. Upper GI panendoscopy revealed isolated gastric varices at the fundus and upper body. Ultrasonography and computed tomography showed a tumor mass at the pancreatic tail causing a splenic vein obstruction, engorged vessels near the fundus of the stomach, and splenomegaly. After distal pancreatectomy and splenectomy, the bleeding did not recur. The final pathologic diagnosis was endocrine carcinoma of the pancreas. Gastric variceal bleeding is a possible manifestation of nonfunctional endocrine carcinoma of the pancreas if the splenic vein is affected by a tumor. In non-cirrhotic patients with isolated gastric variceal bleeding, the differential diagnosis should include pancreatic disorders.

  11. Clinical approach to a patient with abnormal uterine bleeding ...

    African Journals Online (AJOL)

    Abnormal excessive uterine bleeding forms a large proportion of gynaecological complaints. Of postpubertal girls who experience excessive menstrual loss, about one quarter will never regain a normal cycle and flow. As she grows older many other factors may arise causing menstrual abnormalities. South African Family ...

  12. Clinical predictors of outcome in acute upper gastrointestinal bleeding

    African Journals Online (AJOL)

    Objective. Endoscopy has traditionally been used to risk stratify patients with upper gastrointestinal bleeding (UGIB). This is problematic in resource-poor environments. The study aimed to identify patients who would not require urgent endoscopy by identifying clinical variables before endoscopy that predict uneventful ...

  13. Primary prevention and management of variceal bleeding: Review ...

    African Journals Online (AJOL)

    Background: Prevention and control of active bleeding caused by portal hypertension is still a challenge. Surgery used to be the only option in the earlier days, but now many options exist. Choice of the correct mode of treatment is important and is determined by many factors dictated by the condition of each patient and the

  14. Endoscopic Evaluation of Upper and Lower Gastro‑Intestinal Bleeding

    African Journals Online (AJOL)

    Injection sclerotherapy was successfully performed in the hemorrhoids and a case of gastric varices. The mortality recorded was 0%. Conclusion: Endoscopy is vital in the diagnosis and treatment of GIB. Gastritis and Haemorrhoid are the most common causes of upper and lower GI bleeding respectively, in our environment.

  15. The characteristics of adults with upper gastrointestinal bleeding ...

    African Journals Online (AJOL)

    53.9 years, p=0.001). The most common cause of UGIB was peptic ulcer (37.1%) of which duodenal ulcer was the most common (30.7% of all UGIB), especially amongst male patients (36.4%). The second most common cause was bleeding due to varices (29.8%), especially amongst females (35.1%). Additionally, smoking ...

  16. Open heart surgery: management of nonsurgical bleeding in the peri ...

    African Journals Online (AJOL)

    The data analyzed were patients' demographics, the total number of open heart surgery cases, the number that had perioperative nonsurgical bleeding,clinical detection strategies,treatment and preventive modalities as well as the outcome. RESULTS: During the period,a total number of 78 cases of open heart surgery ...

  17. Therapeutic Plasma Transfusion in Bleeding Patients: A Systematic Review.

    Science.gov (United States)

    Levy, Jerrold H; Grottke, Oliver; Fries, Dietmar; Kozek-Langenecker, Sibylle

    2017-04-01

    Plasma products, including fresh frozen plasma, are administered extensively in a variety of settings from massive transfusion to vitamin K antagonist reversal. Despite the widespread use of plasma as a hemostatic agent in bleeding patients, its effect in comparison with other available choices of hemostatic therapies is unclear. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, PubMed Central, and databases of ongoing trials for randomized controlled trials that assessed the efficacy and/or safety of therapeutic plasma as an intervention to treat bleeding patients compared with other interventions or placebo. Of 1243 unique publications retrieved in our initial search, no randomized controlled trials were identified. Four nonrandomized studies described the effect of therapeutic plasma in bleeding patients; however, data gathered from these studies did not allow for comparison with other therapeutic interventions primarily as a result of the low number of patients and the use of different (or lack of) comparators. We identified two ongoing trials investigating the efficacy and safety of therapeutic plasma, respectively; however, no data have been released as yet. Although plasma is used extensively in the treatment of bleeding patients, evidence from randomized controlled trials comparing its effect with those of other therapeutic interventions is currently lacking.

  18. A longitudinal study of the prevalence of gingival bleeding among ...

    African Journals Online (AJOL)

    Objective: To assess the prevalence of gingival bleeding following gentle periodontal probing during pregnancy as compared to after child birth in the same set of women. Method: Three hundred and eighty-four consecutive pregnant women in third trimester were selected at the antenatal clinics of Adeoyo Maternity ...

  19. The diagnostic work-up of women with postmenopausal bleeding

    NARCIS (Netherlands)

    van Hanegem, N.

    2015-01-01

    In this thesis we describe the diagnostic work-up that can be used to diagnose or exclude endometrial cancer in women with postmenopausal bleeding. Despite the many studies investigating this, there is no consensus in literature. The diagnostic steps vary in different guidelines, depending on the

  20. Massive bleeding from colonic diverticular disease in an elderly ...

    African Journals Online (AJOL)

    Colonic diverticular disease is one of the most common and costly gastrointestinal disorders among industrialized countries. The disease was thought to be rare in the African population, but is being increasingly diagnosed with the advent of modern imaging techniques and colonoscopy. Diverticular bleeding is a common ...

  1. Postmenopausal bleeding: causes and risk of genital tract malignancy

    International Nuclear Information System (INIS)

    Dawood, N.S.; Peter, K.; Ibrar, F.; Dawood, A.

    2010-01-01

    Background: Postmenopausal bleeding (PMB) is bleeding occurring after 6-12 months of amenorrhea in a woman of age where the menopause can be expected. Objectives of this study were to ascertain various causes and prevalence of genital organ malignancy in patients presenting with postmenopausal bleeding. Methods: A prospective observational study carried out in the Department of Obstetrics and Gynaecology, Fauji Foundation Hospital, Rawalpindi comprising of 167 consecutive cases presenting with postmenopausal bleeding one year after menopause. Women having undergone hysterectomy and bilateral salpingo-oophorectomy, receiving radiotherapy or chemotherapy, suffered trauma to the genital tract, having coagulation disorder or on anticoagulant or hormone replacement therapy were excluded. Detailed history was obtained and a thorough clinical examination was conducted. Data were entered into hospital computer database (Medix) system. Mean +- SD were calculated for age, percentage was calculated for types of histopathological findings. Results: The commonest cause of PMB was atrophic endometritis and vaginitis 33 (21.2%). Overall incidence of various genital tract malignancies was 25 (16.0%). Conclusion: The overall incidence of genital tract malignancies in patients presenting with PMB is high (16.0%), therefore, it needs to be taken seriously and requires prompt and thorough investigations. (author)

  2. Gynecologic bleeding revealing vaginal metastasis of renal cell ...

    African Journals Online (AJOL)

    Tumour was classified pT3bN0M0 and grade III of Furhmann grading. One year later, scanner discovered mediastinal and lombo-aortic lymph nodes. She received 2 months of immunotherapy associated with bevacizumab, but stopped because of intolerance. She was readmitted in our institute for vaginal bleeding. Clinical ...

  3. Non-bleeding Spontaneous Rupture of Hepatocellular Carcinoma ...

    African Journals Online (AJOL)

    Non-bleeding Spontaneous Rupture of Hepatocellular Carcinoma. M Islam, P Deka, R Kapur, AM Ansari. Abstract. Rupture of hepatocellular carcinoma (HCC) is not uncommon and most ruptured HCC present with hemoperitoneum and hemorrhagic shock. Management of ruptured HCC is different than non.ruptured one.

  4. Nodular Purpura and Intracranial Bleeding due to Late Onset ...

    African Journals Online (AJOL)

    She developed nodular purpuric spots for about three days prior to the intracranial bleeding. She was unconscious and responding only to pain, and was severely pale. She was transfused with two units of whole blood and underwent a craniotomy for draining the hemorrhage. She was treated with Vitamin K supplements.

  5. Does any relationship exist between self reported gingival bleeding ...

    African Journals Online (AJOL)

    Individuals with gingival bleeding were significantly more likely to rate their dental and gingival health as fair/poor, use strong brushing stroke during tooth brushing and report worsening condition of teeth despite daily tooth brushing, express worry about the gingival color and less likely to be satisfied about the appearance ...

  6. The effect of different interdental cleaning devices on gingival bleeding.

    Science.gov (United States)

    Rosema, Nanning A M; Hennequin-Hoenderdos, Nienke L; Berchier, Claire E; Slot, Dagmar E; Lyle, Deborah M; van der Weijden, Godefridus A

    2011-01-01

    To compare the effectiveness of an oral irrigator (OI) with a prototype jet tip or a standard jet tip to floss as adjunct to daily toothbrushing on gingival bleeding. In this single masked, 3-group parallel, 4-week home use experiment, 108 subjects were randomly assigned to one of three groups: 1) 01 with a prototype jet tip; 2) OI with a standard jet tip; 3) waxed dental floss. All groups used their assigned product once a day as adjunct to twice daily toothbrushing for two minutes with a standard ADA reference toothbrush. Professional instructions were given by a dental hygienist in 01 use or floss use according to written instructions. All subjects also received a toothbrush instruction leaflet (Bass technique). Subjects were assessed for both bleeding and plaque at baseline and after two weeks and four weeks and were instructed to brush their teeth approximately 2 to 3 hours prior to their assessment. With respect to mean bleeding scores the ANCOVA analysis with baseline as covariate and week 4 as dependent variable showed a significant difference between groups in favor of both the oral irrigator groups. For plaque, however, no significant difference among groups was observed. When combined with manual toothbrushing the daily use of an oral irrigator, either with prototype or standard jet tip, is significantly more effective in reducing gingival bleeding scores than is the use of dental floss, as determined within the limits of this 4-week study design.

  7. Vaginal Bleeding In 6 Years Old Young Female: Diagnostic Challenge

    African Journals Online (AJOL)

    A 6 year old young girl was referred to Mendefera (Zoba Debub Referral) Hospital with vaginal bleeding of 4 days duration. She had a history of swimming in a river prior to the incident. An aquatic leech bloated with blood detached from the vagina after 100 milliliters of normal saline flushing into the vagina. The patient was ...

  8. The effect of different interdental cleaning devices on gingival bleeding

    NARCIS (Netherlands)

    Rosema, N.A.M.; Hennequin-Hoenderdos, N.L.; Berchier, C.E.; Slot, D.E.; Lyle, D.M.; van der Weijden, G.A.

    2011-01-01

    Objective: To compare the effectiveness of an oral irrigator (OI) with a prototype jet tip or a standard jet tip to floss as adjunct to daily toothbrushing on gingival bleeding. Methods: In this single masked, 3-group parallel, 4-week home use experiment, 108 subjects were randomly assigned to one

  9. Acute Leukemia Presenting with Gingival Bleeding. A Case Report ...

    African Journals Online (AJOL)

    This is a case report of a five year-old girl with acute lymphoblastic leukaemia who presented in our clinic with gingival bleeding. Sepcific highlights were focused on the management of the patient and current trends in the treatment of the disease with emphasis on early diagnosis of the disease in other to improve the ...

  10. Selective serotonin reuptake inhibitors and risk for gastrointestinal bleeding

    Directory of Open Access Journals (Sweden)

    Batić-Mujanović Olivera

    2014-01-01

    Full Text Available The most of the known effects of selective serotonin reuptake inhibitors, beneficial or harmful, are associated with the inhibitory action of the serotonin reuptake transporter. This mechanism is present not only in neurons, but also in other cells such as platelets. Serotoninergic mechanism seems to have an important role in hemostasis, which has long been underestimated. Abnormal activation may lead to a prothrombotic state in patients treated with selective serotonin reuptake inhibitors. On one hand there may be an increased risk of bleeding, and on the other hand reduction in thrombotic risk may be possible. Serotonin is critical to maintain a platelet haemostatic function, such as platelet aggregation. Evidences from the studies support the hypothesis that antidepressants with a relevant blockade of action of serotonin reuptake mechanism may increase the risk of bleeding, which can occur anywhere in the body. Epidemiological evidences are, however, the most robust for upper gastrointestinal bleeding. It is estimated that this bleeding can occur in 1 in 100 to 1 in 1.000 patient-years of exposure to the high-affinity selective serotonin reuptake inhibitors, with very old patients at the highest risk. The increased risk may be of particular relevance when selective serotonin reuptake inhibitors are taken simultaneously with nonsteroidal anti-inflammatory drugs, low dose of aspirin or warfarin.

  11. Risk of bleeding after dentoalveolar surgery in patients taking anticoagulants

    NARCIS (Netherlands)

    Broekema, Ferdinand I.; van Minnen, Baucke; Jansma, Johan; Bos, Rudolf R. M.

    To avoid increasing the risk of thromboembolic events, it is recommended that treatment with anticoagulants should be continued during dentoalveolar operations. We have evaluated the incidence of bleeding after dentoalveolar operations in a prospective study of 206 patients, 103 who were, and 103

  12. Gastrointestinal bleeding due to an erosion of the superior ...

    African Journals Online (AJOL)

    The erosion of a pancreatic pseudocyst into an adjacent artery is a rare and highly lethal complication of pancreatitis with reported death rates of 12% to 40%. The majority of patients had bleeding from the splenic artery, the gastroduodenal artery and the anterior pacreaticoduodenal artery. Exceptionally, some cases with ...

  13. Embolotherapy using N-butyl cyanoacrylate for abdominal wall bleeding

    International Nuclear Information System (INIS)

    Choi, Young Ho; Koh, Young Hwan; Han, Dae Hee; Kim, Ji Hoon; Cha, Joo Hee; Lee, Eun Hye; Song, Chi Sung

    2008-01-01

    We describe our experience with the use of N-butyl cyanoacrylate (NBCA) embolization of abdominal wall bleeding and we evaluate the clinical effectiveness of the procedure. Embolization was performed in nine patients with abdominal wall bleeding. The sites of embolization were the left first lumbar (n = 1), left second lumbar (n = 1), right inferior epigastric (n 2), left inferior epigastric (n = 3), right circumflex iliac (n = 1), and left circumflex iliac artery (n = 1). A coil was used with NBCA in one patient due to difficulty in selecting only a bleeding focus and anticipated reflux. NBCA was mixed with Lipiodol at the ratio of 1:1 to 1:4. Blood pressure and heart rate were measured before and after the embolization procedure, and the serial hemoglobin and hematocrit levels and transfusion requirements were reviewed to evaluate hemostasis and rebleeding. Hemostasis was obtained in six out of the nine patients and technical success was achieved in all patients. There were no procedure-related complications. Four out of the nine patients died due to rebleeding of a subarachnoid hemorrhage (n = 1), multiorgan failure (n = 1), and hepatic failure (n =2) that occurred two to nine days after the embolization procedure. One patient had rebleeding. The five surviving patients had no rebleeding, and the patients continue to visit the clinical on an outpatient basis. NBCA embolization is a clinically safe procedure and is effective for abdominal wall bleeding

  14. Colonoscopy in the diagnosis of acute lower gastrointestinal bleeding

    Directory of Open Access Journals (Sweden)

    Igor Borba de Souza e Benevides

    2016-10-01

    Full Text Available Lower gastrointestinal bleeding is defined as a bleeding originated from a source distal to the Treitz ligament and the colonoscopy is well established as the diagnostic procedure of choice. Objective: To evaluate the results of colonoscopies performed to diagnose the cause of acute lower gastrointestinal bleeding in a general hospital at Mato Grosso do Sul. Material and methods: Colonoscopy procedures performed in the Endoscopy service of the Hospital Regional de Mato Grosso do Sul in those patients admitted due to an acute lower gastrointestinal bleeding from January 2014 to December 2015 were analyzed retrospectively. The studied variables were age, gender, diagnosis and localization of the lesion. Results: The mean age was 66 years, and there was a little predominance of the male gender. Diverticular disease was the main cause of lower gastrointestinal bleeding in this study, followed by cancer, inflammatory gastrointestinal disease, polyps, and angiodysplasia. Conclusion: The colonoscopy showed to be an effective diagnostic method in the case of acute lower gastrointestinal bleeding and a good therapeutic tool in the case of diverticular disease and angiodysplasia. Resumo: Hemorragia digestiva baixa é definida como sangramento originado de uma fonte distal ao ligamento de Treitz e a colonoscopia esta bem estabelecida como o seu procedimento diagnóstico de escolha. Objetivo: Avaliar os resultados das colonoscopias realizadas para elucidação diagnóstica dos casos de Hemorragia digestiva baixa aguda em um Hospital Geral de Mato Grosso do Sul. Materiais e métodos: Foram analisadas, de forma retrospectiva, as colonoscopias realizadas nos pacientes internados devido à hemorragia digestiva baixa aguda, no período de janeiro de 2014 a dezembro de 2015, no serviço de endoscopia digestiva do Hospital Regional de Mato Grosso do Sul. As variáveis estudadas foram a idade, sexo, diagnóstico e localização da lesão. Resultados: A média de

  15. Frequency of endometrial carcinoma in patients with postmenopausal bleeding

    International Nuclear Information System (INIS)

    Yousaf, S.; Shaheen, M.; Rana, T.

    2010-01-01

    Introduction: Postmenopausal bleeding (PMB) is defined as bleeding that occurs after 1 year of amenorrhea in a woman who is not receiving hormone replacement therapy (HRT). About 10% of women with postmenopausal bleeding have a primary or secondary malignancy. Common malignancies among them are endometrial cancer (80%), cervical cancer or an ovarian tumour. Endometrial cancer is the second most common cancer associated with hereditary non-polyposis colorectal cancer. Ninety percent of patients have benign causes. Objective: The objective of this study was to determine the frequency of endometrial carcinoma in patients with post-menopausal bleeding. Study Design: Descriptive case series study. Setting: Department of obstetrics and gynaecology, Lady Willingdon, Lahore. Duration of Study: This study was conducted over a period of six months from January, 1 2009 to June 30, 2009. Subjects and Methods: 50 cases with postmenopausal bleeding. Results: During the period of this study a total number of 50 consecutive patients who met inclusion criteria were enrolled in the study. Ages of the patients who presented with PMB ranged between 48 years and 80 years with a mean age of 59 years. Malignancy was found in 18 out of 50 cases (36%).Cases with endometrial CA were 14 out of 50 cases (28%) and CA cervix constituted 4 out of 50 cases (8%). Benign pathology was more frequent (64%). 13 of 50 cases (26%) had hyperplasia out of which 1 case (2%) was of atypical hyperplasia. Endometrial polyp was found in 4 of 50 cases (8%). 3 of 50 cases (6%) had chronic endometritis. 5 of 50 cases (10%) had chronic cervicitis. While 7 cases (14%) had postmenopausal bleeding due to decubitus ulcer of uterovaginal prolapse. Among malignancies (36%), endometrial cancer is the most frequent malignancy in women with postmenopausal bleeding with mean age of 65 years. Conclusion: In this study it was concluded that the majority of cases of PMB would be expected to be suffering from benign problems

  16. A STUDY ON ENDOSCOPIC EVALUATION OF UPPER GASTROINTESTINAL BLEEDING

    Directory of Open Access Journals (Sweden)

    Pranaya Kumar

    2016-03-01

    Full Text Available CONTEXT Upper gastrointestinal bleeding (UGIB is one of the commonest gastrointestinal emergencies encountered by clinicians. Peptic ulcers are the most common cause of UGIB. Endoscopy has become the preferred method for diagnosis in patients with acute UGIB. This study is done in a diagnostic upper gastrointestinal endoscopy (UGIE setup of a tertiary care hospital to ascertain the causes of UGIB prevalent in this part of our country which might differ from other studies. AIM To ascertain prevalent causes of UGIB in patients of this part of India admitted to a Govt. Tertiary Hospital with a provisional diagnosis of UGIB. METHOD One hundred consecutive patients with UGIB were subjected to UGIE to find out the aetiology. The clinical profile and endoscopic findings were analysed and compared with the data on UGIB from other studies. RESULTS The mean age of patients was 47.03 years with male: female ratio of 2.33:1. 58% of patients were first time bleeders. Majority of patients presented with melaena. Visualisation of active bleeding achieved to 85.7% when endoscopy was done within first 24 hrs. The commonest cause of UGIB was duodenal ulcer (DU which accounted for 41% cases. Gastric ulcer was responsible in 13% of cases. Portal hypertension was responsible for bleed in only 13%. Neoplasms accounted for 25% of cases. Other less common causes were erosive gastritis (3%, gastric polyp (3%, Mallory-Weiss tear (1%, and Dieulafoy’s lesion (1%. Among bleeding peptic ulcers, 27.8% of cases were classified as Forrest IIa and 20.4% in Forrest IIb & IIc each. Acid peptic disease was past history elicited in majority (33% followed by NSAID (26% and alcohol (26%. CONCLUSION The present study has diagnosed various causes of upper gastrointestinal bleeding in this part of country. The incidence of gastric carcinoma as a cause of upper gastrointestinal bleeding is significantly high compared to those in other studies. UGI endoscopy should be done in every case

  17. N-butyl cyanoacrylate embolotherapy for acute gastroduodenal ulcer bleeding

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Young Ho; Kim, Ji Hoon; Koh, Young Hwan; Han, Dae Hee; Cha, Joo Hee; Seong, Chang Kyu; Song, Chi Sung [Seoul National University Boramae Hospital, Seoul (Korea, Republic of)

    2007-01-15

    Various embolic agents have been used for embolization of acute gastrointestinal (GI) arterial bleeding. N-butyl cyanoacrylate (NBCA) is not easy to handle, but it is a useful embolic agent. In this retrospective study, we describe our experience with NBCA embolization of acute gastroduodenal ulcer bleeding. NBCA embolization was performed in seven patients with acute upper GI arterial bleeding; they had five gastric ulcers and two duodenal ulcers. NBCA embolization was done in the left gastric artery (n = 3), right gastric artery (n = 2), gastroduodenal artery (n = 1) and pancreaticoduodenal artery (n = 1). Coil was used along with NBCA in a gastric bleeding patient because of difficulty in selecting a feeding artery. NBCA was mixed with Lipiodol at the ratio of 1:1 to 1:2. The blood pressure and heart rate around the time of embolization, the serial hemoglobin and hematocrit levels and the transfusion requirements were reviewed to evaluate hemostasis and rebleeding. Technical success was achieved in all the cases. Two procedure-related complications happened; embolism of the NBCA mixture to the common hepatic artery occurred in a case with embolization of the left gastric artery, and reflux of the NBCA mixture occurred into the adjacent gastric tissue, but these did not cause any clinical problems. Four of seven patients did not present with rebleeding, but two had rebleeding 10 and 16 days, respectively, after embolization and they died of cardiac arrest at 2 months and 37 days, respectively. One other patient died of sepsis and respiratory failure within 24 hours without rebleeding. NBCA embolization with or without other embolic agents could be safe and effective for treating acute gastroduodenal ulcer bleeding.

  18. [Embolization of carotid arteria branch in stanching of nasal bleeding].

    Science.gov (United States)

    Rzewnicki, Ireneusz; Kordecki, Kazimierz; Łukasiewicz, Adam; Puławska-Stalmach, Magdalena; Lewszuk, Andrzej; Bondyra, Zofia; Rogowski, Marek; Łebkowska, Urszula

    2013-01-01

    Epistaxis is a common clinical problem, especially in otolaryngology. This disorder affects equally both genders. Most cases manifest as spontaneous nasal bleeding. It can also appear as a result of trauma, high blood pressure, Osler-Rendu-Weber disease. When the bleeding is massive it can be potentially life-threatening. A great majority of epistaxis can be treated conservatively, if not it sometimes requires endovascular treatment. It is specially reserved for extensive, dangerous epistaxis. Angiography with selective embolization has become an accepted method of treating epistaxis that is not controlled with conservative methods. Authors analyzed the efficacy of selective embolization treatment of epistaxis. 61 patients treated in the Department of Otolaryngology in Bialystok in years 1999-2011 were examined. There were 39 men and 22 women aged 24-48 years. Patients were referred for endovascular treatment when primary management was ineffective. Arteries suspected of bleeding were embolized superselectively. Immediate, complete control of bleeding was achieved in 100% patients. After few hours recurrent nasal bleeding occurred in 4 (7%) patients who underwent successful reembolization. There were no severe complications after procedure. Nine patients experienced few days lasting mild headache which disappeared after medicament treatment. Five patients suffered from unaided removing facial oedema. Out of 61 patients, 56 were available for 12-month follow-up evaluation. No neurological or otolaryngological complications were certified. There was also no relapse of epistaxis. Selective angiographic embolization is an effective method that should be considered in the treatment of refractory epistaxis. It is safe and not traumatic for patients. Copyright © 2012 Polish Otorhinolaryngology - Head and Neck Surgery Society. Published by Elsevier Urban & Partner Sp. z.o.o. All rights reserved.

  19. Endoscopic Evaluation of Upper and Lower Gastro‑Intestinal Bleeding

    African Journals Online (AJOL)

    or tabs bisacodyl and castor oil or colostomy washout with 2 days dietary restriction preceding elective cases. Conscious sedation was achieved with intravenous .... developing economy and expertise discouraged their use. In approximately 5% of all patients with gastrointestinal hemorrhaging and anemia, standard ...

  20. Modelling of a thermally activated building system (TABS) combined with free-hanging acoustic ceiling units using computational fluid dynamics (CFD)

    DEFF Research Database (Denmark)

    Lacarte, Luis Marcos Domínguez; Fan, Jianhua

    2017-01-01

    . The active surfaces of TABS need to be as exposed as possible, but exposing bare concrete surfaces has a negative impact on the acoustic quality in the premises. Acoustic solutions capable of providing optimal acoustic comfort while allowing the heat exchange between the TABS and the room are desirable...... of the heat exchange between the TABS and the room and the occupants. The simulations are validated by comparison with full scale measurements in laboratory conditions. The study shows that for equivalent sound absorption levels, free-hanging vertical sound absorbers have a lower impact on the heat exchange......Thermally Activated Building Systems (TABS) have proven to be an energy-efficient solution to achieve optimal indoor thermal environment in buildings. This solution uses the building mass to store heat and by means of water pipes embedded in the concrete slabs adjust the temperature in the premises...

  1. Theoretical study of O- and Zn-face polarity effect on the optical properties of the conventional and staggered ZnO/Zn{sub 1−x}Cd{sub x}O/ZnO quantum wells

    Energy Technology Data Exchange (ETDEWEB)

    Shtepliuk, I., E-mail: ivan.shtepliuk@liu.se; Khranovskyy, V.; Yakimova, R.

    2015-11-02

    In this work we present a comparative study of Zn-face and O-face polarity Zn{sub 1−x}CdxO-based conventional and staggered quantum-well (QW) structures. The calculation of optical properties of QWs was performed by means of self-consistent Schrodinger–Poisson solver with consideration of polarization-induced effects. The conventional Zn-face and O-face QWs possess similar values of transition energy and an overlap of electron and hole wave functions. A change of the polarity from Zn-face to O-face for the conventional QWs influences only a shape of the conduction and valence band edge profile. It is revealed that the utilization of the staggered QWs leads to an improvement of the confinement characteristics. In addition, the O-face staggered QW structure has larger values of transition energy and overlap integral compared to the Zn-face staggered QW structure. O-terminated staggered QW structure is less dependent on the well thickness and has lower sensitivity to Cd content in embedded Zn{sub 1−x}CdxO layer. Control of the material polarity and design of the staggered QWs provide cost-effective approach for engineering the QW band structures with enhanced QW performance. This enables constructing of the Zn{sub 1−x}CdxO-based light emission diodes with improved radiative efficiency emitting, applicable for solid state lighting. - Highlights: • Effect of polar face on properties of Zn{sub 1−x}Cd{sub x}O quantum wells (QWs) was studied. • O-face staggered QWs were found to possess improved optical properties. • Sensitivity of transition energy to well width was found to be weaker for O-face QW. • Using of the embedded layer in QW reduces quantum confinement Stark effect.

  2. Repeat colonoscopy’s value in gastrointestinal bleeding

    Science.gov (United States)

    Mekaroonkamol, Parit; Chaput, Kimberly Jegel; Chae, Young Kwang; Davis, Michael L; Mekaroonkamol, Pojnicha; Pomerantz, Sherry; Katz, Philip O

    2013-01-01

    AIM: To assess the diagnostic yield and clinical value of early repeat colonoscopies for indications other than colorectal cancer (CRC) screening/surveillance. METHODS: A retrospective review of patients who had more than one colonoscopy performed for the same indication within a three year time frame at our tertiary care referral hospital between January 1, 2000 and January 1, 2010 was conducted. Exclusion criteria included repeat colonoscopies performed for CRC screening/surveillance, poor bowel preparation, suspected complications from the index procedure, and incomplete initial procedure. Primary outcome was new endoscopic finding that led to an endoscopic therapeutic intervention or any change in clinical management. Clinical parameters including age, sex, race, interval between procedures, indication of the procedure, presenting symptoms, severity of symptoms, hemodynamic instability, duration between onset of symptoms and when the procedure was performed, change in endoscopist, withdrawal time, location of colonic lesions and improvement of quality of bowel preparation were analyzed using bivariate analysis and logistic regression analysis to examine correlation with this primary outcome. RESULTS: Among 19  772 colonoscopies performed during the above mentioned period, 947 colonoscopies (4.79%) were repeat colonoscopies performed within 3 years from the index procedure. Out of these repeat colonoscopies, 139 patient pairs met the inclusion criteria. The majority of repeat colonoscopies were for lower gastrointestinal bleeding (88.4%), change in bowel habits (6.4%) and abdominal pain (5%). Among 139 eligible patient pairs of colonoscopies, only repeat colonoscopies that were done for lower gastrointestinal bleeding and abdominal pain produced endoscopic findings that led to a change in management [25 out of 123 (20.33%) and 2 out of 7 (28.57%), respectively]. When looking at only recurrent lower gastrointestinal bleeding cases, new endoscopic findings

  3. Colonoscopic examination of rectal bleeding in children: A report of two cases

    Directory of Open Access Journals (Sweden)

    Abdulfatai B Olokoba

    2012-01-01

    Full Text Available Rectal bleeding in children is a frightening and cause of great concern, and of parental anxiety. In this report, we present the value of colonoscopy to unravel the diagnostic conundrum often associated with rectal bleeding in children.

  4. Maintenance Solutions for Bleeding and Flushed Pavements Surfaced with a Seal Coat or Surface Treatment

    Science.gov (United States)

    2007-02-01

    This report summarizes the findings of research directed at identifying maintenance solutions for bleeding and : flushed asphalt pavements surfaced with seal coats or surface treatments. Although the basic mechanism associated with : both bleeding an...

  5. Comparison of the 2nd-order and 4th-order Staggered-Grid Finite-Difference Implementations of the TSN Method for Rupture Propagation

    Science.gov (United States)

    Kristek, J.; Moczo, P.; Galis, M.

    2006-12-01

    The TSN (Traction-at-Split-Nodes) method has been developed independently by Andrews (1973, 1976, 1999) and Day (1977, 1982). Andrews implemented his TSN formulation in the finite-difference scheme in which spatial differentiation is equivalent to the 2nd-order finite-element method. Day implemented his slightly different formulation of the TSN method in the 2nd-order partly-staggered finite-difference scheme. Dalguer and Day (2006) adapted the TSN method to the velocity-stress staggered-grid finite-difference scheme. Whereas the 4th-order spatial differencing is applied outside the fault, the 2nd-order differencing is applied along the fault plane. We present two implementations of the Day's TSN formulation in the velocity-stress staggered-grid finite-difference scheme for a 3D viscoelastic medium. In the first one we apply the 2nd-order spatial differencing everywhere in the grid including derivatives at the fault in the direction perpendicular to the fault plane. In the second implementation we similarly apply the 4th-order spatial differencing. In both cases we use the adjusted finite-difference approximations (AFDA, Kristek et al. 2002, Moczo et al. 2004) to derivatives in the direction perpendicular to the fault plane in order to have the same order of approximation everywhere. We numerically investigate convergence rates of both implementations with respect to rupture-time, final-slip, and peak-slip-rate metrics. Moreover, we compare the numerical solutions to those obtained by the finite-element implementation of the TSN method.

  6. [Hysteroscopy clinic: diagnostic and therapeutic method in abnormal uterine bleeding].

    Science.gov (United States)

    Alanis Fuentes, José; Obregón Zegarra, Eva Haydee

    2012-12-01

    Abnormal uterine bleeding is a public health problem prevalence exceeded only by abnormal vaginal discharge as a reason for medical consultation. To describe the findings reported by the Hysteroscopy clinic of the Hospital GEA Gonzalez on patients with Abnormal Uterine bleeding diagnosis. Retrospective, transversal, descriptive study. The total 2546 records of those patient that were evaluated by Office Hysteroscopic between January 2007 and December 2008 on the Hysteroscopy Clinic of Hospital Manuel GEA Gonzalez, then we selected the 1482 records of those patients that were sended because of an Abnormal Uterine bleeding condition. We descrive the frequencies of the diagnosis and its interrelation with the age of the patients. We also report the therapeutical interventions during office hysteroscopy. The mean age of the patients was 42.15 +/- 9.30 years (from 12 a 92 years); the age groups of patients that belonged to 40-44 years and 45-49 years are the most frequent patient and they represent the 25% y el 23.3% of the records. The abnormal findings occurred on the 66% de of the patients. Those patients of 65 years old and older do not have any report of normal cavities, all of then have abnormal findings. The leiomyoma (26.9%) and the endometrial polyps (27.3%) were the most frequent findings. The postmenopausal bleeding had a rate of 90.9% abnormal findings and in this group of patients the most frequent diagnosis was atrophic endometrium (32.2%) and polyps (24.3%). Besides that the office hysteroscopy show its therapeutical usefulness because of the 67% and 77.5% of polipectomy perform for endometrial and cervical polyps respectively The office Hysteroscopy is a well tolerated diagnosis and therapeutic method that is useful for any women with abnormal uterine bleeding condition and it is the ideal technique for the examination of abnormal uterine bleeding in postmenopausal women... The office hysteroscopy is a efficient cost-effective and cost-benefic method for

  7. Recent pharmacological management of oral bleeding in hemophilic patient

    Directory of Open Access Journals (Sweden)

    Monica Widyawati Setiawan

    2011-09-01

    Full Text Available Background: Hemophilia is a hereditary bleeding disorder that can increase the risk of disease in oral cavity. Sometimes hemophilia is not always established already in a patient. The lack of awareness of hemophilia presence can cause serious problem. Purpose: The purpose of this review is to explain about dental bleeding manifestation and management in hemophilic patient. Reviews: Hemophilia can be manifested as dental bleeding that cannot stop spontaneously. It should be treated with factor VIIII either by giving whole blood, fresh plasma, fresh frozen plasma, cryoprecipitate, and factor VIII concentrate. Factor VIII dose for hemophilia treatment can be calculated based on factor VIII present in hemophilia patient’s body. Factor VIII can also be given as prophylaxis to prevent bleeding. Complications that can be caused by factor VIII replacement therapy are the presence of factor VIII inhibitor and transfusion related diseases. Treatment of dental bleeding due to hemophilia consists of factor replacement therapy and supportive therapy. Conclusion: Treatment of dental bleeding due to hemophilia consists of factor replacement therapy and supportive therapy. There are complications that can happen due to factor VIII replacement therapy that should be considered and anticipated.Latar belakang: Hemofilia adalah kelainan pembekuan darah yang diturunkan. Hemophilia dapat meningkatkan resiko penyakit rongga mulut. Hemofilia tidak selalu sudah terdiagnosa saat penderita melakukan kunjungan ke dokter gigi. Kurangnya kewaspadaan akan adanya hemofilia dapat menyebabkan masalah serius. Tujuan: Tujuan dari kajian pustaka ini adalah memaparkan tentang manifestasi dan penanganan perdarahan gigi pada penderita hemofilia. Tinjauan pustaka: hemofilia dapat bermanifestasi sebagai perdarahan gigi yang tidak dapat berhenti secara spontan. Pada keadaan perdarahan tersebut, pemberian faktor VIII yang diberikan sebagai whole blood, fresh plasma, fresh frozen plasma

  8. Virological failure of staggered and simultaneous treatment interruption in HIV patients who began Efavirenz-based regimens after allergic reactions to nevirapine

    Directory of Open Access Journals (Sweden)

    Siripassorn Krittaecho

    2013-01-01

    Full Text Available Abstract Objective The objective of this work was to study the virological outcomes associated with two different types of treatment interruption strategies in patients with allergic reactions to nevirapine (NVP. We compared the virological outcomes of (1 HIV-1-infected patients who discontinued an initial NVP-based regimen because of cutaneous allergic reactions to NVP; different types of interruption strategies were used, and second-line regimen was based on efavirenz (EFV; and (2 HIV-1-infected patients who began an EFV-based regimen as a first-line therapy (controls. Methods This retrospective cohort included patients who began an EFV-based regimen, between January 2002 and December 2008, as either an initial regimen or as a subsequent regimen after resolving a cutaneous allergic reaction against an initial NVP-based regimen. The study ended in March 2010. The primary outcome was virological failure, which was defined as either (a two consecutive plasma HIV-1 RNA levels >400 copies/mL or (b a plasma HIV-1 RNA level >1,000 copies/mL plus any genotypic resistance mutation. Results A total of 559 patients were stratified into three groups: (a Simultaneous Interruption, in which the subjects simultaneously discontinued all the drugs in an NVP-based regimen following an allergic reaction (n=161; (b Staggered Interruption, in which the subjects discontinued NVP treatment while continuing nucleoside reverse transcriptase inhibitor (NRTI backbone therapy for a median of 7 days (n=82; and (c Control, in which the subjects were naïve to antiretroviral therapy (n=316. The overall median follow-up time was 43 months. Incidence of virological failure in Simultaneous Interruption was 12.9 cases per 1,000 person-years, which trended toward being higher than the incidences in Staggered Interruption (5.4 and Control (6.6. However, differences were not statistically significant. Conclusions Among the patients who had an acute allergic reaction to first

  9. Preoperative hemostatic testing and the risk of postoperative bleeding in coronary artery bypass surgery patients

    DEFF Research Database (Denmark)

    Rafiq, Sulman; Johansson, Pär I; Kofoed, Klaus F

    2016-01-01

    enrolled in this prospective observational study. TEG, Multiplate aggregometry, and coagulation tests were sampled on the day before surgery. Excessive bleeding was defined as >1000 mL over 18 hours. RESULTS: Multiplate-adenosine diphosphate (ADP) measurements were significantly lower in patients...... impedance aggregometry identified patients at risk for excessive bleeding after CABG. Low fibrinogen levels were associated with increased bleeding. Neither routine TEG parameters nor conventional coagulation tests were correlated with bleeding....

  10. Von Willebrand disease and other bleeding disorders in women: consensus on diagnosis and management from an international expert panel

    NARCIS (Netherlands)

    James, Andra H.; Kouides, Peter A.; Abdul-Kadir, Rezan; Edlund, Mans; Federici, Augusto B.; Halimeh, Susan; Kamphuisen, Pieter W.; Konkle, Barbara A.; Martínez-Perez, Oscar; McLintock, Claire; Peyvandi, Flora; Winikoff, Rochelle

    2009-01-01

    Reproductive tract bleeding in women is a naturally occurring event during menstruation and childbirth. In women with menorrhagia, however, congenital bleeding disorders historically have been underdiagnosed. This consensus is intended to allow physicians to better recognize bleeding disorders as a

  11. Scintigraphic demonstration of acute gastrointestinal bleeding caused by gallbladder carcinoma eroding the colon

    Energy Technology Data Exchange (ETDEWEB)

    Czerniak, A.; Zwas, S.T.; Rabau, M.Y.; Avigad, I.; Borag, B.; Wolfstein, I.

    1985-08-01

    Massive lower gastrointestinal (GI) bleeding caused by gallbladder carcinoma eroding into the colonic wall was demonstrated accurately by Tc-99m RBCs. In addition, retrograde bleeding into the gallbladder was also identified while arteriography did not show contrast extravasation. This case supports the use of Tc-99m RBCs over Tc-99m sulfur colloid for more accurate localization of lower GI bleeding.

  12. Clinical management and outcome of major bleeding in patients on treatment with vitamin K antagonists.

    Science.gov (United States)

    Becattini, C; Franco, L; Masotti, L; Nitti, C; Cattinelli, S; Cappelli, R; Manina, G; Sbrojavacca, R; Pomero, F; Agnelli, G

    2016-09-01

    The optimal management of major bleeding associated with vitamin K antagonists remains unclear. The aim of the study was to assess the determinants of outcome of vitamin K antagonists-associated major bleeding and the outcome of bleeding in relation with the therapeutic management. Patients hospitalized for major bleeding while on vitamin K antagonists were included in a prospective, cohort study. Major bleeding was defined according to the criteria of the International Society of Thrombosis Haemostasis. The primary study outcome was death at 30days from major bleeding. 544 patients were included in this study, of which 282 with intracranial hemorrhage. Prothrombin complex concentrates were used in 51% and in 23% of patients with intracranial hemorrhage or non-intracranial major bleeding, respectively (ppatients with intracranial hemorrhage or non-intracranial major bleeding (ppatients (18%), 72 patients with intracranial hemorrhage and 28 patients with non-intracranial major bleeding. Age over 85years, low Glasgow Coma Scale score and shock were independent predictors of death at 30days. Invasive procedures were associated with decreased risk of death. Among the patients hospitalized for major bleeding while on vitamin K antagonists, the risk for death is substantial. The risk for death is associated with the clinical severity of major bleeding as assessed by the GCS score and by the presence of shock more than with the initial localization of major bleeding (ICH vs other sites). Copyright © 2016 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  13. An experimental model for measuring gastrointestinal bleeding rate using Tc-99m DTPA in rabbits

    International Nuclear Information System (INIS)

    Owunwanne, A.; Abdel-Dayem, H.M.; Sadek, S.; Yakoub, T.; Mahajan, K.K.; Ericsson, S.B.

    1987-01-01

    An animal experimental model to measure the rate of gastrointestinal bleeding rate in a rabbit using Tc-99m DTPA is described. It was possible to detect a bleeding rate of 0.1 ml/min. However, the model could not be used to calculate the minimum amount of radioactivity needed to detect the bleeding site. (orig.) [de

  14. Gynaecological and obstetrical bleeding in women with factor XI deficiency - a systematic review

    NARCIS (Netherlands)

    Wiewel-Verschueren, S.; Arendz, I. J.; Knol, H. M.; Meijer, Karina

    Menstrual bleeding, pregnancy and delivery present an intrinsic haemostatic challenge to women with bleeding disorders such as factor XI (FXI) deficiency. Aim: To provide a systematic overview of studies on gynaecological and obstetrical bleeding problems in women with FXI deficiency. Methods: We

  15. Angiographically Negative Acute Arterial Upper and Lower Gastrointestinal Bleeding: Incidence, Predictive Factors, and Clinical Outcomes

    International Nuclear Information System (INIS)

    Kim, Jin Hyoung; Shin, Ji Hoon; Yoon, Hyun Ki; Chae, Eun Young; Myung, Seung Jae; Ko, Gi Young; Gwon, Dong Il; Sung, Kyu Bo

    2009-01-01

    To evaluate the incidence, predictive factors, and clinical outcomes of angiographically negative acute arterial upper and lower gastrointestinal (GI) bleeding. From 2001 to 2008, 143 consecutive patients who underwent an angiography for acute arterial upper or lower GI bleeding were examined. The angiographies revealed a negative bleeding focus in 75 of 143 (52%) patients. The incidence of an angiographically negative outcome was significantly higher in patients with a stable hemodynamic status (p < 0.001), or in patients with lower GI bleeding (p = 0.032). A follow-up of the 75 patients (range: 0-72 months, mean: 8 ± 14 months) revealed that 60 of the 75 (80%) patients with a negative bleeding focus underwent conservative management only, and acute bleeding was controlled without rebleeding. Three of the 75 (4%) patients underwent exploratory surgery due to prolonged bleeding; however, no bleeding focus was detected. Rebleeding occurred in 12 of 75 (16%) patients. Of these, six patients experienced massive rebleeding and died of disseminated intravascular coagulation within four to nine hours after the rebleeding episode. Four of the 16 patients underwent a repeat angiography and the two remaining patients underwent a surgical intervention to control the bleeding. Angiographically negative results are relatively common in patients with acute GI bleeding, especially in patients with a stable hemodynamic status or lower GI bleeding. Most patients with a negative bleeding focus have experienced spontaneous resolution of their condition

  16. Clinical approach to obscure GI bleeding - Diagnostic testing and management

    Directory of Open Access Journals (Sweden)

    Prashanth Prabakaran

    2013-01-01

    Full Text Available Obscure gastrointestinal bleeding (OGIB can present as a diagnostic dilemma and management can be challenging. The search for causes of OGIB is usually centered on visualizing the small bowel, and in the past decade, the technology to visualize the entire small bowel has significantly advanced. Moreover, small bowel endoscopic imaging has replaced, in many instances, prior radiographic evaluation for obscure GI bleeding. These new modalities, such as small bowel capsule endoscopy (CE, balloon-assisted deep enteroscopy [double balloon enteroscopy (DBE and single balloon enteroscopy (SBE], and overtube-assisted deep enteroscopy (spiral enteroscopy, are paving the way toward more accurately identifying and treating patients with OGIB. We will review the diagnostic modalities available in evaluating a patient with OGIB and also propose the management based on clinical and endoscopic findings.

  17. [Management of new oral anticoagulants in gastrointestinal bleeding and endoscopy].

    Science.gov (United States)

    del Molino, Fátima; Gonzalez, Isabel; Saperas, Esteve

    2015-10-01

    New oral direct anticoagulants agents are alternatives to warfarin for long-term anticoagulation in a growing number of patients that require long-term anticoagulation for atrial fibrillation, deep venous thrombosis and pulmonary embolism. These new agents with predictable pharmacokinetic and pharmacodynamics profiles offer a favorable global safety profile, but increased gastrointestinal bleeding compared to the vitamin K antagonists. Many gastroenterologists are unfamiliar and may be wary of these newer drugs, since Clinical experience is limited and no specific antidote is available to reverse their anticoagulant effect. In this article the risk of these new agents and, how to manage these agents in both the presence of acute gastrointestinal bleeding and in patients undergoing endoscopic procedures is reviewed. Copyright © 2014 Elsevier España, S.L.U. and AEEH y AEG. All rights reserved.

  18. Animal Models of Hemophilia and Related Bleeding Disorders

    Science.gov (United States)

    Lozier, Jay N.; Nichols, Timothy C.

    2013-01-01

    Animal models of hemophilia and related diseases are important for development of novel treatments and to understand the pathophysiology of bleeding disorders in humans. Testing in animals with the equivalent human disorder provides informed estimates of doses and measures of efficacy, which aids in design of human trials. Many models of hemophilia A, hemophilia B, and von Willebrand disease have been developed from animals with spontaneous mutations (hemophilia A dogs, rats, sheep; hemophilia B dogs; and von Willebrand disease pigs and dogs), or by targeted gene disruption in mice to create hemophilia A, B, or VWD models. Animal models have been used to generate new insights into the pathophysiology of each bleeding disorder and also to perform pre-clinical assessments of standard protein replacement therapies as well as novel gene transfer technology. Both the differences between species and differences in underlying causative mutations must be considered in choosing the best animal for a specific scientific study PMID:23956467

  19. TV sonographic assessment in postmenopausal women with bleeding.

    Science.gov (United States)

    Tsikouras, P; Liberis, V; Galazios, G; Grapsas, X; Kantari, P; Papageorgiou, S; Maroulis, G

    2008-01-01

    The aim of this study was to evaluate retrospectively the usefulness of transvaginal sonography for the detection of endometrial disease in postmenopausal women with bleeding. This study involved 275 postmenopausal women aged 47-81 years (median 62). None of them were on hormone replacement therapy and all had had amenorrhea for more than one year. Concerning the age of the study patients, we confirm that endometrial cancer occurs at any age, but more commonly in ages above 58 years. Transvaginal sonography was performed in all women. About 89.2% of malignant diseases were discovered in the study women whose endometrial thickness was above 4 mm, but we also found endometrial cancer in 10.2% of the cases in women whose endometrial thickness was below 4 mm. In postmenopausal symptomatic women premalignant or malignant causes of bleeding can not be excluded with just transvaginal ultrasound.

  20. [Endoscopic hemostasis in the treatment of bleeding peptic ulcer].

    Science.gov (United States)

    Trevisani, Lucio; Chiamenti, Carlo M; Gaudenzi, Piergiorgio; Alvisi, Vittorio; Sartori, Sergio; Abbasciano, Vincenzo

    2002-09-01

    Upper gastrointestinal bleeding is still an important clinical problem, even though about 80% of bleedings due to peptic lesions stop spontaneously. Starting from 1970, a lot of endoscopic hemostatic procedures has been developed and employed with good results, but, at present, the key problem is represented by the selection and management of the patients at highest risk of rebleeding. This work reviews both techniques and devices most commonly used, but at present none of them can be considered actually better than the other ones. According to the SIED (Società Italiana di Endoscopia Digestiva) guidelines, the techniques of choice should be cheap, effective, safe and easy to perform, the pivotal role in determining the success rate of endoscopic hemostasis being played by the endoscopist's experience.