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Sample records for subdock septic tank

  1. A RATIONAL APPROACH TO SEPTIC TANK DESIGN

    African Journals Online (AJOL)

    2012-03-01

    Mar 1, 2012 ... A Rational Approach to Septic Tank Design. 69. Table 1: Schedule of Septic Tank Sizing and Dimensions (PWD, 1943). ... ficiency, hence three classes of plan specifications will be included in the evolving design .... 15 people in a typical Nigerian middle class city, say Enugu. It is required to construct a ...

  2. Effect of temperature increments in septic tank efficiency

    Energy Technology Data Exchange (ETDEWEB)

    Chi-Tec, M.; Caballero-Arzapalo, N.; Giacoman Vallejo, G.; Mendez-Novelo, R.; Quintal-Franco, C.

    2009-07-01

    Septic tanks are the main sewage disposal system used in Yucatan, Mexico. Septic tank content is stabilized under anaerobic conditions and is considered the temperature has a significant effect on the efficiency. This work was developed in order asses the feasibility to improve communal septic tanks efficiency by increasing content temperature. Temperatures inside the tank were increased using a hybrid heater system (solar and electricity). (Author)

  3. Closure Report for Corrective Action Unit 563: Septic Systems, Nevada Test Site, Nevada

    Energy Technology Data Exchange (ETDEWEB)

    NSTec Environmental Restoration

    2010-02-28

    Corrective Action Unit (CAU) 563 is identified in the Federal Facility Agreement and Consent Order (FFACO) as “Septic Systems” and consists of the following four Corrective Action Sites (CASs), located in Areas 3 and 12 of the Nevada Test Site: · CAS 03-04-02, Area 3 Subdock Septic Tank · CAS 03-59-05, Area 3 Subdock Cesspool · CAS 12-59-01, Drilling/Welding Shop Septic Tanks · CAS 12-60-01, Drilling/Welding Shop Outfalls Closure activities were conducted from September to November 2009 in accordance with the FFACO (1996, as amended February 2008) and the Corrective Action Plan for CAU 563. The corrective action alternatives included No Further Action and Clean Closure.

  4. Corrective Action Investigation Plan for Corrective Action Unit 563: Septic Systems, Nevada Test Site, Nevada, with Errata Sheet, Revision 0

    Energy Technology Data Exchange (ETDEWEB)

    Alfred Wickline

    2007-01-01

    Corrective Action Unit 563, Septic Systems, is located in Areas 3 and 12 of the Nevada Test Site, which is 65 miles northwest of Las Vegas, Nevada. Corrective Action Unit 563 is comprised of the four corrective action sites (CASs) below: • 03-04-02, Area 3 Subdock Septic Tank • 03-59-05, Area 3 Subdock Cesspool • 12-59-01, Drilling/Welding Shop Septic Tanks • 12-60-01, Drilling/Welding Shop Outfalls These sites are being investigated because existing information on the nature and extent of potential contamination is insufficient to evaluate and recommend corrective action alternatives. Additional information will be obtained by conducting a corrective action investigation (CAI) before evaluating corrective action alternatives and selecting the appropriate corrective action for each CAS. The results of the field investigation will support a defensible evaluation of viable corrective action alternatives that will be presented in the Corrective Action Decision Document.

  5. Preliminary characterization of abandoned septic tank systems. Volume 1

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-12-01

    This report documents the activities and findings of the Phase I Preliminary Characterization of Abandoned Septic Tank Systems. The purpose of the preliminary characterization activity was to investigate the Tiger Team abandoned septic systems (tanks and associated leachfields) for the purpose of identifying waste streams for closure at a later date. The work performed was not to fully characterize or remediate the sites. The abandoned systems potentially received wastes or effluent from buildings which could have discharged non-domestic, petroleum hydrocarbons, hazardous, radioactive and/or mixed wastes. A total of 20 sites were investigated for the preliminary characterization of identified abandoned septic systems. Of the 20 sites, 19 were located and characterized through samples collected from each tank(s) and, where applicable, associated leachfields. The abandoned septic tank systems are located in Areas 5, 12, 15, 25, and 26 on the Nevada Test Site.

  6. Changes in Septic Tank Effluent Due to Water Softener Use

    OpenAIRE

    Hogan, Patrick Lynn

    2012-01-01

    The compatibility of home water softeners and septic tanks is of concern for the on-site wastewater treatment community. Research has shown that high sodium levels in activated sludge plants can lead to deflocculation and poor effluent quality. Therefore, it is logical to assume that high sodium levels that result from the exchange of calcium and magnesium for sodium in home softeners could give rise to poor effluent quality from septic tanks, leading to shortened lives of drain fields. Addit...

  7. Retainment of the antimicrobial agent triclosan in a septic tank

    DEFF Research Database (Denmark)

    Kirjanova, Ala; Rimeika, Mindaugas; Vollertsen, Jes

    2014-01-01

    Laboratory experiments were conducted to investigate the fate of the antimicrobial agent triclosan (TCS) in a conventional septic tank. The main mechanism of TCS removal from wastewater was identified to be rapid TCS sorption to suspended particles followed by settling of these particles...

  8. A Rational Approach to Septic Tank Design | Nnaji | Nigerian ...

    African Journals Online (AJOL)

    A new approach to the design of septic tanks was developed based on a number of critical parameters, namely: residual detention time, minimum residual detention time, residual depth and minimum residual depth. This method involved rst specifying a desired desludging interval. This interval was then substituted in a ...

  9. Aquatic Plant/microbial Filters for Treating Septic Tank Effluent

    Science.gov (United States)

    Wolverton, B. C.

    1988-01-01

    The use of natural biological processes for treating many types of wastewater have been developed by NASA at the John C. Stennis Space Center, NSTL, Mississippi, during the past 15 years. The simplest form of this technology involves the use of aquatic plant/marsh filters for treatment of septic tank effluent. Septic tank effluent from single home units can be treated to advanced secondary levels and beyond by using a 37.2 sq m (400 sq ft) surface area washed gravel filter. This filter is generally 0.3 m (1 ft) deep with a surface cover of approximately 0.15 m (6 in.) of gravel. The plants in this filter are usually aesthetic or ornamental such as calla lily (Zantedeschia aethiopica), canna lily (Canna flaccida), elephant ear (Colocasia esculenta), and water iris (Iris pseudacorus).

  10. Microbial diversity of septic tank effluent and a soil biomat.

    Science.gov (United States)

    Tomaras, Jill; Sahl, Jason W; Siegrist, Robert L; Spear, John R

    2009-05-01

    Microbial diversity of septic tank effluent (STE) and the biomat that is formed as a result of STE infiltration on soil were characterized by 16S rRNA gene sequence analysis. Results indicate that microbial communities are different within control soil, STE, and the biomat and that microbes found in STE are not found in the biomat. The development of a stable soil biomat appears to provide the best on-site water treatment or protection for subsequent groundwater interactions of STE.

  11. SEPTIC TANK SETBACK DISTANCES: A WAY TO MINIMIZE VIRUS CONTAMINATION OF DRINKING WATER

    Science.gov (United States)

    Septic tanks are the most frequently reported causes of contamination in ground-water disease outbreaks associated with the consumption of untreated ground water in the United States. The placement of septic tanks is generally controlled by county-wide or state-wide regulations, ...

  12. Effect of temperature on anaerobic treatment of black water in UASB-septic tank systems

    NARCIS (Netherlands)

    Luostarinen, S.; Sanders, W.T.M.; Kujawa-Roeleveld, K.; Zeeman, G.

    2007-01-01

    The effect of northern European seasonal temperature changes and low temperature on the performance of upflow anaerobic sludge blanket (UASB)-septic tanks treating black water was studied. Three UASB-septic tanks were monitored with different operational parameters and at different temperatures. The

  13. COLLOIDS IN SEPTIC TANK EFFLUENT AND THEIR INFLUENCE ON FILTER PERMEABILITY

    OpenAIRE

    Marcin Spychała; Jakub Nieć; Natalia Walczak; Anna Marciniak

    2015-01-01

    The aim of the study was to evaluate the content of colloids in septic tank effluent and their impact on textile filter permeability. Measurements were performed on septic tank effluent without suspended solids but containing colloids and without colloids - including only dissolved substances (filtered by micro-filters and centrifuged). The study was conducted on unclogged and clogged textile filter coupons. During the study the following measurements were determined: turbidity, chemical oxyg...

  14. Domestic wells have high probability of pumping septic tank leachate

    Directory of Open Access Journals (Sweden)

    J. E. Bremer

    2012-08-01

    Full Text Available Onsite wastewater treatment systems are common in rural and semi-rural areas around the world; in the US, about 25–30% of households are served by a septic (onsite wastewater treatment system, and many property owners also operate their own domestic well nearby. Site-specific conditions and local groundwater flow are often ignored when installing septic systems and wells. In areas with small lots (thus high spatial septic system densities, shallow domestic wells are prone to contamination by septic system leachate. Mass balance approaches have been used to determine a maximum septic system density that would prevent contamination of groundwater resources. In this study, a source area model based on detailed groundwater flow and transport modeling is applied for a stochastic analysis of domestic well contamination by septic leachate. Specifically, we determine the probability that a source area overlaps with a septic system drainfield as a function of aquifer properties, septic system density and drainfield size. We show that high spatial septic system density poses a high probability of pumping septic system leachate. The hydraulic conductivity of the aquifer has a strong influence on the intersection probability. We find that mass balance calculations applied on a regional scale underestimate the contamination risk of individual drinking water wells by septic systems. This is particularly relevant for contaminants released at high concentrations, for substances that experience limited attenuation, and those that are harmful even at low concentrations (e.g., pathogens.

  15. Effect of enzymes on anaerobic digestion of primary sludge and septic tank performance.

    Science.gov (United States)

    Diak, James; Örmeci, Banu; Kennedy, Kevin J

    2012-11-01

    Enzyme additives are believed to improve septic tank performance by increasing the hydrolysis and digestion rates and maintaining a healthy microbial population. Previous studies reported mixed results on the effectiveness of enzymes on mesophilic and thermophilic digestion, and it is not clear whether enzymes would be effective under septic tank conditions where there is no heating or mixing, quantities of enzymes added are small, and they can be washed out quickly. In this study, batch reactors and continuous-flow reactors designed and operated as septic tanks were used to evaluate whether enzymatic treatment would increase the hydrolysis and digestion rates in primary sludge. Total solids, volatile solids, total suspended solids, total and soluble chemical oxygen demand, concentrations of protein, carbohydrate, ammonia and volatile acids in sludge and effluent samples were measured to determine the differences in digestion rates in the presence and absence of enzymes. Overall, no significant improvement was observed in enzyme-treated reactors compared with the control reactors.

  16. Effect of temperature on anaerobic treatment of black water in UASB-septic tank systems.

    Science.gov (United States)

    Luostarinen, Sari; Sanders, Wendy; Kujawa-Roeleveld, Katarzyna; Zeeman, Grietje

    2007-03-01

    The effect of northern European seasonal temperature changes and low temperature on the performance of upflow anaerobic sludge blanket (UASB)-septic tanks treating black water was studied. Three UASB-septic tanks were monitored with different operational parameters and at different temperatures. The results indicated the feasibility of the UASB-septic tank for (pre)treatment of black water at low temperatures with respect to removal of suspended solids and dissolved organic material. Inoculum sludge had little effect on COD(ss) removal, though in the start-up phase some poorly adapted inoculum disintegrated and washed out, thus requiring consideration when designing the process. Removal of COD(dis) was at first negative, but improved as the sludge adapted to low temperature. The UASB-septic tank alone did not comply with Finnish or Dutch treatment requirements and should therefore be considered mainly as a pre-treatment method. However, measuring the requirements as mgCOD l(-1) may not always be the best method, as the volume of the effluent discharged is also an important factor in the final amount of COD entering the receiving water bodies.

  17. The UASB reactor as an alternative for the septic tank for on-site sewage treatment.

    Science.gov (United States)

    Coelho, A L S S; do Nascimento, M B H; Cavalcanti, P F F; van Haandel, A C

    2003-01-01

    Although septic tanks are amply used for on site sewage treatment, these units have serious drawbacks: the removal efficiency of organic material and suspended solids is low, the units are costly and occupy a large area and operational cost is high due to the need for periodic desludging. In this paper an innovative variant of the UASB reactor is proposed as an alternative for the septic tank. This alternative has several important advantages in comparison with the conventional septic tank: (1) Although the volume of the UASB reactor was about 4 times smaller than the septic tank, its effluent quality was superior, even though small sludge particles were present, (2) desludging of the UASB reactor is unnecessary and even counterproductive, as the sludge mass guarantees proper performance, (3) the UASB reactor is easily transportable (compact and light) and therefore can be produced in series, strongly reducing construction costs and (4) since the concentration of colloids in the UASB effluent is much smaller than in the ST effluent, it is expected that the infiltration of the effluent will be much less problematic.

  18. Removal of nutrients from septic tank effluent with baffle subsurface-flow constructed wetlands

    Science.gov (United States)

    Lihu Cui; Ying Ouyang; Weizhi Yang; Zhujian Huang; Qiaoling Xu; Guangwei Yu

    2015-01-01

    Three new baffle flow constructed wetlands (CWs), namely the baffle horizontal flow CW (Z1), baffle vertical flow CW (Z2) and baffle hybrid flow CW (Z3), along with one traditional horizontal subsurface flow CW (Z4) were designed to test the removal efficiency of nitrogen (N) and phosphorus (P) from the septic tank effluent under varying hydraulic retention times (HRTs...

  19. LIQUID WASTE FROM SEPTIC TANKS AS A SOURCE OF MICROBIOLOGICAL POLLUTION OF GROUNDWATER

    Directory of Open Access Journals (Sweden)

    Robert Nowak

    2016-05-01

    Full Text Available Pollution of soil and water environment by liquid waste originating from septic tanks is a huge problem in Poland. This applies especially to rural areas. Negative changes are observed both in the vicinity of the leaking tanks, from which concentrated and rotten sewage infiltrates into the ground, and in surface water as well as arable land, to which impurities from the emptied tanks are discharged. The paper presents the scale of the practice of uncontrolled domestic sewage discharge into the environment on the example of selected municipality. Presented data were compared with the results of the qualitative assessment of groundwater, which is collected in the same municipality for waterworks. In a significant number of wells, water was not safe in sanitary terms, as the presence of microbiological contamination was recorded. Among determined microorganisms, the indicator organisms of domestic waste pollution prevailed. Water quality problems have been reported at intake points located near the properties equipped with septic tanks or in places, to which sewage from emptying septic tanks were transferred in an uncontrolled manner. In this way it has been shown that there is a relationship between improperly maintained wastewater management and groundwater quality collected for the purpose of water supply.

  20. Low flow water quality in rivers; septic tank systems and high-resolution phosphorus signals

    Energy Technology Data Exchange (ETDEWEB)

    Macintosh, K.A. [School of Environmental Sciences, University of Ulster, Coleraine, N. Ireland (United Kingdom); Jordan, P., E-mail: p.jordan@ulster.ac.uk [School of Environmental Sciences, University of Ulster, Coleraine, N. Ireland (United Kingdom); Agricultural Catchments Programme, Teagasc, Wexford (Ireland); Cassidy, R. [School of Planning, Architecture and Civil Engineering, Queen' s University, Belfast, N. Ireland (United Kingdom); Arnscheidt, J. [School of Environmental Sciences, University of Ulster, Coleraine, N. Ireland (United Kingdom); Ward, C. [Blackwater Regional Partnership, Caledon, Tyrone, N. Ireland (United Kingdom)

    2011-12-15

    Rural point sources of phosphorus (P), including septic tank systems, provide a small part of the overall phosphorus budget to surface waters in agricultural catchments but can have a disproportionate impact on the low flow P concentration of receiving rivers. This has particular importance as the discharges are approximately constant into receiving waters and these have restricted dilution capacity during ecologically sensitive summer periods. In this study, a number of identified high impact septic systems were replaced with modern sequential batch reactors in three rural catchments during a monitoring period of 4 years. Sub-hourly P monitoring was conducted using bankside-analysers. Results show that strategic replacement of defective septic tank systems with modern systems and polishing filters decreased the low flow P concentration of one catchment stream by 0.032 mg TP L{sup -1} (0.018 mg TRP L{sup -1}) over the 4 years. However two of the catchment mitigation efforts were offset by continued new-builds that increased the density of septic systems from 3.4 km{sup -2} to 4.6 km{sup -2} and 13.8 km{sup -2} to 17.2 km{sup -2} and subsequently increased low flow P concentrations. Future considerations for septic system mitigation should include catchment carrying capacity as well as technology changes.

  1. Corrective Action Decision Document for Corrective Action Unit 563: Septic Systems, Nevada Test Site, Nevada, Revision 0

    Energy Technology Data Exchange (ETDEWEB)

    Grant Evenson

    2008-02-01

    This Corrective Action Decision Document has been prepared for Corrective Action Unit (CAU) 563, Septic Systems, in accordance with the Federal Facility Agreement and Consent Order (FFACO, 1996; as amended January 2007). The corrective action sites (CASs) for CAU 563 are located in Areas 3 and 12 of the Nevada Test Site, Nevada, and are comprised of the following four sites: •03-04-02, Area 3 Subdock Septic Tank •03-59-05, Area 3 Subdock Cesspool •12-59-01, Drilling/Welding Shop Septic Tanks •12-60-01, Drilling/Welding Shop Outfalls The purpose of this Corrective Action Decision Document is to identify and provide the rationale for the recommendation of a corrective action alternative (CAA) for the four CASs within CAU 563. Corrective action investigation (CAI) activities were performed from July 17 through November 19, 2007, as set forth in the CAU 563 Corrective Action Investigation Plan (NNSA/NSO, 2007). Analytes detected during the CAI were evaluated against appropriate final action levels (FALs) to identify the contaminants of concern (COCs) for each CAS. The results of the CAI identified COCs at one of the four CASs in CAU 563 and required the evaluation of CAAs. Assessment of the data generated from investigation activities conducted at CAU 563 revealed the following: •CASs 03-04-02, 03-59-05, and 12-60-01 do not contain contamination at concentrations exceeding the FALs. •CAS 12-59-01 contains arsenic and chromium contamination above FALs in surface and near-surface soils surrounding a stained location within the site. Based on the evaluation of analytical data from the CAI, review of future and current operations at CAS 12-59-01, and the detailed and comparative analysis of the potential CAAs, the following corrective actions are recommended for CAU 563.

  2. Nutrient loading on subsoils from on-site wastewater effluent, comparing septic tank and secondary treatment systems

    OpenAIRE

    MISSTEAR, BRUCE DUDLEY; O'LUANAIGH, NIALL; JOHNSTON, PAUL MEREDITH; Gill, Laurence William

    2009-01-01

    PUBLISHED The performance of six separate percolation areas was intensively monitored to ascertain the attenuation effects of unsaturated subsoils with respect to on-site wastewater effluent: three sites receiving septic tank effluent, the other three sites receiving secondary treated effluent. The development of a biomat across the percolation areas receiving secondary treated effluent was restricted on these sites compared to those sites receiving septic tank effluent and this created si...

  3. A small scale field trial with expanded polystyrene beads for mosquito control in septic tanks.

    Science.gov (United States)

    Chang, M S; Lian, S; Jute, N

    1995-01-01

    A field trial of the use of expanded polystyrene beads (EPSB) to control the breeding of mosquito larvae in household septic tanks was conducted in Sarawak. One week after treatment, the breeding of Culex quinquefasciatus and Aedes albopictus was reduced by 100% and 68.7% respectively. For both species combined, a 57.25% reduction in the adult emergence rate was achieved. No adult was caught in the emergence trap one month after treatment. A reduction in mosquito biting rates was reported by 87.3% of respondents. All households regarded the EPSB treatment as effective. This study has reduced the relatively high infestation rate of A. albopictus in the septic tanks to 16-20%. The EPSB treatment is feasible and practical. Post-treatment assessment using adult emergence traps and the implications for the vector control programme of the local authority are discussed.

  4. Microbial Diversity of Septic Tank Effluent and a Soil Biomat▿ †

    OpenAIRE

    Tomaras, Jill; Sahl, Jason W.; Siegrist, Robert L.; Spear, John R.

    2009-01-01

    Microbial diversity of septic tank effluent (STE) and the biomat that is formed as a result of STE infiltration on soil were characterized by 16S rRNA gene sequence analysis. Results indicate that microbial communities are different within control soil, STE, and the biomat and that microbes found in STE are not found in the biomat. The development of a stable soil biomat appears to provide the best on-site water treatment or protection for subsequent groundwater interactions of STE.

  5. COLLOIDS IN SEPTIC TANK EFFLUENT AND THEIR INFLUENCE ON FILTER PERMEABILITY

    Directory of Open Access Journals (Sweden)

    Marcin Spychała

    2015-09-01

    Full Text Available The aim of the study was to evaluate the content of colloids in septic tank effluent and their impact on textile filter permeability. Measurements were performed on septic tank effluent without suspended solids but containing colloids and without colloids - including only dissolved substances (filtered by micro-filters and centrifuged. The study was conducted on unclogged and clogged textile filter coupons. During the study the following measurements were determined: turbidity, chemical oxygen demand and hydraulic conductivity of textile filter coupons. The colloid size range was assumed to be less than 1.2 microns according to the literature. Despite the relatively low content in the septic tank effluent the colloids played an important role in the clogging process. Both the filtering media, filled with low (unclogged and high content of biomass (clogged were sensitive to the clogging process of colloid acceleration due to the possibility of small diameter pore closure and oxygen access termination. Moreover, small size pores were probably sensitive to closing or bridging by small size colloidal particles.

  6. Geologic and Landuse Controls of the Risk for Domestic Well Pollution from Septic Tank Leachate

    Science.gov (United States)

    Horn, J.; Harter, T.

    2006-12-01

    A highly resolved three-dimensional groundwater model containing a domestic drinking water well and its surrounding gravel pack is simulated with MODFLOW. Typical recharge rates, domestic well depths and well sealing lengths are obtained by analyzing well log data from eastern Stanislaus County, California, an area with a significant rural and suburban population relying on domestic wells and septic tank systems. The domestic well model is run for a range of hydraulic conductivities of both, the gravel pack and the aquifer. Reverse particle tracking with MODPATH 3D is carried out to determine the capture zone of the well as a function of hydraulic conductivity. The resulting capture zone is divided into two areas: Particles representing water entering the top of the well screen represent water that flows downward through the gravel pack from somewhere below the well seal and above the well screen. The source area associated with these particles forms a narrow well-ward elongation of the main capture zone, which represents that of particles flowing horizontally across the gravel pack into the well screen. The properties of the modeled capture zones are compared to existing analytical capture zone models. A clear influence of the gravel pack on capture zone shape and size is shown. Using the information on capture zone geometry, a risk assessment tool is developed to estimate the chance that a domestic well capture zone intersects at least one septic tank drainfield in a checkerboard of rural or suburban lots of a given size, but random drainfield and domestic well distribution. Risk is computed as a function of aquifer and gravel pack hydraulic conductivity, and as a function of lot size. We show the risk of collocation of a septic tank leach field with a domestic well capture zone for various scenarios. This risk is generally highest for high hydraulic conductivities of the gravel pack and the aquifer, limited anisotropy, and higher septic system densities. Under

  7. Maintenance of submersible pumps in the septic tanks: ergonomic and biological risks to the worker.

    Science.gov (United States)

    Mariño, Suzi; Figueiredo, Alex

    2012-01-01

    In this study was observed the maintenance task of submersible pumps septic tanks installed in industrial bathrooms. This maintenance activity operators are exposed to various biological and ergonomic risks. This type of activity requires its great physical performers who are also subject to contact with human waste in the form of liquids, gases and solids. Besides the problems mentioned, are still exposed to high temperatures that can cause diseases such as hyperthermia or heatstroke. These aspects were observed using the ergonomic assessment methodology in order to suggest improvements that are reflected in productivity and employee satisfaction.

  8. Microbial Diversity of Septic Tank Effluent and a Soil Biomat▿ †

    Science.gov (United States)

    Tomaras, Jill; Sahl, Jason W.; Siegrist, Robert L.; Spear, John R.

    2009-01-01

    Microbial diversity of septic tank effluent (STE) and the biomat that is formed as a result of STE infiltration on soil were characterized by 16S rRNA gene sequence analysis. Results indicate that microbial communities are different within control soil, STE, and the biomat and that microbes found in STE are not found in the biomat. The development of a stable soil biomat appears to provide the best on-site water treatment or protection for subsequent groundwater interactions of STE. PMID:19304840

  9. Pathogen reduction in septic tank sludge through vermicomposting using Eisenia fetida.

    Science.gov (United States)

    Rodríguez-Canché, L G; Cardoso Vigueros, L; Maldonado-Montiel, T; Martínez-Sanmiguel, M

    2010-05-01

    This study evaluated the potential of earthworms (Eisenia fetida) to remove pathogens from the sludge from septic tanks. Three earthworm population densities, equivalent to 1, 2, and 2.5kgm(-2), were tested for pathogen removal from sludge. The experimental phase lasted 60days, starting from the initial earthworm inoculation. After 60days, it was found that earthworms reduced concentrations of fecal coliforms, Salmonella spp., and helminth ova to permissible levels (NOM-004-SEMARNAT-2002) (SEMARNAT, 2002). Thus, sludge treatment with earthworms generated Class A biosolids, useful for forest, agricultural, and soil improvement. Copyright 2009 Elsevier Ltd. All rights reserved.

  10. Performance Evaluation of Membrane-Based Septic Tank and Its Reuse Potential for Irrigating Crops.

    Science.gov (United States)

    Khalid, Mehwish; Hashmi, Imran; Khan, Sher Jamal

    2017-08-01

      Membrane technology, being the most emerging wastewater treatment option, has gained substantial importance with the massive objective of the reuse potential of wastewater. Keeping this in view, the present study was conducted with the rationale to evaluate the performance efficiency of membrane-based septic tank (MBST), and its reuse perspective for irrigating crops. The septic tank was designed by submerging a woven fiber microfiltration membrane module to treat domestic wastewater. Three crops Triticum aestivum (wheat), Coriandrum sativum (coriander), and Mentha arvensis (mint) were selected to be irrigated with treated MBST effluent, untreated wastewater, and tap water (as a control) for comparative growth analysis. Two pathogenic strains, Escherichia coli and Salmonella sp. were selected as reference microbes and their translocation rate was observed in root, shoot, and leaves. Upon maturity, the roots, shoots, and leaves of the above-mentioned plants were aseptically removed for microbiological analysis. Strains were analyzed, using analytical profile index and PCR analysis. Maximum removal efficiencies for MBST in terms of chemical oxygen demand (COD), turbidity, nutrients deduction (phosphorus), and indicator bacteria (Escherichia coli) were found to be 73, 96, 48, and 88%, respectively. Significant bacterial load reduction (p < 0.001) in terms of E. coli (3.8 log CFU/100 mL) and helminths (2 eggs/L) was observed in treated water. High plant yield was observed when irrigated with treated water as compared to tap water, as minimal nutrient removal (48%) was recorded in treated water, with the germination percentage of 88.8%.

  11. Effect of soil fortified by polyurethane foam on septic tank effluent treatment.

    Science.gov (United States)

    Nie, J Y; Zhu, N W; Lin, K M; Song, F Y

    2011-01-01

    Fortified soil was made up of a mixture at a mass ratio 4/1000-6/1000 of sponge and natural soil according to the results of column experiment. The fortified soil had bigger porosity and higher hydraulic conductivity than the natural soil. The columns packed with 900 mm of the fortified soil endured a flow rate equivalent to 100 L/m(2)/d of septic tank effluent and the average chemical oxygen demand, nitrogen, and phosphorus removal rates were around 92%, 75% and 96%, respectively. After 100 weeks of operation, the saturated hydraulic conductivity of the fortified soil kept higher than 0.2 m/d. The bigger porosity of sponge improved the effective porosity, and the bigger specific surface area of sponge acted as an ideal support for biomat growth and ensured the sewage treatment performance of the fortified soil. The comparable performance was due to a similar and sufficient degree of soil clogging genesis coupled with bioprocesses that effectively purified the septic tank effluent given the adequate retention times.

  12. Bioremediation of domestic sewage: the case of green septic tank in arid rural communities of Alagoas.

    Directory of Open Access Journals (Sweden)

    Antonio Oliveira Netto

    2015-12-01

    Full Text Available The deficit regarding the coverage of collection and treatment of sewage requires systems that combine proper disposal of wastewater and low construction and operating costs. In this context the bioremediation through the green septic tank, sustainable social and low cost technology, presents itself as a viable alternative especially for rural municipalities. This objective social technology contribute to confronting the domestic sewage problem and its consequences for public health and the environment; It is alternative for allocation of domestic sewage, as well as allowing the cultivation of some fruit species. Through partnership with the project Renas-Ser engaged in the management of surface and underground water bodies, three green septic tanks were constructed and are in the initial phase of operation in arid rural communities of Alagoas, contemplating the proper conditioning of domestic sewage. The first results of reduction in organic matter are very encouraging, with a view to removing approximately 38% of COD on the first support layer. The next phase is to define the others parameters to monitor and verify the approval of users of the technology.

  13. Treatment of septic tank effluents by a full-scale capillary seepage soil biofiltration system.

    Science.gov (United States)

    Fan, Chihhao; Chang, Fang-Chih; Ko, Chun-Han; Teng, Chia-Ji; Chang, Tzi-Chin; Sheu, Yiong-Shing

    2009-03-01

    The purpose of this study is to evaluate the efficiency of septic tank effluent treatment by an underground capillary seepage soil biofiltration system in a suburban area of Taipei, Taiwan. In contrast to traditional subsurface wastewater infiltration systems, capillary seepage soil biofiltration systems initially draw incoming influent upwards from the distribution pipe by capillary and siphonage actions, then spread influent throughout the soil biofiltration bed. The underground capillary seepage soil biofiltration system consists of a train of underground treatment units, including one wastewater distribution tank, two capillary seepage soil biofiltration units in series, and a discharge tank. Each capillary seepage soil biofiltration unit contains one facultative digestion tank and one set of biofiltration beds. At the flow rate of 50 m3/day, average influent concentrations of biochemical oxygen demand (BOD), suspended solid (SS), ammonia nitrogen (NH3-N), and total phosphates (TP), were 36.15 mg/L, 29.14 mg/L, 16.05 mg/L, and 1.75 mg/L, respectively. After 1.5 years of system operation, the measured influent and effluent results show that the treatment efficiencies of the soil biofiltration system for BOD, SS, NH3-N, TP, and total coliforms are 82.96%, 60.95%, 67.17%, 74.86%, and 99.99%, respectively.

  14. Preliminary Study on the Effect of Wastewater Storage in Septic Tank on E. coli Concentration in Summer

    Directory of Open Access Journals (Sweden)

    James K. Bradshaw

    2013-07-01

    Full Text Available On-site wastewater treatment systems (OWTS work by first storing the wastewater in a septic tank before releasing it to soils for treatment that is generally effective and sustainable. However, it is not clear how the abundance of E. coli changes during its passage through the tank. In this study, which was conducted under the UGA young Scholar Program in summer of 2010, we examined the change in wastewater quality parameters during the passage of the wastewater through the tank and after its release into soil. We collected wastewater samples at the inlet and outlet of an experimental septic tank in addition to obtaining water samples from lysimeters below trenches where the drainpipes were buried. We report that E. coli concentration was higher by 100-fold in the septic tank effluent than influent wastewater samples, indicating the growth of E. coli inside the tank under typical Georgian summer weather. This is contrary to the assumption that E. coli cells do not grow outside their host and suggests that the microbial load of the wastewater is potentially enhanced during its storage in the tank. Electrical conductivity, pH and nitrogen were similar between the influent and effluent wastewater samples. E. coli and total coliform concentrations were mainly below detection in lysimeter samples, indicating the effectiveness of the soil in treating the wastewater.

  15. Nitrogen and COD Removal from Septic Tank Wastewater in Subsurface Flow Constructed Wetlands: Plants Effects.

    Science.gov (United States)

    Collison, R S; Grismer, M E

    2015-11-01

    We evaluated subsurface flow (SSF) constructed wetland treatment performance with respect to organics (COD) and nitrogen (ammonium and nitrate) removal from domestic (septic tank) wastewater as affected by the presence of plants, substrate "rock" cation exchange capacity (CEC), laboratory versus field conditions and use of synthetic as compared to actual domestic wastewater. This article considers the effects of plants on constructed wetland treatment in the field. Each constructed wetland system was comprised of two beds (2.6 m long by 0.28 m wide and deep filled with ~18 mm crushed lava rock) separated by an aeration tank connected in series. The lava rock had a porosity of ~47% and a CEC of 4 meq/100 gm. One pair of constructed wetland systems was planted with cattails in May 2008, while an adjacent pair of systems remained un-planted. Collected septic tank or synthesized wastewater was allowed to gravity feed each constructed wetland system and effluent samples were regularly collected and tested for COD and nitrogen species during four time periods spanning November 2008 through June 2009. These effluent concentrations were tested for statistical differences at the 95% level for individual time periods as well as the overall 6-month period. Organics removal from domestic wastewater was 78.8% and 76.1% in the planted and un-planted constructed wetland systems, respectively, while ammonium removal was 94.5% and 90.2%, respectively. Similarly, organics removal from the synthetic wastewater of equivalent strength was 88.8% and 90.1% for planted and un-planted constructed wetland systems, respectively, while ammonium removal was 96.9% and 97.3%, respectively.

  16. Nutrient loading on subsoils from on-site wastewater effluent, comparing septic tank and secondary treatment systems.

    Science.gov (United States)

    Gill, L W; O'Luanaigh, N; Johnston, P M; Misstear, B D R; O'Suilleabhain, C

    2009-06-01

    The performance of six separate percolation areas was intensively monitored to ascertain the attenuation effects of unsaturated subsoils with respect to on-site wastewater effluent: three sites receiving septic tank effluent, the other three sites receiving secondary treated effluent. The development of a biomat across the percolation areas receiving secondary treated effluent was restricted on these sites compared to those sites receiving septic tank effluent and this created significant differences in terms of the potential nitrogen loading to groundwater. The average nitrogen loading per capita at 1.0m depth of unsaturated subsoil equated to 3.9 g total-N/d for the sites receiving secondary treated effluent, compared to 2.1 g total-N/d for the sites receiving septic tank effluent. Relatively high nitrogen loading was, however, found on the septic tank sites discharging effluent into highly permeable subsoil that counteracted any significant denitrification. Phosphorus removal was generally very good on all of the sites although a clear relationship to the soil mineralogy was determined.

  17. Plant available nitrogen from anaerobically digested sludge and septic tank sludge applied to crops grown in the tropics.

    Science.gov (United States)

    Sripanomtanakorn, S; Polprasert, C

    2002-04-01

    Agricultural land is an attractive alternative for the disposal of biosolids since it utilises the recyclable nutrients in the production of crops. In Thailand and other tropical regions, limited field-study information exists on the effect of biosolids management strategies on crop N utilisation and plant available N (PAN) of biosolids. A field study was conducted to quantify the PAN of the applied biosolids, and to evaluate the N uptake rates of some tropical crops. Sunflower (Helianthus annuus) and tomato (Lycopersicon esculentum) were chosen in this study. Two types of biosolids used were: anaerobically digested sludge and septic tank sludge. The soil is acid sulfate and is classified as Sulfic Tropaquepts with heavy clay in texture. The anaerobically digested sludge applied rates were: 0, 156 and 312 kg N ha(-1) for the sunflower plots, and 0, 586, and 1172 kg N ha(-1) for the tomato plots. The septic tank sludge applied rates were: 0, 95 and 190 kg N ha(-1) for the sunflower plots, and 0, 354 and 708 kg N ha(-1) for the tomato plots, respectively. The results indicated the feasibility of applying biosolids to grow tropical crops. The applications of the anaerobically digested sludge and the septic tank sludge resulted in the yields of sunflower seeds and tomato fruits and the plant N uptakes comparable or better than that applied with only the chemical fertiliser. The estimated PAN of the anaerobically digested sludge was about 27-42% of the sludge organic N during the growing season. For the septic tank sludge, the PAN was about 15-58% of the sludge organic N. It is interesting to observe that an increase of the rate of septic tank sludge incorporated into this heavy clay soil under the cropping system resulted in the decrease of N mineralisation rate. This situation could cause the reduction of yield and N uptake of crops.

  18. Efficiency of a natural wetland for effluent polishing of a septic tank

    Directory of Open Access Journals (Sweden)

    Z. Yousefi

    2014-04-01

    Full Text Available Wetlands now days apply as a polishing system for the classical wastewater treatment, in addition of different usages. Usually wetland systems are inexpensive methods vs. expensive high technology treatment systems. Objective of this study is an evaluation of natural wetland treatment in polishing of a septic effluent. Research duration works extended for 10 months on a natural wetland system in Pardis of Mazandaran University of medical sciences and eastern north of health faculty. Wastewater quality index such as pH, EC, BOD, COD, TSS, Nitrate, Phosphorus, Ammonia and Temperature performed on the samples of influent and effluent of the system. The study showed the system works as a buffering system for flow and pH. Results indicated that average of BOD5 and TSS efficiency were 67.70and 83%, respectively. Efficiency of COD was 65.26 and 80 % for a Low and moderate strength influent respectively. Average of phosphorus, NH3 and Nitrate in effluent were 0.032 mg/L, 7.18 and 0.036 mg/L, respectively. Efficiency of ammonia and Phosphorus were slightly increased in best condition. Based on this study result, natural wetland can be success in BOD, COD, and TSS removal of the classical septic tank, but for nitrogen and Phosphorus removal do not have considerable effects.

  19. Assessment of the impact of traditional septic tank soakaway systems on water quality in Ireland.

    Science.gov (United States)

    Keegan, Mary; Kilroy, Kate; Nolan, Daniel; Dubber, Donata; Johnston, Paul M; Misstear, Bruce D R; O'Flaherty, Vincent; Barrett, Maria; Gill, Laurence W

    2014-01-01

    One of the key threats to groundwater and surface water quality in Ireland is the impact of poorly designed, constructed or maintained on-site wastewater treatment systems. An extensive study was carried out to quantify the impact of existing sites on water quality. Six existing sites, consisting of a traditional septic tank and soakaway system, located in various ranges of subsoil permeabilities were identified and monitored to determine how well they function under varying subsoil and weather conditions. The preliminary results of the chemical and microbiological pollutant attenuation in the subsoil of the systems have been assessed and treatment performance evaluated, as well as impact on local surface water and groundwater quality. The source of any faecal contamination detected in groundwater, nearby surface water and effluent samples was confirmed by microbial source tracking. From this, it can be seen that the transport and treatment of percolate vary greatly depending on the permeability and composition of the subsoil.

  20. Septic tank combined with anaerobic filter and conventional UASB: results from full scale plants

    Directory of Open Access Journals (Sweden)

    F. J. A. da Silva

    2013-03-01

    Full Text Available Anaerobic digestion is an important alternative for domestic wastewater treatment, especially in warm climate regions. Two full-scale anaerobic schemes were investigated: septic tank combined with anaerobic filter (S T A NF and conventional UASB reactors. Treated effluents from these systems were subjected to disinfection by chlorination. The operational performance of 56 full-scale plants (36 S T A NF and 20 UASB provided a realistic view. Findings showed that the plants operated with low OLR (< 2.0 kg COD/m³.day. Despite this, the removal of organic material was below values suggested by the literature (around 60% for COD. A removal of 4.0 Log10 units of total coliform and E. coli can be reached with residual chlorine (R CL of at least 2.0 Cl-Cl2/l. Although UASB plants have performed better, improvement of maintenance is needed in both treatment configurations.

  1. Use of G3-DHS Bioreactor for Secondary Treatment of Septic Tank Desludging Wastewater

    Directory of Open Access Journals (Sweden)

    Izarul Machdar

    2016-01-01

    Full Text Available Study was done for the use of the third-generation of downflow hanging sponge (G3-DHS bioreactor for secondary treatment of septic tank desludging wastewater. The main objective of this study was to evaluate the prospective system of G3-DHS bioreactor to be applied in Indonesia. During experiment, the G3-DHS bioreactor kept a relatively high dissolved oxygen concentration under natural aeration. At a relatively short hydraulic retention (HRT of 3 h, the G3-DHS bioreactor could remove up to 21% (SD 15% of total COD, 21% (SD = 7% of filtered-COD, 58% (SD = 24% of unfiltered-BOD, and 33% (SD = 24% of ammonium removal. The final effluent had an unfiltered-BOD of only 46 mg.L-1 (SD = 20 mg.L-1 that it was below the Indonesian standard (unfiltered-BOD = 100 mg.L-1 for thresholds of domestic wastewater treatment plants effluent.

  2. Preliminary Study on the Effect of Wastewater Storage in Septic Tank on E. coli Concentration in Summer

    OpenAIRE

    James K. Bradshaw; David Radcliffe; Dominique Appling; Mussie Y. Habteselassie

    2013-01-01

    On-site wastewater treatment systems (OWTS) work by first storing the wastewater in a septic tank before releasing it to soils for treatment that is generally effective and sustainable. However, it is not clear how the abundance of E. coli changes during its passage through the tank. In this study, which was conducted under the UGA young Scholar Program in summer of 2010, we examined the change in wastewater quality parameters during the passage of the wastewater through the tank and after it...

  3. Operational Evaluation Of Vectomax® WSP (Bacillus thuringiensis Subsp. israelensis+Bacillus sphaericus) Against Larval Culex pipiens in Septic Tanks (1).

    Science.gov (United States)

    Cetin, Huseyin; Oz, Emre; Yanikoglu, Atila; Cilek, James E

    2015-06-01

    The residual effectiveness of VectoMax® WSP (a water-soluble pouch formulation containing a combination of Bacillus thuringiensis subsp. israelensis strain AM65-52 and B. sphaericus strain ABTS 1743) when applied to septic tanks against 3rd- and 4th-stage larvae of Culex pipiens L. was evaluated in this study. This formulation was evaluated at operational application rates of 1 pouch (10 g) and 2 pouches (20 g) per septic tank. Both application rates resulted in >96% control of larvae for 24 days. Operationally, VectoMax WSP has proven to be a useful tool for the nonchemical control of Culex species in septic tank environments.

  4. A comparative study on the treatment performance of a conventional septic tank system and reed bed-soil absorption system receiving domestic effluent

    OpenAIRE

    O'LUANAIGH, NIALL; Johnston, Paul; Misstear, Bruce; Patel, Titiksh; Gill, Laurence

    2009-01-01

    PUBLISHED In Ireland, the most prevalent domestic wastewater treatment application in unsewered areas is the conventional septic tank system comprising of septic tank and soil absorption system, the latter more commonly referred to as a percolation area in Ireland. Recent concern has been expressed over the discharge of on-site effluent to highly permeable soils which, although permitted in current Irish EPA guidelines, has generated debate as to whether an insufficient level o...

  5. Analysis of the bacterial community changes in soil for septic tank effluent treatment in response to bio-clogging.

    Science.gov (United States)

    Nie, J Y; Zhu, N W; Zhao, K; Wu, L; Hu, Y H

    2011-01-01

    Soil columns were set up to survey the bacterial community in the soil for septic tank effluent treatment. When bio-clogging occurred in the soil columns, the effluent from the columns was in poorer quality. To evaluate changes of the soil bacterial community in response to bio-clogging, the bacterial community was characterized by DNA gene sequences from soil samples after polymerase chain reaction coupled with denaturing gradient gel electrophoresis process. Correspondence analysis showed that Proteobacteria related bacteria were the main bacteria within the soil when treating septic tank effluent. However, Betaproteobacteria related bacteria were the dominant microorganisms in the normal soil, whereas Alphaproteobacteria related bacteria were more abundant in the clogged soil. This study provided insight into changes of the soil bacterial community in response to bio-clogging. The results can supply some useful information for the design and management of soil infiltration systems.

  6. Treatment and utilization of septic tank effluent using vertical-flow constructed wetlands and vegetable hydroponics.

    Science.gov (United States)

    Cui, Li-Hua; Luo, Shi-Ming; Zhu, Xi-Zhen; Liu, Ying-Hu

    2003-01-01

    Vertical flow constructed wetlands is a typical ecological sanitation system for sewage treatment. The removal rates for COD, BOD5, SS, TN, and TP were 60%, 80%, 74%, 49% and 79%, respectively, when septic tank effluent was treated by vertical flow filter. So the concentration of COD and BOD5 in the treated effluent could meet the quality standard for irrigation water. After that the treated effluent was used for hydroponic cultivation of water spinach and romaine lettuce, the removal efficiencies of the whole system for COD, BOD5, SS, TN and TP were 71.4%, 97.5%, 96.9%, 86.3%, and 87.4%, respectively. And it could meet the integrated wastewater discharge standard for secondary biological treatment plant. It was found that using treated effluent for hydroponic cultivation of vegetables could reduce the nitrate content in vegetables. The removal rates for total bacteria and coliform index by using vertical flow bed system with cinder substrate were 80%-90% and 85%-96%, respectively.

  7. Assessment of contamination by percolation of septic tank effluent through natural and amended soils.

    Science.gov (United States)

    Cheung, K C; Venkitachalam, T H

    2004-01-01

    Fly ash has been found to be a potential material for the treatment of municipal and industrial wastewater, and may be useful in the treatment of septic tank effluent. Laboratory columns (30 cm) were used to determine the sorption capacity and hydraulic properties of lagoon fly ash, loamy sand, sand, and sand amended by lagoon fly ash (30 and 60%) and red mud gypsum (20%). The removal of chemical oxygen demand (COD) was high in all column effluents (71-93%). Extent of nitrification was high in Spearwood sand, Merribrook loamy sand and 20% red mud gypsum amended Spearwood sand. However, actual removal of nitrogen (N) was high in columns containing lagoon fly ash. Unamended Spearwood sand possessed only minimal capacity for P sorption. Merribrook loamy sand and red mud gypsum amended sand affected complete P removal throughout the study period of 12 weeks. Significant P leakage occurred from lagoon fly ash amended sand columns following 6-10 weeks of operation. Neither lagoon fly ash nor red mud gypsum caused any studied heavy metal contamination including manganese (Mn), lead (Pb), zinc (Zn), cadmium (Cd) and chromium (Cr) of effluent. It can be concluded that Merribrook loamy sand is better natural soil than Spearwood sand as a filter medium. The addition of lagoon fly ash enhanced the removal of P in Spearwood sand but the efficiency was lower than with red mud gypsum amendment.

  8. Resource recovery from septic tank effluent using duckweed-based tilapia aquaculture.

    Science.gov (United States)

    El-Shafai, Saber A; Abdel-Gawad, Fagr Kh; Samhan, Farag; Nasr, Fayza A

    2013-01-01

    Two parallel duckweed ponds were deployed to utilize nutrients from the effluent of a septic tank treating domestic wastewater. The effluent and fresh biomass of duckweed pond were fed to two subsequent fish ponds stocked with Nile tilapia (Oreochromis niloticus). Fish ponds receiving freshwater and commercial feed were used as control. The results of specific growth rate and feed conversion ratio showed no significant difference between the control ponds and treatment ponds. On the other hand, the total and net fish yields were significantly higher in the control. Microbial analysis revealed contamination of gills, intestine and liver of fish in the treatment ponds. The activity of the immune response genes was up-regulated in the brain and liver of the treatment samples. A micronucleus assay revealed a similar percentage of micronuclei in the polychromatic erythrocytes of blood in the control and treatment samples, while the treatment samples a had higher incidence of micronuclei in the polychromatic erythrocytes of gills, compared with the control.

  9. Performance of UASB septic tank for treatment of concentrated black water within DESAR concept.

    Science.gov (United States)

    Kujawa-Roeleveld, K; Fernandes, T; Wiryawan, Y; Tawfik, A; Visser, M; Zeeman, G

    2005-01-01

    Separation of wastewater streams produced in households according to their origin, degree of pollution and affinity to a specific treatment constitutes a starting point in the DESAR concept (decentralised sanitation and reuse). Concentrated black water and kitchen waste carry the highest load of organic matter and nutrients from all waste(water)streams generated from different human activities. Anaerobic digestion of concentrated black water is a core technology in the DESAR concept. The applicability of the UASB septic tank for treatment of concentrated black water was investigated under two different temperatures, 15 and 25 degrees C. The removal of total COD was dependent on the operational temperature and attained 61 and 74% respectively. A high removal of the suspended COD of 88 and 94% respectively was measured. Effluent nutrients were mainly in the soluble form. Precipitation of phosphate was observed. Effective sludge/water separation, long HRT and higher operational temperature contributed to a reduction of E. coli. Based on standards there is little risk of contamination with heavy metals when treated effluent is to be applied in agriculture as fertiliser.

  10. Estimating the water budget for a peat filter treating septic tank effluent in the field

    Science.gov (United States)

    Van Geel, Paul J.; Parker, Wayne J.

    2003-02-01

    The use of peat as a filter medium for the treatment of a variety of liquid and gas waste streams has increased over the past decade. Peat has been used as an alternate treatment medium to treat septic tank effluent (STE) from domestic and small communal systems. Very little research has been completed to study the hydraulics and water budget of a peat filter operating in the field. This study evaluated the water budget of a peat filter operating at an elementary school near Ottawa, Canada. The peat filter was instrumented with tensiometers to measure the pore water pressures within the filter and a weather station to collect weather data required to estimate potential evapotranspiration. A one-dimensional unsaturated flow model, SoilCover, was calibrated using the pressure data and weather data collected in the field. The calibrated model was use to estimate the water budget for the filter operating with and without STE loading. The calibrated model predicted that the annual precipitation exceeded evapotranspiration for both scenarios. For the filter treating 50 mm/day of STE, there was a slight dilution due to the infiltration resulting in a net dilution factor of 0.97 (loading divided by the loading plus infiltration). The largest rainfall event of 49.9 mm resulted in a dilution factor of approximately 0.87, which corresponded to an approximate decrease in the hydraulic retention time (HRT) of between 12 and 33% depending on the calculation used to determine the HRT. When the filter does not receive STE, the precipitation exceeds evapotranspiration and hence the filter should not dry out when the filter is not in use.

  11. Ranking of septic tank and drainfield sites using travel time to the groundwater table

    Energy Technology Data Exchange (ETDEWEB)

    Langkopf, B.S.; McCord, J.T. [Sandia National Labs., Albuquerque, NM (United States). Environmental Risk Assessment and Risk Management Dept.

    1994-09-01

    The Environmental Restoration Program at Sandia National Laboratories, New Mexico (SNL/NM) is tasked with performing assessments and cleanup of waste sites that belong to SNL. SNL`s waste sites are divided into several activities. Septic Tanks and Drainfields (STD) is an activity that includes 23 different sites at SNL/NM. All these sites may have released hazardous wastes into the soil from drains or sewers of buildings. The STD sites must be assessed and, if necessary, remediated according to the Resource Conservation and Recovery Act (RCRA) Corrective Action process. A modeling study has been completed to help prioritize the sites for future field investigation based on the risk that each site may pose to human health and the environment. Two of the influences on the risk to human health and environment are addressed in this study--the fluid disposal volume and groundwater depth. These two parameters, as well as several others, were used as input into a computer model to calculate groundwater travel time to the water table. The computer model was based on Darcy`s Law and a simple mass balance. To account for uncertainty in the input parameters, a Monte Carlo approach was used to determine the travel times; 1,000 realizations were completed to determine the travel time for each site. The range assigned to each of the input parameters was sampled according to an assigned statistical distribution using the Latin Hypercube Method to arrive at input for the calculations. The groundwater travel times resulting from these calculations were used to rank the sites for future field investigation.

  12. Evaluation of decentralized treatment of sewage employing Upflow Septic Tank/Baffled Reactor (USBR) in developing countries

    Energy Technology Data Exchange (ETDEWEB)

    Sabry, Tarek, E-mail: tsabry@consultant.com [Ain Shams University, Department of Public Works Engineering, Abbasia, Cairo (Egypt)

    2010-02-15

    A new concept for a low-cost modified septic tank, named Upflow Septic Tank/Baffled Reactor (USBR), was constructed and tested in a small village in Egypt. During almost one year of continuous operation and monitoring, this system was found to have very satisfactory removal results, where the average results of COD, BOD, and TSS removal efficiencies were 84%, 81%, and 89%, respectively, and the results of the experiment proved that the second compartment (Anaerobic Baffled Reactor) was the main treatment unit in removing the pollutants during the start-up period and at the very early steady-state stage. However, after this period and during the steady-state operation conditions, the second compartment served as a polishing step. Also, it was observed that the USBR system was not affected by the imposed shock loads at the peak flow and organic periods. The results showed that the system is slightly influenced by the drop in the temperature. Decreasing in BOD and COD removal by factor of 9% was observed, when temperature decreases from the average of 35 deg. C in summer time (for the first 127 days) to the average of 22 deg. C in winter time (between day 252 and day 280). Whereas, the TSS removals were not affected by the drop in temperature. The results of the sewage flow variations during one year of operation were compared with Goodrich Formula to see the applicability of this equation in rural developing countries. Main finding of the work: The Upflow Septic Tank/Baffled Reactor system could become a promising alternative to the conventional treatment plants in rural developing countries.

  13. Exploration of a Buried Building Foundation and a Septic Tank Plume Dispersion Using a Laboratory-fabricated Resistivity Apparatus

    Science.gov (United States)

    Lachhab, A.; Stepanik, N.; Booterbaugh, A.

    2010-12-01

    In the following study, an electrical resistivity device was built and used in both a laboratory setup and in the field to accurately identify the location of a septic tank and the foundation of Gustavus Adolphus (GA); a building that was burned at Susquehanna University in 1964. The entire apparatus, which costs a fraction of the price of a typical electrical resistivity device, was tested for accuracy in the laboratory prior to its use in the field. The electrical resistivity apparatus consists of a deep-cycle twelve volt battery, an AC to DC inverter and two multimeters to measure the potential and the current intensity from four linear electrodes via a wireless data transmission system. This apparatus was constructed by using basic inexpensive electrical and electronic equipments. The recorded potential and current values were used to calculate the apparent resistivity of different materials adopting the Wenner array for both investigations. Several tests were performed on the tabletop bench, producing consistent results when applied to find small bricks structures with different geometrical arrangement buried under a mixed sand-soil formation. The apparatus was also used to investigate a subsurface salty water plume in the same formation. The horizontal resistivity profile obtained over the vertical small brick wall matched the theoretical apparent resistivity of resistivity versus displacement on a vertical dike in a homogeneous material. In addition, the two-dimensional resistivity profile replicate the salty plume size conformably. Following the success on the small-scale laboratory tabletop bench, the electrical resistivity apparatus was implemented in the field to explore the foundation of GA in one location and the septic tank in another. An array of transects were performed, analyzed and plotted using MATLAB. The three dimensional contours of apparent resistivity depicted exactly the locations of the buried foundation walls, the septic tank and the

  14. Predation and control efficacies of Misgurnus mizolepis (Cypriniformes: Cobitidae) toward Culex pipiens molestus (Diptera: Culicidae) and fish toxicity of temephos in laboratory and septic tank conditions.

    Science.gov (United States)

    Chae, Seong Chun; Kwon, Young Hyun; Min, Kyung Il; Kim, Hyung Soo; Kim, Nam-Jin; Kim, Jun-Ran; Son, Bong Gi; Ahn, Young-Joon

    2014-07-01

    Culex pipiens molestus Forskal (Diptera: Culicidae) is the dominant mosquito species in septic tanks in South Korea. An assessment was made of the biological control potential of mud loaches, Misgurnus mizolepis Günther (Cypriniformes: Cobitidae), toward Cx. p. molestus larvae in laboratory and septic tanks. Results were compared with those of temephos 20% emulsifiable concentrate. In laboratory tests, all mud loaches survived on sedimentation chamber- and effluent chamber-collected water of aerobic septic tanks (ASTs), whereas all mud loaches died within 3-12 h after introduction into sedimentation chamber- and effluent chamber-collected water of anaerobic septic tanks, Gill hyperplasia and hemorrhages at the bases of pectoral fins were detected in all dead mud loaches. These appeared to have been caused by bacterial disease, rather than the physical and chemical characteristics of the septic tank water. A mud loach consumed an average range of 1,072-1,058 larvae of Cx. p. molestus in the AST water at 24 h. At the manufacturer's recommended rate (10 ml/ton) in the AST water, the temephos formulation did not cause fish mortality. In the AST experiment, predation of mosquito larvae by mud loaches at a release rate of one fish per 900 mosquito larvae resulted in complete mosquito control from the third day after treatment throughout the 18-wk survey period, compared with temephos 20% emulsifiable concentrate-treated AST water (reduction rate, 40% at 28 days after treatment). Reasonable mosquito control in aerobic septic tanks can be achieved by mosquito breeding season stocking of a rate of one mud loach per 900 mosquito larvae.

  15. Concentrations and environmental fate of Ra in cation-exchange regeneration brine waste disposed to septic tanks and accumulation in sludge, New Jersey Coastal Plain, USA.

    Science.gov (United States)

    Szabo, Zoltan; Jacobsen, Eric; Kraemer, Thomas F; Parsa, Bahman

    2008-06-01

    Concentrations of Ra in liquid and solid wastes generated from 15 softeners treating domestic well waters from New Jersey Coastal Plain aquifers (where combined Ra ((226)Ra plus (228)Ra) concentrations commonly exceed 0.185 Bq L(-1)) were determined. Softeners, when maintained, reduced combined Ra about 10-fold (septic-tank effluents receiving brine waste were less than in the untreated ground waters. The maximum combined Ra concentration in aquifer sands (40.7 Bq kg(-1) dry weight) was less than that in sludge from the septic tanks (range, 84-363 Bq kg(-1)), indicating Ra accumulation in sludge from effluent. The combined Ra concentration in sludge from the homeowners' septic systems falls within the range reported for sludge samples from publicly owned treatment works within the region.

  16. Decentralised treatment of concentrated sewage at low temperature in a two-step anaerobic system: two upflow-hybrid septic tanks

    NARCIS (Netherlands)

    Elmitwally, T.A.; Sayed, S.; Groendijk, L.; Lier, van J.B.; Zeeman, G.; Lettinga, G.

    2003-01-01

    The decentralised treatment of concentrated sewage (about 3,600 mgCOD/1) at low temperature was investigated in a two-step anaerobic system: two-anaerobic hybrid (AH) septic tanks (each 0.575 m(3)). The two reactors were placed in a temperature controlled-room and the HRT was 2.5 days for each

  17. Pharmaceutical and personal care products in domestic wastewater and their removal in anaerobic treatment systems: septic tank - upflow anaerobic filter

    DEFF Research Database (Denmark)

    Arrubla, Juan Pablo; Cubillos, Janneth A.; Ramírez Vargas, Carlos Andrés

    2016-01-01

    of use, consumption and presence of PPCPs in wastewater from a treatment plant in a rural area of Pereira (Colombia). Domestic sewage is treated in a septic tank followed by an Up-Flow Anaerobic Filter and its ef uent is discharged into the Otún River, upstream of the water intake of the supply system...... of the city. The compounds monitored in this research included ibuprofen, naproxen, diclofenac, aspirin, ketoprofen, caffeine, galaxolide, tonalide and dihydrojasmonate. An adapted method of multi-residue analysis was used, which is based on solid phase extraction with hydrophilic-lipophilic balance...... in 15 %; and caffeine, ibuprofen and ketoprofen were not removed. Results provided basic information to decide over the necessity of complementary treatments for ef uents from systems with the mentioned units....

  18. Efficiency of a natural wetland for effluent polishing of a septic tank

    OpenAIRE

    Z Yousefi; S. Jowhari; Sh. Nasiri

    2014-01-01

    Wetlands now days apply as a polishing system for the classical wastewater treatment, in addition of different usages. Usually wetland systems are inexpensive methods vs. expensive high technology treatment systems. Objective of this study is an evaluation of natural wetland treatment in polishing of a septic effluent. Research duration works extended for 10 months on a natural wetland system in Pardis of Mazandaran University of medical sciences and eastern north of health faculty. Wastewate...

  19. Assessing Protection Afforded to the Microbiological Quality of Bedrock Groundwater from the Impacts of Septic Tank Effluent by Irish Glacial Till: A Field Study

    Science.gov (United States)

    Orr, Alison; McCarthy, Valerie; Meehan, Robert; Flynn, Raymond

    2010-05-01

    The rural population of Ireland relies almost exclusively on on-site treatment systems for disposal of waste water. Septic tank systems, which discharge effluent to ground, constitute the dominant means of waste water disposal. Many of the areas that employ this technology rely on private or small group groundwater supplies, often located in close proximity of septic tanks. Since many of these water supplies provide raw groundwater to consumers, septic tank effluent (STE) can pose a significant hazard to the microbiological quality of drinking water. T-tests (infiltration testing) carried out prior to tank installation aim to assess the capacity of subsoils to receive STE. Tests completed across Ireland indicate that many existing septic tank systems are located in low permeability subsoils. These subsoils are assumed to afford significant protection to the microbiological quality of groundwater in the underlying bedrock units. A two year investigation in the Lough Muckno Catchment in Co. Monaghan, investigating the impact of STE on water quality, involved carrying out T-tests at three sites where effluent discharged to a dense, silty, ‘fractured' glacial till derived from the underlying bedrock and containing clasts of low grade metamorphic Ordovician and Silurian sandstone and shale. Analysis of groundwater samples collected from 28 piezometers straddling the water table within the till, down-gradient of septic tank systems at two sites, permitted faecal indicator microorganism (FIO) levels in near-surface groundwater to be established. Associated hydraulic conductivity tests (slug tests) at all three sites permitted an evaluation of the levels of horizontal hydraulic conductivity heterogeneity present in the till. Slug test results suggest that till median hydraulic conductivities range from 1.1x10-4 cm/s to 1.1x10-5 cm/s, with variability of up to 2 orders of magnitude across each site. On the other hand no significant differences in properties existed

  20. Structure and Composition of Leachfield Bacterial Communities: Role of Soil Texture, Depth and Septic Tank Effluent Inputs

    Directory of Open Access Journals (Sweden)

    Janet A. Atoyan

    2012-09-01

    Full Text Available Although groundwater quality depends on microbial processes in the soil treatment area (STA of onsite wastewater treatment systems (OWTS, our understanding of the development of these microbial communities is limited. We examined the bacterial communities of sand, sandy loam, and clay STAs at different depths in response to septic tank effluent (STE addition using mesocosms. Terminal restriction fragment length polymorphism (TRFLP analysis was used to compare the bacterial community structure and composition of STE, native soil prior to STE addition (UNX and soil exposed to STE (EXP. Principal component analysis separated communities with depth in sand but not in sandy loam or clay. Indices of richness, diversity, and evenness followed the order: sandy loam > sand > clay. Analysis of TRF peaks indicated that STE contributed least to the composition of STA bacterial communities (5%–16%, followed by UNX soil (18%–48%, with the highest proportion of the community made up of TRFs not detected previously in either UNX or STE (50%–82% for all three soils. Soil type and depth can have a marked effect on the structure and composition of STA bacterial communities, and on the relative contribution of native soil and STE to these communities.

  1. Estimation of septic tank setback distances based on transport of E. coli and F-RNA phages.

    Science.gov (United States)

    Pang, Liping; Close, Murray; Goltz, Mark; Sinton, Lester; Davies, Helen; Hall, Carollyn; Stanton, Greg

    2004-01-01

    Setback distances between septic tank systems and the shorelines of Lake Okareka, New Zealand were determined from model simulations for a worst-case scenario, using the highest hydraulic conductivity and gradient measured in the field, removal rates of the microbial indicators (Escherichia coli and F-RNA phages) determined from a column experiment, and maximum values of the design criteria for the disposal system, and assuming an absence of an unsaturated zone, a continuous discharge of the raw effluent from a failed or non-complying treatment system (both indicators at concentrations of 1x10(7) counts/100 ml) into the groundwater and no sorption of pathogens in the aquifer. Modelling results suggest that the minimal setback distances were 16 m to satisfy the New Zealand Recreational Water Quality Guidelines for E. coli <126 per 100 ml (Ministry for the Environment, 1999) and 48 m to meet the Drinking-Water Standards for New Zealand 2000 for enteric virus <1 per 100 l (Ministry of Health, 2000). These distances may be applicable for other lakeshores in pumice sand aquifers with groundwater velocities <7 m/day. Findings of laboratory column and batch experiments provided an insight into the microbial attenuation and transport processes in pumice sand aquifers. Bacterial removal was predominately through filtration (87-88%) and partially by die-off (12-13%), while viral removal was by both die-off (45%) and filtration (55%). In addition, microbial die-off in groundwater without aquifer material (i.e., free microbes) was much lower than die-off in groundwater with aquifer material (i.e., sorbed microbes) and contributed only 2-6% to the total removal. This implies that the setback distances estimated from die-off rates for the free microbes, determined in the laboratory without considering aquifer media and other removal processes, which are often reported in the literature, could be larger than necessary.

  2. DOJ News Release: West Palm Beach Sellers of Unnecessary Septic Tank Products Plead Guilty to Wire Fraud

    Science.gov (United States)

    Moore, Nouerand and Lincoln, in concert with other employees of FBK Products, LLC., knowingly participated in a scheme to fraudulently market and sell an unnecessary and unneeded septic treatment product to residents of various states across the country.

  3. Anaerobic on-site treatment of kitchen waste in combination with black water in UASB-septic tanks at low temperatures.

    Science.gov (United States)

    Luostarinen, S; Rintala, J

    2007-07-01

    Anaerobic on-site treatment of a mixture of black water and kitchen waste (BWKW) was studied using two-phased upflow anaerobic sludge blanket (UASB) septic tanks at the low temperatures of 20 and 10 degrees C. Black water (BW) was also treated alone as reference. The two-phased UASB-septic tanks removed over 95% of total suspended solids (TSS) and 90% of total chemical oxygen demand (COD(t)) from both BWKW (effluent COD(t) 171-199mg/l) and BW (effluent COD(t) 92-100mg/l). Also, little dissolved COD (COD(dis)) was left in the final effluents (BW 48-70mg/l; BWKW 110-113mg/l). Part of total nitrogen (N(tot)) was removed (BW 18% and BWKW 40%) and especially at 20 degrees C ammonification was efficient. A two-phased process was required to obtain the high removals with BWKW at 10 degrees C, while with BW a single-phased process may have sufficed even at 10 degrees C. BWKW also produced more methane than BW alone. Sludge in phases 1 of BW and BWKW treatment was not completely stabilised after 198d of operation.

  4. Physico-chemical, microbiological and ecotoxicological evaluation of a septic tank/Fenton reaction combination for the treatment of hospital wastewaters.

    Science.gov (United States)

    Berto, Josiani; Rochenbach, Gisele Canan; Barreiros, Marco Antonio B; Corrêa, Albertina X R; Peluso-Silva, Sandra; Radetski, Claudemir Marcos

    2009-05-01

    Hospital wastewater is considered a complex mixture populated with pathogenic microorganisms. The genetic constitution of these microorganisms can be changed through the direct and indirect effects of hospital wastewater constituents, leading to the appearance of antibiotic multi-resistant bacteria. To avoid environmental contamination hospital wastewaters must be treated. The objective of this study was to evaluate the efficiency of hospital wastewater treated by a combined process of biological degradation (septic tank) and the Fenton reaction. Thus, after septic tank biodegradation, batch Fenton reaction experiments were performed in a laboratory-scale reactor and the effectiveness of this sequential treatment was evaluated by a physico-chemical/microbiological time-course analysis of COD, BOD(5), and thermotolerant and total coliforms. The results showed that after 120min of Fenton treatment BOD(5) and COD values decreased by 90.6% and 91.0%, respectively. The BOD(5)/COD ratio changed from 0.46 to 0.48 after 120min of treatment. Bacterial removal efficiency reached 100%, while biotests carried out with Scenedesmus subspicatus and Daphnia magna showed a significant decrease in the ecotoxicity of hospital wastewater after the sequential treatment. The use of this combined system would ensure that neither multi-resistant bacteria nor ecotoxic substances are released to the environment through hospital wastewater discharge.

  5. PENURUNAN COD, TSS DAN TOTAL FOSFAT PADA SEPTIC TANK LIMBAH MATARAM CITRA SEMBADA CATERING DENGAN MENGGUNAKAN WASTEWATER GARDEN (Degradation of COD, TSS and Total Phosphate in Septic Tank Wastewater of Mataram Citra Sembada Catering Using Wastewater

    Directory of Open Access Journals (Sweden)

    Dradjat Suhardjo

    2008-07-01

      from  industrial restaurant of Mataram Citra Sembada Catering (MSCS septic tank was classified into domestic waste category. That wastewater contains of many unwanted component. The wastewater concentration is still above the threshold quality standard, which caused pollution problems. The reactor used  gravel (0,5-1cm and six various kinds of plants. They are melati air (Echinodorus paleaflius, Cyperus (Cyperus, Futoi (Hippochaetes lymnenalis, Pisang air (Holisonia rostrata, Pickerel rush (Pontedoria cordata,  Cattail (Typha latifolia. This research aimed to know the effectivity  of reactor when being used to decrease  COD, TSS and  Total Phosphate concentrations. The research is  using wastewater garden reactor which  batch system and dimensions are 1mx0,5mx1m. Wastewater zone 75cm, substract zone or gravel 80cm. The root planted  in 10-15cm depth. The use of methods depend on SNI which COD refer to SNI 06-6989.2-2004 refluks method isolated spectrophotometrically, TSS refer to SK SNI M-03-1990-F testing method gravimetrically and total phosphorus refer to SNI M-52-1990-03 acid ascorbat method by spectrophotometer. This research is done for 12 days.  Where in  every 3 days,  the sample took  from outlet then analyzed. This research showed that reactor can decrease  COD with  40,81%  optimum effectiveness of day 6, decrease of  TSS 89,12% on  day 12; and of  Total Phosphate 99,73%  on day 6. Those plants can growth fertile.

  6. The Impact of Traditional Septic Tank Soakaway Systems and the Effects of Remediation on Water Quality in Ireland

    Science.gov (United States)

    Kilroy, Kate; Keggan, Mary; Barrett, Maria; Dubber, Donata; Gill, Laurence W.; O'Flaherty, Vincent

    2014-05-01

    In Ireland the domestic wastewater of over 1/3 of the population is treated by on-site systems. These systems are based on a traditional design for disposal of domestic wastewater and rely on the surrounding subsoil for further treatment. Inefficient treatment is often associated with these systems and can cause pollution of local aquifers and waterways. The effluent nutrient load can contribute to eutrophication, depletion of dissolved oxygen and excessive algae growth in surface water bodies. Human enteric pathogens associated with faecal pollution of water sources may promote the outbreak of disease through contamination of drinking water supplies. The subsoil attenuation plays an important role in the protection of groundwater from effluent pollution. Therefore, as over 25% of the countries domestic water supplies are provided by groundwater, the protection of groundwater resources is crucial. This project involves both the assessment of traditional septic tank soakaway systems and the effects of remediation in low permeability subsoil settings on water quality in Ireland. The study aims to confirm by microbial source tracking (MST), the source (human and/or animal) of faecal microorganisms detected in groundwater, surface water and effluent samples, and to monitor the transport of pathogens specific to on-site wastewater outflows. In combination with MST, the evaluation of nitrification and denitrification in surrounding soil and effluent samples aims to assess nitrogen removal at specific intervals; pre-remediation and post-remediation. Two experimental sites have been routinely sampled for effluent, soil and groundwater samples as well as soil moisture samples using suction lysimeters located at various depths. A robust and reproducible DNA extraction method was developed, applicable to both sites. MST markers based on host-specific Bacteriodales bacteria for universal, human and cow-derived faecal matter are being employed to determine quantitative target

  7. Understanding the transformation, speciation, and hazard potential of copper particles in a model septic tank system using zebrafish to monitor the effluent.

    Science.gov (United States)

    Lin, Sijie; Taylor, Alicia A; Ji, Zhaoxia; Chang, Chong Hyun; Kinsinger, Nichola M; Ueng, William; Walker, Sharon L; Nel, André E

    2015-02-24

    Although copper-containing nanoparticles are used in commercial products such as fungicides and bactericides, we presently do not understand the environmental impact on other organisms that may be inadvertently exposed. In this study, we used the zebrafish embryo as a screening tool to study the potential impact of two nano Cu-based materials, CuPRO and Kocide, in comparison to nanosized and micron-sized Cu and CuO particles in their pristine form (0-10 ppm) as well as following their transformation in an experimental wastewater treatment system. This was accomplished by construction of a modeled domestic septic tank system from which effluents could be retrieved at different stages following particle introduction (10 ppm). The Cu speciation in the effluent was identified as nondissolvable inorganic Cu(H2PO2)2 and nondiffusible organic Cu by X-ray diffraction, inductively coupled plasma mass spectrometry (ICP-MS), diffusive gradients in thin-films (DGT), and Visual MINTEQ software. While the nanoscale materials, including the commercial particles, were clearly more potent (showing 50% hatching interference above 0.5 ppm) than the micron-scale particulates with no effect on hatching up to 10 ppm, the Cu released from the particles in the septic tank underwent transformation into nonbioavailable species that failed to interfere with the function of the zebrafish embryo hatching enzyme. Moreover, we demonstrate that the addition of humic acid, as an organic carbon component, could lead to a dose-dependent decrease in Cu toxicity in our high content zebrafish embryo screening assay. Thus, the use of zebrafish embryo screening, in combination with the effluents obtained from a modeled exposure environment, enables a bioassay approach to follow the change in the speciation and hazard potential of Cu particles instead of difficult-to-perform direct particle tracking.

  8. Development of an efficient anaerobic co-digestion process for garbage, excreta, and septic tank sludge to create a resource recycling-oriented society.

    Science.gov (United States)

    Sun, Zhao-Yong; Liu, Kai; Tan, Li; Tang, Yue-Qin; Kida, Kenji

    2017-03-01

    In order to develop a resource recycling-oriented society, an efficient anaerobic co-digestion process for garbage, excreta and septic tank sludge was studied based on the quantity of each biomass waste type discharged in Ooki machi, Japan. The anaerobic digestion characteristics of garbage, excreta and 5-fold condensed septic tank sludge (hereafter called condensed sludge) were determined separately. In single-stage mesophilic digestion, the excreta with lower C/N ratios yielded lower biogas volumes and accumulated higher volumes of volatile fatty acid (VFA). On the other hand, garbage allowed for a significantly larger volatile total solid (VTS) digestion efficiency as well as biogas yield by thermophilic digestion. Thus, a two-stage anaerobic co-digestion process consisting of thermophilic liquefaction and mesophilic digestion phases was proposed. In the thermophilic liquefaction of mixed condensed sludge and household garbage (wet mass ratio of 2.2:1), a maximum VTS loading rate of 24g/L/d was achieved. In the mesophilic digestion of mixed liquefied material and excreta (wet mass ratio of 1:1), biogas yield reached approximately 570ml/g-VTS fed with a methane content of 55% at a VTS loading rate of 1.0g/L/d. The performance of the two-stage process was evaluated by comparing it with a single-stage process in which biomass wastes were treated separately. Biogas production by the two-stage process was found to increase by approximately 22.9%. These results demonstrate the effectiveness of a two-stage anaerobic co-digestion process in enhancement of biogas production. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. Performance of a system with full- and pilot-scale sludge drying reed bed units treating septic tank sludge in Brazil.

    Science.gov (United States)

    Calderón-Vallejo, Luisa Fernanda; Andrade, Cynthia Franco; Manjate, Elias Sete; Madera-Parra, Carlos Arturo; von Sperling, Marcos

    2015-01-01

    This study investigated the performance of sludge drying reed beds (SDRB) at full- and pilot-scale treating sludge from septic tanks in the city of Belo Horizonte, Brazil. The treatment units, planted with Cynodon spp., were based on an adaptation of the first-stage of the French vertical-flow constructed wetland, originally developed for treating sewage. Two different operational phases were investigated; in the first one, the full-scale unit was used together with six pilot-scale columns in order to test different feeding strategies. For the second phase, only the full-scale unit was used, including a recirculation of the filtered effluent (percolate) to one of the units of the French vertical wetland. Sludge application was done once a week emptying a full truck, during 25 weeks. The sludge was predominantly diluted, leading to low solids loading rates (median values of 18 kgTS m(-2) year(-1)). Chemical oxygen demand removal efficiency in the full-scale unit was reasonable (median of 71%), but the total solids removal was only moderate (median of 44%) in the full-scale unit without recirculation. Recirculation did not bring substantial improvements in the overall performance. The other loading conditions implemented in the pilot columns also did not show statistically different performances.

  10. Applicability of a septic tank/engineered wetland coupled system in the treatment and recycling of wastewater from a small community.

    Science.gov (United States)

    Mbuligwe, Stephen E

    2005-01-01

    A septic tank (ST)/engineered wetland coupled system used to treat and recycle wastewater from a small community in Dar es Salaam, Tanzania was monitored to assess its performance. The engineered wetland system (EWS) had two parallel units each with two serial beds packed with different sizes of media and vegetated differently. The larger-sized medium bed was upstream and was planted with Phragmites (reeds) and the smaller-sized medium bed was downstream and was planted with Typha (cattails). The ST/EWS coupled system was able to remove ammonia by an average of 60%, nitrate by 71%, sulfate by 55%, chemical oxygen demand by 91%, and fecal coliform as well as total coliform by almost 100%. The effluent from the ST/EWS coupled system is used for irrigation. Notably, users of the recycled irrigation water do not harbor any negative feelings about it. This study demonstrates that it is possible to treat and recycle domestic wastewater using ST/ EWS coupled systems. The study also brings attention to the fact that an ST/EWS coupled system has operation and maintenance (O&M) needs that must be fulfilled for its effectiveness and acceptability. These include removal of unwanted weeds, harvesting of wetland plants when the EWS becomes unappealingly bushy, and routine repair.

  11. Pharmaceutical and personal care products in domestic wastewater and their removal in anaerobic treatment systems: Septic tank – up flow anaerobic filter.

    Directory of Open Access Journals (Sweden)

    Juan Pablo Arrubla Vélez

    2016-04-01

    Full Text Available In several countries around the world, Pharmaceutical and Personal Care Products (PPCPs exist in aquatic environments, a fact that increases the awareness within the scientific community with respect to their possible fate and environment effects. This research presents a preliminary monitoring of use, consumption and presence of PPCPs in wastewater from a treatment plant in a rural area of Pereira (Colombia. Domestic sewage is treated in a septic tank followed by an Up-Flow Anaerobic Filter and its effluent is discharged into the Otún River, upstream of the water intake of the supply system of the city. The compounds monitored in this research included ibuprofen, naproxen, diclofenac, aspirin, ketoprofen, caffeine, galaxolide, tonalide and dihydrojasmonate. An adapted method of multi-residue analysis was used, which is based on solid phase extraction with hydrophilic-lipophilic balance cartridges, and determination by gas chromatography-mass spectrometry. The removal efficiencies demonstrated that the treatment plant could eliminate less than 50% of dihydrojasmonate, diclofenac and galaxolide existing in wastewater; concentration of aspirin, naproxen and tonalide could only be reduced in 15%; and caffeine, ibuprofen and ketoprofen were not removed. Results provided basic information to decide over the necessity of complementary treatments for effluents from systems with the mentioned units.

  12. Septic Cardiomyopathy.

    Science.gov (United States)

    Beesley, Sarah J; Weber, Gerhard; Sarge, Todd; Nikravan, Sara; Grissom, Colin K; Lanspa, Michael J; Shahul, Sajid; Brown, Samuel M

    2017-12-08

    To describe, with an emphasis on clinical applications, what is known about the pathophysiology, management, and implications of septic cardiomyopathy in the adult ICU. A PubMed literature review was performed for relevant articles. Only articles in English that studied human adults with sepsis were included. Multiple competing definitions for septic cardiomyopathy hinder understanding of this entity. Although many patients with sepsis develop cardiac dysfunction, the impact of septic cardiomyopathy on prognosis and therapy remains to be demonstrated. Treatment of septic cardiomyopathy is aimed at treating the underlying sepsis and providing specific supportive care for cardiogenic shock when present. Septic cardiomyopathy is an important contributor to organ dysfunction in sepsis. Guided treatment of septic cardiomyopathy may affect patients' prognosis, especially when their cardiac index is substantially decreased. The implication of septic cardiomyopathy for both short- and long-term outcomes is an important area for future investigation.

  13. Septic arthritis

    Science.gov (United States)

    ... develop symptoms of septic arthritis. Prevention Preventive (prophylactic) antibiotics may be helpful for people at high risk. Alternative Names Bacterial arthritis; Non-gonococcal bacterial arthritis References ...

  14. Septic Systems - What to Do after the Flood

    Science.gov (United States)

    Where can I find information on my septic system? Do I pump my tank during flooded or saturated drainfield conditions? What if my septic system has been used to dispose wastewater from my business? What do I do with my septic system after the flood?

  15. Geophysical Assessment of Two Collapsed and Concealed Septic ...

    African Journals Online (AJOL)

    A geophysical study was carried out in the vicinity of two collapsed and concealed septic tanks to delineate the structures responsible for their failure. Two-dimensional resistivity and seismic refraction tomography data were collected along a profile laid across the septic tanks. The data were collected using ABEM ...

  16. Septic Arthritis

    Science.gov (United States)

    ... the joint — contributes to the damage. Risk factors Risk factors for septic arthritis include: Existing joint problems. Chronic diseases and conditions that affect your joints — such as osteoarthritis, gout, rheumatoid arthritis or lupus — can increase your ...

  17. Septic Shock

    Science.gov (United States)

    Seymour, Christopher W.; Rosengart, Matthew R.

    2015-01-01

    IMPORTANCE Septic shock is a clinical emergency that occurs in more than 230 000 US patients each year. OBSERVATIONS AND ADVANCES In the setting of suspected or documented infection, septic shock is typically defined in a clinical setting by low systolic (≤90 mm Hg) or mean arterial blood pressure (≤65 mm Hg) accompanied by signs of hypoperfusion (eg, oliguria, hyperlactemia, poor peripheral perfusion, or altered mental status). Focused ultrasonography is recommended for the prompt recognition of complicating physiology (eg, hypovolemia or cardiogenic shock), while invasive hemodynamic monitoring is recommended only for select patients. In septic shock, 3 randomized clinical trials demonstrate that protocolized care offers little advantage compared with management without a protocol. Hydroxyethyl starch is no longer recommended, and debate continues about the role of various crystalloid solutions and albumin. CONCLUSIONS AND RELEVANCE The prompt diagnosis of septic shock begins with obtainment of medical history and performance of a physical examination for signs and symptoms of infection and may require focused ultrasonography to recognize more complex physiologic manifestations of shock. Clinicians should understand the importance of prompt administration of intravenous fluids and vasoactive medications aimed at restoring adequate circulation, and the limitations of protocol-based therapy, as guided by recent evidence. PMID:26284722

  18. Compostagem aeróbia conjugada de lodo de tanque séptico e resíduos sólidos vegetais Conjugated aerobic composting of septic tank sludge and vegetable solid waste

    Directory of Open Access Journals (Sweden)

    André Gustavo da Silva

    2008-12-01

    Full Text Available O lodo sanitário, principal subproduto do tratamento de esgotos, constitui um dos maiores problemas ambientais urbanos da atualidade. Em meio a este contexto, objetivou-se nesse estudo avaliar o processo da compostagem conjugada de lodo de tanque séptico (LS e resíduos sólidos vegetais (RV e determinar a importância da temperatura para o processo de sanitização do substrato tratado. O experimento, inteiramente casualizado com três tratamentos e três repetições, consistiu de nove reatores aeróbios com 100 litros de capacidade. Os resíduos foram utilizados nas seguintes proporções - T1: 100% RV; T2: 5% LS + 95% RV; T3: 10% LS + 90% RV. A compostagem aeróbia conjugada mostrou ser uma alternativa viável para destruição de ovos de helminto e estabilização dos resíduos, sendo fundamentais para tal, a temperatura, o pH e as relações ecológicas presentes nos reatores.The sanitary sludge, principal byproduct of sewage treatment, constitutes one of the major municipal environmental problems of the present time. The present study was aimed to evaluate the composting of septic tank sludge (SS and vegetable solid waste (VW and to determine the importance of the temperature for the process of sanitization of the treated substrate. The experiment, entirely randomized with three treatments and three repetitions, constituted of nine aerobic reactors with 100 L capacity. The proportions of the wastes utilized were T1: 100%VW; T2: 5%SS + 95%VW; T3: 10%SS + 90%VW. The conjugated composting showed to be a feasible alternative for destruction of helminth eggs and stabilization of the wastes. The temperature, pH and ecological relations present in the reactors were fundamental for this purpose.

  19. [Proteus mirabilis septic arthritis].

    Science.gov (United States)

    Sbiti, Mohammed; Bouhamidi, Bahia; Louzi, Lhoussaine

    2017-01-01

    Acute septic arthritis is rare. It is associated with poor prognosis in terms of mortality and morbidity. We report the case of a 61-year old patient with spontaneous Proteus mirabilis septic arthritis. He suffered from complicated diabetes associated with positive blood cultures and synovial fluid cultures. Patient's evolution was favorable thanks to early diagnosis and initiation of adequate antibiotic therapy. Proteus mirabilis septic arthritis is rare. On that basis we conducted a literature review of cases of Proteus mirabilis pyogenic arthritis to highlight the risk factors, pathogenesis, treatment and evolution of these diseases. Diagnosis is commonly based on microbiological analysis, early articular puncture biopsy is performed before the initiation of antibiotic treatment, direct examination, culture and antibiogram which are useful as guidance for antibiotic therapy. Septic arthritis is a diagnostic and therapeutic emergency; early management of this disease allows total healing without after-effects.

  20. Septic arthritis in children

    African Journals Online (AJOL)

    Age in years . \\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\M. -~ A It. Aki/zy/mla at a! 30 “". Elbow Ankle. 3(32) 2(2.1). %. 74.2. 69.9. 38.7. Shoulder. 14(15.1). Septic (li'I/ll'iti.\\' in children. 2. 69. 36. Hip Knee. No of patients. 14. Age distribution and prevalence of septic arthritis of different joints. Total(%) 45(48.4) 24(25.8). Age (yrs). Table]. 0-1. >10~ 15.

  1. Gastrointestinal perfusion in septic shock.

    NARCIS (Netherlands)

    Haren, E.M. van; Sleight, J.W.; Pickkers, P.; Hoeven, J.G. van der

    2007-01-01

    Septic shock is characterised by vasodilation, myocardial depression and impaired microcirculatory blood flow, resulting in redistribution of regional blood flow. Animal and human studies have shown that gastrointestinal mucosal blood flow is impaired in septic shock. This is consistent with

  2. An interesting septic embolism

    Directory of Open Access Journals (Sweden)

    Funda Uluorman

    2014-01-01

    Full Text Available Septic pulmonary embolism is a rare disease but mortality and morbidity of it is high. Septic pulmonary emboli comes from infected heart valves, thrombophlebitis, and pulmonary artery catheter or infected pacemaker wires as many sources [1,2]. In recent years, pacemaker is a common treatment of the bradiarrhythmia that is persisted in the etiology of septic embolism, its applications has started to pick up [3]. There is the growing number of patients with pacemaker, according to this the frequency of pacemaker lead infection and the number of patients at risk for right-sided endocarditis increase [4]. The patients don't have specific clinical and radiological features because of this it is very difficult to define, so the diagnosis is often delayed [5]. A detailed medical history, a detailed physical examination in diagnosis and evaluation of good additional imaging methods is very important. Early diagnosis and proper treatment, the implementation of the management, can provide good results.

  3. Remaining Sites Verification Package for the 1607-D4 Septic System, Waste Site Reclassification Form 2005-036

    Energy Technology Data Exchange (ETDEWEB)

    R. A. Carlson

    2006-02-23

    The 1607-D4 Septic System was a septic tank and tile field that received sanitary sewage from the 115-D/DR Gas Recirculation Facility. This septic system operated from 1944 to 1968. Decommissioning took place in 1985 and 1986 when all above-grade features were demolished and the tank backfilled. The results of verification sampling demonstrated that residual contaminant concentrations do not preclude any future uses and allow for unrestricted use of shallow zone soils. The results also showed that residual contaminant concentrations are protective of groundwater and the Columbia River.

  4. Micropollutants in groundwater from septic systems: Transformations, transport mechanisms, and human health risk assessment.

    Science.gov (United States)

    Yang, Yun-Ya; Toor, Gurpal S; Wilson, P Chris; Williams, Clinton F

    2017-10-15

    Septic systems may contribute micropollutants to shallow groundwater and surface water. We constructed two in situ conventional drainfields (drip dispersal and gravel trench) and an advanced drainfield of septic systems to investigate the fate and transport of micropollutants to shallow groundwater. Unsaturated soil-water and groundwater samples were collected, over 32 sampling events (January 2013 to June 2014), from the drainfields (0.31-1.07 m deep) and piezometers (3.1-3.4 m deep). In addition to soil-water and groundwater, effluent samples collected from the septic tank were also analyzed for 20 selected micropollutants, including wastewater markers, hormones, pharmaceuticals and personal care products (PPCPs), a plasticizer, and their transformation products. The removal efficiencies of micropollutants from septic tank effluent to groundwater were similar among three septic systems and were 51-89% for sucralose and 53->99% for other micropollutants. Even with high removal rates within the drainfields, six PPCPs and sucralose with concentrations ranging from groundwater, respectively. The human health risk assessment showed that the risk to human health due to consumption of groundwater is negligible for the micropollutants monitored in the study. A better understanding of ecotoxicological effects of micropollutant mixtures from septic systems to ecosystem and human health is warranted for the long-term sustainability of septic systems. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Septic wastewater treatment using recycled rubber particles as biofiltration media.

    Science.gov (United States)

    Oh, Jin Hwan; Park, Jaeyoung; Ellis, Timothy G

    2014-01-01

    Performance of the laboratory-scale recycled rubber particles (RRP) biofilter was compared to a conventional gravel system and a peat biofilter for treatment of septic tank effluent. During the study, the RRP biofilter provided similar or better performance than other systems in terms of organic removal and hydraulic capacity. After the start-up period, RRP biofilter achieved removal efficiencies for BOD5, total suspended solids (TSS), ammonia nitrogen of 96%, 93%, and 90%, respectively, over the range of hydraulic loading rates of 57-204 L/m2/d. On the other hand, the peat biofilter failed hydraulically and the gravel system showed high TSS concentrations in the effluent. RRP provided high surface area and sufficient time for biological treatment. In addition, RRP was observed to provide ammonia adsorption capacity. The results showed that RRP has the potential to be used as substitutes for natural aggregate such as gravel in septic system drainfields. The RRP biofilter can be used as alternative septic systems for the sites where an existing septic system has failed or site conditions, such as high groundwater table or small lot size, are not suitable for the installation of conventional septic systems.

  6. Septic systems as hot-spots of pollutants in the environment: Fate and mass balance of micropollutants in septic drainfields.

    Science.gov (United States)

    Yang, Yun-Ya; Toor, Gurpal S; Wilson, P Chris; Williams, Clinton F

    2016-10-01

    Septic systems, a common type of onsite wastewater treatment systems, can be an important source of micropollutants in the environment. We investigated the fate and mass balance of 17 micropollutants, including wastewater markers, hormones, pharmaceuticals and personal care products (PPCPs) in the drainfield of a septic system. Drainfields were replicated in lysimeters (1.5m length, 0.9m width, 0.9m height) and managed similar to the field practice. In each lysimeter, a drip line dispersed 9L of septic tank effluent (STE) per day (equivalent to 32.29L/m(2) per day). Fourteen micropollutants in the STE and 12 in the leachate from drainfields were detected over eight months. Concentrations of most micropollutants in the leachate were low (85% of the added micropollutants except for sucralose were attenuated in the drainfield. We discovered that sorption was the key mechanism for retention of carbamazepine and partially for sulfamethoxazole, whereas microbial degradation likely attenuated acetaminophen in the drainfield. This data suggests that sorption and microbial degradation limited transport of micropollutants from the drainfields. However, the leaching of small amounts of micropollutants indicate that septic systems are hot-spots of micropollutants in the environment and a better understanding of micropollutants in septic systems is needed to protect groundwater quality. Copyright © 2016 Elsevier B.V. All rights reserved.

  7. Enhanced attenuation of septic system phosphate in noncalcareous sediments.

    Science.gov (United States)

    Robertson, W D

    2003-01-01

    Review of phosphate behavior in four mature septic system plumes on similar textured sand has revealed a strong correlation between carbonate mineral content and phosphate concentrations. A plume on calcareous sand (Cambridge site, 27 wt % CaCO3 equiv.) has proximal zone PO4 concentrations (4.8 mg/L P average) that are about 75% of the septic tank effluent value, whereas three plumes on noncalcareous sand (Muskoka, L. Joseph, and Nobel sites, effluent values. Phosphate attenuation at the noncalcareous sites appears to be an indirect result of the development of acidic conditions (site average pH 3.5 to 5.9) and elevated Al concentrations (up to 24 mg/L), which subsequently causes the precipitation of Al-P minerals such as variscite (AlPO4 x 2H2O). This is supported by scanning electron microscope analyses, which show the widespread occurrence of (Al+P)--rich secondary mineral coatings on sand grains below the infiltration beds. All of these septic systems are more than 10 years old, indicating that these attenuation reactions have substantial longevity. A field lysimeter experiment demonstrated that this reaction sequence can be readily incorporated into engineered waste water treatment systems. We feel this important P removal mechanism has not been adequately recognized, particularly for its potential significance in reducing P loading from septic systems in lakeshore environments.

  8. Pluggable microbial fuel cell stacks for septic wastewater treatment and electricity production.

    Science.gov (United States)

    Yazdi, Hadi; Alzate-Gaviria, Liliana; Ren, Zhiyong Jason

    2015-03-01

    Septic tanks and other decentralized wastewater treatment systems play an important role in protecting public health and water resource for remote or developing communities. Current septic systems do not have energy production capability, yet such feature can be very valuable for areas lack access to electricity. Here we present an easy-to-operate microbial fuel cell (MFC) stack that consists a common base and multiple pluggable units, which can be connected in either series or parallel for electricity generation during waste treatment in septic tanks. Lab studies showed such easy configuration obtained a power density of 142±6.71mWm(-2) when 3 units are connected in parallel, and preliminary calculation indicates that a system that costs approximately US $25 can power a 6-watt LED light for 4h per day with great improvement potential. Detailed electrochemical characterizations provide insights on system internal loss and technology advancement needed. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. Removal of Nutrients from Septic Effluent with Re-circulated Hybrid Tidal Flow Constructed Wetland

    Science.gov (United States)

    Lihua Cui; Jigkun Feng; Ying Ouyang; Peiwen. Deng

    2012-01-01

    Hybrid tidal flow constructed wetland (CW) with recirculation is an improved biological and engineering technique for removal of excess nutrients and certain pollutants from wastewater. This study investigated the removal efficiency of total phosphorus (TP), ammonia-nitrogen (NH3-N), and total nitrogen (TN) from septic tank effluent with the hybrid tidal flow CW system...

  10. Turbidez e cloro residual livre na monitoração de ETE tipo tanque séptico seguido de filtro anaeróbio - doi: 10.4025/actascitechnol.v33i4.9603 Turbidity and free residual chlorine for monitoring plants comprised by septic tank followed by anaerobic filter

    Directory of Open Access Journals (Sweden)

    Raimundo Oliveira de Souza

    2011-09-01

    Full Text Available A avaliação dos dados agrupados da monitoração de 16 ETEs do tipo tanque séptico (TSEP seguido por filtro anaeróbio (FAN mostrou remoção média global de 55% para DQO e SST. O desempenho alcançado foi abaixo do sugerido pela literatura, porém compatível com o de estudos recentes sobre sistemas em escala real no país. A remoção média global de bactérias do grupo coliforme, após desinfecção com solução de hipoclorito de sódio, foi de 3,0 unidades de log. Remoção mais elevada ocorreu com Escherichia coli como indicador (3,5 logs. Em geral, as maiores remoções de coliformes foram alcançadas com concentrações de cloro residual livre (CRL variando de 2,0 a 2,5 mg L-1. Os resultados mostraram a aplicabilidade da turbidez para estimar concentrações de SST e DQO no efluente tratado. Observou-se também que a concentração de CRL é útil para estimar as concentrações de bactérias do grupo coliforme.Grouped monitoring data of 16 wastewater treatment plants was investigated. The plants were comprised by septic tanks followed by anaerobic filters and effluent disinfection with sodium hypochlorite. Removal of COD and total suspended solids was about 55%. This number was below values observed by the literature. However, the results were in accordance with recent findings in Brazilian full-scale plants. Coliform removal was about 3.0 log units with better results for Escherichia coli (3.5 logs. Best results were achieved with free residual chorine concentrations ranging from 2.0 to 2.5 mg L-1. Findings showed that turbidity is a useful parameter to estimate COD and TSS concentrations in the treated effluent. Free residual chlorine may also be applied to estimate coliform numbers.

  11. Corrective Action Decision Document/Closure Report for Corrective Action Unit 557: Spills and Tank Sites, Nevada Test Site, Nevada, Revision 0

    Energy Technology Data Exchange (ETDEWEB)

    Alfred Wickline

    2009-05-01

    This Corrective Action Decision Document/Closure Report has been prepared for Corrective Action Unit (CAU) 557, Spills and Tank Sites, in Areas 1, 3, 6, and 25 of the Nevada Test Site, Nevada, in accordance with the Federal Facility Agreement and Consent Order. Corrective Action Unit 557 comprises the following corrective action sites (CASs): • 01-25-02, Fuel Spill • 03-02-02, Area 3 Subdock UST • 06-99-10, Tar Spills • 25-25-18, Train Maintenance Bldg 3901 Spill Site The purpose of this Corrective Action Decision Document/Closure Report is to identify and provide the justification and documentation that supports the recommendation for closure of the CAU 557 CASs with no further corrective action. To achieve this, a corrective action investigation (CAI) was conducted from May 5 through November 24, 2008. The CAI activities were performed as set forth in the Corrective Action Investigation Plan for Corrective Action Unit 557: Spills and Tank Sites, Nevada Test Site, Nevada.

  12. A Rational Approach to Septic Tank Design | Nnaji | Nigerian ...

    African Journals Online (AJOL)

    Nigerian Journal of Technology. Journal Home · ABOUT · Advanced Search · Current Issue · Archives · Journal Home > Vol 31, No 1 (2012) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Download this PDF file. The PDF file you selected should load here if your ...

  13. Sepsis and Septic Shock Strategies.

    Science.gov (United States)

    Armstrong, Bracken A; Betzold, Richard D; May, Addison K

    2017-12-01

    Three therapeutic principles most substantially improve organ dysfunction and survival in sepsis: early, appropriate antimicrobial therapy; restoration of adequate cellular perfusion; timely source control. The new definitions of sepsis and septic shock reflect the inadequate sensitivity, specify, and lack of prognostication of systemic inflammatory response syndrome criteria. Sequential (sepsis-related) organ failure assessment more effectively prognosticates in sepsis and critical illness. Inadequate cellular perfusion accelerates injury and reestablishing perfusion limits injury. Multiple organ systems are affected by sepsis and septic shock and an evidence-based multipronged approach to systems-based therapy in critical illness results in improve outcomes. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. 10 Kinyanjui-Septic.indd

    African Journals Online (AJOL)

    It can be difficult to differentiate septic from aseptic loosening of prosthesis and especially those due to delayed and late prosthetic-joint infection. In delayed and late prosthetic-joint infection, the acute signs and symptoms of infection such as fever, swelling, erythema and warmth are usually absent and the only.

  15. Nitrogen tank

    CERN Multimedia

    2006-01-01

    Wanted The technical file about the pressure vessel RP-270 It concerns the Nitrogen tank, 60m3, 22 bars, built in 1979, and installed at Point-2 for the former L3 experiment. If you are in possession of this file, or have any files about an equivalent tank (probably between registered No. RP-260 and -272), please contact Marc Tavlet, the ALICE Glimos.

  16. Corrective Action Decision Document for Corrective Action Unit 428: Area 3 Septic Waste Systems 1 and 5, Tonopah Test Range, Nevada

    Energy Technology Data Exchange (ETDEWEB)

    U.S. Department of Energy, Nevada Operations Office

    2000-02-08

    This Corrective Action Decision Document identifies and rationalizes the US Department of Energy, Nevada Operations Office's selection of a recommended corrective action alternative (CAA) appropriate to facilitate the closure of Corrective Action Unit (CAU) 428, Septic Waste Systems 1 and 5, under the Federal Facility Agreement and Consent Order. Located in Area 3 at the Tonopah Test Range (TTR) in Nevada, CAU 428 is comprised of two Corrective Action Sites (CASs): (1) CAS 03-05-002-SW01, Septic Waste System 1 and (2) CAS 03-05-002- SW05, Septic Waste System 5. A corrective action investigation performed in 1999 detected analyte concentrations that exceeded preliminary action levels; specifically, contaminants of concern (COCs) included benzo(a) pyrene in a septic tank integrity sample associated with Septic Tank 33-1A of Septic Waste System 1, and arsenic in a soil sample associated with Septic Waste System 5. During this investigation, three Corrective Action Objectives (CAOs) were identified to prevent or mitigate exposure to contents of the septic tanks and distribution box, to subsurface soil containing COCs, and the spread of COCs beyond the CAU. Based on these CAOs, a review of existing data, future use, and current operations in Area 3 of the TTR, three CAAs were developed for consideration: Alternative 1 - No Further Action; Alternative 2 - Closure in Place with Administrative Controls; and Alternative 3 - Clean Closure by Excavation and Disposal. These alternatives were evaluated based on four general corrective action standards and five remedy selection decision factors. Based on the results of the evaluation, the preferred CAA was Alternative 3. This alternative meets all applicable state and federal regulations for closure of the site and will eliminate potential future exposure pathways to the contaminated soils at the Area 3 Septic Waste Systems 1 and 5.

  17. Mortality rates in pediatric septic shock

    OpenAIRE

    Desy Rusmawatiningtyas; Nurnaningsih Nurnaningsih

    2017-01-01

    Background Septic shock remains a major cause of morbidity and mortality in children admitted to the intensive care unit. Recent investigations from developed countries have reported mortality rates of 20-30%. Few studies have reported mortality rates from pediatric septic shock in intensive care settings in developing countries with limited resources.  Objective  To determine the current mortality rates for pediatric patients with septic shock in a developing country. Methods A retr...

  18. Underground Storage Tanks - Storage Tank Locations

    Data.gov (United States)

    NSGIC Education | GIS Inventory — A Storage Tank Location is a DEP primary facility type, and its sole sub-facility is the storage tank itself. Storage tanks are aboveground or underground, and are...

  19. Dual Tank Fuel System

    Science.gov (United States)

    Wagner, Richard William; Burkhard, James Frank; Dauer, Kenneth John

    1999-11-16

    A dual tank fuel system has primary and secondary fuel tanks, with the primary tank including a filler pipe to receive fuel and a discharge line to deliver fuel to an engine, and with a balance pipe interconnecting the primary tank and the secondary tank. The balance pipe opens close to the bottom of each tank to direct fuel from the primary tank to the secondary tank as the primary tank is filled, and to direct fuel from the secondary tank to the primary tank as fuel is discharged from the primary tank through the discharge line. A vent line has branches connected to each tank to direct fuel vapor from the tanks as the tanks are filled, and to admit air to the tanks as fuel is delivered to the engine.

  20. Septic and non-septic olecranon bursitis in the accident and emergency department--an approach to management.

    OpenAIRE

    Stell, I M

    1996-01-01

    Olecranon bursitis is relatively common. One third of episodes are septic. Most of the remainder are non-septic, with occasional rheumatological causes. Trauma can cause both septic and non-septic olecranon bursitis. Clinical features are helpful in separating septic from non-septic olecranon bursitis, but there may be local erythema in both. Aspiration should be carried out in all cases, and if the presence of infection is still in doubt, microscopy, Gram staining, and culture of the aspirat...

  1. Norovirus outbreak caused by a new septic system in a dolomite aquifer.

    Science.gov (United States)

    Borchardt, Mark A; Bradbury, Kenneth R; Alexander, E Calvin; Kolberg, Rhonda J; Alexander, Scott C; Archer, John R; Braatz, Laurel A; Forest, Brian M; Green, Jeffrey A; Spencer, Susan K

    2011-01-01

    Septic systems that are built in compliance with regulations are generally not expected to be the cause of groundwater borne disease outbreaks, especially in areas with thick vadose zones. However, this case study demonstrates that a disease outbreak can occur in such a setting and outlines the combination of epidemiological, microbiological, and hydrogeological methods used to confirm the source of the outbreak. In early June 2007, 229 patrons and employees of a new restaurant in northeastern Wisconsin were affected by acute gastroenteritis; 6 people were hospitalized. Epidemiological case-control analysis indicated that drinking the restaurant's well water was associated with illness (odds ratio = 3.2, 95% confidence interval = 0.9 to 11.4, P = 0.06). Microbiological analysis (quantitative reverse transcription-polymerase chain reaction) measured 50 genomic copies per liter of norovirus genogroup I in the well water. Nucleotide sequencing determined the genotype as GI.2 and further showed the identical virus was present in patrons' stool specimens and in the septic tank. Tracer tests using dyes injected at two points in the septic system showed that effluent was traveling from the tanks (through a leaking fitting) and infiltration field to the well in 6 and 15 d, respectively. The restaurant septic system and well (85-m deep, in a fractured dolomite aquifer) both conformed to state building codes. The early arrival of dye in the well, which was 188 m from the septic field and located beneath a 35-m thick vadose zone, demonstrates that in highly vulnerable hydrogeological settings, compliance with regulations may not provide adequate protection from fecal pathogens. Copyright © 2010 The Author(s). Journal compilation © 2010 National Ground Water Association.

  2. Closure Report for Corrective Action Unit 516: Septic Systems and Discharge Points

    Energy Technology Data Exchange (ETDEWEB)

    NSTec Environmental Restoration

    2007-02-01

    Corrective Action Unit (CAU) 516 is located in Areas 3, 6, and 22 of the Nevada Test Site. CAU 516 is listed in the Federal Facility Agreement and Consent Order of 1996 as Septic Systems and Discharge Points, and is comprised of six Corrective Action Sites (CASs): {sm_bullet} CAS 03-59-01, Bldg 3C-36 Septic System {sm_bullet} CAS 03-59-02, Bldg 3C-45 Septic System {sm_bullet} CAS 06-51-01, Sump and Piping {sm_bullet} CAS 06-51-02, Clay Pipe and Debris {sm_bullet} CAS 06-51-03, Clean Out Box and Piping {sm_bullet} CAS 22-19-04, Vehicle Decontamination Area The Nevada Division of Environmental Protection (NDEP)-approved corrective action alternative for CASs 06-51-02 and 22-19-04 is no further action. The NDEP-approved corrective action alternative for CASs 03-59-01, 03-59-02, 06-51-01, and 06-51-03 is clean closure. Closure activities included removing and disposing of total petroleum hydrocarbon (TPH)-impacted septic tank contents, septic tanks, distribution/clean out boxes, and piping. CAU 516 was closed in accordance with the NDEP-approved CAU 516 Corrective Action Plan (CAP). The closure activities specified in the CAP were based on the recommendations presented in the CAU 516 Corrective Action Decision Document (U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office, 2004). This Closure Report documents CAU 516 closure activities. During closure activities, approximately 186 tons of hydrocarbon waste in the form of TPH-impacted soil and debris, as well as 89 tons of construction debris, were generated and managed and disposed of appropriately. Waste minimization techniques, such as field screening of soil samples and the utilization of laboratory analysis to characterize and classify waste streams, were employed during the performance of closure work.

  3. Norovirus outbreak caused by a new septic system in a dolomite aquifer

    Science.gov (United States)

    Borchardt, M. A.; Bradbury, K.R.; Alexander, E.C.; Kolberg, R.J.; Alexander, S.C.; Archer, John R.; Braatz, L.A.; Forest, B.M.; Green, J.A.; Spencer, S. K.

    2011-01-01

    Septic systems that are built in compliance with regulations are generally not expected to be the cause of groundwater borne disease outbreaks, especially in areas with thick vadose zones. However, this case study demonstrates that a disease outbreak can occur in such a setting and outlines the combination of epidemiological, microbiological, and hydrogeological methods used to confirm the source of the outbreak. In early June 2007, 229 patrons and employees of a new restaurant in northeastern Wisconsin were affected by acute gastroenteritis; 6 people were hospitalized. Epidemiological case-control analysis indicated that drinking the restaurant's well water was associated with illness (odds ratio = 3.2, 95% confidence interval = 0.9 to 11.4, P = 0.06). Microbiological analysis (quantitative reverse transcription-polymerase chain reaction) measured 50 genomic copies per liter of norovirus genogroup I in the well water. Nucleotide sequencing determined the genotype as GI.2 and further showed the identical virus was present in patrons' stool specimens and in the septic tank. Tracer tests using dyes injected at two points in the septic system showed that effluent was traveling from the tanks (through a leaking fitting) and infiltration field to the well in 6 and 15 d, respectively. The restaurant septic system and well (85-m deep, in a fractured dolomite aquifer) both conformed to state building codes. The early arrival of dye in the well, which was 188 m from the septic field and located beneath a 35-m thick vadose zone, demonstrates that in highly vulnerable hydrogeological settings, compliance with regulations may not provide adequate protection from fecal pathogens.

  4. Control groups in recent septic shock trials

    DEFF Research Database (Denmark)

    Pettilä, Ville; Hjortrup, Peter B; Jakob, Stephan M

    2016-01-01

    PURPOSE: The interpretation of septic shock trial data is profoundly affected by patients, control intervention, co-interventions and selected outcome measures. We evaluated the reporting of control groups in recent septic shock trials. METHODS: We searched for original articles presenting...... randomized clinical trials (RCTs) in adult septic shock patients from 2006 to 2016. We included RCTs focusing on septic shock patients with at least two parallel groups and at least 50 patients in the control group. We selected and evaluated data items regarding patients, control group characteristics...... % the proportion of patients with elevated lactate values. Five studies (21 %) provided data to estimate the proportion of septic shock patients fulfilling the Sepsis-3 definition. The mean data completeness score was 19 out of 36 (range 8-32). Of 18 predefined control group characteristics, a mean of 8 (range 2...

  5. Closure Report for Corrective Action Unit 151: Septic Systems and Discharge Area, Nevada Test Site, Nevada

    Energy Technology Data Exchange (ETDEWEB)

    NSTec Environmental Restoration

    2008-04-01

    Corrective Action Unit (CAU) 151 is identified in the Federal Facility Agreement and Consent Order (FFACO) as Septic Systems and Discharge Area. CAU 151 consists of the following eight Corrective Action Sites (CASs), located in Areas 2, 12, and 18 of the Nevada Test Site, approximately 65 miles northwest of Las Vegas, Nevada: (1) CAS 02-05-01, UE-2ce Pond; (2) CAS 12-03-01, Sewage Lagoons (6); (3) CAS 12-04-01, Septic Tanks; (4) CAS 12-04-02, Septic Tanks; (5) CAS 12-04-03, Septic Tank; (6) CAS 12-47-01, Wastewater Pond; (7) CAS 18-03-01, Sewage Lagoon; and (8) CAS 18-99-09, Sewer Line (Exposed). CAU 151 closure activities were conducted according to the FFACO (FFACO, 1996; as amended February 2008) and the Corrective Action Plan for CAU 151 (U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office, 2007) from October 2007 to January 2008. The corrective action alternatives included no further action, clean closure, and closure in place with administrative controls. CAU 151 closure activities are summarized in Table 1. Closure activities generated liquid remediation waste, sanitary waste, hydrocarbon waste, and mixed waste. Waste generated was appropriately managed and disposed. Waste that is currently staged onsite is being appropriately managed and will be disposed under approved waste profiles in permitted landfills. Waste minimization activities included waste characterization sampling and segregation of waste streams. Some waste exceeded land disposal restriction limits and required offsite treatment prior to disposal. Other waste meeting land disposal restrictions was disposed of in appropriate onsite or offsite landfills. Waste disposition documentation is included as Appendix C.

  6. Partial nitrification enhances natural attenuation of nitrogen in a septic system plume.

    Science.gov (United States)

    Caschetto, M; Robertson, W; Petitta, M; Aravena, R

    2018-01-03

    Natural attenuation of nitrogen (N) was investigated in a well characterized septic system plume at a campground in Ontario, Canada. Total inorganic N (TIN) concentrations in deeper portions of the plume were about one third of the septic tank value of 40.7mgL-1. NH4+ and NO3- isotopic characterization were used to provide insight into potential attenuation processes. Concentrations of NH4+ and NO3- were highly variable in the plume, but approached the septic tank TIN value in some shallow zones and exhibited δ15N values like the tank value of +6‰. However, isotopic enrichment (up to +24‰ for NH4+ and +45‰ for NO3-) and declining TIN concentrations in the deeper zones indicated that anaerobic ammonium oxidation contributed to the TIN attenuation. The degree of isotopic enrichment increased at lower NH4+ concentrations and was consistent with Rayleigh-type distillation with an enrichment factor (Ɛ) of -5.1‰. Additionally, decreasing DOC values with depth and the concomitant enrichment of δ15NNO3 and δ18ONO3, suggested that denitrification was also active. The N attenuation observed in the Killarney plume was partly due to incomplete nitrification that occurred because of the shallow water table, which varied from only 0.2-0.7m below the tile bed infiltration pipes. Moreover, some of the monitoring locations with the shallowest water table distances from the infiltration pipes, had the highest degree of TIN attenuation (70-90%) in the plume. This behavior suggests that controlling water table distance from the infiltration pipes could be a useful mechanism for enhancing N attenuation in septic system plumes. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. Storage and mobilization of natural and septic nitrate in thick unsaturated zones, California

    Science.gov (United States)

    Izbicki, John A.; Flint, Alan L.; O'Leary, David R.; Nishikawa, Tracy; Martin, Peter; Johnson, Russell D.; Clark, Dennis A.

    2015-01-01

    Mobilization of natural and septic nitrate from the unsaturated zone as a result of managed aquifer recharge has degraded water quality from public-supply wells near Yucca Valley in the western Mojave Desert, California. The effect of nitrate storage and potential for denitrification in the unsaturated zone to mitigate increasing nitrate concentrations were investigated. Storage of water extractable nitrate in unsaturated alluvium up to 160 meters (m) thick, ranged from 420 to 6600 kilograms per hectare (kg/ha) as nitrogen (N) beneath undeveloped sites, from 6100 to 9200 kg/ha as N beneath unsewered sites. Nitrate reducing and denitrifying bacteria were less abundant under undeveloped sites and more abundant under unsewered sites; however, δ15N–NO3, and δ18O–NO3 data show only about 5–10% denitrification of septic nitrate in most samples—although as much as 40% denitrification occurred in some parts the unsaturated zone and near the top of the water table. Storage of nitrate in thick unsaturated zones and dilution with low-nitrate groundwater are the primary attenuation mechanisms for nitrate from septic discharges in the study area. Numerical simulations of unsaturated flow, using the computer program TOUGH2, showed septic effluent movement through the unsaturated zone increased as the number and density of the septic tanks increased, and decreased with increased layering, and increased slope of layers, within the unsaturated zone. Managing housing density can delay arrival of septic discharges at the water table, especially in layered unsaturated alluvium, allowing time for development of strategies to address future water-quality issues.

  8. Feed tank transfer requirements

    Energy Technology Data Exchange (ETDEWEB)

    Freeman-Pollard, J.R.

    1998-09-16

    This document presents a definition of tank turnover. Also, DOE and PC responsibilities; TWRS DST permitting requirements; TWRS Authorization Basis (AB) requirements; TWRS AP Tank Farm operational requirements; unreviewed safety question (USQ) requirements are presented for two cases (i.e., tank modifications occurring before tank turnover and tank modification occurring after tank turnover). Finally, records and reporting requirements, and documentation which will require revision in support of transferring a DST in AP Tank Farm to a privatization contractor are presented.

  9. Genetics and genomics in pediatric septic shock.

    Science.gov (United States)

    Wong, Hector R

    2012-05-01

    Pediatric septic shock continues to be an important public health problem. Several investigative groups have applied genetic and genomic approaches as a means of identifying novel pathways and therapeutic targets, discovery of sepsis-related biomarkers, and identification of septic shock subclasses. This review will highlight studies in pediatric sepsis with a focus on gene association studies and genome-wide expression profiling. A summary of published literature involving gene association and expression profiling studies specifically involving pediatric sepsis and septic shock. Several polymorphisms of genes broadly involved in inflammation, immunity, and coagulation have been linked with susceptibility to sepsis, or outcome of sepsis in children. Many of these studies involve meningococcemia, and the strongest association involves a functional polymorphism of the plasminogen activator inhibitor-1 promoter region and meningococcal sepsis. Expression profiling studies in pediatric septic shock have identified zinc supplementation and inhibition of matrix metalloproteinase-8 activity as potential, novel therapeutic approaches in sepsis. Studies focused on discovery of sepsis-related biomarkers have identified interleukin-8 as a robust outcome biomarker in pediatric septic shock. Additional studies have demonstrated the feasibility and clinical relevance of gene expression-based subclassification of pediatric septic shock. Pediatric sepsis and septic shock are increasingly being studied by genetic and genomic approaches and the accumulating data hold the promise of enhancing our future approach to this ongoing clinical problem.

  10. Long-term physical outcome in patients with septic shock

    DEFF Research Database (Denmark)

    Poulsen, J. B.; Møller, Kirsten; Kehlet, H

    2009-01-01

    Limited information is available on physical function after septic shock. The aim of the present study was to assess the physical outcome in survivors 1 year after septic shock.......Limited information is available on physical function after septic shock. The aim of the present study was to assess the physical outcome in survivors 1 year after septic shock....

  11. Closure Report for Corrective Action Unit 224: Decon Pad and Septic Systems, Nevada Test Site, Nevada

    Energy Technology Data Exchange (ETDEWEB)

    NSTec Environmental Restoration

    2007-10-01

    Corrective Action Unit (CAU) 224 is located in Areas 02, 03, 05, 06, 11, and 23 of the Nevada Test Site, which is situated approximately 65 miles northwest of Las Vegas, Nevada. CAU 224 is listed in the Federal Facility Agreement and Consent Order (FFACO) of 1996 as Decon Pad and Septic Systems and is comprised of the following nine Corrective Action Sites (CASs): CAS 02-04-01, Septic Tank (Buried); CAS 03-05-01, Leachfield; CAS 05-04-01, Septic Tanks (4)/Discharge Area; CAS 06-03-01, Sewage Lagoons (3); CAS 06-05-01, Leachfield; CAS 06-17-04, Decon Pad and Wastewater Catch; CAS 06-23-01, Decon Pad Discharge Piping; CAS 11-04-01, Sewage Lagoon; and CAS 23-05-02, Leachfield. The Nevada Division of Environmental Protection (NDEP)-approved corrective action alternative for CASs 02-04-01, 03-05-01, 06-03-01, 11-04-01, and 23-05-02 is no further action. As a best management practice, the septic tanks and distribution box were removed from CASs 02-04-01 and 11-04-01 and disposed of as hydrocarbon waste. The NDEP-approved correction action alternative for CASs 05-04-01, 06-05-01, 06-17-04, and 06-23-01 is clean closure. Closure activities for these CASs included removing and disposing of radiologically and pesticide-impacted soil and debris. CAU 224 was closed in accordance with the NDEP-approved CAU 224 Corrective Action Plan (CAP). The closure activities specified in the CAP were based on the recommendations presented in the CAU 224 Corrective Action Decision Document (U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office, 2005). This Closure Report documents CAU 224 closure activities. During closure activities, approximately 60 cubic yards (yd3) of mixed waste in the form of soil and debris; approximately 70 yd{sup 3} of sanitary waste in the form of soil, liquid from septic tanks, and concrete debris; approximately 10 yd{sup 3} of hazardous waste in the form of pesticide-impacted soil; approximately 0.5 yd{sup 3} of universal waste in

  12. Remaining Sites Verification Package for the 331 Life Sciences Laboratory Drain Field Septic System, Waste Site Reclassification Form 2008-020

    Energy Technology Data Exchange (ETDEWEB)

    J. M. Capron

    2008-10-16

    The 331 Life Sciences Laboratory Drain Field (LSLDF) septic system waste site consists of a diversion chamber, two septic tanks, a distribution box, and a drain field. This septic system was designed to receive sanitary waste water, from animal studies conducted in the 331-A and 331-B Buildings, for discharge into the soil column. However, field observations and testing suggest the 331 LSLDF septic system did not receive any discharges. In accordance with this evaluation, the confirmatory sampling results support a reclassification of the 331 LSLDF waste site to No Action. This site does not have a deep zone or other condition that would warrant an institutional control in accordance with the 300-FF-2 ROD under the industrial land use scenario.

  13. Corrective Action Plan for Corrective Action Unit 262: Area 25 Septic Systems and Underground Discharge Point, Nevada Test Site, Nevada

    Energy Technology Data Exchange (ETDEWEB)

    K. B. Campbell

    2002-06-01

    This Corrective Action Plan (CAP) provides selected corrective action alternatives and proposes the closure methodology for Corrective Action Unit (CAU) 262, Area 25 Septic Systems and Underground Discharge Point. CAU 262 is identified in the Federal Facility Agreement and Consent Order (FFACO) of 1996. Remediation of CAU 262 is required under the FFACO. CAU 262 is located in Area 25 of the Nevada Test Site (NTS), approximately 100 kilometers (km) (62 miles [mi]) northwest of Las Vegas, Nevada. The nine Corrective Action Sites (CASs) within CAU 262 are located in the Nuclear Rocket Development Station complex. Individual CASs are located in the vicinity of the Reactor Maintenance, Assembly, and Disassembly (R-MAD); Engine Maintenance, Assembly, and Disassembly (E-MAD); and Test Cell C compounds. CAU 262 includes the following CASs as provided in the FFACO (1996); CAS 25-02-06, Underground Storage Tank; CAS 25-04-06, Septic Systems A and B; CAS 25-04-07, Septic System; CAS 25-05-03, Leachfield; CAS 25-05-05, Leachfield; CAS 25-05-06, Leachfield; CAS 25-05-08, Radioactive Leachfield; CAS 25-05-12, Leachfield; and CAS 25-51-01, Dry Well. Figures 2, 3, and 4 show the locations of the R-MAD, the E-MAD, and the Test Cell C CASs, respectively. The facilities within CAU 262 supported nuclear rocket reactor engine testing. Activities associated with the program were performed between 1958 and 1973. However, several other projects used the facilities after 1973. A significant quantity of radioactive and sanitary waste was produced during routine operations. Most of the radioactive waste was managed by disposal in the posted leachfields. Sanitary wastes were disposed in sanitary leachfields. Septic tanks, present at sanitary leachfields (i.e., CAS 25-02-06,2504-06 [Septic Systems A and B], 25-04-07, 25-05-05,25-05-12) allowed solids to settle out of suspension prior to entering the leachfield. Posted leachfields do not contain septic tanks. All CASs located in CAU 262 are

  14. Mortality rates in pediatric septic shock

    National Research Council Canada - National Science Library

    Rusmawatiningtyas, Desy; Nurnaningsih, Nurnaningsih

    2017-01-01

    .... Recent investigations from developed countries have reported mortality rates of 20-30%. Few studies have reported mortality rates from pediatric septic shock in intensive care settings in developing countries with limited resources.  Objective...

  15. [Concomitant septic and gouty olecranon bursitis].

    Science.gov (United States)

    Abrazhda, D; Andras, L; Van Linthoudt, D

    2007-09-26

    A case of coexistent acute gout and septic olecranon bursitis is presented. Our hypothesis is that asymptomatic monosodium urate crystals, possibly present in the bursa could secondarily been triggered by the infection.

  16. Corrective Action Plan for Corrective Action Unit 428: Area 3 Septic Waste Systems 1 and 5 Tonopah Test Range, Nevada

    Energy Technology Data Exchange (ETDEWEB)

    D. S. Tobiason

    2000-08-01

    Area 3 Septic Waste Systems 1 and 5 are located in Area 3 of the Tonopah Test Range (TTR) (Figure 1). The site is listed in the Federal Facility Agreement and Consent Order (FFACO, 1996) as Corrective Action Unit (CAU) 428 and includes Corrective Action Sites 03-05-002-SW01 (Septic Waste System 1 [SWS 1]), and 03-05-002-SW05 (Septic Waste System 5 [SWS 5]). The site history for the CAU is provided in the Corrective Action Investigation Plan (U.S. Department of Energy, Nevada Operations Office [DOE/NV], 1999). SWS 1 consists of two leachfields and associated septic tanks. SWS 1 received effluent from both sanitary and industrial sources from various buildings in Area 3 of the TTR (Figure 2). SWS 5 is comprised of one leachfield and outfall with an associated septic tank. SWS 5 received effluent from sources in Building 03-50 in Area 3 of the TTR (Figure 2). Both systems were active until 1990 when a consolidated sewer system was installed. The purpose of this Corrective Action Plan (CAP) is to provide the strategy and methodology to close the Area 3 SWS 1 and 5. The CAU will be closed following state and federal regulations and the FFACO (1996). Site characterization was done during May and June 1999. Samples of the tank contents, leachfield soil, and soil under the tanks and pipes were collected. The results of the characterization were reported in the Corrective Action Decision Document (CADD) (DOE/NV, 2000). Additional sampling was done in May 2000, the results of which are presented in this plan. Soil sample results indicated that two constituents of concern were detected above Preliminary Action Levels (PALs). Total arsenic was detected at a concentration of 68.7 milligrams per kilogram (mg/kg). The arsenic was found under the center distribution line at the proximal end of the SWS 5 Leachfield (Figure 3). Total benzo(a)pyrene was detected at a concentration of 480 micrograms per kilogram ({micro}g/kg). The benzo(a)pyrene was found in the soil under the

  17. AX Tank Farm tank removal study

    Energy Technology Data Exchange (ETDEWEB)

    SKELLY, W.A.

    1999-02-24

    This report examines the feasibility of remediating ancillary equipment associated with the 241-AX Tank Farm at the Hanford Site. Ancillary equipment includes surface structures and equipment, process waste piping, ventilation components, wells, and pits, boxes, sumps, and tanks used to make waste transfers to/from the AX tanks and adjoining tank farms. Two remedial alternatives are considered: (1) excavation and removal of all ancillary equipment items, and (2) in-situ stabilization by grout filling, the 241-AX Tank Farm is being employed as a strawman in engineering studies evaluating clean and landfill closure options for Hanford single-shell tanks. This is one of several reports being prepared for use by the Hanford Tanks Initiative Project to explore potential closure options and to develop retrieval performance evaluation criteria for tank farms.

  18. Closure Report for Corrective Action Unit 428: Area 3 Septic Waste Systems 1 and 5 Tonopah Test Range, Nevada

    Energy Technology Data Exchange (ETDEWEB)

    D. H. Cox

    2001-06-01

    The following site closure activities were performed at the CAU 428 site located at the TTR and are documented in this report: Preplanning and site preparation; Excavating and removing impacted soil; Removing septic tank contents; Closing septic tanks by filling them with clean soil; Collecting verification samples to verify that COCs have been removed to approved levels; Backfilling the excavations to surface grade with clean soil; Disposal of excavated materials following applicable federal, state, and DOE/NV regulations in accordance with Section 2.3 of the CAP (DOE/NV, 2000); and Decontamination of equipment as necessary. Closure was accomplished following the approved CAP (DOE/NV, 2000). Verification sample data demonstrate that all COCs were removed to the remediation standards. Therefore, the site is clean-closed.

  19. Clinical characteristics and outcomes of septic bursitis.

    Science.gov (United States)

    Lieber, Sarah B; Fowler, Mary Louise; Zhu, Clara; Moore, Andrew; Shmerling, Robert H; Paz, Ziv

    2017-12-01

    Limited data guide practice in evaluation and treatment of septic bursitis. We aimed to characterize clinical characteristics, microbiology, and outcomes of patients with septic bursitis stratified by bursal involvement, presence of trauma, and management type. We conducted a retrospective cohort study of adult patients admitted to a single center from 1998 to 2015 with culture-proven olecranon and patellar septic bursitis. Baseline characteristics, clinical features, microbial profiles, operative interventions, hospitalization lengths, and 60-day readmission rates were determined. Patients were stratified by bursitis site, presence or absence of trauma, and operative or non-operative management. Of 44 cases of septic bursitis, patients with olecranon and patellar bursitis were similar with respect to age, male predominance, and frequency of bursal trauma; patients managed operatively were younger (p = 0.05). Clinical features at presentation and comorbidities were similar despite bursitis site, history of trauma, or management. The most common organism isolated from bursal fluid was Staphylococcus aureus. Patients managed operatively were discharged to rehabilitation less frequently (p = 0.04). This study of septic bursitis is among the largest reported. We were unable to identify presenting clinical features that differentiated patients treated surgically from those treated conservatively. There was no clear relationship between preceding trauma or bursitis site and clinical course, management, or outcomes. Patients with bursitis treated surgically were younger. Additional study is needed to identify patients who would benefit from early surgical intervention for septic bursitis.

  20. Septic pericarditis in a cat with pyometra.

    Science.gov (United States)

    Majoy, Sean B; Sharp, Claire R; Dickinson, Amy E; Cunningham, Suzanne M

    2013-01-01

    To describe a unique cause of septic pericarditis in a cat and detail the successful case management strategy. A 6-year-old sexually intact female Ragdoll cat was evaluated for a 7-day history of progressive lethargy, anorexia, and vaginal discharge. Thoracic radiographs revealed a markedly globoid cardiac silhouette and pleural effusion while the initial echocardiogram showed moderate volume pericardial effusion. Following pericardiocentesis, cytologic evaluation of the pericardial effusion revealed septic suppurative inflammation with intra- and extracellular Gram-negative rod-shaped bacteria. Abdominal ultrasound demonstrated a moderate amount of echogenic uterine fluid accumulation with a right-sided uterine horn mass. After stabilization with pericardiocentesis, IV fluid therapy and IV antimicrobials, the cat underwent ovariohysterectomy and partial pericardiectomy. Histopathology confirmed a diagnosis of pyometra and septic pericarditis. Uterine and pericardial fluid bacterial culture yielded Escherichia coli with identical antimicrobial sensitivity spectrums. Septic pericarditis is a rare cause of pericardial effusion in the cat. Previous reported cases have either suggested the cause to be secondary to transient bacteremia resulting from a local infection seeding the pericardium or for the cause to remain unknown. To the authors' knowledge, this is the first veterinary report of septic pericarditis resulting from hematogeneously spread bacteria originating from a urogenital infection. It is also the first report of successful surgical management of septic pericarditis in the cat. © Veterinary Emergency and Critical Care Society 2012.

  1. AX Tank Farm tank removal study

    Energy Technology Data Exchange (ETDEWEB)

    SKELLY, W.A.

    1998-10-14

    This report considers the feasibility of exposing, demolishing, and removing underground storage tanks from the 241-AX Tank Farm at the Hanford Site. For the study, it was assumed that the tanks would each contain 360 ft{sup 3} of residual waste (corresponding to the one percent residual Inventory target cited in the Tri-Party Agreement) at the time of demolition. The 241-AX Tank Farm is being employed as a ''strawman'' in engineering studies evaluating clean and landfill closure options for Hanford single-shell tank farms. The report is one of several reports being prepared for use by the Hanford Tanks Initiative Project to explore potential closure options and to develop retrieval performance evaluation criteria for tank farms.

  2. Septic and non-septic olecranon bursitis in the accident and emergency department--an approach to management.

    Science.gov (United States)

    Stell, I M

    1996-09-01

    Olecranon bursitis is relatively common. One third of episodes are septic. Most of the remainder are non-septic, with occasional rheumatological causes. Trauma can cause both septic and non-septic olecranon bursitis. Clinical features are helpful in separating septic from non-septic olecranon bursitis, but there may be local erythema in both. Aspiration should be carried out in all cases, and if the presence of infection is still in doubt, microscopy, Gram staining, and culture of the aspirate will resolve the issue. Septic olecranon bursitis should be treated by aspiration, which may need to be repeated, and a long course of antibiotics. Some cases will need admission, and a few will need surgical treatment. Non-septic olecranon bursitis can be managed with aspiration alone. Non-steroidal anti-inflammatory drugs probably hasten symptomatic improvement. Intrabursal corticosteroids produce a rapid resolution but concern remains over their long term local effects. Recovery from septic olecranon bursitis can take months.

  3. Effects of aeration on water quality from septic system leachfields.

    Science.gov (United States)

    Potts, David A; Görres, Josef H; Nicosia, Erika L; Amador, José A

    2004-01-01

    We conducted a pilot-scale study at a research facility in southeastern Connecticut to assess the effects of leachfield aeration on removal of nutrients and pathogens from septic system effluent. Treatments consisted of lysimeters periodically aerated to maintain a headspace O(2) concentration of 0.209 mol mol(-1) (AIR) or vented to an adjacent leachfield trench (LEACH) and were replicated three times. All lysimeters were dosed with effluent from a septic tank for 24 mo at a rate of 12 cm d(-1) and subsequently for 2 mo at 4 cm d(-1). LEACH lysimeters had developed a clogging mat, or biomat, 20 mo before the beginning of our study. The level of aeration in the AIR treatment was held constant regardless of loading rate. No conventional biomat developed in the AIR treatment, whereas a biomat was present in the LEACH lysimeters. The headspace of LEACH lysimeters was considerably depleted in O(2) and enriched in CH(4), CO(2), and H(2)S relative to AIR lysimeters. Drainage water from AIR lysimeters was saturated with O(2) and had significantly lower pH, five-day biological oxygen demand (BOD(5)), and ammonium, and higher levels of nitrate and sulfate than LEACH lysimeters regardless of dosing rate. By contrast, significantly lower levels of total N and fecal coliform bacteria were observed in AIR than in LEACH lysimeters only at the higher dosing rate. No significant differences in total P removal were observed. Our results suggest that aeration may improve the removal of nitrogen, BOD(5), and fecal coliforms in leachfield soil, even in the absence of a biomat.

  4. Corrective Action Decision Document/Closure Report for Corrective Action 405: Area 3 Septic Systems, Tonopah Test Range, Nevada Rev. No.: 0, April 2002

    Energy Technology Data Exchange (ETDEWEB)

    IT Coroporation, Las Vegas, NV

    2002-04-17

    This Corrective Action Decision Document/Closure Report (CADD/CR) has been prepared for Corrective Action Unit (CAU) 405, Area 3 Septic Systems, in accordance with the Federal Facility Agreement and Consent Order. Located on the Tonopah Test Range (TTR) approximately 235 miles north of Las Vegas, Nevada, CAU 405 consists of three Corrective Action Sites (CASs): 03-05-002-SW03, Septic Waste System (aka: Septic Waste System [SWS] 3); 03-05-002-SW04, Septic Waste System (aka: SWS 4); 03-05-002-SW07, Septic Waste System (aka: SWS 7). The CADD and CR have been combined into one report because no further action is recommended for this CAU, and this report provides specific information necessary to support this recommendation. The CAU consists of three leachfields and associated collection systems that were installed in or near Area 3 for wastewater disposal. These systems were used until a consolidated sewer system was installed in 1990. Historically, operations within various buildin gs in and near Area 3 of the TTR generated sanitary and industrial wastewaters. There is a potential that contaminants of concern (COCs) were present in the wastewaters and were disposed of in septic tanks and leachfields. The justification for closure of this CAU without further action is based on process knowledge and the results of the investigative activities. Closure activities were performed at these CASs between January 14 and February 2, 2002, and included the removal and proper disposal of media containing regulated constituents and proper closure of septic tanks. No further action is appropriate because all necessary activities have been completed. No use restrictions are required to be imposed for these sites since the investigation showed no evidence of COCs identified in the soil for CAU 405.

  5. Modeling Serum Creatinine in Septic ICU Patients

    DEFF Research Database (Denmark)

    De Gaetano, Andrea; Cortese, Giuliana; Pedersen, Morten Gram

    2004-01-01

    Serum creatinine is a metabolite assumed to be constantly produced by the normally functioning muscle mass and is a good measure for monitoring daily renal function in the intensive care unit (ICU). High serum creatinine levels or an abnormal departure from normal pre-disease basal levels...... are indices of acute renal failure (ARF). Septic ICU patients develop multi-organ failure and ARF is often an important complication. In order to attempt to substitute artificially for the failing renal function, septic ARF patients often undergo hemodialytic procedures until kidney damage resolves....... The present work details the structure of a model describing observed creatinine serum concentration (CSC) variations, depending on the time-varying septic insult to renal function in ICU patients, as well as the estimation of its parameters. CSC determinations were routinely obtained from 12 patients...

  6. Red blood cell transfusion in septic shock

    DEFF Research Database (Denmark)

    Rosland, Ragnhild G; Hagen, Marte U; Haase, Nicolai

    2014-01-01

    BACKGROUND: Treating anaemia with red blood cell (RBC) transfusion is frequent, but controversial, in patients with septic shock. Therefore we assessed characteristics and outcome associated with RBC transfusion in this group of high risk patients. METHODS: We did a prospective cohort study at 7...... general intensive care units (ICUs) including all adult patients with septic shock in a 5-month period. RESULTS: Ninety-five of the 213 included patients (45%) received median 3 (interquartile range 2-5) RBC units during shock. The median pre-transfusion haemoglobin level was 8.1 (7.4-8.9) g...... and SAPS II and SOFA-score on day 1. CONCLUSIONS: The decision to transfuse patients with septic shock was likely affected by disease severity and bleeding, but haemoglobin level was the only measure that consistently differed between transfused and non-transfused patients....

  7. Tank characterization report: Tank 241-C-109

    Energy Technology Data Exchange (ETDEWEB)

    Simpson, B.C.; Borshiem, G.L.; Jensen, L.

    1993-09-01

    Single-shell tank 241-C-109 is a Hanford Site Ferrocyanide Watch List tank that was most recently sampled in September 1992. Analyses of materials obtained from tank 241-C-109 were conducted to support the resolution of the ferrocyanide unreviewed safety question (USQ) and to support Hanford Federal Facility Agreement and consent Order (Tri- Party Agreement) Milestone M-10-00. This report describes this analysis.

  8. Improving adherence to PALS septic shock guidelines.

    Science.gov (United States)

    Paul, Raina; Melendez, Elliot; Stack, Anne; Capraro, Andrew; Monuteaux, Michael; Neuman, Mark I

    2014-05-01

    Few studies have demonstrated improvement in adherence to Pediatric Advanced Life Support guidelines for severe sepsis and septic shock. We sought to improve adherence to national guidelines for children with septic shock in a pediatric emergency department with poor guideline adherence. Prospective cohort study of children presenting to a tertiary care pediatric emergency department with septic shock. Quality improvement (QI) interventions, including repeated plan-do-study-act cycles, were used to improve adherence to a 5-component sepsis bundle, including timely (1) recognition of septic shock, (2) vascular access, (3) administration of intravenous (IV) fluid, (4) antibiotics, and (5) vasoactive agents. The intervention focused on IV fluid delivery as a key driver impacting bundle adherence, and adherence was measured using statistical process control methodology. Two-hundred forty-two patients were included: 126 subjects before the intervention (November 2009 to March 2011), and 116 patients during the QI intervention (October 2011 to May 2013). We achieved 100% adherence for all metrics, including (1) administration of 60 mL/kg IV fluid within 60 minutes (increased from baseline adherence rate of 37%), (2) administration of vasoactive agents within 60 minutes (baseline rate of 35%), and (3) 5-component bundle adherence (baseline rate of 19%). Improvement was sustained over 9 months. The number of septic shock cases between each death from this condition increased after implementation of the QI intervention. Using QI methodology, we have demonstrated improved adherence to national guidelines for severe sepsis and septic shock. Copyright © 2014 by the American Academy of Pediatrics.

  9. Septic arthritis caused by Peptostreptococcus asaccharolyticus

    Directory of Open Access Journals (Sweden)

    Carlos Costa

    2016-07-01

    Full Text Available Peptostreptococcus spp are commensal organisms, usually involved in periodontal disease. Peptostreptococcus asaccharolyticus is an anaerobic gram-negative cocci, difficult to isolate due to its slow growth. Septic arthritis by this microorganism is a rare entity, but it can occur by hematogenous dissemination from a distant focus. Colonization and growth are more likely to occur in an already damaged articulation. We report the case of a 57 year-old woman with peripheral spondyloarthritis who developed knee septic arthritis by Peptostreptococcus asaccharolyticus.

  10. Quantification of Shallow Groundwater Nutrient Dynamics in Septic Areas

    Science.gov (United States)

    Ying Ouyang; Jia-En Zhang

    2012-01-01

    Of all groundwater pollution sources, septic systems are the second largest source of groundwater nitrate contamination in USA. This study investigated shallow groundwater (SGW) nutrient dynamics in septic areas at the northern part of the Lower St. Johns River Basin, Florida, USA. Thirty-five SGW-monitoring wells, located at nine different urban areas served by septic...

  11. Think Tanks in Europe

    DEFF Research Database (Denmark)

    Kelstrup, Jesper Dahl

    The emergence of more think tanks in recent decades has spawned some interest in how they function and impact policy-making in the European Union and its member states. So far however few empirical studies of think tanks have been carried out and think tanks have mainly been studied in their nati......The emergence of more think tanks in recent decades has spawned some interest in how they function and impact policy-making in the European Union and its member states. So far however few empirical studies of think tanks have been carried out and think tanks have mainly been studied...

  12. Septic Shock: Advances in Diagnosis and Treatment.

    Science.gov (United States)

    Seymour, Christopher W; Rosengart, Matthew R

    2015-08-18

    Septic shock is a clinical emergency that occurs in more than 230,000 US patients each year. OBSERVATIONS AND ADVANCES: In the setting of suspected or documented infection, septic shock is typically defined in a clinical setting by low systolic (≤90 mm Hg) or mean arterial blood pressure (≤65 mm Hg) accompanied by signs of hypoperfusion (eg, oliguria, hyperlactemia, poor peripheral perfusion, or altered mental status). Focused ultrasonography is recommended for the prompt recognition of complicating physiology (eg, hypovolemia or cardiogenic shock), while invasive hemodynamic monitoring is recommended only for select patients. In septic shock, 3 randomized clinical trials demonstrate that protocolized care offers little advantage compared with management without a protocol. Hydroxyethyl starch is no longer recommended, and debate continues about the role of various crystalloid solutions and albumin. The prompt diagnosis of septic shock begins with obtainment of medical history and performance of a physical examination for signs and symptoms of infection and may require focused ultrasonography to recognize more complex physiologic manifestations of shock. Clinicians should understand the importance of prompt administration of intravenous fluids and vasoactive medications aimed at restoring adequate circulation, and the limitations of protocol-based therapy, as guided by recent evidence.

  13. Severe sepsis and septic shock [author's reply

    NARCIS (Netherlands)

    Angus, Derek C.; van der Poll, Tom

    2013-01-01

    To the Editor: We would like to address two potentially confusing issues concerning venous oxygen saturation (Svo(2)) as presented in Table 1 of the review by Angus and van der Poll (Aug. 29 issue).(1) First, Table 1 suggests that Svo(2) is raised in sepsis, severe sepsis, and septic shock.

  14. Septic arthritis of the pubic symphysis.

    Science.gov (United States)

    Nitsche, A; Mogni, G O; Gorostiaga, P E

    1989-01-01

    Septic arthritis of the pubic symphysis developed in a previously healthy 13-year-old boy. Blood cultures and the culture of material taken by joint aspiration of the pubic symphysis under radioscopic control yielded Staphilococcus aureus. Early treatment with parenteral antibiotics prevented the development of osteomyelitis of the pubic rami in our patient. Open debridement was not necessary.

  15. Deficit of interleukin 7 in septic patients.

    Science.gov (United States)

    Andreu-Ballester, Juan C; Cuellar, Carmen; Garcia-Ballesteros, Carlos; Pérez-Griera, Jaime; Amigó, Victoria; Peiró-Gómez, Ana; Peñarroja-Otero, Carlos; Ballester, Ferran; Mayans, José; Tormo-Calandín, Constantino

    2014-11-01

    We recently demonstrated an overall decrease of all αβ and specially γδ T cell subsets in patients with sepsis compared with healthy subjects. IL-7 is a crucial factor for development of γδ T cells and survival in sepsis but its association with sepsis severity, evolution of organ failure and death still has not been investigated. Sera from 78 patients who met criteria for sepsis were analyzed vs control group. Septic patients showed the lowest levels of IL-7. Patients with severe sepsis reached levels of IL-7 higher than those observed in the groups of uncomplicated sepsis and septic shock. The frequency of γδ T cells at admission was lower in septic patients vs control group. At the time of admission, the frequency of γδ T cells in septic patients who subsequently died was lower than the observed in the group of patients that instead survived. Copyright © 2014 Elsevier B.V. All rights reserved.

  16. Tank 241-AZ-101 tank characterization plan

    Energy Technology Data Exchange (ETDEWEB)

    Schreiber, R.D.

    1995-02-06

    The Defense Nuclear Facilities Safety Board has advised the DOE to concentrate the near-term sampling and analysis activities on identification and resolution of safety issues. The Data Quality Objective (DQO) process was chosen as a tool to be used in the resolution of safety issues. As a result, A revision in the Federal Facilities Agreement and Consent Order (Tri-Party Agreement) milestone M-44 has been made, which states that ``A Tank Characterization Plan (TCP) will also be developed for each double-shell tank (DST) and single-shell tank (SST) using the DQO process. Development of TCPs by the DQO process is intended to allow users to ensure their needs will be met and that resources are devoted to gaining only necessary information``. This document satisfies that requirement for Tank 241-AZ-101 (AZ-101) sampling activities. Tank AZ-101 is currently a non-Watch List tank, so the only DQOs applicable to this tank are the safety screening DQO and the compatibility DQO, as described below. The contents of Tank AZ-101, as of October 31, 1994, consisted of 3,630 kL (960 kgal) of dilute non-complexed waste and aging waste from PUREX (NCAW, neutralized current acid waste). Tank AZ-101 is expected to have two primary layers. The bottom layer is composed of 132 kL of sludge, and the top layer is composed of 3,500 kL of supernatant, with a total tank waste depth of approximately 8.87 meters.

  17. Feed tank transfer requirements

    Energy Technology Data Exchange (ETDEWEB)

    Freeman-Pollard, J.R.

    1998-09-16

    This document presents a definition of tank turnover; DOE responsibilities; TWRS DST permitting requirements; TWRS Authorization Basis (AB) requirements; TWRS AP Tank Farm operational requirements; unreviewed safety question (USQ) requirements; records and reporting requirements, and documentation which will require revision in support of transferring a DST in AP Tank Farm to a privatization contractor for use during Phase 1B.

  18. Septic Systems Contribution to Phosphorus in Shallow Groundwater: Field-Scale Studies Using Conventional Drainfield Designs.

    Science.gov (United States)

    Mechtensimer, Sara; Toor, Gurpal S

    2017-01-01

    Septic systems can be a potential source of phosphorus (P) in groundwater and contribute to eutrophication in aquatic systems. Our objective was to investigate P transport from two conventional septic systems (drip dispersal and gravel trench) to shallow groundwater. Two new in-situ drainfields (6.1 m long by 0.61 m wide) with a 3.72 m2 infiltrative surface were constructed. The drip dispersal drainfield was constructed by placing 30.5 cm commercial sand on top of natural soil and the gravel trench drainfield was constructed by placing 30.5 cm of gravel on top of 30.5 cm commercial sand and natural soil. Suction cup lysimeters were installed in the drainfields (at 30.5, 61, 106.7 cm below infiltrative surface) and piezometers were installed in the groundwater (>300 cm below infiltrative surface) to capture P dynamics from the continuum of unsaturated to saturated zones in the septic systems. Septic tank effluent (STE), soil-water, and groundwater samples were collected for 64 events (May 2012-Dec 2013) at 2 to 3 days (n = 13), weekly (n = 29), biweekly (n = 17), and monthly (n = 5) intervals. One piezometer was installed up-gradient of the drainfields to monitor background groundwater (n = 15). Samples were analyzed for total P (TP), orthophosphate-P (PO4-P), and other-P (TP-PO4-P). The gravel trench drainfield removed significantly (p300 cm in the groundwater, both systems had similar TP reductions of >97%. After 18 months of STE application, there was no significant increase in groundwater TP concentrations in both systems. We conclude that both drainfield designs are effective at reducing P transport to shallow groundwater.

  19. Corrective Action Investigation Plan for Corrective Action Unit 151: Septic Systems and Discharge Area, Nevada Test Site, Nevada, Rev. No.: 0

    Energy Technology Data Exchange (ETDEWEB)

    David A. Strand

    2004-06-01

    This Corrective Action Investigation Plan (CAIP) contains project-specific information for conducting site investigation activities at Corrective Action Unit (CAU) 151: Septic Systems and Discharge Area, Nevada Test Site, Nevada. Information presented in this CAIP includes facility descriptions, environmental sample collection objectives, and criteria for the selection and evaluation of environmental corrective action alternatives. Corrective Action Unit 151 is located in Areas 2, 12, 18, and 20 of the Nevada Test Site, which is 65 miles northwest of Las Vegas, Nevada. Corrective Action Unit 151 is comprised of the nine Corrective Action Sites (CAS) listed below: (1) 02-05-01, UE-2ce Pond; (2) 12-03-01, Sewage Lagoons (6); (3) 12-04-01, Septic Tanks; (4) 12-04-02, Septic Tanks; (5) 12-04-03, Septic Tank; (6) 12-47-01, Wastewater Pond; (7) 18-03-01, Sewage Lagoon; (8) 18-99-09, Sewer Line (Exposed); and (9) 20-19-02, Photochemical Drain. The CASs within CAU 151 are discharge and collection systems. Corrective Action Site 02-05-01 is located in Area 2 and is a well-water collection pond used as a part of the Nash test. Corrective Action Sites 12-03-01, 12-04-01, 12-04-02, 12-04-03, and 12-47-01 are located in Area 12 and are comprised of sewage lagoons, septic tanks, associated piping, and two sumps. The features are a part of the Area 12 Camp housing and administrative septic systems. Corrective Action Sites 18-03-01 and 18-99-09 are located in the Area 17 Camp in Area 18. These sites are sewage lagoons and associated piping. The origin and terminus of CAS 18-99-09 are unknown; however, the type and configuration of the pipe indicates that it may be a part of the septic systems in Area 18. Corrective Action Site 20-19-02 is located in the Area 20 Camp. This site is comprised of a surface discharge of photoprocessing chemicals.

  20. Fe(III) reduction-mediated phosphate removal as vivianite (Fe3(PO4)2⋅8H2O) in septic system wastewater.

    Science.gov (United States)

    Azam, Hossain M; Finneran, Kevin T

    2014-02-01

    Phosphate is a water contaminant from fertilizers, soaps, and detergents that enters municipal and onsite wastewater from households, businesses, and other commercial operations. Phosphate is a limiting nutrient for algae, and is one of the molecules that promotes eutrophication of water bodies. Phosphate is especially problematic in onsite wastewater because there are few removal mechanisms under normal operating conditions; a system must be amended specifically with compounds to bond to or adsorb phosphate in the septic tank or within the leach field. Vivianite (Fe3(PO4)2⋅8H2O) is a stable mineral formed from ferrous iron and phosphate, often as the result of Fe(III) reducing microbial activity. What was unknown was the concentration of phosphate that could be removed by this process, and whether it was relevant to mixed microbial systems like septic tank wastewater. Data presented here demonstrate that significant concentrations of phosphate (12-14mM) were removed as vivianite in growing cultures of Geobacter metallireducens strain GS-15. Vivianite precipitates were identified on the cell surfaces and within multi cell clusters using TEM-EDX; the mineral phases were directly characterized using XRD. Phosphate was also removed in dilute and raw (undiluted) septic wastewater amended with different forms of Fe(III) including solid phase and soluble Fe(III). Vivianite precipitates were recovered and identified using XRD, along with siderite (ferrous carbonate), which was expected given that the systems were likely bicarbonate buffered. These data demonstrate that ferric iron amendments in septic wastewater increase phosphate removal as the mineral vivianite, and this may be a good strategy for phosphate attenuation in the septic tank portion of onsite wastewater systems. Copyright © 2013 Elsevier Ltd. All rights reserved.

  1. Tank truck purging system

    Energy Technology Data Exchange (ETDEWEB)

    Yazin, G.R.

    1984-09-04

    Apparatus and method are disclosed for purging a vehicle tank compartment to permit access for repair, or maintenance without environmental pollution or hazard to workmen entering the tank. In accordance with the invention an elongated cylindrical storage tank is tilted about its horizontal axis, to form a reservoir for purge water. The tank is connectable as by flexible hoses to fill and drain connections for a tank compartment of a truck, rail car, or other bulk liquid vehicle. Purge water is pumped from the storage tank at a level above the lower tilted end of the elongated tank and vapor displaced from the tank compartment by the water is recovered through a vapor recovery system. Desirably, the compartment is filled until it overflows into the vapor recovery line. Water is returned to the storage tank at a position near the upwardly tilted end. The tilted arrangement permits gravity separation and accumulation of minor amounts of light hydrocarbons, such as diesel fuel or gasoline at an upper separation zone formed by the upwardly tilted end. A similar separation zone or volume for accumulation of rust particles, sludge and the like is formed at the lower tilted end. Hydrocarbons lighter than water are flushed from the tilted upper end of the reservoir tank by adding water to the reservoir tank so that it overflows through a line connected to a separator tank. Heavy particles from the lower tilted end are removed through a cleanout line entering near the lower tilted end of the reservoir tank. Water may also be removed from the tank to lower the water level at the upper tilted end to increase the surface area of the separation zone for accumulation of such lighter hydrocarbons.

  2. EARLY GOAL DIRECTED THERAPY AT SEPTIC SYOK

    Directory of Open Access Journals (Sweden)

    Ayu Widyanti

    2013-04-01

    Full Text Available Sepsis is the most commom cause of death in children with critically ill. Using WHO criteria (severe sepsis defined as sepsis with acidosis, hypotension or both, it was determined that in 1995 there were more than 42.000 cases of severe sepsis in children in the United States with mortality rate was 10.3%. To answer that finding, evicende based protocol was made, it called early goal directed therapy (EGDT. EGDT is a comprehensive strategy to evaluate patient with septic shock include, challenge of fluid, antibiotic, vasopressor, measurement of central vein oxygen saturation, PRC transfusion, administering inotropic dan mechanic ventilation. All of these must be done in the first 6 hours since sepsis or septic shock was found, because if there is a delay of resuscitation, anything we do to increase oxygenation level of the cell will be useless.

  3. Acute septic arthritis due to Streptococcus sanguis.

    Science.gov (United States)

    Papaioannides, Demetrios; Boniatsi, Loukia; Korantzopoulos, Panagiotis; Sinapidis, Demetrios; Giotis, Christos

    2006-01-01

    To present a case of acute septic arthritis due to Streptococcussanguis, a member of the viridans group streptococci. A 73-year-old woman presented with fever and increasing swelling and pain of the right knee several weeks after she had been treated for severe periodontal disease. Arthrocentesis yielded purulent synovial fluid. S. sanguis was isolated in synovial fluid cultures, and the patient was treated with intravenous cefotaxime for 3 weeks and repeated aspiration of the knee joint with gradual resolution of fever, joint swelling and effusion. Although S. sanguis is believed to be a rare cause of septic arthritis in native joints, it should be considered in the differential diagnosis of this disorder, especially in patients with recent treatment of severe dental caries and periodontal disease.

  4. Clinical management guidelines of pediatric septic shock

    OpenAIRE

    Khilnani Praveen

    2005-01-01

    Septic shock in children is the prototype combination of hypovolemia,cardiogenic and distributive shock. Recently published American college of critical care medinie(ACCM )recommendations for hemodynamic support of neonatal and pediatric patients with sepsis,Surviving sepsis campaign and its pediatric considerations and subsequent revision of definitions for pediatric sepsis has led to compilation of this review article. Practical application of this information in Indian set up in a child wi...

  5. Myocardial dysfunction in pediatric septic shock.

    Science.gov (United States)

    Raj, Shashi; Killinger, James S; Gonzalez, Jennifer A; Lopez, Leo

    2014-01-01

    To evaluate the prevalence and significance of myocardial dysfunction in children with septic shock. Thirty patients with septic shock were evaluated by transthoracic echocardiography within 24 hours of admission to a pediatric critical care unit. Transthoracic echocardiography evaluation included left ventricular (LV) size and function, mitral valve inflow velocities in early and late diastole, mitral valve annular velocities in systole and early and late diastole, and LV myocardial performance index. LV systolic dysfunction was defined as an ejection fraction or shortening fraction z-score 2. Secondary outcomes included troponin I concentration, acute kidney injury, and 28-day mechanical ventilation-free duration. Mortality for the 30 patients (mean age, 9.5 ± 7 years) was 7%. The prevalence of LV systolic and/or diastolic dysfunction was 53% (16 of 30). Eleven patients (37%) had systolic dysfunction, 10 (33%) had diastolic dysfunction, and 5 (17%) had both. Systolic and/or diastolic dysfunction was significantly associated with troponin I level (P = .007) and acute kidney injury (P = .02), but not with ventilation-free duration (P = .12). Kaplan-Meier analyses for pediatric critical care unit and hospital length of stay identified no differences between patients with and those without myocardial dysfunction. Myocardial dysfunction occurs frequently in children with septic shock but might not affect hospital length of stay. Copyright © 2014 Mosby, Inc. All rights reserved.

  6. MR findings of septic cavernous sinus thrombosis

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hyeong Lae; Lee, Nam Joon; Lee, Jung Hee; Pyo, Hyeon Soon; Eo, Geun; Kim, Kyo Nam; Kim, Young Soon; Kim, Jang Min [Kwang Myung Sung Ae Hospital, Kwang Myung (Korea, Republic of); Lee, Don Young [Korea University Anam Hospital, Seoul (Korea, Republic of)

    2000-08-01

    To evaluate the MR findings of septic thrombosis of the cavernous sinus. Eleven MR images of six patients with septic cavernous sinus thrombosis obtained over a five-year period and proven clinically or radiologically were retrospectively reviewed. The contour and enhancement pattern of the cavernous sinus, changes in the internal carotid artery, orbit, pituitary gland and sphenoid sinus, and intracranial abnormalities were analyzed and compared with the findings of follow-up studies. In all six patients, contrast study revealed asymmetrical enlargement of the ipsilateral cavernous sinus and multiple irregular filling defects within it. Narrowing of the cavernous portion of the ipsilateral internal carotid artery was noted in five patients, upward displacement of the ipsilateral internal carotid artery in four, ipsilateral proptosis with engorgement of the superior ophthalmic vein in two, pituitary enlargement in five, and inflammatory change in the sphenoid sinus in six. Associated intracranial abnormalities included edema and enhancement in the meninx, temporal lobe, or pons adjacent to the cavernous sinus in four patients, hydrocephalus in one, and cerebral infarction in one. Follow-up MR imaging indicated that the extent of asymmetrical enlargement of the cavernous sinus, filling defects within it, as seen on contrast study, and enlarged pituitary glands had all decreased, without significant interval change. MR imaging is useful in the diagnosis of septic cavernous sinus thrombosis. Asymmetrical enlargement of the cavernous sinus, multiple irregular filling defect within it, as seen on contrast study, and changes in the internal carotid artery are characteristic findings. (author)

  7. Angiotensin II in Refractory Septic Shock.

    Science.gov (United States)

    Antonucci, Elio; Gleeson, Patrick J; Annoni, Filippo; Agosta, Sara; Orlando, Sergio; Taccone, Fabio Silvio; Velissaris, Dimitrios; Scolletta, Sabino

    2017-05-01

    Refractory septic shock is defined as persistently low mean arterial blood pressure despite volume resuscitation and titrated vasopressors/inotropes in patients with a proven or suspected infection and concomitant organ dysfunction. Its management typically requires high doses of catecholamines, which can induce significant adverse effects such as ischemia and arrhythmias. Angiotensin II (Ang II), a key product of the renin-angiotensin-aldosterone system, is a vasopressor agent that could be used in conjunction with other vasopressors to stabilize critically ill patients during refractory septic shock, and reduce catecholamine requirements. However, very few clinical data are available to support Ang II administration in this setting. Here, we review the current literature on this topic to better understand the role of Ang II administration during refractory septic shock, differentiating experimental from clinical studies. We also consider the potential role of exogenous Ang II administration in specific organ dysfunction and possible pitfalls with Ang II in sepsis. Various issues remain unresolved and future studies should investigate important topics such as: the optimal dose and timing of Ang II administration, a comparison between Ang II and the other vasopressors (epinephrine; vasopressin), and Ang II effects on microcirculation.

  8. Dopamine versus noradrenaline in septic shock

    Directory of Open Access Journals (Sweden)

    Bo Xu

    2011-10-01

    Full Text Available BackgroundThe ‘Surviving Sepsis’ Campaign guidelines recommend theuse of dopamine or noradrenaline as the first vasopressor inseptic shock. However, information that guides clinicians inchoosing between dopamine and noradrenaline as the firstvasopressor in patients with septic shock is limited.ObjectiveThis article presents a review of the literature regarding theuse of dopamine versus noradrenaline in patients with septicshock.ResultsTwo randomised controlled trials (RCT and two largeprospective cohort studies were analysed. RCT data showeddopamine was associated with increased arrhythmic events.One cohort study found dopamine was associated with higher30-day mortality. The other cohort study found noradrenalinewas associated with higher 28-day mortality.DiscussionData on the use of dopamine versus noradrenaline in patientswith septic shock is limited. Following the recent SOAP IIstudy, there is now strong evidence that the use of dopaminein septic shock is associated with significantly morecardiovascular adverse events, compared tonoradrenaline.ConclusionNoradrenaline should be used as the initial vasopressor inseptic shock to avoid the arrhythmic events associatedwith dopamine.

  9. [Current epidemiologic features of septic abortion].

    Science.gov (United States)

    Spina, V; Bertelli, S; Bartucca, B; Bonessio, L; Aleandri, V

    2001-04-01

    This article deals with the current epidemiological features of septic abortion. Forty-two of 431 abortions (9,74%) were diagnosed as septic abortions during 1998 at the I and II Institute of Obstetrics and Gynecology, University of Rome La Sapienza , and are retrospectively analyzed. Thirty-four women (81%) came from an EEC country, whereas 8 (19%) from a developing country. Their mean age was 31,4 years (range: 18-43 years). Eighteen patients (43%) were nulliparous; 24 (57%) multiparous; 14 (33%) had previous abortions, none had previous septic abortions. Among risk factors, premature rupture of membranes was found in 5 cases (12%); whereas amniocentesis, HIV positivity, diabetes, positive urine culture and illegal pregnancy termination procedures were found in 5 further cases. No risk factors were found in 76% of patients. It is observed that, due to medical-scientific advances, previously unknown risk factors have emerged during the last three decades in Western Countries, such as invasive procedures of prenatal diagnosis, IUD contraception and AIDS immunodepression. However, other previously frequent risk factors, such as sepsis from illegal abortion, may emerge again in Countries where abortion is legal (such as Italy), due to massive immigration of clandestine women from developing Countries.

  10. Septic arthritis due to Streptococcus sanguis.

    Science.gov (United States)

    Mandac, Inga; Prkacin, Ingrid; Matovinović, Mirjana Sabljar; Sustercić, Dunja

    2010-06-01

    Septic arthritis may represent a direct invasion of joint space by various microorganisms, including bacteria, viruses and fungi. Although any infectious agent may cause bacterial arthritis, bacterial pathogens are the most significant because of their rapidly destructive nature. We present a case of septic arthritis in a 56-year old male patient due to Streptococcus viridans which is member of the viridans group streptococci. Patient was admitted to Our Hospital presented as fever of unknown origin, losing more than 30 kg of body weight during couple of months, and anemia of chronic disease as paraneoplastic process. He had long history of arterial hypertension and stroke. There was swelling and pain of the right sternoclavicular joint and precordial systolic murmur in physical status. A large diagnostic panel has been made, computerized tomography (CT) of right sternoclavicular joint showed widening of periarticular soft tissue and loss of clavicular corticalis. Cytologic analysis of synovial fluid showed more than 90% of polymorphonuclear leukocytes. There were no crystals on microscopic examination and Gram stain of fluid was negative. Blood cultures were positive for S. sanguis and there was a consideration about possible periodontal disease. Stomatologic examination verified periapical ostitis and extraction of potential cause of infection has been done. Therapy with benzilpenicilline was followed by the gradual improvement of clinical and laboratory parameters. Although viridans group streptococci and Streptococcus sanguis in particular are rare causes of septic arthritis in native joints, they should be considered in the differential diagnosis of periodontal disease.

  11. Using Cl/Br ratios and other indicators to assess potential impacts on groundwater quality from septic systems: A review and examples from principal aquifers in the United States

    Science.gov (United States)

    Katz, B.G.; Eberts, S.M.; Kauffman, L.J.

    2011-01-01

    A detailed review was made of chemical indicators used to identify impacts from septic tanks on groundwater quality. Potential impacts from septic tank leachate on groundwater quality were assessed using the mass ratio of chloride-bromide (Cl/Br), concentrations of selected chemical constituents, and ancillary information (land use, census data, well depth, soil characteristics) for wells in principal aquifers of the United States. Chemical data were evaluated from 1848 domestic wells in 19 aquifers, 121 public-supply wells in 6 aquifers, and associated monitoring wells in four aquifers and their overlying hydrogeologic units. Based on previously reported Cl/Br ratios, statistical comparisons between targeted wells (where Cl/Br ratios range from 400 to 1100 and Cl concentrations range from 20 to 100 mg/L) and non-targeted wells indicated that shallow targeted monitoring and domestic wells (0.5. mg/L) shallow groundwater from target domestic wells, relative to non-target wells (1.5. mg/L), corresponded to significantly higher potassium, boron, chloride, dissolved organic carbon, and sulfate concentrations, which may also indicate the influence of septic-tank effluent. Impacts on groundwater quality from septic systems were most evident for the Eastern Glacial Deposits aquifer and the Northern High Plains aquifer that were associated with the number of housing units using septic tanks, high permeability of overlying sediments, mostly oxic conditions, and shallow wells. Overall, little or no influence from septic systems were found for water samples from the deeper public-supply wells.The Cl/Br ratio is a useful first-level screening tool for assessing possible septic tank influence in water from shallow wells (<20 m) with the range of 400-1100. The use of this ratio would be enhanced with information on other chloride sources, temporal variability of chloride and bromide concentrations in shallow groundwater, knowledge of septic-system age and maintenance, and the

  12. Think tanks in Denmark

    DEFF Research Database (Denmark)

    Ørsten, Mark; Nørgaard Kristensen, Nete

    2016-01-01

    outside the media. The study shows that the two largest and oldest think tanks in Denmark, the liberal think tank CEPOS and the social democratic think tank ECLM, are very active and observable in the media; that the media’s distribution of attention to these think tanks, to some extent, confirms a re......-politicization of Danish newspapers; but also that the news media as an arena of influence is only one part of the equation, since some of the corporatist political networks are still intact and working outside the media...... half of the 2010s, because in this national setting think tanks are still a relatively new phenomenon. Based on theories of mediatization and de-corporatization, we present 1) an analysis of the visibility of selected Danish think tanks in the media and 2) an analysis of their political networks...

  13. Nonseptic and Septic Lateral Sinus Thrombosis: A Review

    OpenAIRE

    Viswanatha, B.; Thriveni, C. N.; Naseeruddin, Khaja

    2011-01-01

    Thrombosis of the lateral sinus can be classified into nonseptic lateral sinus thrombosis and septic lateral sinus thrombosis. Nonseptic lateral sinus thrombosis differs from septic lateral sinus thrombosis in that it is not associated with ear or sinus infection. Etiologies of these conditions are different and hence the management of these conditions is different. Nonseptic lateral sinus thrombosis requires medical line of management and anticoagulant therapy, where as septic lateral sinus ...

  14. Septic arthritis and subsequent fatal septic shock caused by Vibrio vulnificus infection

    DEFF Research Database (Denmark)

    Emamifar, Amir; Asmussen Andreasen, Rikke; Andersen, Nanna Skaarup

    2015-01-01

    Vibrio vulnificus is a rare but potential fatal bacterium that can cause severe infections. Wound infections, primary sepsis and gastroenteritis are the most common clinical features. Septic arthritis caused by V. vulnificus is an atypical presentation that has been reported in only two case...... reports; however, it has not been previously noted in Denmark. The authors report a case of septic arthritis caused by V. vulnificus in an immunocompromised patient. The disease progressed to severe sepsis and subsequent death within 10 h of admission....

  15. Hanford tanks initiative plan

    Energy Technology Data Exchange (ETDEWEB)

    McKinney, K.E.

    1997-07-01

    Abstract: The Hanford Tanks Initiative (HTI) is a five-year project resulting from the technical and financial partnership of the U.S. Department of Energy`s Office of Waste Management (EM-30) and Office of Science and Technology Development (EM-50). The HTI project accelerates activities to gain key technical, cost performance, and regulatory information on two high-level waste tanks. The HTI will provide a basis for design and regulatory decisions affecting the remainder of the Tank Waste Remediation System`s tank waste retrieval Program.

  16. Coenzyme Q10 deficiency in septic shock patients

    OpenAIRE

    Dupic, Laurent; Huet, Olivier; Duranteau, Jacques

    2011-01-01

    Donnino and colleagues provide new insights into the field of oxidative stress and mitochondrial dysfunction during septic shock. These authors suggest a coenzyme Q10 (CoQ10) deficiency in patients with septic shock. Larger prospective observational trials measuring CoQ10 in patients with septic shock are required to confirm the possibility of CoQ10 depletion. This study is a new step toward a study testing CoQ10 as a potential therapeutic agent for patients with septic shock.

  17. The Role of Complement System in Septic Shock

    Directory of Open Access Journals (Sweden)

    Jean Charchaflieh

    2012-01-01

    Full Text Available Septic shock is a critical clinical condition with a high mortality rate. A better understanding of the underlying mechanisms is important to develop effective therapies. Basic and clinical studies suggest that activation of complements in the common cascade, for example, complement component 3 (C3 and C5, is involved in the development of septic shock. The involvement of three upstream complement pathways in septic shock is more complicated. Both the classical and alternative pathways appear to be activated in septic shock, but the alternative pathway may be activated earlier than the classical pathway. Activation of these two pathways is essential to clear endotoxin. Recent investigations have shed light on the role of lectin complement pathway in septic shock. Published reports suggest a protective role of mannose-binding lectin (MBL against sepsis. Our preliminary study of MBL-associated serine protease-2 (MASP-2 in septic shock patients indicated that acute decrease of MASP-2 in the early phase of septic shock might correlate with in-hospital mortality. It is unknown whether excessive activation of these three upstream complement pathways may contribute to the detrimental effects in septic shock. This paper also discusses additional complement-related pathogenic mechanisms and intervention strategies for septic shock.

  18. N-terminal-pro-brain natriuretic peptide elevations in the course of septic and non-septic shock reflect systolic left ventricular dysfunction assessed by transpulmonary thermodilution

    NARCIS (Netherlands)

    A.J. Groeneveld; R.J. Trof (R.)

    2016-01-01

    textabstractBackground: The cardiac correlates, if any, of N-terminal probrain natriuretic peptide (NT-proBNP) levels in septic and non-septic shock patients remain controversial. Methods: In the 38 septic and 22 non-septic shock patients in the transpulmonary thermodilution arm of a previous

  19. Fuel tank integrity research : fuel tank analyses and test plans

    Science.gov (United States)

    2013-04-15

    The Federal Railroad Administrations Office of Research : and Development is conducting research into fuel tank : crashworthiness. Fuel tank research is being performed to : determine strategies for increasing the fuel tank impact : resistance to ...

  20. Septic and non-septic olecranon bursitis in the accident and emergency department--an approach to management.

    Science.gov (United States)

    Stell, I M

    1996-01-01

    Olecranon bursitis is relatively common. One third of episodes are septic. Most of the remainder are non-septic, with occasional rheumatological causes. Trauma can cause both septic and non-septic olecranon bursitis. Clinical features are helpful in separating septic from non-septic olecranon bursitis, but there may be local erythema in both. Aspiration should be carried out in all cases, and if the presence of infection is still in doubt, microscopy, Gram staining, and culture of the aspirate will resolve the issue. Septic olecranon bursitis should be treated by aspiration, which may need to be repeated, and a long course of antibiotics. Some cases will need admission, and a few will need surgical treatment. Non-septic olecranon bursitis can be managed with aspiration alone. Non-steroidal anti-inflammatory drugs probably hasten symptomatic improvement. Intrabursal corticosteroids produce a rapid resolution but concern remains over their long term local effects. Recovery from septic olecranon bursitis can take months. PMID:8894865

  1. The race against the "septic shark".

    Science.gov (United States)

    Westphal, Martin; Kampmeier, Tim

    2015-01-01

    Great white sharks are responsible for about 10 cases of death annually worldwide, as compared with millions of deaths caused by sepsis. However, the basic principles of avoiding shark attacks and fighting sepsis seem to be similar: avoidance, attention, and speed, if necessary. The present review discusses the current status of the systemic inflammatory response syndrome (SIRS) criteria, which are actually content for discussion because of their low specificity. Current data suggest that one in eight patients with severe sepsis does not fulfill the SIRS criteria and is consequently missed, and therefore the calls for new definitions of sepsis are getting louder. Furthermore, the need for early treatment of sepsis and fast admission to an intensive care unit (ICU) with experienced stuff is reviewed as well as the early and appropriate initiation of therapy, namely antibiotic and volume therapy. A key feature is the analysis of the studies from the so-called "Sepsis Trilogy" (ProCESS, ARISE, and ProMiSe studies), with a focus on the status of early goal-directed therapy (EGDT). The authors of the "Sepsis Trilogy" concluded that there is no benefit regarding survival in septic patients by using EGDT as compared with standard therapy. However, the low mortality of the control groups within the "Sepsis Trilogy" studies as compared with the Rivers et al. study from 2001 leads to the conclusion that there has been an improvement in the therapy of septic patients, most probably due to the early initiation of therapy as a kind of "standard" in sepsis therapy. Finally, the phenomenon of a "large trial disease" is discussed, exemplary in a trial which investigated the maintenance of the "right" mean arterial pressure in sepsis patients. Even if the result of a large randomized trial might be that there is no difference between two study groups, the real exercise is to identify the patient collectives who might benefit or experience harm due to an intervention. In summary, as

  2. Septic lens implantation syndrome in a cat.

    Science.gov (United States)

    Dalesandro, Nicole; Stiles, Jean; Miller, Margaret

    2011-09-01

    A 13-year-old female spayed domestic shorthair cat was presented initially for a change in the appearance of the left eye. On initial examination, a small penetrating wound was suspected as the cause for a corneal scar, an anterior cortical incipient cataract and mild iritis. The cat was not re-presented until 1 year later at which time ocular pain was marked. Severe anterior uveitis and glaucoma were diagnosed and the eye enucleated. Histopathology documented intralenticular coccoid bacteria and septic lens implantation syndrome. © 2011 American College of Veterinary Ophthalmologists.

  3. The Impact of the Sepsis-3 Septic Shock Definition on Previously Defined Septic Shock Patients.

    Science.gov (United States)

    Sterling, Sarah A; Puskarich, Michael A; Glass, Andrew F; Guirgis, Faheem; Jones, Alan E

    2017-09-01

    The Third International Consensus Definitions Task Force (Sepsis-3) recently recommended changes to the definitions of sepsis. The impact of these changes remains unclear. Our objective was to determine the outcomes of patients meeting Sepsis-3 septic shock criteria versus patients meeting the "old" (1991) criteria of septic shock only. Secondary analysis of two clinical trials of early septic shock resuscitation. Large academic emergency departments in the United States. Patients with suspected infection, more than or equal to two systemic inflammatory response syndrome criteria, and systolic blood pressure less than 90 mm Hg after fluid resuscitation. Patients were further categorized as Sepsis-3 septic shock if they demonstrated hypotension, received vasopressors, and exhibited a lactate greater than 2 mmol/L. We compared in-hospital mortality in patients who met the old definition only with those who met the Sepsis-3 criteria. Four hundred seventy patients were included in the present analysis. Two hundred (42.5%) met Sepsis-3 criteria, whereas 270 (57.4%) met only the old definition. Patients meeting Sepsis-3 criteria demonstrated higher severity of illness by Sequential Organ Failure Assessment score (9 vs 5; p definition demonstrated significant mortality benefit following implementation of a quantitative resuscitation protocol (35% vs 10%; p = 0.006). In this analysis, 57% of patients meeting old definition for septic shock did not meet Sepsis-3 criteria. Although Sepsis-3 criteria identified a group of patients with increased organ failure and higher mortality, those patients who met the old criteria and not Sepsis-3 criteria still demonstrated significant organ failure and 14% mortality rate.

  4. Septic Abortion Managed in a Tertiary Hospital in West Bengal ...

    African Journals Online (AJOL)

    Background: Septic abortion is still a challenging problem and a major cause of maternal mortality and morbidity in developing countries. Aim: The present study was conducted to estimate incidence, causes, risk factors, associated microorganisms, and treatment modalities of cases of septic abortion managed in a tertiary ...

  5. Enteral nutrition intolerance in critically ill septic burn patients.

    Science.gov (United States)

    Lavrentieva, Athina; Kontakiotis, Theodore; Bitzani, Militsa

    2014-01-01

    The purpose of this study was to investigate the frequency of enteral feeding intolerance in critically ill septic burn patients, the effect of enteral feeding intolerance on the efficacy of feeding, the correlation between the infection marker (procalcitonin [PCT]) and the nutrition status marker (prealbumin) and the impact of feeding intolerance on the outcome of septic burn patients. From January 2009 to December 2012 the data of all burn patients with the diagnosis of sepsis who were placed on enteral nutrition were analyzed. Septic patients were divided into two groups: group A, septic patients who developed feeding intolerance; group B, septic patients who did not develop feeding intolerance. Demographic and clinical characteristics of patients were analyzed and compared. The diagnosis of sepsis was applied to 29% of all patients. Of these patients 35% developed intolerance to enteral feeding throughout the septic period. A statistically significant increase in mean PCT level and a decrease in prealbumin level was observed during the sepsis period. Group A patients had statistically significant lower mean caloric intake, higher PCT:prealbumin ratio, higher pneumonia incidence, higher Sequential Organ Failure Assessment Maximum Score, a longer duration of mechanical ventilation, and a higher mortality rate in comparison with the septic patients without gastric feeding intolerance. The authors concluded that a high percentage of septic burn patients developed enteral feeding intolerance. Enteral feeding intolerance seems to have a negative impact on the patients' nutritional status, morbidity, and mortality.

  6. Arthroscopy of septic carpitis in donkeys ( Equus asinus ) | Elkasapy ...

    African Journals Online (AJOL)

    Experimental septic arthritis was induced in the radiocarpal joint of 18 donkeys by intra-articular injection of Staphylococcus aureus (3-4X106 CFU). The inoculated animals were divided into three groups (6 donkeys in each group). The arthroscopic examination was carried out before induction of septic carpitis and 3 days ...

  7. Outcome of management of non-gonococcal septic arthritis at ...

    African Journals Online (AJOL)

    Septic arthritis is an acute bacterial infection of a synovial joint. It is an orthopaedic emergency that can lead to morbidity or mortality if not properly treated. The fundamental issues in the management of septic arthritis include the duration of antibiotic therapy, the mode of joint drainage and the role of physiotherapy. There is ...

  8. Red blood cell transfusion during septic shock in the ICU

    DEFF Research Database (Denmark)

    Perner, A; Smith, S H; Carlsen, S

    2012-01-01

    Transfusion of red blood cells (RBCs) remains controversial in patients with septic shock, but current practice is unknown. Our aim was to evaluate RBC transfusion practice in septic shock in the intensive care unit (ICU), and patient characteristics and outcome associated with RBC transfusion....

  9. Tank 241-BX-103 tank characterization plan

    Energy Technology Data Exchange (ETDEWEB)

    Bell, K.E. [Westinghouse Hanford Co., Richland, WA (United States)

    1995-04-21

    This document is a plan which serves as the contractual agreement between the Characterization Program, Sampling Operations, and WHC 222-S Laboratory. The scope of this plan is to provide guidance for the sampling and analysis of samples for tank 241-BX-103.

  10. Development of effluent removal prediction model efficiency in septic sludge treatment plant through clonal selection algorithm.

    Science.gov (United States)

    Ting, Sie Chun; Ismail, A R; Malek, M A

    2013-11-15

    This study aims at developing a novel effluent removal management tool for septic sludge treatment plants (SSTP) using a clonal selection algorithm (CSA). The proposed CSA articulates the idea of utilizing an artificial immune system (AIS) to identify the behaviour of the SSTP, that is, using a sequence batch reactor (SBR) technology for treatment processes. The novelty of this study is the development of a predictive SSTP model for effluent discharge adopting the human immune system. Septic sludge from the individual septic tanks and package plants will be desuldged and treated in SSTP before discharging the wastewater into a waterway. The Borneo Island of Sarawak is selected as the case study. Currently, there are only two SSTPs in Sarawak, namely the Matang SSTP and the Sibu SSTP, and they are both using SBR technology. Monthly effluent discharges from 2007 to 2011 in the Matang SSTP are used in this study. Cross-validation is performed using data from the Sibu SSTP from April 2011 to July 2012. Both chemical oxygen demand (COD) and total suspended solids (TSS) in the effluent were analysed in this study. The model was validated and tested before forecasting the future effluent performance. The CSA-based SSTP model was simulated using MATLAB 7.10. The root mean square error (RMSE), mean absolute percentage error (MAPE), and correction coefficient (R) were used as performance indexes. In this study, it was found that the proposed prediction model was successful up to 84 months for the COD and 109 months for the TSS. In conclusion, the proposed CSA-based SSTP prediction model is indeed beneficial as an engineering tool to forecast the long-run performance of the SSTP and in turn, prevents infringement of future environmental balance in other towns in Sarawak. Copyright © 2013 Elsevier Ltd. All rights reserved.

  11. Streptococcus gordonii septic arthritis : two cases and review of literature

    Directory of Open Access Journals (Sweden)

    Yombi Jean cyr

    2012-09-01

    Full Text Available Abstract Background Despite advances in antimicrobial and surgical therapy, septic arthritis remains a rheumatologic emergency that can lead to rapid joint destruction and irreversible loss of function. In adults, Staphylococcus aureus is the most common microorganism isolated from native joints. Streptococcus gordonii is a prominent member of the viridans group of oral bacteria and is among the bacteria most frequently identified as being primary agent of subacute bacterial endocarditis. To the best of our knowledge, Streptococcus gordonii has not yet been described as agent of septic arthritis. Case Presentation We describe here two cases of septic arthritis due to Streptococcus gordonii. It gives us an opportunity to review epidemiology, diagnosis criteria and management of septic arthritis. Conclusion Although implication of S. gordonii as aetiologic agent of subacute endocarditis is well known, this organism is a rare cause of septic arthritis. In this case, the exclusion of associated endocarditis is warranted.

  12. [Pneumococcal septic arthritis in a Spanish university hospital (1993- 2003)].

    Science.gov (United States)

    Barahona, Lucía; Soriano, Francisco; Fernández-Robles, Ricardo; Granizo, Juan José; López-Durán, Juan Carlos

    2005-01-01

    Cases of pneumococcal septic arthritis treated in the Fundación Jiménez Díaz (Madrid, Spain) were reviewed. A retrospective record review was conducted for all patients presenting with pneumococcal septic arthritis between January 1993 and August 2003. Four patients out of a total of 267 reviewed had a clinical and microbiological diagnosis of septic arthritis caused by Streptococcus pneumoniae. The most frequent locations were the knee, ankle and tarsus. Three of the four patients had underlying diseases and one patient died. Pneumococcal septic arthritis, a very rare clinical entity diagnosed by clinical and microbiological findings, should be suspected in patients with underlying disease. Early antibiotic therapy focussed on the most common microorganisms causing septic arthritis is necessary for optimal outcome.

  13. Leucocyte esterase in the rapid diagnosis of paediatric septic arthritis.

    LENUS (Irish Health Repository)

    Kelly, E G

    2013-02-01

    Septic arthritis may affect any age group but is more common in the paediatric population. Infection is generally bacterial in nature. Prompt diagnosis is crucial, as delayed treatment is associated with lifelong joint dysfunction. A clinical history and application of Kocher\\'s criteria may indicate that there is a septic arthritis. However, definitive diagnosis is made on culture of septic synovial fluid. The culture process can take over 24h for the initial culture to yield bacterial colonies. Leucocyte esterase is released by leucocytes at the site of an infection. We hypothesise that leucocyte esterase can be utilized in the rapid diagnosis of septic arthritis and shorten the time to decisive treatment whilst simultaneously decreasing unnecessary treatment of non-septic joints.

  14. Prediction analysis of effluent removal in a septic sludge treatment plant: a biomimetics engineering approach.

    Science.gov (United States)

    Chun, Ting Sie; Malek, M A; Ismail, Amelia Ritahani

    2014-09-20

    Effluent discharge from septic tanks is affecting the environment in developing countries. The most challenging issue facing these countries is the cost of inadequate sanitation, which includes significant economic, social, and environmental burdens. Although most sanitation facilities are evaluated based on their immediate costs and benefits, their long-term performance should also be investigated. In this study, effluent quality-namely, the biological oxygen demand (BOD), chemical oxygen demand (COD), and total suspended solid (TSS)-was assessed using a biomimetics engineering approach. A novel immune network algorithm (INA) approach was applied to a septic sludge treatment plant (SSTP) for effluent-removal predictive modelling. The Matang SSTP in the city of Kuching, Sarawak, on the island of Borneo, was selected as a case study. Monthly effluent discharges from 2007 to 2011 were used for training, validating, and testing purposes using MATLAB 7.10. The results showed that the BOD effluent-discharge prediction was less than 50% of the specified standard after the 97(th) month of operation. The COD and TSS effluent removals were simulated at the 85(th) and the 121(st) months, respectively. The study proved that the proposed INA-based SSTP model could be used to achieve an effective SSTP assessment and management technique.

  15. Current Opinions in Pediatric Septic Shock

    Directory of Open Access Journals (Sweden)

    José Irazuzta

    2009-11-01

    Full Text Available Objectives: Our aim is to describe the current clinical practice related to the management of septic shock (SS. Methods: Review of medical literature using the MEDLINE database. Articles were selected according to their relevancy to the objective and according to the author’s opinion. Summary of the findings: The outcome from SS is dependent on an early recognition and a sequential implementation of time-sensitive goal-directed therapies. The goals of the resuscitation are rapid restoration of micro circulation and improved organ tissue perfusion. Clinical and laboratory markers are needed to assess the adequacy of the treatments. Initial resuscitation involves the use of isotonic solutions (>60ml/kg either crystalloid (normal saline or colloid infusion often followed by vasoactive medications. Altered pharmacokinetics and pharmacodynamics responses dictate that vasoactive agents should be adjusted to achieve predetermined goals. An assessment of central venous pressure complements clinical and serological findings to tailor therapies. Elective airway instrumentation and mechanical ventilation as well as adjunctive therapy with stress dose of corticosteroid are indicated in selected populations. In neonates, a special attention to the presence of electrolyte imbalance and increase pulmonary vascular resistance needs to be considered early. Conclusions: Septic shock hemodynamic is a changing process that requires frequent assessment and therapeutic adjustments.

  16. Corrective Action Decision Document/Closure Report for Corrective Action Unit 560: Septic Systems, Nevada Test Site, Nevada, Revision 0

    Energy Technology Data Exchange (ETDEWEB)

    Grant Evenson

    2010-04-01

    Corrective Action Unit 560 comprises seven corrective action sites (CASs): •03-51-01, Leach Pit •06-04-02, Septic Tank •06-05-03, Leach Pit •06-05-04, Leach Bed •06-59-03, Building CP-400 Septic System •06-59-04, Office Trailer Complex Sewage Pond •06-59-05, Control Point Septic System The purpose of this CADD/CR is to provide justification and documentation supporting the recommendation for closure of CAU 560 with no further corrective action. To achieve this, corrective action investigation (CAI) activities were performed from October 7, 2008, through February 24, 2010, as set forth in the Corrective Action Investigation Plan for Corrective Action Unit 560: Septic Systems, Nevada Test Site, Nevada, and Record of Technical Change No. 1. The purpose of the CAI was to fulfill the following data needs as defined during the data quality objective (DQO) process: •Determine whether contaminants of concern (COCs) are present. •If COCs are present, determine their nature and extent. •Provide sufficient information and data to complete appropriate corrective actions. The CAU 560 dataset from the investigation results was evaluated based on the data quality indicator parameters. This evaluation demonstrated the quality and acceptability of the dataset for use in fulfilling the DQO data needs. Analytes detected during the CAI were evaluated against final action levels (FALs) established in this document. The following contaminants were determined to be present at concentrations exceeding their corresponding FALs: •No contamination exceeding the FALs was identified at CASs 03-51-01, 06-04-02, and 06-59-04. •The soil at the base of the leach pit chamber at CAS 06-05-03 contains arsenic above the FAL of 23 milligrams per kilogram (mg/kg) and polychlorinated biphenyl (PCBs) above the FAL of 0.74 mg/kg, confined vertically from a depth of approximately 5 to 20 feet (ft) below ground surface. The contamination is confined laterally to the walls of the

  17. Closure Report for Corrective Action Unit 262: Area 25 Septic Systems and Underground Discharge Point, Nevada Test Site, Nevada

    Energy Technology Data Exchange (ETDEWEB)

    D. S. Tobiason

    2003-07-01

    This Closure Report (CR) documents the activities undertaken to close Corrective Action Unit (CAU) 262: Area 25 Septic Systems and Underground Discharge Point, in accordance with the Federal Facility Agreement and Consent Order (FFACO) of 1996. Site closure was performed in accordance with the Nevada Division of Environmental Protection (NDEP)-approved Corrective Action Plan (CAP) for CAU 262 (U.S. Department of Energy, National Nuclear Security Administration Nevada Operations Office [NNSA/NV, 2002a]). CAU 262 is located at the Nevada Test Site (NTS) approximately 105 kilometers (65 miles) northwest of Las Vegas, Nevada. CAU 262 consists of the following nine Corrective Action Sites (CASs) located in Area 25 of the NTS: CAS 25-02-06, Underground Storage tank CAS 25-04-06, Septic Systems A and B CAS 25-04-07, Septic System CAS 25-05-03, Leachfield CAS 25-05-05, Leachfield CAS 25-05-06, Leachfield CAS 25-05-08, Radioactive Leachfield CAS 25-05-12, Leachfield CAS 25-51-01, Dry Well.

  18. Corrective Action Investigation Plan for Corrective Action Unit 560: Septic Systems, Nevada Test Site, Nevada with ROTC1, Revision 0

    Energy Technology Data Exchange (ETDEWEB)

    Grant Evenson

    2008-05-01

    Corrective Action Unit (CAU) 560 is located in Areas 3 and 6 of the Nevada Test Site, which is approximately 65 miles northwest of Las Vegas, Nevada. Corrective Action Unit 560 is comprised of the seven corrective action sites (CASs) listed below: • 03-51-01, Leach Pit • 06-04-02, Septic Tank • 06-05-03, Leach Pit • 06-05-04, Leach Bed • 06-59-03, Building CP-400 Septic System • 06-59-04, Office Trailer Complex Sewage Pond • 06-59-05, Control Point Septic System These sites are being investigated because existing information on the nature and extent of potential contamination is insufficient to evaluate and recommend corrective action alternatives. Additional information will be obtained by conducting a corrective action investigation before evaluating corrective action alternatives and selecting the appropriate corrective action for each CAS. The results of the field investigation will support a defensible evaluation of viable corrective action alternatives that will be presented in the Corrective Action Decision Document. The sites will be investigated based on the data quality objectives (DQOs) developed on January 22, 2008, by representatives from the Nevada Division of Environmental Protection; U.S. Department of Energy (DOE), National Nuclear Security Administration Nevada Site Office; Stoller-Navarro Joint Venture; and National Security Technologies, LLC. The DQO process was used to identify and define the type, amount, and quality of data needed to develop and evaluate appropriate corrective actions for CAU 560.

  19. Development of smart solar tanks

    DEFF Research Database (Denmark)

    Furbo, Simon; Andersen, Elsa

    1999-01-01

    The aim of the project is to develop smart solar tanks. A smart solar tank is a tank in which the domestic water can bee heated both by solar collectors and by an auxiliary energy supply system. The auxiliary energy supply system heats up the hot-water tank from the top and the water volume heated...

  20. Ocean Technology Development Tank

    Data.gov (United States)

    Federal Laboratory Consortium — The new SWFSC laboratory in La Jolla incorporates a large sea- and fresh-water Ocean Technology Development Tank. This world-class facility expands NOAA's ability to...

  1. Sonar Tank Area

    Data.gov (United States)

    Federal Laboratory Consortium — The Sonar Tank Facility permits low cost initial 'wet' testing and check out prior to full scale deployment at sea. It can manage controlled conditions calibration...

  2. An alternate pathophysiologic paradigm of sepsis and septic shock

    Science.gov (United States)

    Kumar, Anand

    2014-01-01

    The advent of modern antimicrobial therapy following the discovery of penicillin during the 1940s yielded remarkable improvements in case fatality rate of serious infections including septic shock. Since then, pathogens have continuously evolved under selective antimicrobial pressure resulting in a lack of significant improvement in clinical effectiveness in the antimicrobial therapy of septic shock despite ever more broad-spectrum and potent drugs. In addition, although substantial effort and money has been expended on the development novel non-antimicrobial therapies of sepsis in the past 30 years, clinical progress in this regard has been limited. This review explores the possibility that the current pathophysiologic paradigm of septic shock fails to appropriately consider the primacy of the microbial burden of infection as the primary driver of septic organ dysfunction. An alternate paradigm is offered that suggests that has substantial implications for optimizing antimicrobial therapy in septic shock. This model of disease progression suggests the key to significant improvement in the outcome of septic shock may lie, in great part, with improvements in delivery of existing antimicrobials and other anti-infectious strategies. Recognition of the role of delays in administration of antimicrobial therapy in the poor outcomes of septic shock is central to this effort. However, therapeutic strategies that improve the degree of antimicrobial cidality likely also have a crucial role. PMID:24184742

  3. Salmonella enteridis Septic Arthritis: A Report of Two Cases

    Directory of Open Access Journals (Sweden)

    Esat Uygur

    2013-01-01

    Full Text Available Introduction. Nontyphoidal salmonellosis causes significant morbidity, is transmitted via fecal-oral route, and is a worldwide cause of gastroenteritis, bacteremia, and local infections. Salmonella is a less common etiologic factor for septic arthritis compared with other gram-negative bacteria. Cases. We present two septic arthritis cases with Salmonella enteridis as a confirmed pathogen and also discuss the predisposing factors and treatment. Discussion. Septic arthritis is an orthopedic emergency. The gold standard treatment of septic arthritis is joint debridement, antibiotic therapy according to the culture results, and physiotherapy, which should start in the early postoperative period to prevent limitation of motion. Salmonella is an atypical agent for septic arthritis. It must be particularly kept in mind as an etiologic factor for the acute arthritis of a patient with sickle cell anemia and systemic lupus erythematosus. Clinicians should be cautious that the white blood cell count in synovial fluid can be under 50.000/mm3 in immune compromised individuals with septic arthritis. The inflammatory response can be deficient, or the microorganism may be atypical. Conclusion. Atypical bacteria such as Salmonella species in immune compromised patients can cause joint infections. Therefore, Salmonella species must always be kept in mind for the differential diagnosis of septic arthritis in a clinically relevant setting.

  4. The impact of co-contaminants and septic system effluent quality on the transport of estrogens and nonylphenols through soil.

    Science.gov (United States)

    Stanford, Benjamin D; Amoozegar, Aziz; Weinberg, Howard S

    2010-03-01

    The impact that varying qualities of wastewater may have on the movement of steroid estrogens through soils into groundwater is little understood. In this study, the steroid estrogens 17beta-estradiol (E2) and estrone (E1) were followed through batch and column studies to examine the impact that organic wastewater constituents from on-site wastewater treatment systems (i.e., septic systems or decentralized systems) may have on influencing the rate of transport of estrogens through soils. Total organic carbon (TOC) content (as a surrogate indicator of overall wastewater quality) and the presence of nonyl-phenol polyethoxylate surfactants (NPEO) at concentrations well below the critical micelle concentration were independently shown to be indicative of earlier breakthrough and less partitioning to soil in batch and column experiments. Both NPEO and wastewater with increasing TOC concentrations led to shifts in the equilibrium of E1 and E2 towards the aqueous phase and caused the analytes to have an earlier breakthrough than in control experiments. The presence of nonylphenols, on the other hand, did not appreciably impact partitioning of E1 or E2. Biodegradation of the steroids in soil was also lower in the presence of septic tank effluents than in an organic-free control water. Furthermore, the data indicate that the rate of movement of E1 and E2 present in septic tank effluent through soils and into groundwater can be decreased by removing the NPEOs and TOC through wastewater treatment prior to sub-surface disposal. This study offers some insights into mechanisms which impact degradation, transformation, and retardation, and shows that TOC and NPEO surfactants play a role in estrogen transport. Copyright 2009 Elsevier Ltd. All rights reserved.

  5. Theoretical comparison between solar combisystems based on bikini tanks and tank-in-tank solar combisystems

    DEFF Research Database (Denmark)

    Yazdanshenas, Eshagh; Furbo, Simon; Bales, Chris

    2008-01-01

    Theoretical investigations have shown that solar combisystems based on bikini tanks for low energy houses perform better than solar domestic hot water systems based on mantle tanks. Tank-in-tank solar combisystems are also attractive from a thermal performance point of view. In this paper, theore...

  6. Corrective Action Decision Document for Corrective Action Unit 224: Decon Pad and Septic Systems Nevada Test Site, Nevada, Rev. No.: 0

    Energy Technology Data Exchange (ETDEWEB)

    David A. Strand

    2005-05-01

    This Corrective Action Decision Document has been prepared for Corrective Action Unit (CAU) 224, Decon Pad and Septic Systems, in Areas 2, 3, 5, 6, 11, and 23 of the Nevada Test Site, Nevada, in accordance with the ''Federal Facility Agreement and Consent Order'' (1996). Corrective Action Unit 224 is comprised of the following corrective action sites (CASs): (1) 02-04-01, Septic Tank (Buried); (2) 03-05-01, Leachfield; (3) 05-04-01, Septic Tanks (4)/Discharge Area; (4) 06-03-01, Sewage Lagoons (3); (5) 06-05-01, Leachfield; (6) 06-17-04, Decon Pad and Wastewater Catch; (7) 06-23-01, Decon Pad Discharge Piping; (8) 11-04-01, Sewage Lagoon; and (9) 23-05-02, Leachfield. The purpose of this Corrective Action Decision Document is to identify and provide the rationale for the recommendation of a corrective action alternative for the nine CASs within CAU 224. Corrective action investigation activities were performed from August 10, 2004, through January 18, 2005, as set forth in the CAU 224 Corrective Action Investigation Plan.

  7. Septic Arthritis of the Shoulder Complicating Pregnancy

    Directory of Open Access Journals (Sweden)

    Sara Raiser

    2014-01-01

    Full Text Available Septic arthropathy leads to rapid joint destruction, impairment, and disability. Staphylococcus can be particularly virulent to bone and joints leading to adverse obstetric events. At 28 of weeks gestation, a patient presented with pyelonephritis and progressive left shoulder pain. Magnetic resonance imaging indicated early clavicular destruction and acromial involvement. Glenohumeral joint aspiration produced Staphylococcus aureus. The patient then had premature rupture of membranes and progressed rapidly to preterm delivery. Placental pathology revealed chorioamnionitis and microabscesses. Treatment of the infected joint required further surgical drainage and bone resection as well as extended antibiotics. It is important to remember that joint pain in pregnancy may indicate infective arthritis, and pyelonephritis can be a source of such an infection. Evaluation includes magnetic resonance imaging and consultation for joint aspiration. Prompt recognition and treatment are necessary to prevent joint destruction.

  8. Blood coagulation disorders in septic patients.

    Science.gov (United States)

    Knoebl, Paul

    2010-03-01

    Host defense and blood coagulation are tightly connected and interacting systems, necessary for the integrity of an organism. Complex mechanisms regulate the intensity of a host response to invading pathogens or other potentially dangerous situations. Under regular conditions, this response is limited in time and located to the site of injury. Sometimes, however, systemic host response is overwhelming and disproportional and causes damage, not cure. Dependent on the genetical predisposition of the host, its current immunocompetence, or the type of injury, the reaction leads to the clinical picture of the different degrees of sepsis. Septic organ dysfunction is caused by intravascular fibrin deposition as a result of coagulation activation, anticoagulant breakdown, and shut down of fibrinolysis. This article describes the major pathophysiologic reactions in these situations and presents www.SepDIC.eu, an online tool on sepsis and associated coagulopathy.

  9. Adjunctive Steroid Therapy for Treatment of Pediatric Septic Shock.

    Science.gov (United States)

    Zimmerman, Jerry J

    2017-10-01

    Septic shock remains the major cause of childhood morbidity and mortality worldwide. Although early sepsis recognition, fluid resuscitation, timely administration of antimicrobials, and vasoactive-inotropic drug infusions are all key to achieving good sepsis outcomes, therapy using various steroid drug classes remains an attractive adjunctive intervention to minimize the duration of septic shock and transition to multiple organ dysfunction syndrome. All steroid drug classes possess biological plausibility to affect a beneficial clinical effect among children with septic shock, but none has undergone rigorous, prospective assessment in a large, high-quality pediatric interventional trial. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Thiamine in septic shock patients with alcohol use disorders

    DEFF Research Database (Denmark)

    Holmberg, Mathias Johan; Moskowitz, Ari; Patel, Parth Vijay

    2018-01-01

    PURPOSE: Alcohol-use disorders (AUDs) have been associated with increased sepsis-related mortality. As patients with AUDs are often thiamine deficient, we investigated practice patterns relating to thiamine administration in patients with AUDs presenting with septic shock and explored...... the association between receipt of thiamine and mortality. MATERIALS: We performed a retrospective cohort study of patients presenting with septic shock between 2008 and 2014 at a single tertiary care center. We identified patients with an AUD diagnosis, orders for microbial cultures and use of antibiotics...... with AUDs admitted for septic shock do not receive thiamine. Thiamine administration in this patient population was associated with decreased mortality....

  11. Septic/unsafe abortion: a preventable tragedy.

    Science.gov (United States)

    Sultana, Ruqqia; Noor, Shehla; Fawwad, Ali; Abbasi, Nasreen; Bashir, Rubina

    2012-01-01

    Unsafe abortion is one of the greatest neglected problems of health care in developing countries like Pakistan. In countries where abortions are restricted women have to resort to clandestine interventions to have an unwanted pregnancy terminated. The study was conducted to find out the prevalence of septic induced abortion and the associated morbidity and mortality and to highlight the measures to reduce it. This cross-sectional descriptive study was carried out in Obs/Gyn B Unit, Ayub Teaching Hospital, Abbottabad from January 2007 to December 2011. During this period all the patients presenting with pyrexia lower abdominal pain, vaginal bleeding, acute abdomen, septic or hypovolaemic shock after undergoing some sort of intervention for abortion outside the hospital were included. After thorough history, examination and detailed investigations including high vaginal and endocervical swabs for culture and sensitivity and pelvic ultrasound supportive management was given followed by antibiotics, surgical evacuation of uterus/ major laparotomy in collaboration with surgeon as required. Patients with DIC or multiple system involvement were managed in High Dependency Unit (HDU) by multidisciplinary team. During the study period out of a total 6,906 admissions 968 presented with spontaneous abortion. There were 110 cases (11.36%) of unsafe abortion, 56.4% presented with vaginal discharge, 34.5% with vaginal bleeding, 21.8% with acute abdomen, while 18.9% in shock and 6.8% with DIC. Forty-nine percent patients used termination as a method of contraception. Mortality rate was 16.36%, leading cause being septicaemia. Death and severe morbidity from unsafe abortions and its complications is avoidable through health education, effective contraception, early informed recognition and management of the problem once it occurs.

  12. USE OF WETLANDS TO TREAT SEPTIC TANK EFFLUENT FROM A CONFERENCE FACILITY

    Science.gov (United States)

    The Grailville Retreat Center near Loveland, OH built a wastewater treatment wetland under an experimental permit from OEPA to eliminate overflow from a failing leach field. Grailville allowed the USEPA Risk Management Research Lab in Cincinnati to subdivide the wetland into fiv...

  13. Performance of UASB septic tank for treatment of concentrated black water within DESAR concept

    NARCIS (Netherlands)

    Kujawa-Roeleveld, K.; Fernandes, T.; Wiryawan, Y.; Tafwik, A.; Visser, de M.; Zeeman, G.

    2005-01-01

    Separation of wastewater streams produced in households according to their origin, degree of pollution and affinity to a specific treatment constitutes a starting point in the DESAR concept (decentralised sanitation and reuse). Concentrated black water and kitchen waste carry the highest load of

  14. Evaluation of Aedes Aegypti Presence and Abundance in Septic Tanks and Their Impacts on Dengue Transmission

    Science.gov (United States)

    2009-03-10

    fever In: Gubler DJ,Kuno G, eds. Dengue and Dengue Hemorrhagic Fever. Cambridge: CABI Publishing, 2001;405-423. 27. Centers for Disease Control...virus-vector relationships In: Gubler DJ,Kuno G, eds. Dengue and Dengue Hemorrhagic Fever. Cambridge, MA: CABI Publishing, 2001;45-60. 47. Rosen L...475. 50. Kuno G. Factors influencing virus transmission In: Gubler DJ,Kuno G, eds. Dengue and Dengue Hemorrhagic Fever. Cambridge: CABI Publishing

  15. Septic arthritis of the acromioclavicular joint: an uncommon location.

    Science.gov (United States)

    Martínez-Morillo, Melania; Mateo Soria, Lourdes; Riveros Frutos, Anne; Tejera Segura, Beatriz; Holgado Pérez, Susana; Olivé Marqués, Alejandro

    2014-01-01

    Septic pyogenic arthritis of the acromioclavicular joint is a rare entity that occurs in immunosuppressed patients or those with discontinuity of defense barriers. There are only 15 cases described in the literature. The diagnosis is based on clinical features and the isolation of a microorganism in synovial fluid or blood cultures. The evidence of arthritis by imaging (MRI, ultrasound or scintigraphy) may be useful. Antibiotic treatment is the same as in septic arthritis in other locations. Staphylococcus aureus is the microorganism most frequently isolated. Our objective was to describe the clinical features, treatment and outcome of patients diagnosed with septic arthritis of the acromioclavicular joint at a Rheumatology Department. We developed a study with a retrospective design (1989-2012). The medical records of patients with septic arthritis were reviewed (101 patients). Those involving the acromioclavicular joint were selected (6 patients; 6%). Copyright © 2013 Elsevier España, S.L. All rights reserved.

  16. Location of Septic Sewer Systems in the Pacific Northwest

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — Septic systems are useful for removing and processing human waste. However, they have the potential of leaking or discharging waste into the nearby system and...

  17. Bordetella holmesii, an emerging cause of septic arthritis.

    Science.gov (United States)

    Abouanaser, Salaheddin F; Srigley, Jocelyn A; Nguyen, Tram; Dale, Suzanne E; Johnstone, Jennie; Wilcox, Lindsay; Jamieson, Frances; Rawte, Prasad; Pernica, Jeffrey M

    2013-04-01

    Bordetella holmesii is a well-described pathogen in asplenic and immunocompromised patients. Here we report the first two published cases of septic arthritis caused by B. holmesii documented in apparently immunocompetent patients and unaccompanied by bacteremia.

  18. Current concepts on hemodynamic support and therapy in septic shock.

    Science.gov (United States)

    Rocha, Leonardo Lima; Pessoa, Camila Menezes Souza; Corrêa, Thiago Domingos; Pereira, Adriano José; de Assunção, Murillo Santucci Cesar; Silva, Eliézer

    2015-01-01

    Severe sepsis and septic shock represent a major healthcare challenge. Much of the improvement in mortality associated with septic shock is related to early recognition combined with timely fluid resuscitation and adequate antibiotics administration. The main goals of septic shock resuscitation include intravascular replenishment, maintenance of adequate perfusion pressure and oxygen delivery to tissues. To achieve those goals, fluid responsiveness evaluation and complementary interventions - i.e. vasopressors, inotropes and blood transfusion - may be necessary. This article is a literature review of the available evidence on the initial hemodynamic support of the septic shock patients presenting to the emergency room or to the intensive care unit and the main interventions available to reach those targets, focusing on fluid and vasopressor therapy, blood transfusion and inotrope administration. Copyright © 2014 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

  19. Current concepts on hemodynamic support and therapy in septic shock

    Directory of Open Access Journals (Sweden)

    Leonardo Lima Rocha

    2015-10-01

    Full Text Available ABSTRACTSevere sepsis and septic shock represent a major healthcare challenge. Much of the improvement in mortality associated with septic shock is related to early recognition combined with timely fluid resuscitation and adequate antibiotics administration. The main goals of septic shock resuscitation include intravascular replenishment, maintenance of adequate perfusion pressure and oxygen delivery to tissues. To achieve those goals, fluid responsiveness evaluation and complementary interventions - i.e. vasopressors, inotropes and blood transfusion - may be necessary. This article is a literature review of the available evidence on the initial hemodynamic support of the septic shock patients presenting to the emergency room or to the intensive care unit and the main interventions available to reach those targets, focusing on fluid and vasopressor therapy, blood transfusion and inotrope administration.

  20. [Current concepts on hemodynamic support and therapy in septic shock].

    Science.gov (United States)

    Rocha, Leonardo Lima; Pessoa, Camila Menezes Souza; Corrêa, Thiago Domingos; Pereira, Adriano José; de Assunção, Murillo Santucci Cesar; Silva, Eliézer

    2015-01-01

    Severe sepsis and septic shock represent a major healthcare challenge. Much of the improvement in mortality associated with septic shock is related to early recognition combined with timely fluid resuscitation and adequate antibiotics administration. The main goals of septic shock resuscitation include intravascular replenishment, maintenance of adequate perfusion pressure and oxygen delivery to tissues. To achieve those goals, fluid responsiveness evaluation and complementary interventions - i.e. vasopressors, inotropes and blood transfusion - may be necessary. This article is a literature review of the available evidence on the initial hemodynamic support of the septic shock patients presenting to the emergency room or to the intensive care unit and the main interventions available to reach those targets, focusing on fluid and vasopressor therapy, blood transfusion and inotrope administration. Copyright © 2014 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  1. Safety and vasopressor effect of rosuvastatin in septic patients

    Directory of Open Access Journals (Sweden)

    Hanaa A. El Gendy

    2014-07-01

    Conclusions: Rosuvastatin 20 mg/day in septic patients increased number ABPSPD, decreased time to initial ABPSPD, norepinephrine dose and duration, with no significant elevation in transaminases or CPK.

  2. Cardiac Arrhythmias in a Septic ICU Population: A Review

    Directory of Open Access Journals (Sweden)

    Schwartz Andrei

    2015-10-01

    Full Text Available Progressive cardiovascular deterioration plays a central role in the pathogenesis of multiple organ failure (MOF caused by sepsis. Evidence of various cardiac arrhythmias in septic patients has been reported in many published studies. In the critically ill septic patients, compared to non-septic patients, new onset atrial fibrillation episodes are associated with high mortality rates and poor outcomes, amongst others being new episodes of stroke, heart failure and long vasopressor usage. The potential mechanisms of the development of new cardiac arrhythmias in sepsis are complex and poorly understood. Cardiac arrhythmias in critically ill septic patients are most likely to be an indicator of the severity of pre-existing critical illness.

  3. Higher vs. lower fluid volume for septic shock

    DEFF Research Database (Denmark)

    Smith, Søren H; Perner, Anders

    2012-01-01

    ABSTRACT: INTRODUCTION: Patients with septic shock require fluid, but the optimum amount is unknown. Therefore we assessed patient characteristics and outcome associated with fluid volume in unselected patients with septic shock including those with three days of shock. METHODS: We conducted...... a prospective, multicenter, observational study of all adult patients with septic shock during a 3-month study period at six general ICUs: three in university hospitals and three in regional hospitals. After day 1 and 3 of shock, patients were divided into two groups according to the overall median fluid...... volumes. Characteristics between these groups were compared using non-parametric and Chi-square statistics. RESULTS: The 164 included patients received median 4.0 l (IQR 2.3-6.3) of fluid during the first day of septic shock. Patients receiving higher volumes (> 4.0 l) on day 1 had higher p-lactate (3...

  4. Early recognition and management of septic shock in children

    Directory of Open Access Journals (Sweden)

    Paolo Biban

    2012-03-01

    Full Text Available Septic shock remains a major cause of morbidity and mortality among children, mainly due to acute haemodynamic compromise and multiple organ failures. In the last decade, international guidelines for the management of septic shock, as well as clinical practice parameters for hemodynamic support of pediatric patients, have been published. Early recognition and aggressive therapy of septic shock, by means of abundant fluid resuscitation, use of catecholamines and other adjuvant drugs, are widely considered of pivotal importance to improve the short and long-term outcome of these patients. The aim of this paper is to summarize the modern approach to septic shock in children, particularly in its very initial phase, when pediatric healthcare providers may be required to intervene in the pre-intensive care unit setting or just on admission in the pediatric intensive care unit.

  5. Prognostic value of nitric oxide in pediatric septic shock

    OpenAIRE

    Ari L. Runtunuwu; Jeanette I. Ch. Manoppo; Dasril Daud; Irawan Yusuf; Idham Jaya Ganda

    2016-01-01

    Background Nitric oxide (NO) play a key role in the pathogenesis of septic shock. Nitrit oxide metabolite is reported as a good predictor for shock although its role as mortality predictor in sepsis still controversial. Objective To assess the serum nitric oxide (NO) levels and outcomes in pediatric patients with septic shock. Methods We conducted a prospective cohort study from January 2013 to April 2014 in Pediatric Intensive Care Unit (PICU) Prof. Dr. R. D. Kandou Hospital, Manad...

  6. Septic Acromioclavicular Arthritis in a Patient with Diabetes Mellitus

    OpenAIRE

    Laktašić-Žerjavić, Nadica; Babić-Naglić, Đurđica; Ćurković, Božidar; Potočki, Kristina; Soldo-Jureša, Dragica

    2005-01-01

    A 44-year-old diabetic man with isolated septic arthritis of the left acromioclavicular joint (A–C) caused by Staphylococcus aureus is described. He was admitted to the Department of Rheumatology with clinical symptoms of left shoulder arthritis and fever. Laboratory findings showed leukocytosis, elevated levels of erythrocyte sedimentation rate and C-reactive protein, all indicating septic arthritis. Blood culture was positive for Staphylococcus aureus. Left A–C joint x-ray and ultrasonograp...

  7. An Unusual Case of Septic Arthritis of the Hip.

    Science.gov (United States)

    Ray, Ujjwayini; Dutta, Soma; Sutradhar, Arpita

    2016-11-01

    Non-typhoidal Salmonella, particularly Salmonella enterica serovar typhimurium is food borne pathogen causing mild self-limiting diarrhoea in healthy adults. It can occasionally cause extraintestinal focal infection in susceptible patients. Salmonella, as the aetiological agent of osteomyelitis and septic arthritis is rare and has been mostly reported in patients with sickle cell disease or thalassaemia. We report a case of septic arthritis by Salmonellatyphimurium in an immunocompromised patient who was successfully treated following timely isolation and identification of the aetiological agent.

  8. The intensive care medicine research agenda on septic shock

    DEFF Research Database (Denmark)

    Perner, Anders; Gordon, Anthony C; Angus, Derek C

    2017-01-01

    Septic shock remains a global health challenge with millions of cases every year, high rates of mortality and morbidity, impaired quality of life among survivors and relatives, and high resource use both in developed and developing nations. Care and outcomes are improving through organisational...... and translational work. In this review, international experts summarize the current position of clinical research in septic shock and propose a research agenda to advance this field....

  9. WWTP Process Tank Modelling

    DEFF Research Database (Denmark)

    Laursen, Jesper

    hydrofoil shaped propellers. These two sub-processes deliver the main part of the supplied energy to the activated sludge tank, and for this reason they are important for the mixing conditions in the tank. For other important processes occurring in the activated sludge tank, existing models and measurements...... zones in mind, its special construction poses strict demands to the hydrodynamic model. In case study three the model is extended to a three-phase model where also the injection of air bubbles during the aeration process is modeled. The aeration of sludge is controlled through a simple expression...... for the reoxygenation of the wastewater phase as a function of the local volume fraction of air and the concentration of soluble oxygen. A simple model for the bulk consumption of oxygen is linked to the reoxygenation expression in order to model measured oxygen concentrations in the suspension. In the final case study...

  10. Material selection for Multi-Function Waste Tank Facility tanks

    Energy Technology Data Exchange (ETDEWEB)

    Larrick, A.P.; Blackburn, L.D.; Brehm, W.F.; Carlos, W.C.; Hauptmann, J.P. [Westinghouse Hanford Co., Richland, WA (United States); Danielson, M.J.; Westerman, R.E. [Pacific Northwest Lab., Richland, WA (United States); Divine, J.R. [ChemMet Ltd., West Richland, WA (United States); Foster, G.M. [ICF Kaiser Hanford Co., Richland, WA (United States)

    1995-03-01

    This paper briefly summarizes the history of the materials selection for the US Department of Energy`s high-level waste carbon steel storage tanks. It also provides an evaluation of the materials for the construction of new tanks at the evaluation of the materials for the construction of new tanks at the Multi-Function Waste Tank Facility. The evaluation included a materials matrix that summarized the critical design, fabrication, construction, and corrosion resistance requirements: assessed. each requirement: and cataloged the advantages and disadvantages of each material. This evaluation is based on the mission of the Multi-Function Waste Tank Facility. On the basis of the compositions of the wastes stored in Hanford waste tanks, it is recommended that tanks for the Multi-Function Waste Tank Facility be constructed of ASME SA 515, Grade 70, carbon steel.

  11. Non activated protein C supplementation in septic pediatric hematological patients

    Directory of Open Access Journals (Sweden)

    Teresa Perillo

    2016-06-01

    Full Text Available The purpose of the study was to examine safety and efficacy of non-activated Protein C (PC supplementation in our cohort of septic pediatric hematological patients. We conducted a retrospective study of 22 septic patients receiving human plasma-derived PC concentrate from 2008 to 2015 at our Pediatric Oncology Center (Bari, Italy. The Surviving sepsis campaign definitions for sepsis, severe sepsis and septic shock were used to define the patients’ septic status. For each patient, we calculated Lansky performance status scale (LPSS and a risk score defined the Hematologic risk score (HRS that we created in 2007. Patients were defined as High risk for severe sepsis/septic shock in case of HRS>3. HRS10% PC concentration decrease within 12 hours from the first evaluation. All patients received 80 U/kg/day PC, intravenously, every twenty-four hours. No drug-related adverse event was observed. The observed sepsis-related mortality rate in our cohort was 9%. PC supplementation in our cohort appeared to be safe, and, probably due to prompt PC administration, we observed an overall mortality that was much lower than expected mortality in cancer severe septic patients.

  12. Racial differences in vasopressor requirements for septic shock.

    Science.gov (United States)

    Bauman, Zachary M; Killu, Keith F; Rech, Megan A; Bernabei-Combs, Jenna L; Gassner, Marika Y; Coba, Victor E; Tovbin, Alina; Kunkel, Patti L; Mlynarek, Mark E

    2014-03-01

    The objective of this study was to compare vasopressor requirements between African American (AA) patients and white patients in septic shock. This was a retrospective cohort review conducted over a 2-year period measuring total and mean dosage of various vasopressors used between two racial groups during the treatment of patients admitted with septic shock. The study included patients admitted to the intensive care unit with septic shock at an 805-bed tertiary, academic center. All septic shock patients were managed with vasopressors. Vasopressor selection, dosage, and duration were at the discretion of the treating physician. Total, mean, and duration of vasopressor dosing requirements were obtained for study participants. Comorbidities, prehospitalization antihypertensive medication requirements, intravenous fluids given during the septic shock phase, and source of infection were analyzed. One hundred fifty-nine patients with septic shock were analyzed, of which 96 (60.4%) were AAs (P shock were treated with higher doses of NE and required longer duration of NE administration compared with white patients.

  13. Inerting ballast tanks

    Energy Technology Data Exchange (ETDEWEB)

    Baes, Gabriel L.; Bronneberg, Jos [SBM Offshore, AA Schiedam (Netherlands); Barros, Maria A.S.D. de [Universidade Estadual de Maringa (UEM), PR (Brazil)

    2012-07-01

    This report expands upon the work conducted by SBM Offshore to develop a tank preservation treatment, which is intended to achieve a service life of 30 years. This work focuses on the corrosion problems, in the ballast tanks, based on new built hulls, both for the Gas Exploration Market, the FLNG - Floating Liquefied Natural Gas, and for the Oil Exploration market - FPSO's - Floating Production Storage and offloading Units. Herein, the corrosion rate input comes from the various references related to the process of nitrogen injection, which is expected to extend the vessel's time life. The essential elements of this solution comprise the deoxygenation process, corrosion models, coating effects, tests from laboratory, shipboard tests, corrosion institutes and regulations applicable to the operation. The best corrosion protection system for ballast tanks area combines a coating system and an inert gas system. The condition of the tanks will be dependent upon the level of protection applied to the steel structure, including, but not limited to coating, cathodic protection, etc. There is a need for products which extend the life time. It is not sufficient, only have good theoretical base for the corrosion and an excellent treatment system. In addition, the design of the ships structure must also eliminate the presence of local stress concentrations which can result in fatigue cracking and rupture of the protective coating barrier starting the corrosion. As a direct result of this, more problems in corrosion can be mitigated, vessels can have a better corrosion performance with less maintenance and repairs to coating systems in ballast tanks. Furthermore ships will be positively impacted operationally due to less frequent dry docking. There is a huge potential in the application of inert gas to combat the corrosion rate inside the ballast tanks, one of the most corrosive environments on earth. This application can have a direct impact on vessel structure

  14. TANK SPACE OPTIONS REPORT

    Energy Technology Data Exchange (ETDEWEB)

    WILLIS WL; AHRENDT MR

    2009-08-11

    Since this report was originally issued in 2001, several options proposed for increasing double-shell tank (DST) storage space were implemented or are in the process of implementation. Changes to the single-shell tank (SST) waste retrieval schedule, completion of DST space saving options, and the DST space saving options in progress have delayed the projected shortfall of DST storage space from the 2007-2011 to the 2018-2025 timeframe (ORP-11242, River Protection Project System Plan). This report reevaluates options from Rev. 0 and includes evaluations of new options for alleviating projected restrictions on SST waste retrieval beginning in 2018 because of the lack of DST storage space.

  15. Dwelling Water Tanks in Diyarbakir

    Directory of Open Access Journals (Sweden)

    Ali Ceylan

    2008-02-01

    Full Text Available BACKGROUND: In this connection, the object of this study has been to identify and compare the microbiological contamination and residue chlorine levels in the main network water that is taken from the Dicle Dam and distributed in Diyarbakir Province Centre and in the tanks of dwellings that use this water as well as the effects of the maintenance, hygiene, and physical conditions of these tanks on microbiological contamination. METHODS: Water samples were taken from both the tank input side network water and tank output side tank waters of 200 dwellings with water tanks in Diyarbakir city centre (tank entrance network side water for 200 and tank output side tank water for 200 within the framework of the research study. RESULTS: Coliform bacteria were detected in 35% of the tank entrance side network water samples and in 52.0% percent of the tank output side water samples. Faecal coliform bacteria were not detected in tank entrance side network water samples, but they existed in 2.5% of the tank output side water samples. Free residue chlorine level was found to be over 0.2 ppm in 67% of tank entrance side network water samples and in 35% of the tank output side water samples. Coliform bacteria were detected in 95.5% of the tank entrance side network water samples, of which free residue chlorine level were below 0.2 ppm. Total germ growth was detected in 52.0% of the tank entrance side network water samples and in 67.5% of the tank output side water samples. The most frequently isolated bacteria both in tank entrance side network and tank output side water samples were found to be Bacillus spp. Bacillus type bacteria were found in 48% of tank entrance side network water samples and 57.5% of the tank output side water samples. Filamentous fungi were prevalent in 8% of all the samples examined within the study and the most commonly isolated filamentous fungi were Aspergillus spp (5.5% and Penicillum spp (2.5%. Water tanks of dwellings contain more

  16. Tank plan for tank 241-C-104 retrieval testing

    Energy Technology Data Exchange (ETDEWEB)

    HERTING, D.L.

    1999-05-21

    Tank 241-C-104 has been identified as one of the first tanks to be retrieved for high-level waste pretreatment and immobilization. Retrieval of the tank waste will require dilution. Laboratory tests are needed to determine the amount of dilution required for safe retrieval and transfer of feed. The proposed laboratory tests are described in this document.

  17. Think Tank Initiative and Think Tank Fund Peer Exchanges | IDRC ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    The Think Tank Initiative (TTI) and the Think Tank Fund (TTF) are partnering to support peer exchanges between think tanks in regions where the programs are active: Africa, Latin America, South Asia, and Central and Eastern Europe (the former Soviet Union). This project will help reduce cooperation barriers among ...

  18. Fuel tank crashworthiness : loading scenarios

    Science.gov (United States)

    2011-03-16

    The Federal Railroad Administrations Office of Research and Development is conducting research into fuel tank crashworthiness. The breaching of fuel tanks during passenger : rail collisions and derailments increases the potential of serious injury...

  19. Septic and nonseptic olecranon bursitis. Utility of the surface temperature probe in the early differentiation of septic and nonseptic cases.

    Science.gov (United States)

    Smith, D L; McAfee, J H; Lucas, L M; Kumar, K L; Romney, D M

    1989-07-01

    Forty-six consecutive cases of olecranon bursitis were prospectively analyzed during a 1-year period. Eleven cases were septic; 35 cases were nonseptic. In addition to bursal fluid analysis, the surface temperature over the involved olecranon bursa and the contralateral (control) olecranon process was obtained by using a surface temperature probe. We compared the temperature difference between the involved and control sides in all septic and nonseptic cases. In nonseptic cases, the mean surface temperature difference was 0.7 degree C vs 3.7 degrees C in septic cases. In all septic cases, the temperature difference was 2.2 degrees C or greater (range, 2.2 degrees C to 5.1 degrees C; SD, 1.1). Use of the surface probe temperature difference proved 100% sensitive and 94% specific in discriminating septic from nonseptic cases. It seems to be more helpful than the bursal fluid leukocyte count, the predominant cell type, or Gram's stain in the early differentiation of septic and nonseptic olecranon bursitis.

  20. [Pneumococcal septic arthritis in HIV infection].

    Science.gov (United States)

    Trivalle, C; Cremieux, A C; Carbon, C

    1995-11-04

    Infections due to pneumococci are frequent in patients infected with the human immunodeficiency virus (HIV), but joint infections are rare. We observed two cases of septic arthritis due to pneumococci in two non-haemophilic HIV seropositive patients. In the first case, a 31-year old drug addict who had undergone splenectomy, developed hip joint infection during an episode of meningitis due to pneumococci. The germ was moderately sensitive to ampicillin. The second case involved the knee joint in a 29-year-old woman who developed pneumococcal pneumonia after a trip to Zaire. In both cases, joint infection developed after antibiotics had been initiated, and in the first case, after the infection appear to be under control. This would be similar to "post-infectious" arthritis described in gonococcal and meningococcal infections. In HIV positive patients, joint infections are rare compared with other types of immunodepression, but can be observed in all stages of the disease. A total of 75 cases have been reported in the literature, including 8 cases due to pneumococci. These joint infections could be another argument in favour of anti-pneumococcal vaccination in HIV positive patients.

  1. Limited use of antiseptics in septic surgery.

    Science.gov (United States)

    Röhner, Eric; Hoff, Paula; Pfitzner, Tilman; Seeger, Joern Bengt; Buttgereit, Frank; Perka, Carsten; Matziolis, Georg

    2012-10-01

    In septic joint surgery, treatment with antiseptics is a standard procedure. Postinfectious degeneration of cartilage often results in early arthritis that necessitates joint replacement, even in young patients. It is still unclear whether antiseptics have only a toxic effect on chondrocytes or also induce late cell death through apoptosis. We hypothesized that commonly used antiseptics (polyhexanide, hydrogen peroxide, and chlorhexidine) induce different stages of apoptosis on human chondrocytes. Human chondrocytes were isolated and cultured. Polyhexanide, hydrogen peroxide, and chlorhexidine were added to the monolayer cultures. Early and late apoptotic cells were analyzed using flow cytometric detection of Annexin V, active caspases, and 7AAD, and fluorescence microscopy using Annexin V and propidium iodide staining. Flow cytometric analysis revealed an increase of Annexin V and active caspases expression of human chondrocytes after incubation with polyhexanide, hydrogen peroxide, and chlorhexidine. Fluorescence microscopy demonstrated a high number of apoptotic cells. Our data show that polyhexanide and chlorhexidine only promote the early stages of apoptosis without any differences in toxicity. Conversely, hydrogen peroxide induces early and later stages of apoptosis on primary human chondrocytes in vitro.

  2. [Agranulocytosis and septic shock after metamizole use].

    Science.gov (United States)

    Oude Munnik, Thijs H; Annink-Smoors, Marjon; Hom, Harold W; Sportel, Esther T

    2016-01-01

    Metamizole is an analgesic, the orally administered form of which was withdrawn in the Netherlands in 1989 due to an unacceptably high incidence of agranulocytosis. However, later studies showed a much lower incidence and since 2013 the use of metamizole has been recommended by the national guideline on postoperative pain. A 58-year-old woman was referred by her general practitioner to our hospital with suspected diverticulitis. Three days previously the patient had returned from a four-week period of rehabilitation at a German spa following hip replacement surgery. She had been using metamizole since the operation. Within hours of admission, the patient developed septic shock and was transferred to the intensive care unit. Laboratory tests revealed severe neutropenia of 0.2 × 10(9)/l. Treatment consisted of filgrastim, piperacillin/tazobactam and haemodynamic support. After five days the patient was sufficiently recovered to return to the ward. Metamizole-related agranulocytosis is rare but potentially life-threatening. This condition is expected to occur more frequently as the use of metamizole in the Netherlands increases.

  3. Fuel Tank Technology

    Science.gov (United States)

    1989-11-01

    material resistance to the saprophytic microorganisms is necessary. Some coatings formerly used in fuel tanks, such as the MIL-S-4383 Buna-N, were... microorganisms at bay. It can not be assumed however, that the problem will not arise again. QUALIFICATION REQUIREMENTS Existing military specifications for

  4. Competitive Think Tanks in Europe

    DEFF Research Database (Denmark)

    Kelstrup, Jesper Dahl

    the view that changing policy environments results in convergence of think tank strategies across Europe. As a perspective the paper shows that competitive think tanks do have a high average impact pr. staff on both mass and new media compared to other types of think tanks. This may indicate...

  5. Theoretical study of solar combisystems based on bikini tanks and tank-in-tank stores

    DEFF Research Database (Denmark)

    Yazdanshenas, Eshagh; Furbo, Simon

    2012-01-01

    . Findings - Based on the calculations it is concluded that low flow solar combisystems based on bikini tanks are promising for low energy buildings, while solar combisystems based on tank-in-tank stores are attractive for the houses with medium heating demand and old houses with high heating demand...

  6. Tank farm nuclear criticality review

    Energy Technology Data Exchange (ETDEWEB)

    Bratzel, D.R., Westinghouse Hanford

    1996-09-11

    The technical basis for the nuclear criticality safety of stored wastes at the Hanford Site Tank Farm Complex was reviewed by a team of senior technical personnel whose expertise covered all appropriate aspects of fissile materials chemistry and physics. The team concluded that the detailed and documented nucleonics-related studies underlying the waste tanks criticality safety basis were sound. The team concluded that, under current plutonium inventories and operating conditions, a nuclear criticality accident is incredible in any of the Hanford single-shell tanks (SST), double-shell tanks (DST), or double-contained receiver tanks (DCRTS) on the Hanford Site.

  7. Late Sequelae of Hip Septic Arthritis in Children

    Directory of Open Access Journals (Sweden)

    Shirin Mardookhpour

    2012-07-01

    Full Text Available Septic arthritis of the hip in children has multiple sequelae and may result in severe disability. Significant morbidity can be prevented by early recognition and treatment. The authors reviewed 13 children with 14 hips with sequelae of septic arthritis of the hip. All of children had history of hip septic arthritis before age of 4 years. Six were male subjects, and 7 were female subjects. We evaluated the history, clinical findings and radiographs of all children who had been treated at the Imam Khomeini hospital between 1986 and 2001 for septic arthritis of the hip. Final results of operations in patients include range of motion, presence or absence pain, joint stability, limb-length discrepancy were assessed. Three hips had mild pain in usual daily activities and one patient with cerebral palsy experienced hip instability. Most of patients (80% had flexion contracture about 10-15 degrees .Final results showed average limb length discrepancy was about 2.8 cm. Septic arthritis of the hip in children may result in a spectrum of residual problems and the significant complications can be averted by early detection and treatment. Treatment in younger age cause better outcome.

  8. IL-7 restores lymphocyte functions in septic patients.

    Science.gov (United States)

    Venet, Fabienne; Foray, Anne-Perrine; Villars-Méchin, Astrid; Malcus, Christophe; Poitevin-Later, Françoise; Lepape, Alain; Monneret, Guillaume

    2012-11-15

    Septic syndrome is the leading cause of mortality for critically ill patients worldwide. Patients develop lymphocyte dysfunctions associated with increased risk of death and nosocomial infections. In this study, we performed preclinical experiments testing the potential of recombinant human IL-7 (rhIL-7) as a lymphostimulating therapy in sepsis. Circulating IL-7 and soluble IL-7 receptor α-chain (soluble CD127) concentrations were measured in plasma, whereas cellular CD127 expression was evaluated on circulating CD4(+) and CD8(+) lymphocytes from septic shock patients and healthy volunteers. Lymphocyte proliferation, IFN-γ production, STAT5 phosphorylation, and B cell lymphoma 2 induction were measured ex vivo in response to T cell stimulation in the presence or not of rhIL-7. We show that IL-7 pathway (plasmatic IL-7 concentration and cellular and soluble CD127 expressions) is not overtly altered and remains activable in septic patients. Most importantly ex vivo treatment of patients' cells with rhIL-7 significantly improves lymphocyte functionality (CD4(+) and CD8(+) lymphocyte proliferations, IFN-γ production, STAT5 phosphorylation, and B cell lymphoma 2 induction after stimulation). To our knowledge, this constitutes the first report of rhIL-7 ability to restore normal lymphocyte functions in septic patients. These results support the rational for initiating a clinical trial testing rhIL-7 in septic shock.

  9. Gender differences in septic intensive care unit patients.

    Science.gov (United States)

    Campanelli, Francesco; Landoni, Giovanni; Cabrini, Luca; Zangrillo, Alberto

    2017-12-13

    The world population is mostly male at birth, although there is a shift in predominance over 55 years of age with more females than males. Male gender was recently hypothesized to be a risk factor for sepsis and septic shock; the reasons and the consequences of this odd discrepancy are yet a matter of debate. We investigated the percentage of males and females in a large number of trials performed on septic adult patients admitted to Intensive Care Units. We analysed all the multicentre randomized controlled trials ever published in peer-reviewed Journals reporting a significant effect on mortality in intensive care unit septic adult patients; furthermore, we retrieved all the manuscripts dealing with sepsis or septic shock patients published in the last 3 years in the three medical Journals with the highest impact factor. We analysed data from 12 multicentre randomized controlled trials (for a total of 5080 patients, 61% males) and from further 22 trials published in the New England Journal of Medicine, the Lancet, and the Journal of the American Medical Association (for a total of 493,066 patients, 54% males). Data on gender ratio in survivors were not available. Data from 34 large studies on 498,146 septic adult patients clearly showed a prevalence of males despite the expected female predominance. Further studies are required to explain the reasons, to evaluate if a difference is present in survival rate, and to identify gender-tailored preventive measures and treatments.

  10. Do Fish Enhance Tank Mixing?

    DEFF Research Database (Denmark)

    Rasmussen, Michael R.; Laursen, Jesper; Craig, Steven R.

    2005-01-01

    potential and operational profitability. The hydrodynamic performance of tanks, therefore, represents an important parameter during the tank design process. Because there are significant complexities in combining the rigid principles of hydrodynamics with the stochastic behaviour of fish, however, most data......The design of fish rearing tanks represents a critical stage in the development of optimal aquaculture systems, especially in the context of recirculating systems. Poor hydrodynamics can compromise water quality, waste management and the physiology and behaviour of fish, and thence, production...... upon tank hydrokinetics has been derived using tanks void of fish. Clearly, the presence of randomly moving objects, such as fish, in a water column will influence not only tank volumes by displacing water, but due to their activity, water dynamics and associated in-tank processes. In order...

  11. Arthroscopic management of native shoulder septic arthritis.

    Science.gov (United States)

    Abdel, Matthew P; Perry, Kevin I; Morrey, Mark E; Steinmann, Scott P; Sperling, John W; Cass, Joseph R

    2013-03-01

    There is little information on the results of arthroscopic treatment of native shoulder sepsis. Therefore, the purpose of this study was to determine the presentation, preoperative indices, intraoperative findings, and outcomes related to native shoulder sepsis treated with arthroscopy. We retrospectively reviewed 50 consecutive native shoulders with septic arthritis between 1994 and 2008. Patients (75% male) were an average age of 66 years. Four patients had bilateral involvement. All underwent arthroscopic irrigation and debridement. The mean follow-up was 31 months (range, 1-185 months). Patients were immunocompromised in 57% of cases. The mean preoperative values (normal reference ranges) included white blood cell count, 13 × 10(9)/L (3.5-10.5 × 10(9)/L); erythrocyte sedimentation rate, 66 mm/h (0-29 mm/h), and C-creative protein, 83 mg/L (0-10 mg/L). The average aspiration cell count was 110,988, with a mean differential of 87% neutrophils. The most common organisms were methicillin-susceptible Staphylococcus aureus (44%). Repeat irrigation and debridement was required within the first month in 16 of 50 shoulders (32%). Within 1 year, 17% of patients had died. Final Gächter staging was I or II for 32 shoulders and III or IV for 18 shoulders. Most patients with native shoulder sepsis are elderly and immunocompromised and present with increased inflammatory markers and a supporting aspiration cell count. Patients and surgeons must be aware that after initial arthroscopy, 1 in 3 patients will require additional surgical intervention, whether anticipated or not. Level IV, Case Series, Treatment Study. Copyright © 2013 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

  12. TankSIM: A Cryogenic Tank Performance Prediction Program

    Science.gov (United States)

    Bolshinskiy, L. G.; Hedayat, A.; Hastings, L. J.; Moder, J. P.; Schnell, A. R.; Sutherlin, S. G.

    2015-01-01

    Accurate prediction of the thermodynamic state of the cryogenic propellants in launch vehicle tanks is necessary for mission planning and successful execution. Cryogenic propellant storage and transfer in space environments requires that tank pressure be controlled. The pressure rise rate is determined by the complex interaction of external heat leak, fluid temperature stratification, and interfacial heat and mass transfer. If the required storage duration of a space mission is longer than the period in which the tank pressure reaches its allowable maximum, an appropriate pressure control method must be applied. Therefore, predictions of the pressurization rate and performance of pressure control techniques in cryogenic tanks are required for development of cryogenic fluid long-duration storage technology and planning of future space exploration missions. This paper describes an analytical tool, Tank System Integrated Model (TankSIM), which can be used for modeling pressure control and predicting the behavior of cryogenic propellant for long-term storage for future space missions. It is written in the FORTRAN 90 language and can be compiled with any Visual FORTRAN compiler. A thermodynamic vent system (TVS) is used to achieve tank pressure control. Utilizing TankSIM, the following processes can be modeled: tank self-pressurization, boiloff, ullage venting, and mixing. Details of the TankSIM program and comparisons of its predictions with test data for liquid hydrogen and liquid methane will be presented in the final paper.

  13. Tank characterization data report: Tank 241-C-112

    Energy Technology Data Exchange (ETDEWEB)

    Simpson, B.C.; Borsheim, G.L.; Jensen, L.

    1993-04-01

    Tank 241-C-112 is a Hanford Site Ferrocyanide Watch List tank that was most recently sampled in March 1992. Analyses of materials obtained from tank 241-C-112 were conducted to support the resolution of the Ferrocyanide Unreviewed Safety Question (USQ) and to support Hanford Federal Facility Agreement and Consent Order (Tri-Party Agreement) Milestone M-10-00. Analysis of core samples obtained from tank 241-C-112 strongly indicates that the fuel concentration in the tank waste will not support a propagating exothermic reaction. It is probable that tank 241-C-112 exceeds the 1,000 g-mol inventory criteria established for the Ferrocyanide USQ; however, extensive energetic analysis of the waste has determined a maximum exothermic value of -9 cal/g dry waste. This value is substantially below any levels of concern (-75 cal/g). In addition, an investigation of potential mechanisms to generate concentration levels of radionuclides high enough to be of concern was performed. No credible mechanism was postulated that could initiate the formation of such concentration levels in the tank. Tank 241-C-112 waste is a complex material made up primarily of water and inert salts. The insoluble solids are a mixture of phosphates, sulfates, and hydroxides in combination with aluminum, calcium, iron, nickel, and uranium. Disodium nickel ferrocyanide and sodium cesium nickel ferrocyanide probably exist in the tank; however, there appears to have been significant degradation of this material since the waste was initially settled in the tank.

  14. Corrective Action Decision Document for Corrective Action Unit 151: Septic Systems and Discharge Area, Nevada Test Site, Nevada, Rev. No.: 0

    Energy Technology Data Exchange (ETDEWEB)

    Grant Evenson

    2006-05-01

    This Corrective Action Decision Document has been prepared for Corrective Action Unit (CAU) 151, Septic Systems and Discharge Area, at the Nevada Test Site, Nevada, according to the ''Federal Facility Agreement and Consent Order'' (FFACO) (1996). Corrective Action Unit 151 is comprised of eight corrective action sites (CASs): (1) CAS 02-05-01, UE-2ce Pond; (2) CAS 12-03-01, Sewage Lagoons (6); (3) CAS 12-04-01, Septic Tanks; (4) CAS 12-04-02, Septic Tanks; (5) CAS 12-04-03, Septic Tank; (6) CAS 12-47-01, Wastewater Pond; (7) CAS 18-03-01, Sewage Lagoon; and (8) CAS 18-99-09, Sewer Line (Exposed). The purpose of this Corrective Action Decision Document is to identify and provide the rationale for the recommendation of corrective action alternatives (CAAs) for each of the eight CASs within CAU 151. Corrective action investigation (CAI) activities were performed from September 12 through November 18, 2005, as set forth in the CAU 151 Corrective Action Investigation Plan and Record of Technical Change No. 1. Additional confirmation sampling was performed on December 9, 2005; January 10, 2006; and February 13, 2006. Analytes detected during the CAI were evaluated against appropriate final action levels (FALs) to identify the contaminants of concern for each CAS. The results of the CAI identified contaminants of concern at two of the eight CASs in CAU 151 and required the evaluation of CAAs. Assessment of the data generated from investigation activities conducted at CAU 151 revealed the following: (1) Soils at CASs 02-05-01, 12-04-01, 12-04-02, 12-04-03, 12-47-01, 18-03-01, 18-99-09, and Lagoons B through G of CAS 12-03-01 do not contain contamination at concentrations exceeding the FALs. (2) Lagoon A of CAS 12-03-01 has arsenic above FALs in shallow subsurface soils. (3) One of the two tanks of CAS 12-04-01, System No.1, has polychlorinated biphenyls (aroclor-1254), trichloroethane, and cesium-137 above FALs in the sludge. Both CAS 12-04-01, System

  15. Improved Tank Testing Methods

    Science.gov (United States)

    1980-01-01

    Nordseewerke Emden Hitachi Shipbuilding and Engineering Company, Ltd. Ishikawajima - Harima Heavy Industries Company, Ltd. Kawasaki Heavy Industries , Ltd... Harima Heavy Industries Co., LTD (U.S. office) Newport News ShipbuildingCo. Sun Shipbuildingand Dry Dock Co. Davie ShipbuildingLtd. Cargo tanks...shipbuilders listed below: American Bureau of Shipping U.S. Coast Guard Avondale Shipyards Co. General Dynamics/Quincy Shipbuilding Division 4 Ishikawajima

  16. Metabolomics as a Novel Approach for Early Diagnosis of Pediatric Septic Shock and Its Mortality

    OpenAIRE

    Mickiewicz, Beata; Vogel, Hans J.; Wong, Hector R.; Winston, Brent W.

    2013-01-01

    Rationale: Septic shock is a significant cause of morbidity and mortality in the pediatric population. Early recognition of septic shock and appropriate treatment increase survival rate; thus, developing new diagnostic tools may improve patients’ outcomes.

  17. Similar Microcirculatory Alterations in Patients with Normodynamic and Hyperdynamic Septic Shock

    NARCIS (Netherlands)

    Edul, Vanina S. Kanoore; Ince, Can; Vazquez, Alejandro Risso; Rubatto, Paolo N.; Espinoza, Emilio D. Valenzuela; Welsh, Sebastián; Enrico, Carolina; Dubin, Arnaldo

    2016-01-01

    Rationale: In normodynamic septic shock, the quantitative assessment of sublingual microcirculation has shown decreases in perfused vascular density and red blood cell velocity. However, no studies have been performed in hyperdynamic septic shock. Objectives: To characterize the microcirculatory

  18. Role of echocardiography in reducing shock reversal time in pediatric septic shock: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Ahmed A. EL‐Nawawy

    2018-01-01

    Conclusion: Serial echocardiography provided crucial data for early recognition of septic myocardial dysfunction and hypovolemia that was not apparent on clinical assessment, allowing a timely management and resulting in shock reversal time reduction among children with septic shock.

  19. Dispatch and prehospital transport for acute septic patients

    DEFF Research Database (Denmark)

    Pedersen, Peter Bank; Henriksen, Daniel Pilsgaard; Mikkelsen, Søren

    2017-01-01

    with a suboptimal mode of transport. Patients with severe sepsis or septic shock suffer from highly time dependent conditions but they present with a wide range of symptoms, which might be difficult to identify in the dispatch system. The aim of the study is to investigate the modes of prehospital transport among...... acute admitted patients with sepsis, severe sepsis and septic shock. METHODS: We included all adult patients (≥15 years) presenting to an acute medical unit at Odense University Hospital with a first-time admission of community-acquired sepsis between September 2010-August 2011. Cases and prehospital...... (36.3%) had sepsis, 1,071 (62.5%) severe sepsis, and 21 (1.2%) septic shock. In the group of sepsis patients, 390 (62.8%) arrived without public prehospital transport, 197 (31.7%) were transported by ambulance, and 34 (5.5%) were assisted by MECU. In the group of severe sepsis patients, the same...

  20. Lower versus Higher Hemoglobin Threshold for Transfusion in Septic Shock

    DEFF Research Database (Denmark)

    Holst, Lars B; Haase, Nicolai; Wetterslev, Jørn

    2014-01-01

    BACKGROUND: Blood transfusions are frequently given to patients with septic shock. However, the benefits and harms of different hemoglobin thresholds for transfusion have not been established. METHODS: In this multicenter, parallel-group trial, we randomly assigned patients in the intensive care...... unit (ICU) who had septic shock and a hemoglobin concentration of 9 g per deciliter or less to receive 1 unit of leukoreduced red cells when the hemoglobin level was 7 g per deciliter or less (lower threshold) or when the level was 9 g per deciliter or less (higher threshold) during the ICU stay...... were similar in the two intervention groups. CONCLUSIONS: Among patients with septic shock, mortality at 90 days and rates of ischemic events and use of life support were similar among those assigned to blood transfusion at a higher hemoglobin threshold and those assigned to blood transfusion...

  1. Higher vs. lower haemoglobin threshold for transfusion in septic shock

    DEFF Research Database (Denmark)

    Rygård, S L; Holst, L B; Wetterslev, J

    2017-01-01

    BACKGROUND: Using a restrictive transfusion strategy appears to be safe in sepsis, but there may be subgroups of patients who benefit from transfusion at a higher haemoglobin level. We explored if subgroups of patients with septic shock and anaemia had better outcome when transfused at a higher vs....... a lower haemoglobin threshold. METHODS: In post-hoc analyses of the full trial population of 998 patients from the Transfusion Requirements in Septic Shock (TRISS) trial, we investigated the intervention effect on 90-day mortality in patients with severe comorbidity (chronic lung disease, haematological...... malignancy or metastatic cancer), in patients who had undergone surgery (elective or acute) and in patients with septic shock as defined by the new consensus definition: lactate above 2 mmol/l and the need for vasopressors to maintain a mean arterial pressure above 65 mmHg. RESULTS: The baseline...

  2. Septic arthritis in a native knee due to Corynebacterium striatum.

    Science.gov (United States)

    Molina Collada, Juan; Rico Nieto, Alicia; Díaz de Bustamante Ussia, Macarena; Balsa Criado, Alejandro

    2017-03-07

    We describe a case of septic arthritis in a native knee due to Corynebacterium striatum, gram-positive bacilli that are usually commensal organisms of skin and mucosal membranes, but are seldom implicated in native septic arthritis. An 84-year-old man with Corynebacterium striatum septic arthritis of his native left knee and no response to conventional antibiotic therapy. Thus, the patient was allowed to take dalbavancin for compassionate use, with an excellent clinical outcome. This case emphasizes de role of Corynebacterium striatum in native joint infections and highlights the importance of early detection and appropriate treatment in improving the clinical outcome. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

  3. ArcNLET: A GIS-based software to simulate groundwater nitrate load from septic systems to surface water bodies

    Science.gov (United States)

    Rios, J. Fernando; Ye, Ming; Wang, Liying; Lee, Paul Z.; Davis, Hal; Hicks, Rick

    2013-03-01

    Onsite wastewater treatment systems (OWTS), or septic systems, can be a significant source of nitrates in groundwater and surface water. The adverse effects that nitrates have on human and environmental health have given rise to the need to estimate the actual or potential level of nitrate contamination. With the goal of reducing data collection and preparation costs, and decreasing the time required to produce an estimate compared to complex nitrate modeling tools, we developed the ArcGIS-based Nitrate Load Estimation Toolkit (ArcNLET) software. Leveraging the power of geographic information systems (GIS), ArcNLET is an easy-to-use software capable of simulating nitrate transport in groundwater and estimating long-term nitrate loads from groundwater to surface water bodies. Data requirements are reduced by using simplified models of groundwater flow and nitrate transport which consider nitrate attenuation mechanisms (subsurface dispersion and denitrification) as well as spatial variability in the hydraulic parameters and septic tank distribution. ArcNLET provides a spatial distribution of nitrate plumes from multiple septic systems and a load estimate to water bodies. ArcNLET's conceptual model is divided into three sub-models: a groundwater flow model, a nitrate transport and fate model, and a load estimation model which are implemented as an extension to ArcGIS. The groundwater flow model uses a map of topography in order to generate a steady-state approximation of the water table. In a validation study, this approximation was found to correlate well with a water table produced by a calibrated numerical model although it was found that the degree to which the water table resembles the topography can vary greatly across the modeling domain. The transport model uses a semi-analytical solution to estimate the distribution of nitrate within groundwater, which is then used to estimate a nitrate load using a mass balance argument. The estimates given by ArcNLET are

  4. The majority of patients in septic shock are transfused with fresh-frozen plasma

    DEFF Research Database (Denmark)

    Reiter, Nanna; Wesche, Nikolaj; Perner, Anders

    2013-01-01

    Fresh-frozen plasma (FFP) transfusion may be widely used in patients in septic shock, but the use is not well-described. Our aim was to describe the current use of FFP transfusion in medical patients with septic shock.......Fresh-frozen plasma (FFP) transfusion may be widely used in patients in septic shock, but the use is not well-described. Our aim was to describe the current use of FFP transfusion in medical patients with septic shock....

  5. Control groups in recent septic shock trials: a systematic review.

    Science.gov (United States)

    Pettilä, Ville; Hjortrup, Peter Buhl; Jakob, Stephan M; Wilkman, Erika; Perner, Anders; Takala, Jukka

    2016-12-01

    The interpretation of septic shock trial data is profoundly affected by patients, control intervention, co-interventions and selected outcome measures. We evaluated the reporting of control groups in recent septic shock trials. We searched for original articles presenting randomized clinical trials (RCTs) in adult septic shock patients from 2006 to 2016. We included RCTs focusing on septic shock patients with at least two parallel groups and at least 50 patients in the control group. We selected and evaluated data items regarding patients, control group characteristics, and mortality outcomes, and calculated a data completeness score to provide an overall view of quality of reporting. A total of 24 RCTs were included (mean n = 287 patients and 71 % of eligible patients were randomized). Of the 24 studies, 14 (58 %) presented baseline data on vasopressors and 58 % the proportion of patients with elevated lactate values. Five studies (21 %) provided data to estimate the proportion of septic shock patients fulfilling the Sepsis-3 definition. The mean data completeness score was 19 out of 36 (range 8-32). Of 18 predefined control group characteristics, a mean of 8 (range 2-17) were reported. Only 2 (8 %) trials provided adequate data to confirm that their control group treatment represented usual care. Recent trials in septic shock provide inadequate data on the control group treatment and hemodynamic values. We propose a standardized trial dataset to be created and validated, comprising characteristics of patient population, interventions administered, hemodynamic values achieved, surrogate organ dysfunction, and mortality outcomes, to allow better analysis and interpretation of future trial results.

  6. Cultured alveolar epithelial cells from septic rats mimic in vivo septic lung.

    Directory of Open Access Journals (Sweden)

    Taylor S Cohen

    2010-06-01

    Full Text Available Sepsis results in the formation of pulmonary edema by increasing in epithelial permeability. Therefore we hypothesized that alveolar epithelial cells isolated from septic animals develop tight junctions with different protein composition and reduced barrier function relative to alveolar epithelial cells from healthy animals. Male rats (200-300 g were sacrificed 24 hours after cecal ligation and double puncture (2CLP or sham surgery. Alveolar epithelial cells were isolated and plated on fibronectin-coated flexible membranes or permeable, non-flexible transwell substrates. After a 5 day culture period, cells were either lysed for western analysis of tight junction protein expressin (claudin 3, 4, 5, 7, 8, and 18, occludin, ZO-1, and JAM-A and MAPk (JNK, ERK, an p38 signaling activation, or barrier function was examined by measuring transepithelial resistance (TER or the flux of two molecular tracers (5 and 20 A. Inhibitors of JNK (SP600125, 20 microM and ERK (U0126, 10 microM were used to determine the role of these pathways in sepsis induced epithelial barrier dysfunction. Expression of claudin 4, claudin 18, and occludin was significantly lower, and activation of JNK and ERK signaling pathways was significantly increased in 2CLP monolayers, relative to sham monolayers. Transepithelial resistance of the 2CLP monolayers was reduced significantly compared to sham (769 and 1234 ohm-cm(2, respectively, however no significant difference in the flux of either tracer was observed. Inhibition of ERK, not JNK, significantly increased TER and expression of claudin 4 in 2CLP monolayers, and prevented significant differences in claudin 18 expression between 2CLP and sham monolayers. We conclude that alveolar epithelial cells isolated from septic animals form confluent monolayers with impaired barrier function compared to healthy monolayers, and inhibition of ERK signaling partially reverses differences between these monolayers. This model provides a unique

  7. Septic arthritis and bursitis: emergency ultrasound can facilitate diagnosis.

    Science.gov (United States)

    Costantino, Thomas G; Roemer, Benjamin; Leber, Ernest H

    2007-04-01

    This article reports the case of a 52-year-old woman with septic arthritis and bursitis of her shoulder. Due to a minor musculoskeletal injury and lack of fever, the diagnosis was missed on her first Emergency Department visit. Sonographic guidance of the shoulder arthrocentesis led to successful aspiration of the larger fluid collection in the subacromial bursa and allowed the diagnosis and treatment to proceed more rapidly. Septic arthritis is a challenging clinical diagnosis, and when it occurs in more difficult to aspirate joints, the diagnosis can become more challenging still. Ultrasound provides a means for the emergency physician to establish the diagnosis more readily.

  8. Bilateral Acromioclavicular Septic Arthritis as an Initial Presentation of Streptococcus pneumoniae Endocarditis

    Directory of Open Access Journals (Sweden)

    Neda Hashemi-Sadraei

    2014-01-01

    Full Text Available Infective endocarditis (IE is infrequently associated with septic arthritis. Moreover, septic arthritis of the acromioclavicular (AC joint is rarely reported in the literature. We report a case of Streptococcus pneumoniae IE in a patient who presented with bilateral AC joint septic arthritis and we review the literature on the topic.

  9. Bilateral Acromioclavicular Septic Arthritis as an Initial Presentation of Streptococcus pneumoniae Endocarditis

    OpenAIRE

    Hashemi-Sadraei, Neda; Gupta, Rohan; Machicado, Jorge D.; Govindu, Rukma

    2014-01-01

    Infective endocarditis (IE) is infrequently associated with septic arthritis. Moreover, septic arthritis of the acromioclavicular (AC) joint is rarely reported in the literature. We report a case of Streptococcus pneumoniae IE in a patient who presented with bilateral AC joint septic arthritis and we review the literature on the topic.

  10. The impact of septic systems density and nearness to spring water ...

    African Journals Online (AJOL)

    The improper use of onsite sanitation facilities such as latrines and septic systems may lead to groundwater contamination. It is true that drain field of septic system located too close to water point, and or over population of the septic systems in a small area can lead to pollution of groundwater. Our study investigated the ...

  11. Tank characterization data report: Tank 241-C-112

    Energy Technology Data Exchange (ETDEWEB)

    Simpson, B.C.; Borsheim, G.L.; Jensen, L.

    1993-09-01

    Tank 241-C-112 is a Hanford Site Ferrocyanide Watch List tank that was most recently sampled in March 1992. Analyses of materials obtained from tank 241-C-112 were conducted to support the resolution of the Ferrocyanide Unreviewed Safety Question (USQ) and to support Hanford Federal Facility Agreement and Consent Order (Tri-Party Agreement) Milestone M-10-00. Analysis of core samples obtained from tank 241-C-112 strongly indicates that the fuel concentration in the tank waste will not support a propagating exothermic reaction. Analysis of the process history of the tank as well as studies of simulants provided valuable information about the physical and chemical condition of the waste. This information, in combination with the analysis of the tank waste, sup ports the conclusion that an exothermic reaction in tank 241-C-112 is not plausible. Therefore, the contents of tank 241-C-112 present no imminent threat to the workers at the Hanford Site, the public, or the environment from its forrocyanide inventory. Because an exothermic reaction is not credible, the consequences of this accident scenario, as promulgated by the General Accounting Office, are not applicable.

  12. Acute collective gas poisoning at work in a manure storage tank.

    Science.gov (United States)

    Żaba, Czesław; Marcinkowski, Jerzy T; Wojtyła, Andrzej; Tężyk, Artur; Tobolski, Jarosław; Zaba, Zbigniew

    2011-01-01

    Cases of deaths in manure or septic tanks are rare in legal-medical practice, more frequently as unfortunate occupational accidents. Poisoning with toxic gases, especially with hydrogen sulfide, is reported as the cause of death, while the exhaustion of oxygen in the air is omitted with the simultaneous excess of carbon dioxide. In such cases, determination of the direct cause of death constitutes a big problem because post-mortem examination does not reveal the specific changes. A case of acute collective poisoning by gases in a manure storage tank is presented of 5 agricultural workers, 2 of whom died. While explaining the cause of poisoning and deaths, toxicological blood tests were performed in the victims of the accident, as well as gases inside the manure storage tank. The post-mortem examinations and toxicological blood tests performed did not allow determination of the direct cause of death. Toxicological tests of gases from inside the manure tank showed a very low concentration of oxygen, with a simultaneous very high concentration of carbon dioxide, and a considerable level of hydrogen sulfide. The cause of fainting of three and deaths of two workers was not the poisoning with hydrogen sulfide, but oxygen deficiency in the air of the tank.

  13. Accountability Tanks Calibration Data Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Wendelberger, James G. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Salazar, William Richard [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Finstad, Casey Charles [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2017-04-25

    MET-1 utilizes tanks to store plutonium in solution. The Nuclear Material Control & Accountability group at LANL requires that MET-1 be able to determine the amount of SNM remaining in solution in the tanks for accountability purposes. For this reason it is desired to determine how well various operators may read the volume of liquid left in the tank with the tank measurement device (glass column or slab). The accuracy of the measurement is then compared to the current SAFE-NMCA acceptance criteria for lean and rich plutonium solutions to determine whether or not the criteria are reasonable and may be met.

  14. Tank Characterization Report for Double Shell Tank (DST) 241-AN-107

    Energy Technology Data Exchange (ETDEWEB)

    ADAMS, M.R.

    2000-03-23

    This report interprets information about the tank answering a series of six questions covering areas such as information drivers, tank history, tank comparisons, disposal implications, data quality and quantity, and unique aspects of the tank.

  15. Tal en tanke

    DEFF Research Database (Denmark)

    Hendricks, Vincent F.; Stjernfelt, Frederik

    Den svenske biskop og poet Esais Tegnèr har engang sagt: "Menneskers ord og tanker fødes sammen, at tale uklart er at tænke uklart." Denne lærebog er et lynkursus i at tænke og tale klart - og i at være på vagt over for uklar tænkning og tale, hvor den end optræder.Tal en tanke er hurtigt læst og...

  16. Tank closure reducing grout

    Energy Technology Data Exchange (ETDEWEB)

    Caldwell, T.B.

    1997-04-18

    A reducing grout has been developed for closing high level waste tanks at the Savannah River Site in Aiken, South Carolina. The grout has a low redox potential, which minimizes the mobility of Sr{sup 90}, the radionuclide with the highest dose potential after closure. The grout also has a high pH which reduces the solubility of the plutonium isotopes. The grout has a high compressive strength and low permeability, which enhances its ability to limit the migration of contaminants after closure. The grout was designed and tested by Construction Technology Laboratories, Inc. Placement methods were developed by the Savannah River Site personnel.

  17. 49 CFR 238.423 - Fuel tanks.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Fuel tanks. 238.423 Section 238.423 Transportation....423 Fuel tanks. (a) External fuel tanks. Each type of external fuel tank must be approved by FRA's Associate Administrator for Safety upon a showing that the fuel tank provides a level of safety at least...

  18. 46 CFR 154.439 - Tank design.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 5 2010-10-01 2010-10-01 false Tank design. 154.439 Section 154.439 Shipping COAST... SELF-PROPELLED VESSELS CARRYING BULK LIQUEFIED GASES Design, Construction and Equipment Independent Tank Type A § 154.439 Tank design. An independent tank type A must meet the deep tank standard of the...

  19. 46 CFR 154.420 - Tank design.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 5 2010-10-01 2010-10-01 false Tank design. 154.420 Section 154.420 Shipping COAST... SELF-PROPELLED VESSELS CARRYING BULK LIQUEFIED GASES Design, Construction and Equipment Integral Tanks § 154.420 Tank design. (a) The structure of an integral tank must meet the deep tank scantling standards...

  20. Microcirculatory monitoring in septic patients: Where do we stand?

    NARCIS (Netherlands)

    Gruartmoner, G.; Mesquida, J.; Ince, C.

    2017-01-01

    Microcirculatory alterations play a pivotal role in sepsis-related morbidity and mortality. However, since the microcirculation has been a "black box", current hemodynamic management of septic patients is still guided by nnacrocirculatory parameters. In the last decades, the development of several

  1. Septic arthritis and osteomyelitis due to Bordetella petrii.

    Science.gov (United States)

    Nogi, Masayuki; Bankowski, Matthew J; Pien, Francis D

    2015-03-01

    A case of Bordetella petrii septic arthritis and osteomyelitis in an elbow resulted from a dirt bike accident in Hawaii. Two months of intravenous antibiotics and repeated surgeries were required to cure this infection. Our case, and literature review, suggests that extended-spectrum penicillins, tetracycline, and trimethoprim-sulfamethoxazole are good treatment options. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

  2. Pattern of Microbial Flora in Septic Incomplete Abortion in Port ...

    African Journals Online (AJOL)

    Alasia Datonye

    ABSTRACT. Background: Septic abortion occurs when there is colonization of the upper genital tract by micro organisms following termination of pregnancy usually before the age of viability. This can result from ascending infections from the lower genital tract or direct inoculation of micro organisms from contaminated and ...

  3. Pattern of Microbial Flora in Septic Incomplete Abortion in Port ...

    African Journals Online (AJOL)

    Background: Septic abortion occurs when there is colonization of the upper genital tract by micro organisms following termination of pregnancy usually before the age of viability. This can result from ascending infections from the lower genital tract or direct inoculation of micro organisms from contaminated and poorly ...

  4. Actinomyces pyogenes septic arthritis in a diabetic farmer.

    LENUS (Irish Health Repository)

    Lynch, M

    2012-02-03

    We report a case of septic arthritis and osteomyelitis of the left ankle due to Actinomyces pyogenes in a diabetic farmer. Few confirmed human cases of A. pyogenes infection have been reported, partly because of inadequate identification of this bacterium. Bacteriological characteristics of the organism, which resembles Arcanobacterium haemolyticum, are described with a review of previous case reports.

  5. Endogenous IL-10 protects mice from death during septic peritonitis

    NARCIS (Netherlands)

    van der Poll, T.; Marchant, A.; Buurman, W. A.; Berman, L.; Keogh, C. V.; Lazarus, D. D.; Nguyen, L.; Goldman, M.; Moldawer, L. L.; Lowry, S. F.

    1995-01-01

    IL-10 production during endotoxic shock is part of a protective mechanism that involves IL-10-induced inhibition of TNF synthesis. We sought to determine the role of IL-10 in septic peritonitis induced by cecal ligation and puncture (CLP). CLP led to a rapid induction of IL-10 mRNA in various organs

  6. Nocardia Septic Arthritis Complicating an Anterior Cruciate Ligament Repair

    OpenAIRE

    Yong, Elaine X. L.; Cheong, Elaine Y.L.; Boutlis, Craig S.; Chen, Darren B.; Liu, Eunice Y.-T.; McKew, Genevieve L.

    2015-01-01

    Nocardia infection following anterior cruciate ligament (ACL) allograft reconstruction is a rare occurrence. We report a case of Nocardia infection of an allograft ACL reconstruction and septic arthritis of the knee joint due to an organism most similar to the novel Nocardia species Nocardia aobensis.

  7. Childhood Pyogenic Septic Arthritis as Seen in a Teaching Hospital ...

    African Journals Online (AJOL)

    Its pattern of presentation that varies from and within subregions has implications on the early recognition, treatment, and outcome. ..... MUA* + physiotherapy. 1. 2.3. Total. 44. 100. *MUA: Manipulation under anesthesia ... Septic shock. 4. 9.09. Joint stiffness. 4. 9.09. Pathologic dislocation (hip). 2. 4.55. Osteonecrosis. 1.

  8. Septic hip dislocations in children in a developing country | Ngom ...

    African Journals Online (AJOL)

    Purpose: To report on a radiological issue and therapeutic aspects encountered in septic hip dislocations in a developing country. Patients and Methods: Nineteen children among whom 11 boys and 8 girls aged on average 5.3-years old presented 7 recent and 12 late hip dislocations. Those dislocations were distributed ...

  9. Childhood Pyogenic Septic Arthritis as Seen in a Teaching Hospital ...

    African Journals Online (AJOL)

    2017-05-18

    May 18, 2017 ... osteomyelitis in the metaphyseal ends of long bones, penetrating and open joint injuries as well as surgical instrumentations.[4,5] Irreversible damage to the articular cartilage by bacteria toxins, proteases from the synovial cells, and chondrocytes in addition to accumulated pus. Introduction. Septic arthritis ...

  10. Septic Abortion Managed in a Tertiary Hospital in West Bengal

    African Journals Online (AJOL)

    endotoxic shock or jaundice or acute renal failure. Statistical analysis was done by using Epi Info™ software (Version 3.5.1,. CDC) after proper arrangement of all the data in tabular form and presented as simple percentage. Results: During the period,. 1297 cases of abortion were admitted among which 107 were septic ...

  11. Adrenal insufficiency in critically ill septic patients at Dr George ...

    African Journals Online (AJOL)

    Rationale: Adrenal insufficiency occurs with varying frequency in critically ill patients. It is usually associated with a high mortality and poor clinical outcome. Objective: To determine the incidence of adrenal failure in patients with severe sepsis and septic shock admitted to our intensive care unit. Design: Prospective ...

  12. Norepinephrine in septic shock : when and how much?

    NARCIS (Netherlands)

    Hamzaoui, Olfa; Scheeren, Thomas W L; Teboul, Jean-Louis

    Purpose of reviewNorepinephrine is the first-line agent recommended during resuscitation of septic shock to correct hypotension due to depressed vascular tone. Important clinical issues are the best timing to start norepinephrine, the optimal blood pressure target, and the best therapeutic options

  13. Adrenal insufficiency in critically ill septic patients at Dr George ...

    African Journals Online (AJOL)

    Adele

    patients with septic shock.5 It is important to recognize these patients since this disorder has a high mortality if untreated.6. The most common cause of adrenal insufficiency in critically ill patients is sepsis and the systemic inflammatory response syndrome (SIRS).5,7 This is presumably due to the circulating suppressive ...

  14. Septic Arthritis of The Hip Joint presenting as Acute Abdomen ...

    African Journals Online (AJOL)

    Septic arthritis of the hip joint in two children, originally thought to be cases of acute abdomen is presented. In one case, the discovery of extra-peritoneal purulent fluid at surgery, obviated the need for laparotomy and in the other, the true nature of the disease became apparent one week after laparotomy. These cases ...

  15. Nocardia Septic Arthritis Complicating an Anterior Cruciate Ligament Repair.

    Science.gov (United States)

    Yong, Elaine X L; Cheong, Elaine Y L; Boutlis, Craig S; Chen, Darren B; Liu, Eunice Y-T; McKew, Genevieve L

    2015-08-01

    Nocardia infection following anterior cruciate ligament (ACL) allograft reconstruction is a rare occurrence. We report a case of Nocardia infection of an allograft ACL reconstruction and septic arthritis of the knee joint due to an organism most similar to the novel Nocardia species Nocardia aobensis. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

  16. Pylephlebitis and Crohn's disease: A rare case of septic shock.

    Science.gov (United States)

    Scaringi, Stefano; Giudici, Francesco; Gabbani, Giacomo; Zambonin, Daniela; Morelli, Marco; Carrà, Rossella; Bechi, Paolo

    2017-08-10

    Troncular pylephlebitis, defined as septic thrombophlebitis of the portal vein, is usually secondary to suppurative infection from the regions drained by the portal system. Therefore, pylephlebitis can occur from the portal vein main tributaries. The occurrence of mesenteric pylephlebitis in Crohn's disease is extremely rare. We describe a case of septic shock due to mesenteric pylephlebitis in a 47 years old male affected with Crohn's disease. The patient was admitted to the emergency department after he had been complained from 3h of a peri-umbilical abdominal pain associated to fever and shivering quickly followed by a severe hypotension. His medical history included histologically confirmed ileal Crohn's disease diagnosed 4 years before and treated with mesalamine only. Computed tomography scan confirmed the mesenteric pylephlebitis diagnosis. After medical therapy with antibiotics and systemic nutrition, the patient was successfully operated to treat his ileal Crohn's disease. In our case, the quick onset of a septic shock was not due to a peritonitis complicating a Crohn's disease, but to a rare condition not needing an urgent surgical resolution. This report shows that, even in Crohn's disease, once diagnosis is performed, antibiotic therapy associated to enteral and parenteral nutrition can lead to a complete clinical remission of mesenteric pylephlebitis, mandatory to perform an elective surgery. This case highlights the importance of promptly considerate and treat mesenteric pylephlebitis in presence of a septic shock in a Crohn's disease patient who is not showing clinical signs of peritonitis. Copyright © 2017. Published by Elsevier Ltd.

  17. Congenital candidiasis presenting as septic shock without rash

    Science.gov (United States)

    Carmo, Kathryn Browning; Evans, Nick; Isaacs, David

    2009-01-01

    Congenital candidiasis is rare and often benign. This report describes the case of twins born at 32 weeks of gestation with different manifestations of congenital candidiasis. One twin was born well though neutropenic, and died from overwhelming sepsis with septic shock at 22 h. The other twin presented with a delayed onset of rash at 2 days, remained well and survived. PMID:21686407

  18. Evolution of Blood Lactate and 90-Day Mortality in Septic Shock. A Post Hoc Analysis of the FINNAKI Study

    DEFF Research Database (Denmark)

    Varis, Elina; Pettilä, Ville; Poukkanen, Meri

    2017-01-01

    Hyperlactatemia predicts mortality in patients with sepsis and septic shock, and its normalization is a potential treatment goal. We investigated the association of blood lactate and its changes over time with 90-day mortality in septic shock. We performed a post hoc analysis of 513 septic shock...... surrogate endpoints for mortality in septic shock patients....

  19. 27 CFR 24.229 - Tank car and tank truck requirements.

    Science.gov (United States)

    2010-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Tank car and tank truck... BUREAU, DEPARTMENT OF THE TREASURY LIQUORS WINE Spirits § 24.229 Tank car and tank truck requirements. Railroad tank cars and tank trucks used to transport spirits for use in wine production will be constructed...

  20. 27 CFR 27.174 - Tank cars and tank trucks to be sealed.

    Science.gov (United States)

    2010-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Tank cars and tank trucks... Tank cars and tank trucks to be sealed. Where a shipment of distilled spirits from customs custody to the distilled spirits plant is made in a tank car or tank truck, all openings affording access to the...

  1. Corrective Action Investigation Plan for Corrective Action Unit 224: Decon Pad and Septic Systems Nevada Test Site, Nevada, Rev. No.: 0, with ROTC 1 and 2

    Energy Technology Data Exchange (ETDEWEB)

    David A. Strand

    2004-04-01

    This Corrective Action Investigation Plan (CAIP) contains project-specific information including facility descriptions, environmental sample collection objectives, and criteria for conducting site investigation activities at Corrective Action Unit (CAU) 224: Decon Pad and Septic Systems, Nevada Test Site (NTS), Nevada. This CAIP has been developed in accordance with the ''Federal Facility Agreement and Consent Order'' (FFACO) (1996) that was agreed to by the State of Nevada, the U.S. Department of Energy (DOE), and the U.S. Department of Defense (DoD). The NTS is approximately 65 miles (mi) northwest of Las Vegas, Nevada (Figure 1-1). Corrective Action Unit 224 is comprised of the nine Corrective Action Sites (CASs) listed below: 02-04-01, Septic Tank (Buried); 03-05-01, Leachfield; 05-04-01, Septic Tanks (4)/Discharge Area; 06-03-01, Sewage Lagoons (3); 06-05-01, Leachfield; 06-17-04, Decon Pad and Wastewater Catch; 06-23-01, Decon Pad Discharge Piping; 11-04-01, Sewage Lagoon; and 23-05-02, Leachfield. Corrective Action Sites 06-05-01, 06-23-01, and 23-05-02 were identified in the 1991 Reynolds Electrical & Engineering Co., Inc. (REECo) inventory (1991). The remaining sites were identified during review of various historical documents. Additional information will be obtained by conducting a corrective action investigation (CAI) prior to evaluating and selecting a corrective action alternative for each CAS. The CAI will include field inspections, radiological and geological surveys, and sample collection. Data will also be obtained to support investigation-derived waste (IDW) disposal and potential future waste management decisions.

  2. Research Award: Think Tank Iniave

    International Development Research Centre (IDRC) Digital Library (Canada)

    Corey Piccioni

    2013-08-07

    Aug 7, 2013 ... These one‐year, paid, in‐house programs of training and mentorship allow award holders to pursue their research goals and work in one of IDRC's dynamic program or division teams. The Think Tank Iniave is a global program that supports independent policy research organizaons – or "think tanks" – in ...

  3. Enhanced Waste Tank Level Model

    Energy Technology Data Exchange (ETDEWEB)

    Duignan, M.R.

    1999-06-24

    'With the increased sensitivity of waste-level measurements in the H-Area Tanks and with periods of isolation, when no mass transfer occurred for certain tanks, waste-level changes have been recorded with are unexplained.'

  4. Surplus yeast tank failing catastrophically

    DEFF Research Database (Denmark)

    Hedlund, Frank Huess

    2016-01-01

    GOOD REASON FOR CAUTION I A large surplus yeast tank shot into the air leaving the floor plate and the contents behind. Although not designed for overpressure, the tank was kept at “very slight overpressure” to suppress nuisance foaming. The brewery was unaware of the hazards of compressed air...

  5. Solitons in a wave tank

    DEFF Research Database (Denmark)

    Olsen, M.; Smith, H.; Scott, Alwyn C.

    1984-01-01

    A wave tank experiment (first described by the nineteenth-century engineer and naval architect John Scott Russell) relates a linear eigenvalue problem from elementary quantum mechanics to a striking feature of modern nonlinear wave theory: multiple generation of solitons. The tank experiment...

  6. Cleaning Validation of Fermentation Tanks

    DEFF Research Database (Denmark)

    Salo, Satu; Friis, Alan; Wirtanen, Gun

    2008-01-01

    Reliable test methods for checking cleanliness are needed to evaluate and validate the cleaning process of fermentation tanks. Pilot scale tanks were used to test the applicability of various methods for this purpose. The methods found to be suitable for validation of the clenlinees were visula...

  7. Research Award: Think Tank Initiative

    International Development Research Centre (IDRC) Digital Library (Canada)

    IDRC CRDI

    One important dimension of the Initiative is to capture and share learning about strategies for supporting and managing policy research organizations. The Think Tank Initiative ... proposals could address one/some of the following research questions: •. How do think tanks communicate effectively in policy environments?

  8. Modelling of baffled stirred tanks

    Energy Technology Data Exchange (ETDEWEB)

    Ahlstedt, H.; Lahtinen, M. [Tampere Univ. of Technology (Finland). Energy and Process Engineering

    1996-12-31

    The three-dimensional flow field of a baffled stirred tank has been calculated using four different turbulence models. The tank is driven by a Rushton-type impeller. The boundary condition for the impeller region has been given as a source term or by calculating the impeller using the sliding mesh technique. Calculated values have been compared with measured data. (author)

  9. Clinical characteristics and outcomes of community-acquired methicillin-resistant Staphylococcus aureus septic arthritis

    Directory of Open Access Journals (Sweden)

    Sian Yik Lim

    2017-01-01

    Full Text Available Objective: We investigated the clinical characteristics, treatment patterns and outcomes of community-acquired methicillin resistant Staphylococcus aureus (CA-MRSA septic arthritis. Methods: This was a retrospective chart review of CA-MRSA septic arthritis in a tertiary care hospital from 2000-2013. We compared CA-MRSA septic arthritis cases with HA-MRSA septic arthritis cases to identify important differences between the two groups. Results: We identified 11 cases of CA-MRSA septic arthritis and 34 cases of hospital-acquired methicillin-resistant SA (HA-MRSA septic arthritis. Community-acquired methicillin-resistant Staphylococcus aureus caused 25% of the MRSA septic arthritis cases. Community-acquired methicillin-resistant Staphylococcus aureus septic arthritis occurred in younger patients with fewer comorbidities or risk factors. There was no difference in initial presentation between CA-MRSA and HA-MRSA. Community-acquired methicillin-resistant Staphylococcus aureus patients were less likely to be treated with appropriate antibiotics initially. Community-acquired methicillin-resistant Staphylococcus aureus septic arthritis was associated with increased morbidity with a high percentage of patients developing poor joint outcomes or osteomyelitis complications.  Community-acquired methicillin-resistant Staphylococcus aureus septic arthritis was also associated with increased utilization of health care resources due to long hospital stays, high readmissions rates, and increased requirements for rehabilitation facility placement and home health support. There was no difference in mortality, poor joint outcome, readmissions, and osteomyelitis complications between CA-MRSA septic arthritis and HA-MRSA septic arthritis. Conclusions: Community-acquired methicillin-resistant Staphylococcus aureus septic arthritis is associated with increased morbidity and health care resource utilization. Increased awareness into CA-MRSA as a cause of septic

  10. Septic-embolic and septic-metabolic brain abscess; Septisch-embolischer und septisch-metastatischer Hirnabszess

    Energy Technology Data Exchange (ETDEWEB)

    Weber, W.; Henkes, H.; Kuehne, D. [Alfried-Krupp-Krankenhaus Essen (Germany). Klinik fuer Radiologie und Neuroradiologie; Felber, S. [Universitaetsklinik Innsbruck (Austria). Klinische Abt. der Radiologie I; Jaenisch, W. [Freie Univ. Berlin (Germany). Inst. fuer Neuropathologie; Woitalla, D. [Bochum Univ. (Germany). St. Josef-Hospital

    2000-11-01

    The hematogeneous spread of bacteria, fungi and protozoa may also reach the brain vessels, which happens mostly through septic emboli. >From such an embolus a metastatic focal encephalitis and later a septic-embolic brain abscess may arise. The most frequently underlying infections that may cause septic emboli are bacterial endocarditis as well as bacterial infections of artificial heart valve prostheses. Congenital heart malformations with a right-to-left shunt also play here a certain role. Basically, however, all septic conditions and bacteriemias may cause septic-embolic brain abscesses. They occur frequently as multiple lesions. MRI is superior to CT in depicting the different stages of evolution from focal encephalitis, through the hardly encapsulated early abscess, to the formation of a membrane and later a dense fibrous capsule. The medical treatment of a brain abscess requires properly performed CT or MRI follow-up examinations in order to realize early enough a possible growing of such a lesion. (orig.) [German] Die haemoatogene Ausbreitung von Bakterien, Pilzen oder Protozoen bis in die Hirngefaesse erfolgt meist durch eine septische Embolie. Es entstehen eine metastatische Herdenzephalitis und im weiteren Verlauf daraus ein septisch-embolischer Hirnabszess. Die haeufigste Grunderkrankung die zu septischen Embolien fuehrt, ist die bakterielle Endokarditis sowie die bakterielle Infektion von Herzklappenprothesen. Eine besondere Bedeutung kommt hier den angeborenen kardialen Fehlbildungen mit Rechts-Links-Shunt zu. Grundsaetzlich koennen jedoch alle Bakteriaemien zu septisch-embolischen Hirnabszessen fuehren. Septisch-embolische Hirnabszesse treten aufgrund ihres Entstehungsmechanismus haeufig multipel auf. Die CT und besser noch die MRT erlauben die Darstellung aller Entwicklungsstadien von der Herdenzephalitis ueber den kaum abgegrenzten Abszess, die Membranbildung bis zur Entstehung einer dicken, die eitergefuellte Hoehle allseits umgebenden

  11. Tank farms hazards assessment

    Energy Technology Data Exchange (ETDEWEB)

    Broz, R.E.

    1994-09-30

    Hanford contractors are writing new facility specific emergency procedures in response to new and revised US Department of Energy (DOE) Orders on emergency preparedness. Emergency procedures are required for each Hanford facility that has the potential to exceed the criteria for the lowest level emergency, an Alert. The set includes: (1) a facility specific procedure on Recognition and Classification of Emergencies, (2) area procedures on Initial Emergency Response and, (3) an area procedure on Protective Action Guidance. The first steps in developing these procedures are to identify the hazards at each facility, identify the conditions that could release the hazardous material, and calculate the consequences of the releases. These steps are called a Hazards Assessment. The final product is a document that is similar in some respects to a Safety Analysis Report (SAR). The document could br produced in a month for a simple facility but could take much longer for a complex facility. Hanford has both types of facilities. A strategy has been adopted to permit completion of the first version of the new emergency procedures before all the facility hazards Assessments are complete. The procedures will initially be based on input from a task group for each facility. This strategy will but improved emergency procedures in place sooner and therefore enhance Hanford emergency preparedness. The purpose of this document is to summarize the applicable information contained within the Waste Tank Facility ``Interim Safety Basis Document, WHC-SD-WM-ISB-001`` as a resource, since the SARs covering Waste Tank Operations are not current in all cases. This hazards assessment serves to collect, organize, document and present the information utilized during the determination process.

  12. Supporting document for the Southeast Quadrant historical tank content estimate report for SY-tank farm

    Energy Technology Data Exchange (ETDEWEB)

    Brevick, C.H.; Gaddis, L.A.; Consort, S.D. [Westinghouse Hanford Co., Richland, WA (United States)

    1995-12-31

    Historical Tank Content Estimate of the Southeast Quadrant provides historical evaluations on a tank by tank basis of the radioactive mixed wastes stored in the underground double-shell tanks of the Hanford 200 East and West Areas. This report summarizes historical information such as waste history, temperature profiles, psychrometric data, tank integrity, inventory estimates and tank level history on a tank by tank basis. Tank Farm aerial photos and in-tank photos of each tank are provided. A brief description of instrumentation methods used for waste tank surveillance are included. Components of the data management effort, such as Waste Status and Transaction Record Summary, Tank Layer Model, Supernatant Mixing Model, Defined Waste Types, and Inventory Estimates which generate these tank content estimates, are also given in this report.

  13. N-terminal-pro-brain natriuretic peptide elevations in the course of septic and non-septic shock reflect systolic left ventricular dysfunction assessed by transpulmonary thermodilution

    Directory of Open Access Journals (Sweden)

    A.B. Johan Groeneveld

    2016-03-01

    Conclusions: In septic and non-septic shock, NT-proBNP elevations reflect systolic left ventricular dysfunction and are associated with a poor outcome. They may help recognition of cardiac dysfunction in shock and its management when invasive hemodynamic monitoring is not yet instituted.

  14. Tank vapor mitigation requirements for Hanford Tank Farms

    Energy Technology Data Exchange (ETDEWEB)

    Rakestraw, L.D.

    1994-11-15

    Westinghouse Hanford Company has contracted Los Alamos Technical Associates to listing of vapors and aerosols that are or may be emitted from the High Level Waste (HLW) tanks at Hanford. Mitigation requirements under Federal and State law, as well as DOE Orders, are included in the listing. The lists will be used to support permitting activities relative to tank farm ventilation system up-grades. This task is designated Task 108 under MJB-SWV-312057 and is an extension of efforts begun under Task 53 of Purchase Order MPB-SVV-03291 5 for Mechanical Engineering Support. The results of that task, which covered only thirty-nine tanks, are repeated here to provide a single source document for vapor mitigation requirements for all 177 HLW tanks.

  15. Comparison of prognostic value of N-terminal pro-brain natriuretic peptide in septic and non-septic intensive care patients.

    Science.gov (United States)

    Ozcan, Namik; Ozcan, Ayse; Kaymak, Cetin; Basar, Hulya; Kotanoglu, Mustafa; Kose, Bektas

    2017-03-01

    The aim of this study is to compare the prognostic value of N-terminal pro-brain natriuretic peptide (NT-proBNP) levels in septic and non-septic intensive care patients. Fifty consecutive patients admitted to the intensive care unit (ICU) were enrolled in either the septic or non-septic group according to the criteria in the International Sepsis Definitions Conference in 2001. Demographic and clinical data, procalcitonin and lactate levels at admission, and death within 28 days were registered. Five blood samples were collected from all patients for NT-proBNP measurements. Septic patients had higher APACHE II (19 (16.00-24.25) vs. 16 (13.00-18.25)), and SOFA (8 (5-10) vs. 6 (4-7)) scores (p care patients.

  16. Initial resuscitation and management of pediatric septic shock.

    Science.gov (United States)

    Martin, K; Weiss, S L

    2015-04-01

    The pediatric sepsis syndrome remains a common cause of morbidity, mortality, and health care utilization costs worldwide. The initial resuscitation and management of pediatric sepsis is focused on 1) rapid recognition of abnormal tissue perfusion and restoration of adequate cardiovascular function; 2) eradication of the inciting invasive infection, including prompt administration of empiric broad-spectrum antimicrobial medications; and 3) supportive care of organ system dysfunction. Efforts to improve early and aggressive initial resuscitation and ongoing management strategies have improved outcomes in pediatric severe sepsis and septic shock, though many questions still remain as to the optimal therapeutic strategies for many patients. In this article, we will briefly review the definitions, epidemiology, clinical manifestations, and pathophysiology of sepsis and provide an extensive overview of both current and novel therapeutic strategies used to resuscitate and manage pediatric patients with severe sepsis and septic shock.

  17. Diagnostics of septic arthritis in the sternoclavicular region

    DEFF Research Database (Denmark)

    Bodker, Tina; Tottrup, Mikkel; Petersen, Klaus Kjaer

    2013-01-01

    Background: Septic arthritis in the sternoclavicular (SC) region is rare and may be difficult to diagnose clinically and radiologically. It mainly affects immunocompromised persons, and can clinically be misinterpreted as tumor and rheumatic disorders. Lacking radiological reference standard......, a multimodality approach may contribute to a prolonged diagnostic process. Purpose: To describe the diagnostics of septic arthritis in the SC region. Material and Methods: Between 2001 and 2011 10 patients with Staphylococcus infection in the SC region were investigated in our institution. Clinical, biochemical......, radiological, and microbiological findings were studied retrospectively; all CT and MR examinations were re-evaluated. Results: Initial radiography in nine patients and ultrasonography in six patients were inconclusive resulting in supplementary MRI and/or CT. Five patients examined by MRI were immediately...

  18. Septic pericarditis and myocardial abscess in an English Springer spaniel.

    Science.gov (United States)

    Fraga Veloso, Gemma; Fraga Manteiga, Eduardo; Trehy, Mary; Freeman, Alistair; McConnell, J Fraser; Dukes McEwan, Joanna

    2014-03-01

    Septic pericarditis and myocardial abscess are rare conditions in dogs. They are usually caused by foreign bodies, penetrating wounds, systemic infections or extension of local infections such as endocarditis, pleuritis or pulmonary infections to the myocardial tissue. Here we report a septic pericardial effusion and myocardial abscess in a young English Springer spaniel presenting with a long history of pyrexia and lethargy. No cause could clearly be identified although a penetrating injury or dissolving foreign body was highly suspected. The patient was successfully treated with a surgical approach in combination with broad spectrum antibacterials resulting in resolution of clinical signs without recurrence of the infection. Copyright © 2013 Elsevier B.V. All rights reserved.

  19. State Waste Discharge Permit application: 400 Area Septic System

    Energy Technology Data Exchange (ETDEWEB)

    1994-06-01

    As part of the Hanford Federal Facility Agreement and Consent Order negotiations, the US Department of Energy, Richland Operations Office, the US Environmental Protection Agency, and the Washington State Department of Ecology agreed that liquid effluent discharges to the ground on the Hanford Site which affects groundwater or has the potential to affect groundwater would be subject to permitting under the structure of Chapter 173-216 (or 173-218 where applicable) of the Washington Administrative Code, the State Waste Discharge Permit Program. This document constitutes the State Waste Discharge Permit application for the 400 Area Septic System. The influent to the system is domestic waste water. Although the 400 Area Septic System is not a Public Owned Treatment Works, the Public Owned Treatment Works application is more applicable than the application for industrial waste water. Therefore, the State Waste Discharge Permit application for Public Owned Treatment Works Discharges to Land was used.

  20. Microcirculatory monitoring in septic patients: Where do we stand?

    Science.gov (United States)

    Gruartmoner, G; Mesquida, J; Ince, C

    Microcirculatory alterations play a pivotal role in sepsis-related morbidity and mortality. However, since the microcirculation has been a "black box", current hemodynamic management of septic patients is still guided by macrocirculatory parameters. In the last decades, the development of several technologies has shed some light on microcirculatory evaluation and monitoring, and the possibility of incorporating microcirculatory variables to clinical practice no longer seems to be beyond reach. The present review provides a brief summary of the current technologies for microcirculatory evaluation, and attempts to explore the potential role and benefits of their integration to the resuscitation process in critically ill septic patients. Copyright © 2016 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

  1. Arthroscopy of septic carpitis in donkeys (Equus asinus).

    Science.gov (United States)

    Elkasapy, A H; AbdelGalil, A I; Al-Akraa, A M; Ibrahim, I M; Ismail, S F

    2014-01-01

    Experimental septic arthritis was induced in the radiocarpal joint of 18 donkeys by intra-articular injection of Staphylococcus aureus (3-4X10(6) CFU). The inoculated animals were divided into three groups (6 donkeys in each group). The arthroscopic examination was carried out before induction of septic carpitis and 3 days (group I), 14 days (group II), and 28 days (group III) after induction of infection. The arthroscopic examination of group I revealed hyperemia of synovial membrane and hypertrophied villi. In group II, severe hyperemia of synovial membrane, hypertrophied villi, pannus in the joint cavity and beginning of articular cartilage erosion were found. In group III, severe hyperemia of synovial membrane, hypertrophied villi and more prominent articular cartilage erosion were present.

  2. Arthroscopy of septic carpitis in donkeys (Equus asinus

    Directory of Open Access Journals (Sweden)

    A.H. Elkasapy

    2014-11-01

    Full Text Available Experimental septic arthritis was induced in the radiocarpal joint of 18 donkeys by intra-articular injection of Staphylococcus aureus (3-4X106 CFU. The inoculated animals were divided into three groups (6 donkeys in each group. The arthroscopic examination was carried out before induction of septic carpitis and 3 days (group I, 14 days (group II, and 28 days (group III after induction of infection. The arthroscopic examination of group I revealed hyperemia of synovial membrane and hypertrophied villi. In group II, severe hyperemia of synovial membrane, hypertrophied villi, pannus in the joint cavity and beginning of articular cartilage erosion were found. In group III, severe hyperemia of synovial membrane, hypertrophied villi and more prominent articular cartilage erosion were present.

  3. Corticosteroids and Pediatric Septic Shock Outcomes: A Risk Stratified Analysis

    Science.gov (United States)

    Atkinson, Sarah J.; Cvijanovich, Natalie Z.; Thomas, Neal J.; Allen, Geoffrey L.; Anas, Nick; Bigham, Michael T.; Hall, Mark; Freishtat, Robert J.; Sen, Anita; Meyer, Keith; Checchia, Paul A.; Shanley, Thomas P.; Nowak, Jeffrey; Quasney, Michael; Weiss, Scott L.; Banschbach, Sharon; Beckman, Eileen; Howard, Kelli; Frank, Erin; Harmon, Kelli; Lahni, Patrick; Lindsell, Christopher J.; Wong, Hector R.

    2014-01-01

    Background The potential benefits of corticosteroids for septic shock may depend on initial mortality risk. Objective We determined associations between corticosteroids and outcomes in children with septic shock who were stratified by initial mortality risk. Methods We conducted a retrospective analysis of an ongoing, multi-center pediatric septic shock clinical and biological database. Using a validated biomarker-based stratification tool (PERSEVERE), 496 subjects were stratified into three initial mortality risk strata (low, intermediate, and high). Subjects receiving corticosteroids during the initial 7 days of admission (n = 252) were compared to subjects who did not receive corticosteroids (n = 244). Logistic regression was used to model the effects of corticosteroids on 28-day mortality and complicated course, defined as death within 28 days or persistence of two or more organ failures at 7 days. Results Subjects who received corticosteroids had greater organ failure burden, higher illness severity, higher mortality, and a greater requirement for vasoactive medications, compared to subjects who did not receive corticosteroids. PERSEVERE-based mortality risk did not differ between the two groups. For the entire cohort, corticosteroids were associated with increased risk of mortality (OR 2.3, 95% CI 1.3–4.0, p = 0.004) and a complicated course (OR 1.7, 95% CI 1.1–2.5, p = 0.012). Within each PERSEVERE-based stratum, corticosteroid administration was not associated with improved outcomes. Similarly, corticosteroid administration was not associated with improved outcomes among patients with no comorbidities, nor in groups of patients stratified by PRISM. Conclusions Risk stratified analysis failed to demonstrate any benefit from corticosteroids in this pediatric septic shock cohort. PMID:25386653

  4. Corticosteroids and pediatric septic shock outcomes: a risk stratified analysis.

    Science.gov (United States)

    Atkinson, Sarah J; Cvijanovich, Natalie Z; Thomas, Neal J; Allen, Geoffrey L; Anas, Nick; Bigham, Michael T; Hall, Mark; Freishtat, Robert J; Sen, Anita; Meyer, Keith; Checchia, Paul A; Shanley, Thomas P; Nowak, Jeffrey; Quasney, Michael; Weiss, Scott L; Banschbach, Sharon; Beckman, Eileen; Howard, Kelli; Frank, Erin; Harmon, Kelli; Lahni, Patrick; Lindsell, Christopher J; Wong, Hector R

    2014-01-01

    The potential benefits of corticosteroids for septic shock may depend on initial mortality risk. We determined associations between corticosteroids and outcomes in children with septic shock who were stratified by initial mortality risk. We conducted a retrospective analysis of an ongoing, multi-center pediatric septic shock clinical and biological database. Using a validated biomarker-based stratification tool (PERSEVERE), 496 subjects were stratified into three initial mortality risk strata (low, intermediate, and high). Subjects receiving corticosteroids during the initial 7 days of admission (n = 252) were compared to subjects who did not receive corticosteroids (n = 244). Logistic regression was used to model the effects of corticosteroids on 28-day mortality and complicated course, defined as death within 28 days or persistence of two or more organ failures at 7 days. Subjects who received corticosteroids had greater organ failure burden, higher illness severity, higher mortality, and a greater requirement for vasoactive medications, compared to subjects who did not receive corticosteroids. PERSEVERE-based mortality risk did not differ between the two groups. For the entire cohort, corticosteroids were associated with increased risk of mortality (OR 2.3, 95% CI 1.3-4.0, p = 0.004) and a complicated course (OR 1.7, 95% CI 1.1-2.5, p = 0.012). Within each PERSEVERE-based stratum, corticosteroid administration was not associated with improved outcomes. Similarly, corticosteroid administration was not associated with improved outcomes among patients with no comorbidities, nor in groups of patients stratified by PRISM. Risk stratified analysis failed to demonstrate any benefit from corticosteroids in this pediatric septic shock cohort.

  5. Continuation of Statin Therapy and Vasopressor Use in Septic Shock.

    Science.gov (United States)

    Zechmeister, Carrie; Hurren, Jeff; McNorton, Kelly

    2015-07-01

    Studies have evaluated the use of statins in sepsis; however, no human studies have explored their effect on vasopressor requirements in septic shock. The primary objective was to determine the effect of prehospital statin continuation on duration of vasopressor therapy in patients with septic shock. Secondary objectives included maximum and average vasopressor dose and in-hospital mortality. This was a retrospective, institutional board-approved, observational cohort study in a community teaching hospital; 119 adult intensive care unit (ICU) patients with an ICD-9 code for septic shock and prehospital statin therapy were evaluated. Multivariate analyses were performed to address confounders. Of the 1229 patients screened, 119 (10%) met inclusion criteria; 73 patients (61%) had a statin continued within 24 hours of ICU admission. Crude analysis demonstrated no difference in vasopressor duration in the statin versus no statin group (3.3 vs 4.8 days; P = 0.21). There was no difference in either maximum (17.9 ± 16.1 vs 23.8 ± 21.7 µg/min norepinephrine equivalents [NEQs]; P = 0.1) or average vasopressor dose (9.5 ± 8.4 vs 12.1 ± 11.5 µg/min NEQ; P = 0.17). There was a decrease in mortality in the statin patients (43% vs 67 %; P = 0.05). On adjustment for potential confounders, there was no difference in any outcome, with a persistent trend toward lower mortality in the statin group. Continuation of prehospital statin therapy decreased neither duration nor dose of vasopressors in patients with septic shock but yielded a trend toward decreased mortality. © The Author(s) 2015.

  6. [Fluid balance and acute kidney injury in septic shock].

    Science.gov (United States)

    Martínez-García, Jesús Javier; León-Sicairos, Nidia Maribel; Canizalez-Román, Adrián; García-Arellano, Bianca Azucena

    In patients with septic shock, excessive fluid administration can lead to increased morbidity and mortality. The aim of this study was to evaluate the association between fluid balance, acute kidney injury and mortality in patients with septic shock. A study of cases and controls was conducted in a Pediatric Intensive Care Unit. The fluid balance in the first 72h and the presence of acute kidney injury was compared in patients diagnosed with septic shock who died against patients who survived the same condition. Univariate and multivariate analyses were performed. Forty-five cases and forty-five controls were included in the analysis. Mortality was associated with Pediatric Risk of Mortality (PRISM III) ≥ 26 points (OR 7.5, 95% CI 2.8-18.7; p=0.000), Pediatric Logistic Organ Dysfunction (PELOD) ≥ 24 points (OR 11.0, 95% CI 4.1-29.4; p=0.000), creatinine ≥ 0.65mg/dl (OR 5.6, 95% CI 2.2-13.9; p=0.000), lactate ≥ 2.5 mmol/l (OR 2.5, 95% CI 1.1-5.9; p=0.033), SvO2 9% in 72h (OR 4.3, 95% CI 1.6-11.7; p=0.003), acute kidney injury (OR 5.7, 95% CI: 2.2-15.1; p=0.000). In the multivariate model, the values of PRISM ≥26 and PELOD ≥24 points were significant. In patients who died due to septic shock, the multivariate model showed an association with PRISM ≥26 and PELOD ≥24 and a trend toward association with SvO2 9%. Copyright © 2017 Hospital Infantil de México Federico Gómez. Publicado por Masson Doyma México S.A. All rights reserved.

  7. Systemic inflammatory response syndrome: a case of septic shock

    Directory of Open Access Journals (Sweden)

    Nicolò Gentiloni Silveri

    2008-09-01

    Full Text Available An elderly, diabetic male, with severe sepsis, swiftly treated with antibiotics that were efficacious in vitro against the E. Coli isolated in his blood, rapidly slides into multiple organ dysfunction syndrome and dies of septic shock after a month in intensive care, despite receiving appropriate pain relief and aetiopathogenetic therapy. This event provides us with the opportunity to take a new look at systemic inflammatory response syndrome and a critical review of the relative therapy

  8. Molecular mechanisms involved in the pathogenesis of septic shock.

    Science.gov (United States)

    López-Bojórquez, Lucia Nikolaia; Dehesa, Alejandro Zentella; Reyes-Terán, Gustavo

    2004-01-01

    Pathogenesis of the development of sepsis is highly complex and has been the object of study for many years. The inflammatory phenomena underlying septic shock are described in this review, as well as the enzymes and genes involved in the cellular activation that precedes this condition. The most important molecular aspects are discussed, ranging from the cytokines involved and their respective transduction pathways to the cellular mechanisms related to accelerated catabolism and multi-organic failure.

  9. Bacillus pumilus Septic Arthritis in a Healthy Child.

    Science.gov (United States)

    Shivamurthy, V M; Gantt, Soren; Reilly, Christopher; Tilley, Peter; Guzman, Jaime; Tucker, Lori

    2016-01-01

    We report a case of septic arthritis caused by a Bacillus species, B. pumilus, occurring in a healthy child. This organism rarely causes serious infections and has only been described in newborns and immunocompromised individuals or as a skin infection. This child developed an indolent joint swelling after a minor skin injury, and symptoms were initially thought most consistent with chronic arthritis. The case demonstrates that clinicians should consider joint infection in children presenting with acute monoarticular swelling, even without prominent systemic features.

  10. Is this septic shock? A rare case of distributive shock

    OpenAIRE

    Val-Flores,Luis Silva; Fior,Alberto; Santos, Ana; Reis, Lu?s; Bento, Lu?s

    2014-01-01

    The authors report a rare case of shock in a patient without significant clinical history, admitted to the intensive care unit for suspected septic shock. The patient was initially treated with fluid therapy without improvement. A hypothesis of systemic capillary leak syndrome was postulated following the confirmation of severe hypoalbuminemia, hypotension, and hemoconcentration - a combination of three symptoms typical of the disease. The authors discussed the differential diagnosis and also...

  11. Is this septic shock? A rare case of distributive shock.

    Science.gov (United States)

    Val-Flores, Luis Silva; Fior, Alberto; Santos, Ana; Reis, Luís; Bento, Luís

    2014-01-01

    The authors report a rare case of shock in a patient without significant clinical history, admitted to the intensive care unit for suspected septic shock. The patient was initially treated with fluid therapy without improvement. A hypothesis of systemic capillary leak syndrome was postulated following the confirmation of severe hypoalbuminemia, hypotension, and hemoconcentration--a combination of three symptoms typical of the disease. The authors discussed the differential diagnosis and also conducted a review of the diagnosis and treatment of the disease.

  12. Arthroscopic treatment of septic arthritis of the knee in children.

    Science.gov (United States)

    Agout, C; Lakhal, W; Fournier, J; de Bodman, C; Bonnard, C

    2015-12-01

    Childhood septic arthritis of the knee is a serious disease that can impair growth and cause serious functional sequelae. There are few data on arthroscopic treatment in children, and series were always less than 20 cases. The objective of this study was to assess clinical and radiographic results of arthroscopic drainage combined with antibiotic therapy for the treatment of childhood septic arthritis of the knee. The hypothesis was that arthroscopic treatment is also effective in children. A retrospective study, conducted between January 2003 and December 2012, included patients under 15 years of age with septic arthritis of the knee treated by arthroscopic drainage with a minimum of 2 years' follow-up. Fifty-six patients, with a mean age at surgery of 3.4 years (range, 3 months to 12 years), were included. Staphylococcus aureus was the most common causative organism. Two patients (3.6%) had recurrence, successfully treated by repeat arthroscopic drainage. Mean Lysholm score was 96.9 (range, 70-100) and mean KOOS-Child pain, symptoms, daily life, sports and quality of life scores were respectively 97 (81-100), 95 (75-100), 98 (89-100), 93 (71-100) and 95 (70-100) at a mean 65 months' follow-up. Ranges of motion were normal. Radiology found no joint damage. Arthroscopic drainage combined with antibiotic treatment is a simple and effective treatment for childhood septic arthritis of the knee and is for our reference attitude. It can also be indicated in case of recurrence. IV, retrospective study. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  13. Clinical presentation and treatment of septic arthritis in children.

    Science.gov (United States)

    Moro-Lago, I; Talavera, G; Moraleda, L; González-Morán, G

    The aim of this study is to determine the epidemiological features, clinical presentation, and treatment of children with septic arthritis. A retrospective review was conducted on a total of 141 children with septic arthritis treated in Hospital Universitario La Paz (Madrid) between the years 2000 to 2013. The patient data collected included, the joint affected, the clinical presentation, the laboratory results, the appearance, Gram stain result, and the joint fluid culture, as well as the imaging tests and the treatment. Most (94%) of the patients were less than 2 years-old. The most common location was the knee (52%), followed by the hip (21%). The septic arthritis was confirmed in 53%. No type of fever was initially observed in 49% of them, and 18% had an ESR (mm/h) or CRP (mg/l) less than 30 in the initial laboratory analysis. The joint fluid was purulent in 45% and turbid in 12%. The Gram stain showed bacteria in 4%. The fluid culture was positive in 17%. Staphylococcus aureus was the most common pathogen found, followed by Streptococcus agalactiae, Streptococcus pneumoniae, and Kingella kingae. Antibiotic treatment was intravenous administration for 7 days, followed by 21 days orally. Surgery was performed in 18% of cases. The diagnosis was only confirmed in 53% of the patients. Some of the confirmed septic arthritis did not present with the classical clinical/analytical signs, demonstrating that the traumatologist or paediatrician requires a high initial level of clinical suspicion of the disease. Copyright © 2017 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

  14. Genome-wide expression profiling in pediatric septic shock.

    Science.gov (United States)

    Wong, Hector R

    2013-04-01

    For nearly a decade, our research group has had the privilege of developing and mining a multicenter, microarray-based, genome-wide expression database of critically ill children (≤10 y of age) with septic shock. Using bioinformatic and systems biology approaches, the expression data generated through this discovery-oriented, exploratory approach have been leveraged for a variety of objectives, which are reviewed here. Fundamental observations include widespread repression of gene programs corresponding to the adaptive immune system and biologically significant differential patterns of gene expression across developmental age groups. The data have also identified gene expression-based subclasses of pediatric septic shock having clinically relevant phenotypic differences. The data have also been leveraged for the discovery of novel therapeutic targets, as well as for the discovery and development of novel stratification and diagnostic biomarkers. Almost a decade of genome-wide expression profiling in pediatric septic shock is now demonstrating tangible results. The studies have progressed from an initial discovery-oriented and exploratory phase to a new phase in which the data are being translated and applied to address several areas of clinical need.

  15. Glucocorticoid Receptor Polymorphisms and Outcomes in Pediatric Septic Shock.

    Science.gov (United States)

    Cvijanovich, Natalie Z; Anas, Nick; Allen, Geoffrey L; Thomas, Neal J; Bigham, Michael T; Weiss, Scott L; Fitzgerald, Julie; Checchia, Paul A; Meyer, Keith; Quasney, Michael; Gedeit, Rainer; Freishtat, Robert J; Nowak, Jeffrey; Raj, Shekhar S; Gertz, Shira; Grunwell, Jocelyn R; Opoka, Amy; Wong, Hector R

    2017-04-01

    Polymorphisms of the glucocorticoid receptor gene are associated with outcome and corticosteroid responsiveness among patients with inflammatory disorders. We conducted a candidate gene association study to test the hypothesis that these polymorphisms are associated with outcome and corticosteroid responsiveness among children with septic shock. We genotyped 482 children with septic shock for the presence of two glucocorticoid receptor polymorphisms (rs56149945 and rs41423247) associated with increased sensitivity and one glucocorticoid receptor polymorphism (rs6198) associated with decreased sensitivity to corticosteroids. The primary outcome variable was complicated course, defined as 28-day mortality or the persistence of two or more organ failures 7 days after a septic shock diagnosis. We used logistic regression to test for an association between corticosteroid exposure and outcome, within genotype group, and adjusted for illness severity. Multiple PICUs in the United States. Standard care. There were no differences in outcome when comparing the various genotype groups. Among patients homozygous for the wild-type glucocorticoid receptor allele, corticosteroids were independently associated with increased odds of complicated course (odds ratio, 2.30; 95% CI, 1.01-5.21; p = 0.047). Based on these glucocorticoid receptor polymorphisms, we could not detect a beneficial effect of corticosteroids among any genotype group. Among children homozygous for the wild-type allele, corticosteroids were independently associated with increased odds of poor outcome.

  16. CE: Managing Sepsis and Septic Shock: Current Guidelines and Definitions.

    Science.gov (United States)

    Makic, Mary Beth Flynn; Bridges, Elizabeth

    2018-02-01

    : Sepsis is a leading cause of critical illness and hospital mortality. Early recognition and intervention are essential for the survival of patients with this syndrome. In 2002, the Society of Critical Care Medicine (SCCM) and the European Society of Intensive Care Medicine (ESICM) launched the Surviving Sepsis Campaign (SSC) to reduce overall patient morbidity and mortality from sepsis and septic shock by driving practice initiatives based on current best evidence. The SSC guidelines have been updated every four years, with the most recent update completed in 2016. The new guidelines have increased the focus on early identification of infection, risks for sepsis and septic shock, rapid antibiotic administration, and aggressive fluid resuscitation to restore tissue perfusion.In 2014, the SCCM and the ESICM convened a task force of specialists to reexamine the definitions of terms used to identify patients along the sepsis continuum. In 2016, this task force published the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). The new definitions and recommendations included tools, based on an updated understanding of the pathobiology of sepsis, that can be used to predict adverse outcomes in patients with infection.This article discusses the new SSC treatment guidelines, changes in the sepsis bundle interventions, and the Sepsis-3 definitions and tools, all of which enable nurses to improve patient outcomes through timely collaborative action.

  17. Bacteria removal in septic effluent: influence of biofilm and protozoa.

    Science.gov (United States)

    Chabaud, Sylvaine; Andres, Yves; Lakel, Abdel; Le Cloirec, Pierre

    2006-09-01

    Numerous biological, physical and chemical parameters are involved in the retention and removal of bacteria in wastewater treatment systems. Biological parameters, such as biofilms and protozoa grazing activity, are often mentioned but few studies provide a better understanding of their influence. In this study, the effect of bacterivorous protozoa on pathogenic indicator bacteria removal was investigated in septic effluent and in the presence of a biofilm coating glass slides. Endogenous bacteria from septic effluent were quantified. First, bacteria removal was compared between septic effluents treated or not with an inhibitor of protozoa (cycloheximide). The mortality rates were 10 times lower in treated effluent (96 CFU mL(-1) d(-1)) than in untreated effluent (1100 CFU mL(-1) d(-1)). Secondly, the efficiency of bacteria removal was studied (i) with a biofilm surface and active protozoa, (ii) with a biofilm surface and inactivated protozoa, (iii) with a clean surface. Protozoa in the presence of a biofilm were responsible for 60% of bacteria removal. Biofilm without protozoa and a clean surface each removed similar quantities of bacteria. Grazing by protozoa could be an important biological mechanism for bacterial elimination in wastewater treatment systems.

  18. How Do I Integrate Hemodynamic Variables When Managing Septic Shock?

    Directory of Open Access Journals (Sweden)

    Olfa Hamzaoui

    2016-11-01

    Full Text Available Hemodynamic management of sepsis-induced circulatory failure is complex since this pathological state includes multiple cardiovascular derangements that can vary from patient to patient according to the degree of hypovolemia, of vascular tone depression, of myocardial depression and of microvascular dysfunction. The treatment of the sepsis-induced circulatory failure is thus not univocal and should be adapted on an individual basis. As physical examination is insufficient to obtain a comprehensive picture of the hemodynamic status, numerous hemodynamic variables more or less invasively collected, have been proposed to well assess the severity of each component of the circulatory failure and to monitor the response to therapy. In this article, we first describe the hemodynamic variables, which are the most relevant to be used, emphasizing on their physiological meaning, their validation and their limitations in patients with septic shock. We then proposed a general approach for managing patients with septic shock by describing the logical steps that need to be followed in order to select and deliver the most appropriate therapies. This therapeutic approach is essentially based on knowledge of physiology, of pathophysiology of sepsis, and of published data from clinical studies that addressed the issue of hemodynamic management of septic shock.

  19. Experimental models of sepsis and septic shock: an overview

    Directory of Open Access Journals (Sweden)

    Garrido Alejandra G.

    2004-01-01

    Full Text Available Sepsis remains a major cause of morbidity and mortality in surgical patients and trauma victims, mainly due to sepsis-induced multiple organ dysfunction. In contrast to preclinical studies, most clinical trials of promising new treatment strategies for sepsis have fails to demonstrate efficacy. Although many reasons could account for this discrepancy, the misinterpretation of preclinical data obtained from experimental studies, and especially the use of animal models that do not adequately mimic human sepsis may have been contributing factors. In this review, the benefits and limitations of various animal models of sepsis are discussed to clarify the extend to which findings are relevant to human sepsis, particularly with respect to the subsequent design and execution of clinical trials. Such models include intravascular infusion of endotoxin or live bacteria, bacterial peritonitis, cecal ligation and perforation, soft tissue infection, pneumonia or meningitis models, using different animal species including rats, mice, rabbits, dogs, pigs, sheep and nonhuman primates. Despite several limitations, animal models remain essential in the development of all new therapies for sepsis and septic shock, because they provide fundamental information about the pharmacokinetics, toxicity, and mechanism of drug action that cannot be duplicated by other methods. New therapeutic agents should be studies in infection models, even after the initiation of the septic process. Furthermore, debility conditions need to be reproduced to avoid the exclusive use of healthy animals, which often do not represent the human septic patient.

  20. 49 CFR 229.217 - Fuel tank.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Fuel tank. 229.217 Section 229.217 Transportation... TRANSPORTATION RAILROAD LOCOMOTIVE SAFETY STANDARDS Locomotive Crashworthiness Design Requirements § 229.217 Fuel tank. (a) External fuel tanks. Locomotives equipped with external fuel tanks shall, at a minimum...

  1. 46 CFR 154.446 - Tank design.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 5 2010-10-01 2010-10-01 false Tank design. 154.446 Section 154.446 Shipping COAST... SELF-PROPELLED VESSELS CARRYING BULK LIQUEFIED GASES Design, Construction and Equipment Independent Tank Type B § 154.446 Tank design. An independent tank type B must meet the calculations under § 154...

  2. 7 CFR 58.218 - Surge tanks.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 3 2010-01-01 2010-01-01 false Surge tanks. 58.218 Section 58.218 Agriculture....218 Surge tanks. If surge tanks are used for hot milk, and temperatures of product including foam being held in the surge tank during processing, is not maintained at a minimum of 150 °F, then two or...

  3. Underground Storage Tanks in Iowa

    Data.gov (United States)

    Iowa State University GIS Support and Research Facility — Underground storage tank (UST) sites which store petroleum in Iowa. Includes sites which have been reported to DNR, and have active or removed underground storage...

  4. Serum free cortisol fraction in healthy and septic neonatal foals.

    Science.gov (United States)

    Hart, K A; Barton, M H; Ferguson, D C; Berghaus, R; Slovis, N M; Heusner, G L; Hurley, D J

    2011-01-01

    Relative cortisol insufficiency occurs in septic foals and impacts survival. Serum free (biologically available) cortisol concentration might be a better indicator of physiologic cortisol status than serum total cortisol concentration in foals. In septic foals, (1) low free cortisol concentration correlates with disease severity and survival and (2) predicts disease severity and outcome better than total cortisol concentration. Fifty-one septic foals; 11 healthy foals; 6 healthy horses. In this prospective clinical study, foals meeting criteria for sepsis at admission were enrolled. University-owned animals served as healthy controls. Basal and cosyntropin-stimulated total cortisol concentration and percent free cortisol (% free cortisol) were determined by chemiluminescent immunoassay and ultrafiltration/ligand-binding methods, respectively. Group data were compared by ANOVA, Mann-Whitney U-tests, and receiver operator characteristic curves. Significance was set at P cortisol was highest in healthy foals at birth (58 ± 8% mean ± SD), and was higher (P ≤ .004) in healthy foals of all ages (33 ± 6 to 58 ± 8%) than in adult horses (7 ± 3%). Cosyntropin-stimulated total and free cortisol concentrations were lower (P ≤ .03) in foals with shock (total = 6.2 ± 8.1 μg/dL; free = 3.5 ± 4.8 μg/dL versus total = 10.8 ± 6.0 μg/dL; free = 6.9 ± 3.3 μg/dL in foals without shock) and in nonsurvivors (total = 3.8 ± 6.9 μg/dL; free = 1.9 ± 3.9 μg/dL versus total = 9.1 ± 7.7 μg/dL; free = 5.5 ± 4.4 μg/dL in survivors). Free cortisol was no better than total cortisol at predicting disease severity or outcome in septic foals. Serum free cortisol is impacted by age and illness in the horse. There is no advantage to measuring free over total cortisol in septic foals. Copyright © 2011 by the American College of Veterinary Internal Medicine.

  5. Role of circulating soluble chemokines in septic shock.

    Science.gov (United States)

    de Pablo, R; Monserrat, J; Prieto, A; Alvarez-Mon, M

    2013-11-01

    Chemokines are a large superfamily of small proteins that function not only in leukocyte trafficking, but are also necessary for linkage between innate and adaptive immunity. Little is known about their role in septic shock. We hypothesized that serum levels of the most important chemokines are related to organ failure, disease severity and outcome. A prospective observational study was carried out. Surgical-clinical Intensive Care Unit. Ninety-two patients diagnosed with septic shock using international criteria. Forty patients were excluded due to acquired immunity disturbances. Samples from 36 healthy controls were also analyzed. None. In 46% of the patients who suffered acute respiratory distress syndrome (ARDS), IL-8 levels were higher than in patients without ARDS (499.9±194.1 vs. 190.8±91.7 pg/ml; P=.039). This molecule was also higher in 36% of the patients with sepsis-induced acute renal failure (ARF) (453.3±181.6 vs. 201.3±95.9 pg/ml; P=.049). Coagulopathy was found in 19% of the septic shock patients with elevated serum IL-8 levels (635.8±292.3 vs. 218.7±87.0 pg/ml; P=.010), elevated MIP-1α (91.4±27.3 vs. 58.8±11.1 pg/ml; P=.044), and low circulating RANTES levels (8162.2±6321.0 vs. 18781.8±11.1 pg/ml; P=.027). No significant differences were found between survivors and non-survivors at any time of follow-up. Upon admission to the ICU, IL-8 is a reliable biomarker of sepsis-induced AFR, ARDS and coagulopathy. Altered circulating MIP-1α and RANTES levels are also found in patients with septic shock and coagulopathy. However, chemokines do not appear to be good biomarkers of mortality in septic shock. Copyright © 2012 Elsevier España, S.L. and SEMICYUC. All rights reserved.

  6. DIAGNOSTICS AND TREATMENT OF THE SEPSIS AND SEPTIC SHOCK IN CHILDREN

    Directory of Open Access Journals (Sweden)

    R.F. Tepaev

    2010-01-01

    Full Text Available Sepsis is one of the leading causes of mortality in children. Timely diagnosis is the most important condition of successful therapy for sepsis. The work provides modern recommendations for diagnosis of the systemic inflammatory response syndrome, sepsis, severe sepsis, septic shock, sets out key guidelines for administering and treating severe sepsis and septic shock in children. Key words: systemic inflammatory response syndrome, sepsis, septic shock, children. (Pediatric Pharmacology. – 2010; 7(5:24-29

  7. Arthroscopic Treatment of Septic Arthritis of the Elbow in a 4-Year-Old Girl

    Directory of Open Access Journals (Sweden)

    Masashi Koide

    2015-01-01

    Full Text Available Pediatric septic arthritis is uncommon and has been traditionally treated by joint aspiration or open arthrotomy. There are some reports about arthroscopic surgery in pediatric septic arthritis of the knee, hip, and shoulder. However, there is no report for the case of elbow. We report a case of pediatric septic arthritis of elbow treated with arthroscopically with good clinical condition at 3-year follow-up. This paper is based on a report first published in Japanese (Tojo (2012.

  8. Restricting volumes of resuscitation fluid in adults with septic shock after initial management

    DEFF Research Database (Denmark)

    Hjortrup, Peter B; Haase, Nicolai; Bundgaard, Helle

    2016-01-01

    PURPOSE: We assessed the effects of a protocol restricting resuscitation fluid vs. a standard care protocol after initial resuscitation in intensive care unit (ICU) patients with septic shock. METHODS: We randomised 151 adult patients with septic shock who had received initial fluid resuscitation...... patients with septic shock. The patient-centred outcomes all pointed towards benefit with fluid restriction, but our trial was not powered to show differences in these exploratory outcomes. TRIAL REGISTRATION: NCT02079402....

  9. A novel method for a fast diagnosis of septic arthritis using mid infrared and deported spectroscopy.

    Science.gov (United States)

    Albert, Jean-David; Monbet, Valérie; Jolivet-Gougeon, Anne; Fatih, Nadia; Le Corvec, Maëna; Seck, Malik; Charpentier, Frédéric; Coiffier, Guillaume; Boussard-Pledel, Catherine; Bureau, Bruno; Guggenbuhl, Pascal; Loréal, Olivier

    2016-05-01

    To assess the ability of mid infrared deported spectroscopy to discriminate synovial fluids samples of septic arthritis patients from other causes of joint effusion. Synovial fluids obtained from patients with clinically suspected arthritis were collected, analysed and classified according to standard diagnostic procedures as septic or non-septic. A spectroscopic analysis on synovial fluid samples was then performed using a coiled optical fiber made with chalcogenide glass. After a factorial analysis of the normalized spectra and the computation of a Fisher test used to select the most relevant components, a logistic regression model was fitted, allowing to attribute a score between 0 - non-septic -, and 1 - septic. In a first phase, we analysed the synovial fluids from 122 different synovial fluids including 6 septic arthritis among arthritis of various origins. Septic synovial fluids were identified with a sensitivity of 95.8% and a specificity of 93.9% and an AUROC of 0.977. The analysis of an independent set of samples (n=42, including two septic arthritis) gave similar values. Our data strongly supports the interest of mid infrared deported spectroscopy, which could be used potentially at point of care, for a rapid and easy diagnosis of septic arthritis. Now, the precision of the diagnosis must be evaluated through a multicentric study on a larger panel of patients. Copyright © 2015 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.

  10. Effects of fluid restriction on measures of circulatory efficacy in adults with septic shock

    DEFF Research Database (Denmark)

    Hjortrup, P. B.; Haase, Nicolai; Wetterslev, Jørn

    2017-01-01

    BACKGROUND: The haemodynamic consequences of fluid resuscitation in septic shock have not been fully elucidated. Therefore, we assessed circulatory effects in the first 24 h of restriction of resuscitation fluid as compared to standard care in intensive care unit (ICU) patients with septic shock....... METHODS: This was a post-hoc analysis of the multicentre CLASSIC randomised trial in which patients with septic shock, who had received the initial fluid resuscitation, were randomised to a protocol restricting resuscitation fluid or a standard care protocol in nine ICUs. The highest plasma lactate...... of restriction of resuscitation fluid as compared with standard care in adults with septic shock who had received initial resuscitation....

  11. ROBOTIC TANK INSPECTION END EFFECTOR

    Energy Technology Data Exchange (ETDEWEB)

    Rachel Landry

    1999-10-01

    The objective of this contract between Oceaneering Space Systems (OSS) and the Department of Energy (DOE) was to provide a tool for the DOE to inspect the inside tank walls of underground radioactive waste storage tanks in their tank farms. Some of these tanks are suspected to have leaks, but the harsh nature of the environment within the tanks precludes human inspection of tank walls. As a result of these conditions only a few inspection methods can fulfill this task. Of the methods available, OSS chose to pursue Alternating Current Field Measurement (ACFM), because it does not require clean surfaces for inspection, nor any contact with the Surface being inspected, and introduces no extra by-products in the inspection process (no coupling fluids or residues are left behind). The tool produced by OSS is the Robotic Tank Inspection End Effector (RTIEE), which is initially deployed on the tip of the Light Duty Utility Arm (LDUA). The RTEE combines ACFM with a color video camera for both electromagnetic and visual inspection The complete package consists of an end effector, its corresponding electronics and software, and a user's manual to guide the operator through an inspection. The system has both coarse and fine inspection modes and allows the user to catalog defects and suspected areas of leakage in a database for further examination, which may lead to emptying the tank for repair, decommissioning, etc.. The following is an updated report to OSS document OSS-21100-7002, which was submitted in 1995. During the course of the contract, two related subtasks arose, the Wall and Coating Thickness Sensor and the Vacuum Scarifying and Sampling Tool Assembly. The first of these subtasks was intended to evaluate the corrosion and wall thinning of 55-gallon steel drums. The second was retrieved and characterized the waste material trapped inside the annulus region of the underground tanks on the DOE's tank farms. While these subtasks were derived from the original

  12. Work plan, health and safety plan, and quality assurance project plan for hazardous waste removal at the CTF K-1654B underground collection tank

    Energy Technology Data Exchange (ETDEWEB)

    Panter, M.S.; Burman, S.N.; Landguth, D.C.; Uziel, M.S.

    1991-10-01

    The Central Training Facility (CTF), located on Bear Creek Road approximately two miles south of the K-25 Site, is utilized for training security personnel at Martin Marietta Energy Systems, Inc., Oak Ridge, Tennessee. At the request of the CTF staff, this plan has been developed for the removal of the waste contents in the facility's 500-gal septic tank and associated distribution box. The septic tank and distribution box were historically located beneath the K-1654B trailer and adjacent to the K-1654A Indoor Firing Range. Recently, however, the K-1654B trailer was removed to accommodate the objectives of this work plan as well as future construction activities planned at CTF. The purpose of this plan is to develop and assign responsibilities, establish personnel protection requirements and mandatory safety procedures, and provide for contingencies that may arise while operations are being conducted by ORNL/MAD at the CTF K-1654B underground collection tank site. This document addresses requirements of 29 CFR 1910.120, Final Rule, with respect to aspects of health and safety applicable to an underground collection tank waste removal.

  13. Work plan, health and safety plan, and quality assurance project plan for hazardous waste removal at the CTF K-1654B underground collection tank

    Energy Technology Data Exchange (ETDEWEB)

    Panter, M.S.; Burman, S.N.; Landguth, D.C.; Uziel, M.S.

    1991-10-01

    The Central Training Facility (CTF), located on Bear Creek Road approximately two miles south of the K-25 Site, is utilized for training security personnel at Martin Marietta Energy Systems, Inc., Oak Ridge, Tennessee. At the request of the CTF staff, this plan has been developed for the removal of the waste contents in the facility`s 500-gal septic tank and associated distribution box. The septic tank and distribution box were historically located beneath the K-1654B trailer and adjacent to the K-1654A Indoor Firing Range. Recently, however, the K-1654B trailer was removed to accommodate the objectives of this work plan as well as future construction activities planned at CTF. The purpose of this plan is to develop and assign responsibilities, establish personnel protection requirements and mandatory safety procedures, and provide for contingencies that may arise while operations are being conducted by ORNL/MAD at the CTF K-1654B underground collection tank site. This document addresses requirements of 29 CFR 1910.120, Final Rule, with respect to aspects of health and safety applicable to an underground collection tank waste removal.

  14. ANNUAL RADIOACTIVE WASTE TANK INSPECTION PROGRAM 2009

    Energy Technology Data Exchange (ETDEWEB)

    West, B.; Waltz, R.

    2010-06-21

    Aqueous radioactive wastes from Savannah River Site (SRS) separations and vitrification processes are contained in large underground carbon steel tanks. Inspections made during 2009 to evaluate these vessels and other waste handling facilities along with evaluations based on data from previous inspections are the subject of this report. The 2009 inspection program revealed that the structural integrity and waste confinement capability of the Savannah River Site waste tanks were maintained. All inspections scheduled per LWO-LWE-2008-00423, HLW Tank Farm Inspection Plan for 2009, were completed. All Ultrasonic measurements (UT) performed in 2009 met the requirements of C-ESG-00006, In-Service Inspection Program for High Level Waste Tanks, Rev. 1, and WSRC-TR-2002-00061, Rev.4. UT inspections were performed on Tank 29 and the findings are documented in SRNL-STI-2009-00559, Tank Inspection NDE Results for Fiscal Year 2009, Waste Tank 29. Post chemical cleaning UT measurements were made in Tank 6 and the results are documented in SRNL-STI-2009-00560, Tank Inspection NDE Results Tank 6, Including Summary of Waste Removal Support Activities in Tanks 5 and 6. A total of 6669 photographs were made and 1276 visual and video inspections were performed during 2009. Twenty-Two new leaksites were identified in 2009. The locations of these leaksites are documented in C-ESR-G-00003, SRS High Level Waste Tank Leaksite Information, Rev.4. Fifteen leaksites at Tank 5 were documented during tank wall/annulus cleaning activities. Five leaksites at Tank 6 were documented during tank wall/annulus cleaning activities. Two new leaksites were identified at Tank 19 during waste removal activities. Previously documented leaksites were reactivated at Tanks 5 and 12 during waste removal activities. Also, a very small amount of additional leakage from a previously identified leaksite at Tank 14 was observed.

  15. Transfusion requirements in septic shock (TRISS) trial - comparing the effects and safety of liberal versus restrictive red blood cell transfusion in septic shock patients in the ICU

    DEFF Research Database (Denmark)

    Holst, Lars B; Haase, Nicolai; Wetterslev, Jørn

    2013-01-01

    BACKGROUND: Transfusion of red blood cells (RBC) is recommended in septic shock and the majority of these patients receive RBC transfusion in the intensive care unit (ICU). However, benefit and harm of RBCs have not been established in this group of high-risk patients. METHODS: The Transfusion...... Requirements in Septic Shock (TRISS) trial is a multicenter trial with assessor-blinded outcome assessment, randomising 1,000 patients with septic shock in 30 Scandinavian ICUs to receive transfusion with pre-storage leuko-depleted RBC suspended in saline-adenine-glucose and mannitol (SAGM) at haemoglobin...

  16. Probiotics improve survival of septic rats by suppressing conditioned pathogens in ascites.

    Science.gov (United States)

    Liu, Da-Quan; Gao, Qiao-Ying; Liu, Hong-Bin; Li, Dong-Hua; Wu, Shang-Wei

    2013-07-07

    To investigate the benefits of probiotics treatment in septic rats. The septic rats were induced by cecal ligation and puncture. The animals of control, septic model and probiotics treated groups were treated with vehicle and mixed probiotics, respectively. The mixture of probiotics included Bifidobacterium longum, Lactobacillus bulgaricus and Streptococcus thermophilus. We observed the survival of septic rats using different amounts of mixed probiotics. We also detected the bacterial population in ascites and blood of experimental sepsis using cultivation and real-time polymerase chain reaction. The severity of mucosal inflammation in colonic tissues was determined. Probiotics treatment improved survival of the rats significantly and this effect was dose dependent. The survival rate was 30% for vehicle-treated septic model group. However, 1 and 1/4 doses of probiotics treatment increased survival rate significantly compared with septic model group (80% and 55% vs 30%, P probiotics treated group compared with septic model group (5.20 ± 0.57 vs 9.81 ± 0.67, P probiotics treated group compared with septic model group (33.3% vs 100.0%, P probiotics treated group were decreased significantly compared with that of septic model group (3.93 ± 0.73 vs 8.80 ± 0.83, P probiotics treatment, there was a decrease in the scores of inflammatory cell infiltration into the intestinal mucosa in septic animals (1.50 ± 0.25 vs 2.88 ± 0.14, P Probiotics improve survival of septic rats by suppressing these conditioned pathogens.

  17. Probiotics improve survival of septic rats by suppressing conditioned pathogens in ascites

    Science.gov (United States)

    Liu, Da-Quan; Gao, Qiao-Ying; Liu, Hong-Bin; Li, Dong-Hua; Wu, Shang-Wei

    2013-01-01

    AIM: To investigate the benefits of probiotics treatment in septic rats. METHODS: The septic rats were induced by cecal ligation and puncture. The animals of control, septic model and probiotics treated groups were treated with vehicle and mixed probiotics, respectively. The mixture of probiotics included Bifidobacterium longum, Lactobacillus bulgaricus and Streptococcus thermophilus. We observed the survival of septic rats using different amounts of mixed probiotics. We also detected the bacterial population in ascites and blood of experimental sepsis using cultivation and real-time polymerase chain reaction. The severity of mucosal inflammation in colonic tissues was determined. RESULTS: Probiotics treatment improved survival of the rats significantly and this effect was dose dependent. The survival rate was 30% for vehicle-treated septic model group. However, 1 and 1/4 doses of probiotics treatment increased survival rate significantly compared with septic model group (80% and 55% vs 30%, P probiotics treated group compared with septic model group (5.20 ± 0.57 vs 9.81 ± 0.67, P probiotics treated group compared with septic model group (33.3% vs 100.0%, P probiotics treated group were decreased significantly compared with that of septic model group (3.93 ± 0.73 vs 8.80 ± 0.83, P probiotics treatment, there was a decrease in the scores of inflammatory cell infiltration into the intestinal mucosa in septic animals (1.50 ± 0.25 vs 2.88 ± 0.14, P Probiotics improve survival of septic rats by suppressing these conditioned pathogens. PMID:23840152

  18. TANK48 CFD MODELING ANALYSIS

    Energy Technology Data Exchange (ETDEWEB)

    Lee, S.

    2011-05-17

    The process of recovering the waste in storage tanks at the Savannah River Site (SRS) typically requires mixing the contents of the tank to ensure uniformity of the discharge stream. Mixing is accomplished with one to four dual-nozzle slurry pumps located within the tank liquid. For the work, a Tank 48 simulation model with a maximum of four slurry pumps in operation has been developed to estimate flow patterns for efficient solid mixing. The modeling calculations were performed by using two modeling approaches. One approach is a single-phase Computational Fluid Dynamics (CFD) model to evaluate the flow patterns and qualitative mixing behaviors for a range of different modeling conditions since the model was previously benchmarked against the test results. The other is a two-phase CFD model to estimate solid concentrations in a quantitative way by solving the Eulerian governing equations for the continuous fluid and discrete solid phases over the entire fluid domain of Tank 48. The two-phase results should be considered as the preliminary scoping calculations since the model was not validated against the test results yet. A series of sensitivity calculations for different numbers of pumps and operating conditions has been performed to provide operational guidance for solids suspension and mixing in the tank. In the analysis, the pump was assumed to be stationary. Major solid obstructions including the pump housing, the pump columns, and the 82 inch central support column were included. The steady state and three-dimensional analyses with a two-equation turbulence model were performed with FLUENT{trademark} for the single-phase approach and CFX for the two-phase approach. Recommended operational guidance was developed assuming that local fluid velocity can be used as a measure of sludge suspension and spatial mixing under single-phase tank model. For quantitative analysis, a two-phase fluid-solid model was developed for the same modeling conditions as the single

  19. 241-AW Tank Farm Construction Extent of Condition Review for Tank Integrity

    Energy Technology Data Exchange (ETDEWEB)

    Barnes, Travis J.; Gunter, Jason R.; Reeploeg, Gretchen E.

    2013-11-19

    This report provides the results of an extent of condition construction history review for the 241-AW tank farm. The construction history of the 241-AW tank farm has been reviewed to identify issues similar to those experienced during tank AY-102 construction. Those issues and others impacting integrity are discussed based on information found in available construction records, using tank AY-102 as the comparison benchmark. In the 241-AW tank farm, the fourth double-shell tank farm constructed, similar issues as those with tank 241-AY-102 construction occured. The overall extent of similary and affect on 241-AW tank farm integrity is described herein.

  20. 241-AY-101 Tank Construction Extent of Condition Review for Tank Integrity

    Energy Technology Data Exchange (ETDEWEB)

    Barnes, Travis J.; Gunter, Jason R.

    2013-08-26

    This report provides the results of an extent of condition construction history review for tank 241-AY-101. The construction history of tank 241-AY-101 has been reviewed to identify issues similar to those experienced during tank AY-102 construction. Those issues and others impacting integrity are discussed based on information found in available construction records, using tank AY-102 as the comparison benchmark. In tank 241-AY-101, the second double-shell tank constructed, similar issues as those with tank 241-AY-102 construction reoccurred. The overall extent of similary and affect on tank 241-AY-101 integrity is described herein.

  1. 241-AP Tank Farm Construction Extent of Condition Review for Tank Integrity

    Energy Technology Data Exchange (ETDEWEB)

    Barnes, Travis J.; Gunter, Jason R.; Reeploeg, Gretchen E.

    2014-04-04

    This report provides the results of an extent of condition construction history review for the 241-AP tank farm. The construction history of the 241-AP tank farm has been reviewed to identify issues similar to those experienced during tank AY-102 construction. Those issues and others impacting integrity are discussed based on information found in available construction records, using tank AY-102 as the comparison benchmark. In the 241-AP tank farm, the sixth double-shell tank farm constructed, tank bottom flatness, refractory material quality, post-weld stress relieving, and primary tank bottom weld rejection were improved.

  2. Tank Waste Disposal Program redefinition

    Energy Technology Data Exchange (ETDEWEB)

    Grygiel, M.L.; Augustine, C.A.; Cahill, M.A.; Garfield, J.S.; Johnson, M.E.; Kupfer, M.J.; Meyer, G.A.; Roecker, J.H. [Westinghouse Hanford Co., Richland, WA (United States); Holton, L.K.; Hunter, V.L.; Triplett, M.B. [Pacific Northwest Lab., Richland, WA (United States)

    1991-10-01

    The record of decision (ROD) (DOE 1988) on the Final Environmental Impact Statement, Hanford Defense High-Level, Transuranic and Tank Wastes, Hanford Site, Richland Washington identifies the method for disposal of double-shell tank waste and cesium and strontium capsules at the Hanford Site. The ROD also identifies the need for additional evaluations before a final decision is made on the disposal of single-shell tank waste. This document presents the results of systematic evaluation of the present technical circumstances, alternatives, and regulatory requirements in light of the values of the leaders and constitutents of the program. It recommends a three-phased approach for disposing of tank wastes. This approach allows mature technologies to be applied to the treatment of well-understood waste forms in the near term, while providing time for the development and deployment of successively more advanced pretreatment technologies. The advanced technologies will accelerate disposal by reducing the volume of waste to be vitrified. This document also recommends integration of the double-and single-shell tank waste disposal programs, provides a target schedule for implementation of the selected approach, and describes the essential elements of a program to be baselined in 1992.

  3. Multidrug resistant bacteria isolated from septic arthritis in horses

    Directory of Open Access Journals (Sweden)

    Rodrigo G. Motta

    Full Text Available ABSTRACT: Septic arthritis is a debilitating joint infectious disease of equines that requires early diagnosis and immediate therapeutic intervention to prevent degenerative effects on the articular cartilage, as well as loss of athletic ability and work performance of the animals. Few studies have investigated the etiological complexity of this disease, as well as multidrug resistance of isolates. In this study, 60 horses with arthritis had synovial fluid samples aseptically collected, and tested by microbiological culture and in vitro susceptibility test (disk diffusion using nine antimicrobials belonging to six different pharmacological groups. Bacteria were isolated in 45 (75.0% samples, as follows: Streptococcus equi subsp. equi (11=18.3%, Escherichia coli (9=15.0%, Staphylococcus aureus (6=10.0%, Streptococcus equi subsp. zooepidemicus (5=8.3%, Staphylococcus intermedius (2=3.3%, Proteus vulgaris (2=3.3%, Trueperella pyogenes (2=3.3%, Pseudomonas aeruginosa (2=3.3%, Klebsiella pneumoniae (1=1.7%, Rhodococcus equi (1=1.7%, Staphylococcus epidermidis (1=1.7%, Klebsiella oxytoca (1=1.7%, Nocardia asteroides (1=1.7%, and Enterobacter cloacae (1=1.7%. Ceftiofur was the most effective drug (>70% efficacy against the pathogens in the disk diffusion test. In contrast, high resistance rate (>70% resistance was observed to penicillin (42.2%, enrofloxacin (33.3%, and amikacin (31.2%. Eleven (24.4% isolates were resistant to three or more different pharmacological groups and were considered multidrug resistant strains. The present study emphasizes the etiological complexity of equine septic arthritis, and highlights the need to institute treatment based on the in vitro susceptibility pattern, due to the multidrug resistance of isolates. According to the available literature, this is the first report in Brazil on the investigation of the etiology. of the septic arthritis in a great number of horses associated with multidrug resistance of the isolates.

  4. Therapy-resistant septic olecranon bursitis due to Mycobacterium gordonae.

    Science.gov (United States)

    Konrads, Christian; Rückl, Kilian; El Tabbakh, Mohammed; Rudert, Maximilian; Kircher, Stefan; Plumhoff, Piet

    2016-01-01

    Septic olecranon bursitis due to atypical mycobacteria is rare. An insidious beginning can delay diagnosis and treatment. Antibacterial therapy recommendations are not well-defined for bursitis caused by atypical mycobacteria. We present a rare case of olecranon bursitis caused by Mycobacterium gordonae, reporting our experiences regarding pathogen identification and antibiotic therapy, which differs from regimes used in common septic bursitis mostly caused by staphylococcus aureus. A 35-year-old male with bursitis olecrani received open bursectomy. Microbiological culture did not reveal bacteria. Due to wound healing complications revision surgery was performed four weeks postoperatively. Finally, Mycobacterium gordonae was identified by PCR and an antibiogram could be developed. A triple antimicrobial combination therapy with Rifampicin, Clarithromycin, and Ethambutol was administered systemically for 12 months. The patient was followed-up for 24 months. After the second operation with pathogen identification and antibiotic combination therapy the wound healed without any additional complications. At last follow-up 24 months after the first surgery with bursectomy and 23 months after revision surgery with debridement, the patient was still pain free with no significant clinical findings or tenderness to touch at the operation site. Elbow range of motion was full. As septic bursitis can be caused by many different and sometimes rare and difficult to identify bacteria, intraoperative probes should be taken and histopathological and microbiological analysis should be conducted, including PCR. In a young man with olecranon bursitis due to Mycobacterium gordonae surgical treatment and an antibiotic combination therapy showed a good clinical outcome after one and two years. © The Authors, published by EDP Sciences, 2016.

  5. SURGICAL TREATMENT OF CHILDREN WITH CONSEQUENCES OF INFANTILE SEPTIC ARTHRITIS

    Directory of Open Access Journals (Sweden)

    M. P. Teplenky

    2017-01-01

    Full Text Available Introduction. The consequences of infantile septic arthritis are quite diverse and can manifest themselves as a damage to the growth zone, deformation and destruction of the articular components, and violation of the articular relationships. To treat this pathology, technically complex and traumatic surgical interventions are used. The purpose of this work is to analyze the medium-term results of the use of these methods in the treatment of children with septic coxitis consequences.Material and methods. The outcomes of treatment for 37 children with consequences of septic coxitis using Ilizarov apparatus were analyzed. Average age of patients at the time of the surgery was 8.2±0.5 years (from 6 to 10 years. Follow up period was from 3 to 10 years (average 4.7 years. Functional outcomes were assessed by C.L. Colton, radiologic indices — by E. Severin score and J. Kruczynski.Results. Patients were distributed into three groups according to anatomical features. Functional outcomes of patients in the 1st group: good (12–15 points — 3 joints, satisfactory (9–11 points — 5 joints, unsatisfactory (8 points — 1 joint. X-ray findings of patients in the 1st group according to J. Kruczynski criteria: good — 5 joints, satisfactory — 4 joints; by E. Severin criteria: Ia — 1, Ib –1, IIa — 2, IIb — 3, III — 2. Functional outcomes of patients in the 2nd group: good (12–14 points — 10 joints, satisfactory (9–11 points — 8 joints. Distribution in the second group by J. Kruczynski criteria: good — 9, satisfactory — 9; by E. Severin criteria: IIa — 14, IIb — 4. Distribution of functional outcomes in the 3rd group in accordance with C.L. Colton criteria: good (12–15 points — 3 joints, satisfactory (9–11 points — 7 joints. Distribution in the third group according to J. Kruczynski criteria: good — 4, satisfactory — 6; by E. Severin criteria: IIa — 5, IIb — 4, III — 1.Conclusion. The use of the presented

  6. Septic arthritis of the ankle due to Salmonella enteritidis.

    LENUS (Irish Health Repository)

    Dineen, Patrick F

    2011-06-01

    Salmonella septic arthritis in healthy, immunocompetent patients is extremely rare. We present the case of a 70-year-old man who presented with a one-day history of painful swelling of his ankle from which was aspirated pus which subsequently grew Salmonella enteritidis. There was no history of trauma or symptoms consistent with Salmonella enterocolitis. Our patient recovered fully after two weeks on intravenous ceftriaxone and six weeks on oral ciprofloxacin. Salmonella is a notifiable disease in the European Union and the United States of America, and is associated with outbreaks as a result of food contamination. The nature of Salmonella arthritis and its appropriate management are outlined.

  7. A Case of Polyarticular Pasteurella multocida Septic Arthritis

    Directory of Open Access Journals (Sweden)

    Sarah Nitoslawski

    2016-01-01

    Full Text Available A 76-year-old man with a history of osteoarthritis presents with right leg erythema and inability to weight-bear and pain in his right shoulder. Synovial fluid cell count of the knee and shoulder showed abundant neutrophils, and cultures of the knee showed growth of Pasteurella multocida. The patient owned four cats with which he had frequent contact, but history and physical examination elicited no evidence of scratches or bites. This case highlights the invasive potential of Pasteurella multocida in an immunocompetent individual and its capacity to cause septic arthritis in the setting of frequent animal contact.

  8. Acute glyco-metabolic decompensation during septic shock

    Directory of Open Access Journals (Sweden)

    Maria Marta Cravino

    2010-09-01

    Full Text Available Hyper-glycemy is commonly described as a complication in patients affected by septic states, regardless of their having had diabetes. Numerous studies also record the presence of glyco-metabolic decompensations in patients affected by leukemia and lymphoma treated with chemotherapy. The case under study interesting and peculiar as there is no mention of glycemy levels so high to be not suitable for life. It is interesting also the patient's good therapeutical response, their marrow aplasia status and general poor health condition notwithstanding.

  9. Bacillus pumilus Septic Arthritis in a Healthy Child

    Directory of Open Access Journals (Sweden)

    V. M. Shivamurthy

    2016-01-01

    Full Text Available We report a case of septic arthritis caused by a Bacillus species, B. pumilus, occurring in a healthy child. This organism rarely causes serious infections and has only been described in newborns and immunocompromised individuals or as a skin infection. This child developed an indolent joint swelling after a minor skin injury, and symptoms were initially thought most consistent with chronic arthritis. The case demonstrates that clinicians should consider joint infection in children presenting with acute monoarticular swelling, even without prominent systemic features.

  10. Lumbar facet septic arthritis. Report of two cases

    Directory of Open Access Journals (Sweden)

    Juan Manuel Velasco

    2017-02-01

    Full Text Available We report two cases with isolated septic arthritis of a lumbar facet after a non articular infection, and sepsis. Being a rarity, it is a condition that goes frequently unnoticed, unless taken into account directly. If it is not treated on time, it can leave serious sequelae. The treatment may vary, according to the time of diagnosis. It might have a good response to antibiotic therapy alone, or it may be necessary to associate surgical drainage.

  11. DEVELOPMENT OF A SMART SOLAR TANK

    DEFF Research Database (Denmark)

    Furbo, Simon; Andersen, Elsa

    1999-01-01

    Theoretical and experimental investigations of small SDHW systems based on so-called smart solar tanks are presented. A smart solar tank is a hot water tank in which the domestic water can both be heated by solar collectors and by an auxiliary energy supply system. The auxiliary energy supply....... The investigations showed that the yearly thermal performance of small SDHW systems can be increased by up to about 30 % if a smart solar tank is used instead of a traditional solar combi tank. The thermal increase is strongly influenced by the hot water consumption and consumption pattern. Recommendations...... for future development of smart solar tanks are given....

  12. first tank of Linac 1

    CERN Multimedia

    This was the first tank of the linear accelerator Linac1, the injection system for the Proton Synchrotron, It ran for 34 years (1958 - 1992). Protons entered at the far end and were accelerated between the copper drift tubes by an oscillating electromagnetic field. The field flipped 200 million times a second (200 MHz) so the protons spent 5 nanoseconds crossing a drift tube and a gap. Moving down the tank, the tubes and gaps had to get longer as the protons gained speed. The tank accelerated protons from 500 KeV to 10 MeV. Linac1 was also used to accelerate deutrons and alpha particles for the Intersecting Storage Rings and oxygen and sulpher ions for the Super Proton Synchrotron heavy ion programme.

  13. Developing a New Definition and Assessing New Clinical Criteria for Septic Shock For the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)

    NARCIS (Netherlands)

    Shankar-Hari, Manu; Phillips, Gary S.; Levy, Mitchell L.; Seymour, Christopher W.; Liu, Vincent X.; Deutschman, Clifford S.; Angus, Derek C.; Rubenfeld, Gordon D.; Singer, Mervyn; Angus, Derek; Annane, Djilalli; Bauer, Michael; Bellomo, Rinaldo; Bernard, Gordon; Chiche, Jean-Daniel; Coopersmith, Craig; Deutschman, Cliff; Hotchkiss, Richard; Levy, Mitchell; Marshall, John; Martin, Greg; Opal, Steve; Rubenfeld, Gordon; Seymour, Christopher; van der Poll, Tom; Vincent, Jean-Louis

    2016-01-01

    IMPORTANCE Septic shock currently refers to a state of acute circulatory failure associated with infection. Emerging biological insights and reported variation in epidemiology challenge the validity of this definition. OBJECTIVE To develop a new definition and clinical criteria for identifying

  14. Do septic systems contribute micropollutants and their transformation products to shallow groundwater?

    Science.gov (United States)

    Septic systems may contribute micropollutants to shallow groundwater and surface water. We constructed two in situ conventional drainfields (drip dispersal and gravel trench) and an advanced drainfield of septic systems to investigate the fate and transport of micropollutants to shallow groundwater....

  15. Metabolomics as a novel approach for early diagnosis of pediatric septic shock and its mortality.

    Science.gov (United States)

    Mickiewicz, Beata; Vogel, Hans J; Wong, Hector R; Winston, Brent W

    2013-05-01

    Septic shock is a significant cause of morbidity and mortality in the pediatric population. Early recognition of septic shock and appropriate treatment increase survival rate; thus, developing new diagnostic tools may improve patients' outcomes. To determine whether a metabolomics approach could be useful in the diagnosis and prognosis of septic shock in pediatric intensive care unit (PICUs). Serum samples were collected from 60 patients with septic shock, 40 PICU patients with systemic inflammatory response syndrome (not suspected of having an infection), and 40 healthy children. Proton nuclear magnetic resonance spectroscopy spectra were analyzed and quantified using targeted profiling methodology. Multivariate statistical analysis was applied to detect specific patterns in metabolic profiles and to highlight differences between patient samples. Supervised analysis afforded good predictive models and managed to separate patient populations. Some of the metabolite concentrations identified in serum samples changed markedly, indicating their influence on the separation between patient groups. These metabolites represent a composite biopattern of the pediatric metabolic response to septic shock and might be considered as the basis for a biomarker panel for the diagnosis of septic shock and its mortality in PICU. Our results indicate that nuclear magnetic resonance metabolite profiling might serve as a promising approach for the diagnosis and prediction of mortality in septic shock in a pediatric population and that quantitative metabolomics methods can be applied in the clinical evaluations of pediatric septic shock.

  16. Corticosteroids are associated with repression of adaptive immunity gene programs in pediatric septic shock.

    Science.gov (United States)

    Wong, Hector R; Cvijanovich, Natalie Z; Allen, Geoffrey L; Thomas, Neal J; Freishtat, Robert J; Anas, Nick; Meyer, Keith; Checchia, Paul A; Weiss, Scott L; Shanley, Thomas P; Bigham, Michael T; Banschbach, Sharon; Beckman, Eileen; Harmon, Kelli; Zimmerman, Jerry J

    2014-04-15

    Corticosteroids are prescribed commonly for patients with septic shock, but their use remains controversial and concerns remain regarding side effects. To determine the effect of adjunctive corticosteroids on the genomic response of pediatric septic shock. We retrospectively analyzed an existing transcriptomic database of pediatric septic shock. Subjects receiving any formulation of systemic corticosteroids at the time of blood draw for microarray analysis were classified in the septic shock corticosteroid group. We compared normal control subjects (n = 52), a septic shock no corticosteroid group (n = 110), and a septic shock corticosteroid group (n = 70) using analysis of variance. Genes differentially regulated between the no corticosteroid group and the corticosteroid group were analyzed using Ingenuity Pathway Analysis. The two study groups did not differ with respect to illness severity, organ failure burden, mortality, or mortality risk. There were 319 gene probes differentially regulated between the no corticosteroid group and the corticosteroid group. These genes corresponded predominately to adaptive immunity-related signaling pathways, and were down-regulated relative to control subjects. Notably, the degree of down-regulation was significantly greater in the corticosteroid group, compared with the no corticosteroid group. A similar pattern was observed for genes corresponding to the glucocorticoid receptor signaling pathway. Administration of corticosteroids in pediatric septic shock is associated with additional repression of genes corresponding to adaptive immunity. These data should be taken into account when considering the benefit to risk ratio of adjunctive corticosteroids for septic shock.

  17. Inhibition of Murine Pulmonary Microvascular Endothelial Cell Apoptosis Promotes Recovery of Barrier Function under Septic Conditions

    Directory of Open Access Journals (Sweden)

    Lefeng Wang

    2017-01-01

    Full Text Available Sepsis is characterized by injury of the pulmonary microvasculature and the pulmonary microvascular endothelial cells (PMVEC, leading to barrier dysfunction and acute respiratory distress syndrome (ARDS. Our recent work identified a strong correlation between PMVEC apoptosis and microvascular leak in septic mice in vivo, but the specific role of apoptosis in septic PMVEC barrier dysfunction remains unclear. Thus, we hypothesize that PMVEC apoptosis is likely required for PMVEC barrier dysfunction under septic conditions in vitro. Septic stimulation (mixture of tumour necrosis factor α, interleukin 1β, and interferon γ [cytomix] of isolated murine PMVEC resulted in a significant loss of barrier function as early as 4 h after stimulation, which persisted until 24 h. PMVEC apoptosis, as reflected by caspase activation, DNA fragmentation, and loss of membrane polarity, was first apparent at 8 h after cytomix. Pretreatment of PMVEC with the pan-caspase inhibitor Q-VD significantly decreased septic PMVEC apoptosis and was associated with reestablishment of PMVEC barrier function at 16 and 24 h after stimulation but had no effect on septic PMVEC barrier dysfunction over the first 8 h. Collectively, our data suggest that early septic murine PMVEC barrier dysfunction driven by proinflammatory cytokines is not mediated through apoptosis, but PMVEC apoptosis contributes to late septic PMVEC barrier dysfunction.

  18. Diabetic Septic Foot Lesions in El Obeid, Western Sudan | El Bushra ...

    African Journals Online (AJOL)

    Objectives: To study the magnitude, presentations and outcomes of diabetic septic foot lesions in El Obeid, Western Sudan. Patients and Methods: The records of 86 diabetic patients with septic foot lesions admitted to the wards of the University Surgical Unit at El Obeid Teaching Hospital, Western Sudan during the years ...

  19. Refractory septic shock in children: a European Society of Paediatric and Neonatal Intensive Care definition

    NARCIS (Netherlands)

    Morin, Luc; Ray, Samiran; Wilson, Clare; Remy, Solenn; Benissa, Mohamed Rida; Jansen, Nicolaas J. G.|info:eu-repo/dai/nl/085432083; Javouhey, Etienne; Peters, Mark J.; Kneyber, Martin; De Luca, Daniele; Nadel, Simon; Schlapbach, Luregn Jan; Maclaren, Graeme; Tissieres, Pierre

    2016-01-01

    Purpose Although overall paediatric septic shock mortality is decreasing, refractory septic shock (RSS) is still associated with high mortality. A definition for RSS is urgently needed to facilitate earlier identification and treatment. We aim to establish a European society of paediatric and

  20. Initial fluid resuscitation of patients with septic shock in the intensive care unit

    DEFF Research Database (Denmark)

    Carlsen, Sarah; Perner, A

    2011-01-01

    Fluid is the mainstay of resuscitation of patients with septic shock, but the optimal composition and volume are unknown. Our aim was to evaluate the current initial fluid resuscitation practice in patients with septic shock in the intensive care unit (ICU) and patient characteristics and outcome...

  1. Lactate concentrations in the rectal lumen in patients in early septic shock

    DEFF Research Database (Denmark)

    Ibsen, Michael; Tenhunen, J.; Wiis, J.

    2010-01-01

    Previously, we observed that rectal luminal lactate was higher in non-survivors compared with survivors of severe sepsis or septic shock persisting >24 h. The present study was initiated to further investigate this tentative association between rectal luminal lactate and mortality in a larger...... population of patients in early septic shock....

  2. Consecutive daily measurements of luminal concentrations of lactate in the rectum in septic shock patients

    DEFF Research Database (Denmark)

    Ibsen, Michael; Wiis, Jørgen; Waldau, Tina

    2012-01-01

    In a recent study we found no difference in the concentrations of luminal lactate in the rectum between nonsurvivors and survivors in early septic shock (......In a recent study we found no difference in the concentrations of luminal lactate in the rectum between nonsurvivors and survivors in early septic shock (...

  3. A holistic approach for perfusion assessment in septic shock: Basic foundations and clinical applications

    NARCIS (Netherlands)

    Hernández Poblete, G.W.

    2013-01-01

    A fundamental challenge in septic shock resuscitation is to evaluate tissue perfusion. In this thesis, we review the basic foundations for the development of a comprehensive and holistic model for perfusion assessment in septic shock, and outline its application to evaluate the impact of

  4. Survivors of septic shock caused by Neisseria meningitidis in childhood : Psychosocial outcomes in young adulthood

    NARCIS (Netherlands)

    Vermunt, Lindy C.; Buysse, Corinne M.; Joosten, Koen F.; Duivenvoorden, Hugo J.; Hazelzet, Jan A.; Verhulst, Frank C.; Utens, Elisabeth M.

    2011-01-01

    Objective: To investigate long-term psychosocial outcomes in young adults who survived septic shock caused by Neisseria meningitidis (meningococcal septic shock) during childhood. Design: A cross-sectional study. Setting: The psychological investigation took place in the department of Child and

  5. Refractory septic shock in children : a European Society of Paediatric and Neonatal Intensive Care definition

    NARCIS (Netherlands)

    Morin, Luc; Ray, Samiran; Wilson, Clare; Remy, Solenn; Benissa, Mohamed Rida; Jansen, Nicolaas J. G.; Javouhey, Etienne; Peters, Mark J.; Kneyber, Martin; De Luca, Daniele; Nadel, Simon; Schlapbach, Luregn Jan; Maclaren, Graeme; Tissieres, Pierre

    2016-01-01

    Although overall paediatric septic shock mortality is decreasing, refractory septic shock (RSS) is still associated with high mortality. A definition for RSS is urgently needed to facilitate earlier identification and treatment. We aim to establish a European society of paediatric and neonatal

  6. The impact of septic systems density and nearness to spring water ...

    African Journals Online (AJOL)

    account

    septic systems density and nearness to water points on spring water quality. Samples from 15 spring wells were analysed for pH, nitrate and faecal coliform contamination. Locations and distances of spring from septic systems were determined using global positioning system (GPS) device and ArcGIS software, respectively.

  7. Tank calibration; Arqueacao de tanques

    Energy Technology Data Exchange (ETDEWEB)

    Chan, Ana [PETROBRAS S.A., Rio de Janeiro, RJ (Brazil)

    2003-07-01

    This work relates the analysis of the norms ISO (International Organization for Standardization) for calibration of vertical cylindrical tanks used in fiscal measurement, established on Joint Regulation no 1 of June 19, 2000 between the ANP (National Agency of Petroleum) and the INMETRO (National Institute of Metrology, Normalization and Industrial Quality). In this work a comparison between norms ISO and norms published by the API (American Petroleum Institute) and the IP (Institute of Petroleum) up to 2001 was made. It was concluded that norms ISO are wider than norms API, IP, and INMETRO methods in the calibration of vertical cylindrical tanks. (author)

  8. Identification of pediatric septic shock subclasses based on genome-wide expression profiling

    Directory of Open Access Journals (Sweden)

    Monaco Marie

    2009-07-01

    Full Text Available Abstract Background Septic shock is a heterogeneous syndrome within which probably exist several biological subclasses. Discovery and identification of septic shock subclasses could provide the foundation for the design of more specifically targeted therapies. Herein we tested the hypothesis that pediatric septic shock subclasses can be discovered through genome-wide expression profiling. Methods Genome-wide expression profiling was conducted using whole blood-derived RNA from 98 children with septic shock, followed by a series of bioinformatic approaches targeted at subclass discovery and characterization. Results Three putative subclasses (subclasses A, B, and C were initially identified based on an empiric, discovery-oriented expression filter and unsupervised hierarchical clustering. Statistical comparison of the three putative subclasses (analysis of variance, Bonferonni correction, P Conclusion Genome-wide expression profiling can identify pediatric septic shock subclasses having clinically relevant phenotypes.

  9. A cluster of septic olecranon bursitis in association with infantry training.

    Science.gov (United States)

    Wasserzug, O; Balicer, R D; Boxman, J; Klement, E; Ambar, R; Zimhony, O

    2011-01-01

    Septic olecranon bursitis (OB) is caused primarily by Staphylococcus aureus (SA) usually in association with occupations involving trauma to the elbows. An outbreak of septic OB was identified in an infantry platoon. The severity of the injury to the skin overlying the elbows was scored and compared to a parallel platoon of the same unit. All soldiers were tested for SA carriage and pulse field gel electrophoresis (PFGE) was performed on available isolates. Nine cases of septic OB were identified only in platoon A. The significant risk factor for septic OB was a moderately or severely injured elbow (RR = 3.86). SA was isolated from the anterior nares and elbows of 29/36 (80.6%) of the soldiers in the unit (platoons A + B); however, this did not account for the difference in morbidity between the two platoons. This is the first report of a cluster of septic OB in association with intense infantry training.

  10. Infectious Etiologies and Patient Outcomes in Pediatric Septic Shock.

    Science.gov (United States)

    Ames, Stefanie G; Workman, Jennifer K; Olson, Jared A; Korgenski, E Kent; Masotti, Susan; Knackstedt, Elizabeth D; Bratton, Susan L; Larsen, Gitte Y

    2017-03-01

    Septic shock remains an important cause of death and disability in children. Optimal care requires early recognition and treatment. We evaluated a retrospective cohort of children (age shock during 2008-2012 to investigate the association between timing of antibiotic therapy and outcomes. The exposures were (1) receipt of empiric antibiotics in ≤1 hour and (2) receipt of appropriate antibiotics in ≤1 hour. The primary outcome was development of new or progressive multiple system organ dysfunction syndrome (NP-MODS). The secondary outcome was mortality. Among 321 patients admitted to intensive care, 48% (n = 153) received empiric antibiotics in ≤1 hour. These patients were more ill at presentation with significantly greater median pediatric index of mortality 2 (PIM2) scores and were more likely to receive recommended resuscitation in the ED (61% vs 14%); however, rates of NP-MODS (9% vs 12%) and hospital mortality (7% vs 4%) were similar to those treated later. Early, appropriate antibiotics were administered to 33% (n = 67) of patients with identified or suspected bacterial infection. These patients had significantly greater PIM2 scores but similar rates of NP-MODS (15% vs 15%) and hospital mortality (10% vs 6%) to those treated later. Critically ill children with septic shock treated in a children's hospital ED who received antibiotics in ≤1 hour were significantly more severely ill than those treated later, but they did not have increased risk of NP-MODS or death.

  11. [Septic abortion. Complications and therapeutic considerations (author's transl)].

    Science.gov (United States)

    Cañas, E; Cararach, V; Fortuny, A

    1980-01-25

    A study is presented on the incidence and complications of septic abortion in a group of patients admited on the 1st. Obstetric and Gynecologic Clinic of the University of Barcelona during a period of 5 years (1971-1975). Abortion is the cause of admision of 20,2% of patients in the gynecology ward and represents the 12,3% of the overall number of patients during the same period. In 7,8% of the patients admited because of abortion we found the criteria for establishing the diagnosis of septic complication and in 15,2% of those extrapelvic involvement is found, mainly endotoxic shock, acute renal failure and difuse peritonitis. Endocervical cultures were positive in 73% of cases and in 65,7% gram negative germs were isolated, being the most common E. coli. The different clinical patterns are discussed in cases in which anaerobics are implicated and the diagnostic and therapeutic aproaches in the different complications are reviewed particularly in concern to the indications of surgery when this may be the only lifesaving procedure.

  12. Simvastatin prevents lipopolysaccharide-induced septic shock in rats.

    Science.gov (United States)

    Yu, Li; Da, Xing-Wen; Wu, Xiao-Ling; He, Ao-di; Long, Ding

    2017-04-01

    Simvastatin is a hypolipidemic drug that inhibits hydroxymethylglutaryl coenzyme A (HMG-CoA) reductase to control elevated cholesterol, or hypercholesterolemia. Previous studies have shown that simvastatin may attenuate inflammation in ischemia-reperfusion injury and sepsis. Herein, we hypothesized that simvastatin may prevent rats from lipopolysaccharide (LPS)-induced septic shock. In our study, rats were divided into a saline group, an LPS group and an LPS plus simvastatin group. Male Sprague-Dawley (SD) rats were pretreated with simvastatin (1 mg/kg) for 30 min before the addition of LPS (8 mg/kg), with variations in left ventricular pressure recorded throughout. Ninety min after LPS injection, whole blood was collected from the inferior vena cava, and neutrophils were separated from the whole blood using separating medium. The neutrophils were then lysed for Western blotting to detect the levels of urokinase-type plasminogen activator (uPA) and plasminogen activator inhibitor-1 (PAI-1). In addition, mesentery microcirculations of inlet diameter, outlet diameter and blood flow rate were measured in all three groups. The results indicated that simvastatin significantly promoted heart systolic function and increased the level of uPA while simultaneously inhibited the expression of PAI-1 as compared with LPS group. Moreover, simvastatin reversed the LPS-induced inhibition of mesentery microcirculation. Taken together, it was suggested that simvastatin can effectively protect the rats from LPS-induced septic shock.

  13. Necrotizing Fasciitis Secondary to Aeromonas Infection Presenting with Septic Shock

    Directory of Open Access Journals (Sweden)

    Nikhil Bhatia

    2017-01-01

    Full Text Available This report describes a case of necrotizing fasciitis presenting with septic shock due to an Aeromonas infection. The patient cut his foot while mowing the lawn and then spent time in a pool with black mold. He began feeling ill and developed swelling and a quarter-sized black area on his right lower extremity. Despite being hemodynamically unstable with systolic blood pressure in the low 70s, the patient was transferred to our facility from outside hospital 100 miles away. Upon arriving to facility, the patient appeared to be septic and the infected area of skin had grown. Irrigation and debridement were performed and appropriate antibiotic therapy was given; however, the patient subsequently died on hospital day 8. On review of the literature, cases of necrotizing fasciitis due to Aeromonas infection have been treated successfully with the aforementioned therapy; however, there is high mortality associated with these infections, many times related to a delayed diagnosis. Our patient also had multiple poor prognostic factors including hepatic dysfunction and immunosuppression.

  14. First diagnosis of septic arthritis in a dinosaur

    Science.gov (United States)

    Anné, Jennifer; Hedrick, Brandon P.; Schein, Jason P.

    2016-08-01

    Identification and interpretation of pathologies in the fossil record allows for unique insights into the life histories of extinct organisms. However, the rarity of such finds limits not only the sample size for palaeopathologic studies, but also the types of analyses that may be performed. In this study, we present the first occurrence of a palaeopathology in a vertebrate from the Mesozoic of the East Coast of North America (Appalachia), a pathologic ulna and radius of an indeterminate hadrosaur from the Navesink Formation (New Jersey). X-ray microtomography allowed for both detailed and more accurate diagnosis of the pathologic condition as well as virtual conservation of the specimen. Based on extant archosaurian comparisons, the hadrosaur was diagnosed with severe septic arthritis affecting the proximal ulna and radius. Diagnosis was based on erosion of the joint and highly reactive periosteal bone growth and fusion of the elements. To the best of our knowledge, this is the first recorded account of septic arthritis in dinosaurs. The severity of the pathology suggests the animal suffered with this condition for some time before death. Unfortunately, only the ulna and radius were found. Thus, the extent to which the condition spread to other parts of the body is unknown.

  15. Septic hip dislocations in children in a developing country

    Directory of Open Access Journals (Sweden)

    Gabriel Ngom

    2011-01-01

    Full Text Available Purpose: To report on a radiological issue and therapeutic aspects encountered in septic hip dislocations in a developing country. Patients and Methods: Nineteen children among whom 11 boys and 8 girls aged on average 5.3-years old presented 7 recent and 12 late hip dislocations. Those dislocations were distributed into in category 1: dislocations without associated lesion; category 2: dislocations associated with minor lesions; category 3: dislocations associated with major lesion. Ten children who presented an elevated erythrocyte sedimentation rate (ESR received antibiotics. An arthrotomy was performed in children with a recent dislocation. Traction was performed in all children with an average duration of 5 weeks. The results were considered good, intermediate or bad using two parameters: ESR and reduction of dislocation. Results: 2 category 1 dislocations, 6 category 2 dislocations and 11 category 3 dislocations were noted. As concerns the recent dislocations, there were 2 category 1 dislocations and 5 category 2 dislocations. For late dislocations, 1 category 2 and 11 category 3 dislocations were recorded. There were 8 good results and 11 bad results. The good results concerned 7 recent dislocations and one late dislocation. The bad results concerned exclusively late dislocations. Conclusion: In children with septic hip dislocations, the good results concern almost exclusively recent dislocations but arthrotomy and immobilization must be done early.

  16. Genomic expression profiling across the pediatric systemic inflammatory response syndrome, sepsis, and septic shock spectrum.

    Science.gov (United States)

    Wong, Hector R; Cvijanovich, Natalie; Allen, Geoffrey L; Lin, Richard; Anas, Nick; Meyer, Keith; Freishtat, Robert J; Monaco, Marie; Odoms, Kelli; Sakthivel, Bhuvaneswari; Shanley, Thomas P

    2009-05-01

    To advance our biological understanding of pediatric septic shock, we measured the genome-level expression profiles of critically ill children representing the systemic inflammatory response syndrome (SIRS), sepsis, and septic shock spectrum. Prospective observational study involving microarray-based bioinformatics. Multiple pediatric intensive care units in the United States. Children shock on day 1. The available day 3 samples included 20 patients still meeting sepsis criteria, 39 patients still meeting septic shock criteria, and 24 patients meeting the exclusive day 3 category, SIRS resolved. None other than standard care. Longitudinal analyses were focused on gene expression relative to control samples and patients having paired day 1 and day 3 samples. The longitudinal analysis focused on up-regulated genes revealed common patterns of up-regulated gene expression, primarily corresponding to inflammation and innate immunity, across all patient groups on day 1. These patterns of up-regulated gene expression persisted on day 3 in patients with septic shock, but not to the same degree in the other patient classes. The longitudinal analysis focused on down-regulated genes demonstrated gene repression corresponding to adaptive immunity-specific signaling pathways and was most prominent in patients with septic shock on days 1 and 3. Gene network analyses based on direct comparisons across the SIRS, sepsis, and septic shock spectrum, and all available patients in the database, demonstrated unique repression of gene networks in patients with septic shock corresponding to major histocompatibility complex antigen presentation. Finally, analyses focused on repression of genes corresponding to zinc-related biology demonstrated that this pattern of gene repression is unique to patients with septic shock. Although some common patterns of gene expression exist across the pediatric SIRS, sepsis, and septic shock spectrum, septic shock is particularly characterized by

  17. Septic Arthritis of the Wrist: Incidence, Risk Factors, and Predictors of Infection.

    Science.gov (United States)

    Jennings, John D; Zielinski, Elizabeth; Tosti, Rick; Ilyas, Asif M

    2017-05-01

    Septic arthritis of the wrist can result in permanent damage to the joint, making timely diagnosis crucial to initiate empiric antibiotics and surgical intervention. Although septic arthritis is routinely included in the differential diagnosis of atraumatic wrist pain, the incidence is unknown. Unlike large joints, there is no consensus on cell count values considered pathognomonic for wrist septic arthritis. The goal of this retrospective study was to determine the incidence of wrist septic arthritis and to identify the clinical, serum, and joint fluid values that predict infection. The records of patients who presented to a single urban hospital with a swollen, painful wrist without trauma during a 10-year period were reviewed. For patients who had a joint fluid analysis, the records were examined for history as well as demographic and laboratory data. Joint fluid analysis consisted of cell count, Gram stain, and cultures. Of 892 patients who met the inclusion criteria, 1.5% had wrist septic arthritis. Variables associated with septic arthritis included serum white blood cell count above 11,000/µL, core temperature above 100.4°F within 24 hours of aspiration, history of intravenous drug abuse, and smoking. No joint cell count analysis predicted septic arthritis, although patients with septic wrists had an elevated joint white blood cell count above 97,000/µL. Wrist septic arthritis is uncommon; however, objective factors can help identify patients at risk. Because joint cell count analysis cannot reliably predict a septic wrist, priority for joint aspirations with limited fluid should be given instead to Gram stain, culture, and crystal analysis. [Orthopedics. 2017; 40(3):e526-e531.]. Copyright 2017, SLACK Incorporated.

  18. [Altered hepatic expression of selenoprotein S1 in septic mouse induced by LPS attack].

    Science.gov (United States)

    Su, Mao-sheng; He, Lei; Yao, Yong-ming; Yu, Yan; Wu, Yao; Dong, Jia-hong

    2010-07-13

    To investigate the change of selenoprotein S1 (SEPS1) hepatic expression in septic mouse induced by LPS attack. The septic murine model induced by LPS attack was established. Ten mice were randomly selected as control group from 84 BALB/c mice and others as septic group. The mice were sacrificed after anesthesia in control group and 10 mg/kg LPS was injected intraperitoneally into septic group mice. Liver and blood samples were taken at 6, 12, 24, 48, 72 and 96 h after LPS injection. Ten mice were randomly selected at each time point. The levels of blood ALT, AST, LDH and liver IL-6, TNF-α were detected. And the SEPS1 expression was simultaneously detected by Western blot. There was liver damage in septic group compared with normal control group. The levels of ALT, AST and LDH markedly increased. And all peaked at 24 h. The levels were (99 ± 11), (299 ± 48) and (1523 ± 131) U/L respectively (versus level at zero hour, P 8239) ng/L, P < 0.05]. Western blot showed that SEPS1 protein expression markedly increased simultaneously in liver of septic mouse. And the peak value was reached at 24 h post-injury. Then there was a gradual decrease and normal level returned at 72 h. Immunohistochemical results showed that SEPS1 protein expression in liver of septic mouse also markedly increased. And the peak value was reached at 24 h post-injury. Pathologic results showed that liver lesion was apparent in septic mouse and it was the worst during 6-12 h. Liver damage to different extents may be induced by LPS attack in septic mouse. The levels of IL-6 and TNF-α markedly increase. The SEPS1 protein expression in liver of septic mouse is also markedly elevated. And it peaks at 24 h post-injury and returns to normal at 72 h.

  19. 40 CFR 61.343 - Standards: Tanks.

    Science.gov (United States)

    2010-07-01

    ... or permanent deformation of the tank or cover resulting from filling or emptying the tank, diurnal... efforts at repair shall be made as soon as practicable, but not later than 45 calendar days after...

  20. The Politics of Think Tanks in Europe

    DEFF Research Database (Denmark)

    Kelstrup, Jesper Dahl

    of a typology of think tanks, quantitative data and interviews with think tank practitioners, the interplay between state and market dynamics and the development of different types of think tanks is analysed. Although think tanks develop along different institutional trajectories, it is concluded that the Anglo......In the 21st century, think tanks have become more than a buzzword in European public discourse. They now play important roles in the policy-making process by providing applied research, building networks and advocating policies. The book studies the development of think tanks and contemporary...... consequences in the United Kingdom, Germany, Denmark and at the EU-level. A Continental think tank tradition in which the state plays a pivotal role and an Anglo-American tradition which facilitates interaction in public policy on market-like terms have shaped the development of think tanks. On the basis...

  1. The Politics of Think Tanks in Europe

    DEFF Research Database (Denmark)

    Kelstrup, Jesper Dahl

    In the 21st century, think tanks have become more than a buzzword in European public discourse. They now play important roles in the policy-making process by providing applied research, building networks and advocating policies. The book studies the development of think tanks and contemporary...... consequences in the United Kingdom, Germany, Denmark and at the EU-level. A Continental think tank tradition in which the state plays a pivotal role and an Anglo-American tradition which facilitates interaction in public policy on market-like terms have shaped the development of think tanks. On the basis...... of a typology of think tanks, quantitative data and interviews with think tank practitioners, the interplay between state and market dynamics and the development of different types of think tanks is analysed. Although think tanks develop along different institutional trajectories, it is concluded that the Anglo...

  2. Leaking Underground Storage Tank (LUST) Trust Fund

    Science.gov (United States)

    In 1986, Congress created the Leaking Underground Storage Tank (LUST) Trust Fund to address releases from federally regulated underground storage tanks (USTs) by amending Subtitle I of the Solid Waste Disposal Act.

  3. Lightweight, Composite Cryogenic Tank Structures Project

    Data.gov (United States)

    National Aeronautics and Space Administration — Microcosm has developed and qualified strong, all-composite LOX tanks for launch vehicles. Our new 42-inch diameter tank design weighs 486 lbs and burst without...

  4. The Politics of Think Tanks in Europe

    DEFF Research Database (Denmark)

    Kelstrup, Jesper Dahl

    In the 21st century, think tanks have become more than a buzzword in European public discourse. They now play important roles in the policy-making process by providing applied research, building networks and advocating policies. The book studies the development of think tanks and contemporary...... consequences in the United Kingdom, Germany, Denmark and at the EU-level. A Continental think tank tradition in which the state plays a pivotal role and an Anglo-American tradition which facilitates interaction in public policy on market-like terms have shaped the development of think tanks. On the basis...... of a typology of think tanks, quantitative data and interviews with think tank practitioners, the interplay between state and market dynamics and the development of different types of think tanks is analysed. Although think tanks develop along different institutional trajectories, it is concluded that the Anglo-American...

  5. 49 CFR 179.400-16 - Access to inner tank.

    Science.gov (United States)

    2010-10-01

    ... TANK CARS Specification for Cryogenic Liquid Tank Car Tanks and Seamless Steel Tanks (Classes DOT-113... design. (b) If a welded closure is used, it must be designed to allow it to be reopened by grinding or...

  6. Pharmaceutical and personal care products in domestic wastewater and their removal in anaerobic treatment systems: septic tank - upflow anaerobic filter

    DEFF Research Database (Denmark)

    Arrubla, Juan Pablo; Cubillos, Janneth A.; Ramírez Vargas, Carlos Andrés

    2016-01-01

    In several countries around the world, Pharmaceutical and Personal Care Products (PPCPs) exist in aquatic environments, a fact that increases the awareness within the scienti c community with respect to their possible fate and environment effects. This research presents a preliminary monitoring o...

  7. Different depth intermittent sand filters for laboratory treatment of synthetic wastewater with concentrations close to measured septic tank effluent.

    Science.gov (United States)

    Rodgers, M; Walsh, G; Healy, M G

    2011-01-01

    The objective of this study was to apply hydraulic and chemical oxygen demand (COD) loading rates at the upper limits of the design criteria for buried sand filters to test the sand filter depth design criteria. Over a 274-day study duration, synthetic effluent with a strength of domestic wastewater was intermittently dosed onto two sand filters of 0.2 m diameter, with depths of 0.3 and 0.4 m. Hydraulic and organic carbon loading rates of 105 L m(-2) d(-1) and 40 g COD m(-2) d(-1), respectively, were applied to the filters. The filters did not clog and had good effluent removal capabilities for 274 and 190 days, respectively. However, the 0.3 m-deep filter did experience a reduced performance towards the end of the study period. In the 0.3 and 0.4 m-deep filters, the effluent COD and SS concentrations were less than 86 and 31 mg L(-1), respectively, and nitrification was nearly complete in both these columns. Ortho-phosphorus (PO(4)-P) removal in fine sand and laterite 'upflow' filters, receiving effluent from the 0.3 m-deep filter, was 10% and 44%, respectively.

  8. Nitrogen and chemical oxygen demand removal from septic tank wastewater in subsurface flow constructed wetlands: substrate (cation exchange capacity) effects.

    Science.gov (United States)

    Collison, Robert S; Grismer, Mark E

    2014-04-01

    The current article focuses on chemical oxygen demand (COD) and nitrogen (ammonium and nitrate) removal performance from synthetic human wastewater as affected by different substrate rocks having a range of porosities and cation exchange capacities (CECs). The aggregates included lava rock, lightweight expanded shale, meta-basalt (control), and zeolite. The first three had CECs of 1 to 4 mequiv/100 gm, whereas the zeolite CEC was much greater (-80 mequiv/100 gm). Synthetic wastewater was gravity fed to each constructed wetland system, resulting in a 4-day retention time. Effluent samples were collected, and COD and nitrogen species concentrations measured regularly during four time periods from November 2008 through June 2009. Chemical oxygen demand and nitrogen removal fractions were not significantly different between the field and laboratory constructed wetland systems when corrected for temperature. Similarly, overall COD and nitrogen removal fractions were practically the same for the aggregate substrates. The important difference between aggregate effects was the zeolite's ammonia removal process, which was primarily by adsorption. The resulting single-stage nitrogen removal process may be an alternative to nitrification and denitrification that may realize significant cost savings in practice.

  9. External Tank - The Structure Backbone

    Science.gov (United States)

    Welzyn, Kenneth; Pilet, Jeffrey C.; Diecidue-Conners, Dawn; Worden, Michelle; Guillot, Michelle

    2011-01-01

    The External Tank forms the structural backbone of the Space Shuttle in the launch configuration. Because the tank flies to orbital velocity with the Space Shuttle Orbiter, minimization of weight is mandatory, to maximize payload performance. Choice of lightweight materials both for structure and thermal conditioning was necessary. The tank is large, and unique manufacturing facilities, tooling, handling, and transportation operations were required. Weld processes and tooling evolved with the design as it matured through several block changes, to reduce weight. Non Destructive Evaluation methods were used to assure integrity of welds and thermal protection system materials. The aluminum-lithium alloy was used near the end of the program and weld processes and weld repair techniques had to be refined. Development and implementation of friction stir welding was a substantial technology development incorporated during the Program. Automated thermal protection system application processes were developed for the majority of the tank surface. Material obsolescence was an issue throughout the 40 year program. The final configuration and tank weight enabled international space station assembly in a high inclination orbit allowing international cooperation with the Russian Federal Space Agency. Numerous process controls were implemented to assure product quality, and innovative proof testing was accomplished prior to delivery. Process controls were implemented to assure cleanliness in the production environment, to control contaminants, and to preclude corrosion. Each tank was accepted via rigorous inspections, including non-destructive evaluation techniques, proof testing, and all systems testing. In the post STS-107 era, the project focused on ascent debris risk reduction. This was accomplished via stringent process controls, post flight assessment using substantially improved imagery, and selective redesigns. These efforts were supported with a number of test programs to

  10. Stabilization of In-Tank Residual Wastes and External-Tank Soil Contamination for the Hanford Tank Closure Program: Applications to the AX Tank Farm

    Energy Technology Data Exchange (ETDEWEB)

    Anderson, H.L.; Dwyer, B.P.; Ho, C.; Krumhansl, J.L.; McKeen, G.; Molecke, M.A.; Westrich, H.R.; Zhang, P.

    1998-11-01

    Technical support for the Hanford Tank Closure Program focused on evaluation of concepts for immobilization of residual contaminants in the Hanford AX tanks and underlying soils, and identification of cost-effective approaches to improve long-term performance of AX tank farm cIosure systems. Project objectives are to develop materials or engineered systems that would significantly reduce the radionuclide transport to the groundwater from AX tanks containing residual waste. We pursued several studies that, if implemented, would help achieve these goals. They include: (1) tank fill design to reduce water inilltration and potential interaction with residual waste; (2) development of in-tank getter materials that would specifically sorb or sequester radionuclides; (3) evaluation of grout emplacement under and around the tanks to prevent waste leakage during waste retrieval or to minimize water infiltration beneath the tanks; (4) development of getters that will chemically fix specific radionuclides in soils under tanks; and (5) geochemical and hydrologic modeling of waste-water-soil-grout interactions. These studies differ in scope from the reducing grout tank fill employed at the Savannah River Site in that our strategy improves upon tank fill design by providing redundancy in the barriers to radionuclide migration and by modification the hydrogeochemistry external to the tanks.

  11. Tank 12H residuals sample analysis report

    Energy Technology Data Exchange (ETDEWEB)

    Oji, L. N. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); Shine, E. P. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); Diprete, D. P. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); Coleman, C. J. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); Hay, M. S. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL)

    2015-06-11

    The Savannah River National Laboratory (SRNL) was requested by Savannah River Remediation (SRR) to provide sample preparation and analysis of the Tank 12H final characterization samples to determine the residual tank inventory prior to grouting. Eleven Tank 12H floor and mound residual material samples and three cooling coil scrape samples were collected and delivered to SRNL between May and August of 2014.

  12. SRS tank closure. Innovative technology summary report

    Energy Technology Data Exchange (ETDEWEB)

    1999-08-01

    High-level waste (HLW) tank closure technology is designed to stabilize any remaining radionuclides and hazardous constituents left in a tank after bulk waste removal. Two Savannah River Site (SRS) HLW tanks were closed after cleansing and then filling each tank with three layers of grout. The first layer consists of a chemically reducing grout. The fill material has chemical properties that retard the movement of some radionuclides and chemical constituents. A layer of controlled low-strength material (CLSM), a self-leveling fill material, is placed on top of the reducing grout. CLSM provides sufficient strength to support the overbearing weight. The final layer is a free-flowing, strong grout similar to normal concrete. After the main tank cavity is filled, risers are filled with grout, and all waste transfer piping connected to the tank is isolated. The tank ventilation system is dismantled, and the remaining systems are isolated. Equipment that remains with the tank is filled with grout. The tank and ancillary systems are left in a state requiring only limited surveillance. Administrative procedures are in place to control land use and access. DOE eventually plans to remove all of its HLW storage tanks from service. These tanks are located at SRS, Hanford, and Idaho National Engineering and Environmental Laboratory. Low-activity waste storage tanks at Oak Ridge Reservation are also scheduled for closure.

  13. Think Tanks, Education and Elite Policy Actors

    Science.gov (United States)

    Savage, Glenn C.

    2016-01-01

    The past decade has seen think tanks operate in sophisticated ways to influence the development of education policies. In this paper, I reflect upon the influence of think tanks in the formation of national reform, using the Common Core State Standards initiative in the USA as an illustrative case. In doing so, I explore how certain think tanks,…

  14. 33 CFR 183.510 - Fuel tanks.

    Science.gov (United States)

    2010-07-01

    ... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Fuel tanks. 183.510 Section 183... SAFETY BOATS AND ASSOCIATED EQUIPMENT Fuel Systems Equipment Standards § 183.510 Fuel tanks. (a) Each fuel tank in a boat must have been tested by its manufacturer under § 183.580 and not leak when...

  15. 7 CFR 58.427 - Paraffin tanks.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 3 2010-01-01 2010-01-01 false Paraffin tanks. 58.427 Section 58.427 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards....427 Paraffin tanks. The metal tank should be adequate in size, have wood rather than metal racks to...

  16. Elevated Tank Due to Earthquake Even

    Directory of Open Access Journals (Sweden)

    Kotrasová Kamila

    2017-12-01

    Full Text Available Elevated reservoirs are mainly used for storing of variety water. During earthquake activity the fluid exerts impulsive and convective (sloshing effects on the walls and bottom of tank. This paper provides theoretical background for analytical calculating of elevated water tank due to earthquake even and deals with simplified seismic design procedures for elevated tanks.

  17. 40 CFR 264.1084 - Standards: Tanks.

    Science.gov (United States)

    2010-07-01

    ... is used for the primary seal, the metallic shoe seal shall be designed so that one end extends into... maximum organic vapor pressure limit for the tank's design capacity category as follows: (A) For a tank design capacity equal to or greater than 151 m3, the maximum organic vapor pressure limit for the tank is...

  18. Results of Hg speciation testing on tank 39 and 1Q16 tank 50 samples

    Energy Technology Data Exchange (ETDEWEB)

    Bannochie, C. J. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL)

    2016-03-07

    The Savannah River National Laboratory (SRNL) was tasked with preparing and shipping samples for Hg speciation by Eurofins Frontier Global Sciences, Inc. in Seattle, WA on behalf of the Savannah River Remediation (SRR) Mercury Task Team.i,ii The seventeenth shipment of samples was designated to include two Tank 39 samples and the 1Q16 Tank 50 Quarterly WAC sample. The surface Tank 39 sample was pulled at 262.1” from the tank bottom, and the depth Tank 39 sample was pulled at 95” from the tank bottom. The 1Q16 Tank 50 WAC sample was drawn from the 1-L variable depth sample received by SRNL.

  19. Bench-to-bedside review: Vasopressin in the management of septic shock

    Science.gov (United States)

    2011-01-01

    This review of vasopressin in septic shock differs from previous reviews by providing more information on the physiology and pathophysiology of vasopressin and vasopressin receptors, particularly because of recent interest in more specific AVPR1a agonists and new information from the Vasopressin and Septic Shock Trial (VASST), a randomized trial of vasopressin versus norepinephrine in septic shock. Relevant literature regarding vasopressin and other AVPR1a agonists was reviewed and synthesized. Vasopressin, a key stress hormone in response to hypotension, stimulates a family of receptors: AVPR1a, AVPR1b, AVPR2, oxytocin receptors and purinergic receptors. Rationales for use of vasopressin in septic shock are as follows: first, a deficiency of vasopressin in septic shock; second, low-dose vasopressin infusion improves blood pressure, decreases requirements for norepinephrine and improves renal function; and third, a recent randomized, controlled, concealed trial of vasopressin versus norepinephrine (VASST) suggests low-dose vasopressin may decrease mortality of less severe septic shock. Previous clinical studies of vasopressin in septic shock were small or not controlled. There was no difference in 28-day mortality between vasopressin-treated versus norepinephrine-treated patients (35% versus 39%, respectively) in VASST. There was potential benefit in the prospectively defined stratum of patients with less severe septic shock (5 to 14 μg/minute norepinephrine at randomization): vasopressin may have lowered mortality compared with norepinephrine (26% versus 36%, respectively, P = 0.04 within stratum). The result was robust: vasopressin also decreased mortality (compared with norepinephrine) if less severe septic shock was defined by the lowest quartile of arterial lactate or by use of one (versus more than one) vasopressor at baseline. Other investigators found greater hemodynamic effects of higher dose of vasopressin (0.06 units/minute) but also unique adverse

  20. Tank characterization report for double-shell tank 241-AP-102

    Energy Technology Data Exchange (ETDEWEB)

    LAMBERT, S.L.

    1999-02-23

    In April 1993, Double-Shell Tank 241-AP-102 was sampled to determine waste feed characteristics for the Hanford Grout Disposal Program. This Tank Characterization Report presents an overview of that tank sampling and analysis effort, and contains observations regarding waste characteristics, expected bulk inventory, and concentration data for the waste contents based on this latest sampling data and information on the history of the tank. Finally, this report makes recommendations and conclusions regarding tank operational safety issues.

  1. Value of Serum Cholinesterase Activity in the Diagnosis of Septic Shock Due to Bacterial Infections.

    Science.gov (United States)

    Bahloul, Mabrouk; Baccouch, Najeh; Chtara, Kamilia; Turki, Mouna; Turki, Olfa; Hamida, Chokri Ben; Chelly, Hedi; Ayedi, Fatma; Chaari, Anis; Bouaziz, Mounir

    2017-06-01

    We aimed to investigate whether serum cholinesterase (SChE) activity can be helpful for the diagnosis of septic shock and to evaluate its usefulness in comparison with procalcitonin (PCT) and C-reactive protein (CRP). A prospective single-blinded study conducted in an intensive care unit of university hospital. Patients were classified as having cardiogenic shock, septic shock, or hemorrhagic shock. We also included a control group without neither hemodynamic instability nor sepsis. For all included patients, SChE, PCT, and CRP were simultaneously sampled. The comparison of sepsis markers between all groups showed that the mean values of PCT and CRP were significantly higher in patients with septic shock. However, SChE activity was significantly lower in this group. The SChE activity was found to be more accurate than PCT and CRP for the diagnosis of septic shock. In fact, an SChE activity ≤ 4000 UI/L predicted the diagnosis of septic shock with a sensitivity of 78%, a specificity of 89%, a predictive negative value of 97%, and a predictive positive value of 65%. However, the prognostic value of SChE activity was poor in multivariate analysis. The SChE activity level was significantly decreased in patients with septic shock. However, its prognostic value is poor. Our results suggest that SChE activity is useful for the diagnosis of septic shock. Further studies are warranted to confirm our findings.

  2. Fish stocking density impacts tank hydrodynamics

    DEFF Research Database (Denmark)

    Rasmussen, Michael R.; Lunger, Angela; Laursen, Jesper

    2006-01-01

    The effect of stocking density upon the hydrodynamics of a circular tank, configured in a recirculation system, was investigated. Red drums Sciaenops ocellatus of approximately 140 g wet weight, were stocked at five rates varying from 0 to 12 kg m-3. The impact of the presence of fish upon tank...... hydrodynamics was established using in-tank-based Rhodamine WT fluorometry at a flow rate of 0.23 l s-1 (tank exchange rate of 1.9 h-1). With increasing numbers of animals, curvilinear relationships were observed for dispersion coefficients and tank mixing times. Stocking densities of 3, 6, 9 and 12 kg m-3...

  3. Comparative Analysis of Direct Hospital Care Costs between Aseptic and Two-Stage Septic Knee Revision

    Science.gov (United States)

    Kasch, Richard; Merk, Sebastian; Assmann, Grit; Lahm, Andreas; Napp, Matthias; Merk, Harry; Flessa, Steffen

    2017-01-01

    Background The most common intermediate and long-term complications of total knee arthroplasty (TKA) include aseptic and septic failure of prosthetic joints. These complications cause suffering, and their management is expensive. In the future the number of revision TKA will increase, which involves a greater financial burden. Little concrete data about direct costs for aseptic and two-stage septic knee revisions with an in depth-analysis of septic explantation and implantation is available. Questions/Purposes A retrospective consecutive analysis of the major partial costs involved in revision TKA for aseptic and septic failure was undertaken to compare 1) demographic and clinical characteristics, and 2) variable direct costs (from a hospital department’s perspective) between patients who underwent single-stage aseptic and two-stage septic revision of TKA in a hospital providing maximum care. We separately analyze the explantation and implantation procedures in septic revision cases and identify the major cost drivers of knee revision operations. Methods A total of 106 consecutive patients (71 aseptic and 35 septic) was included. All direct costs of diagnosis, surgery, and treatment from the hospital department’s perspective were calculated as real purchase prices. Personnel involvement was calculated in units of minutes. Results Aseptic versus septic revisions differed significantly in terms of length of hospital stay (15.2 vs. 39.9 days), number of reported secondary diagnoses (6.3 vs. 9.8) and incision-suture time (108.3 min vs. 193.2 min). The management of septic revision TKA was significantly more expensive than that of aseptic failure ($12,223.79 vs. $6,749.43) (p financial loss for the operating department. PMID:28107366

  4. Pad B Liquid Hydrogen Storage Tank

    Science.gov (United States)

    Hall, Felicia

    2007-01-01

    Kennedy Space Center is home to two liquid hydrogen storage tanks, one at each launch pad of Launch Complex 39. The liquid hydrogen storage tank at Launch Pad B has a significantly higher boil off rate that the liquid hydrogen storage tank at Launch Pad A. This research looks at various calculations concerning the at Launch Pad B in an attempt to develop a solution to the excess boil off rate. We will look at Perlite levels inside the tank, Boil off rates, conductive heat transfer, and radiant heat transfer through the tank. As a conclusion to the research, we will model the effects of placing an external insulation to the tank in order to reduce the boil off rate and increase the economic efficiency of the liquid hydrogen storage tanks.

  5. Obturator Internus Abscess with Ipsilateral Septic Hip Arthritis.

    Science.gov (United States)

    Park, Sang Hyun; Kim, Joo Yong; Kong, Gyu Min; Roh, Sang Myung

    2016-11-01

    Obturator internus muscle (OIM) abscess is an uncommon condition often mistaken for bacterial infection of the hip joint. If the OIM abscess is accompanied by a septic hip, it becomes more difficult to make a diagnosis. Surgical drainage of OIM abscess is difficult because it is located at a deep part of the pelvic cavity. Therefore, intravenous antibiotic therapy or image-guided aspiration were used as a treatment method instead of surgical drainage. When drainage of the abscess was inadequate, prolonged antibiotic treatment was necessary. Here, we report a 12-year boy with abscess in the OIM and ipsilateral pyogenic arthritis of the hip which was accompanied by acute osteomyelitis of the triradiate cartilage of the acetabulum. The patient was successfully treated by surgical drainage of the abscess using the Stoppa approach and arthroscopic irrigation of the hip joint. Staphylococcus aureuswas the causative organism which was sensitive to oxacillin.

  6. Septic arthritis due to tubercular and Aspergillus co-infection

    Directory of Open Access Journals (Sweden)

    Mukesh Kumar

    2016-01-01

    Full Text Available Aspergillus septic arthritis is a rare and serious medical and surgical problem. It occurs mainly in immunocompromised patients. Aspergillus fumigatus is the most common causative organism followed by Aspergillus flavus. The most common site affected is knee followed by shoulder, ankle, wrist, hip and sacroiliac joint. Debridement and voriconazole are primary treatment of articular aspergilosis. To the best of our knowledge, there are no reported cases of co-infection of tuberculosis (TB and Aspergillus infecting joints. We report a case of co-infection of TB and A. flavus of hip and knee of a 60-year-old male, with type 2 diabetes mellitus. He was treated with debridement, intravenous voriconazole, and antitubercular drugs.

  7. Hyperkalemia induced pseudo-myocardial infarction in septic shock

    Directory of Open Access Journals (Sweden)

    S E Pothiawala

    2014-01-01

    Full Text Available Hyperkalemia is an acute life-threatening disorder presenting to the emergency department. Patients with hyperkalemia may manifest characteristic electrocardiographic changes including tented T waves, widening of the QRS complex and loss of P waves, sine wave pattern and eventually asystole. There have been only few reports of hyperkalemia causing ST segment elevation on electrocardiogram simulating an acute myocardial infarction. This case describes pseudo-myocardial infarction due to hyperkalemia and septic shock. Rapid determination of serum potassium levels by bedside blood gas analyzers serves to be a useful guide. ST segment elevation related to hyperkalemia will resolve with successful reduction of the serum potassium levels by appropriate therapy. It is important for physicians to be aware of this condition as this will aid in initiating correct therapy and prevent the patient from unnecessary interventions and the associated risk of complications.

  8. Primary Retroperitoneal Abscess Complicated with Septic Arthritis of the Hip

    Directory of Open Access Journals (Sweden)

    Chuan-Nan Su

    2006-01-01

    Full Text Available Primary retroperitoneal abscess complicated with septic arthritis of the hip is an unusual disease. The insidious and occult nature of abscess coexistent with arthritis causes diagnostic delays, prolonged sepsis, and considerably higher morbidity and mortality. We herein present a case of gouty arthritis and avascular necrosis of the femoral head in a 41-year-old woman who complained of fever, right flank pain, body weight loss, swelling over her right lower limb, and 2 weeks of pain in the right hip. The computed tomographic scan showed a huge abscess (about 32 × 10 × 8 cm over the right posterior pararenal space, with swelling of the right psoas, iliac, and obturator muscles. During surgery, the abscess was drained and sequestrectomy of the right hip was performed. Cultures of pus from the retroperitoneum and right hip showed Escherichia coli and Staphylococcus aureus. We review the literature and discuss possible causes.

  9. Paecilomyces lilacinus septic olecranon bursitis in an immunocompetent host.

    Science.gov (United States)

    Schweitzer, Karl M; Richard, Marc J; Leversedge, Fraser J; Ruch, David S

    2012-05-01

    Paecilomyces lilacinus is a filamentous fungus that is a rare cause of infection in immunocompromised human hosts. We present a case of lilacinus septic olecranon bursitis in an otherwise healthy 78-year-old male. This patient's case was complicated by wound breakdown after bursectomy and appropriate anti-fungal treatment, requiring a local soft tissue rearrangement. This case demonstrates the need for appropriate and timely medical and surgical treatment in infections involving lilacinus, which are not isolated solely to systemically immunocompromised and medically-ill patient populations. In cases where the patient is systemically immumocompromised or has been rendered locally immunocompromised, it is essential to obtain a full culture work-up, including fungi.

  10. Septic Bursitis in an 8-Year-Old Boy

    Directory of Open Access Journals (Sweden)

    Panagiotis Kratimenos

    2014-01-01

    Full Text Available Background. The prepatellar bursa can become inflamed owing to repeated trauma. Prepatellar bursitis is extremely rare in children. Methods. We report the case of an 8-year-old boy who was treated for an erythematous, swollen, and severely painful right knee, fever, inability to bear weight on the leg, and purulent material draining from a puncture wound. We describe the differential diagnosis for tender swollen knee, including infection, gout, rheumatoid arthritis, and osteoarthritis. If untreated, prepatellar bursitis can progress to patellar osteomyelitis. Results. Wound cultures grew Streptococcus pyogenes, with the infection resolving with amoxicillin. Conclusions. A high index of suspicion is necessary in children presenting with prepatellar bursitis to prevent potentially devastating sequelae of infection of the septic joint.

  11. Central venous oxygen saturation for the diagnosis of low cardiac output in septic shock patients

    DEFF Research Database (Denmark)

    Perner, A; Haase, N; Wiis, J

    2010-01-01

    Simple diagnostic tests are needed to screen septic patients for low cardiac output because intervention is recommended in these patients. We assessed the diagnostic value of central venous oxygen saturation in the superior vena cava (ScvO(2)) for detecting low cardiac output in patients with sep...... with septic shock.......Simple diagnostic tests are needed to screen septic patients for low cardiac output because intervention is recommended in these patients. We assessed the diagnostic value of central venous oxygen saturation in the superior vena cava (ScvO(2)) for detecting low cardiac output in patients...

  12. Maximally effective dosing regimens of meropenem in patients with septic shock

    DEFF Research Database (Denmark)

    Sjövall, Fredrik; Alobaid, Abdulaziz S; Wallis, Steven C

    2018-01-01

    Objectives: To use a population pharmacokinetic approach to define maximally effective meropenem dosing recommendations for treatment of Acinetobacter baumannii and Pseudomonas aeruginosa infections in a large cohort of patients with septic shock. Methods: Adult patients with septic shock...... was required for both empirical and targeted treatment. In patients with a CL CR of ≤ 100 mL/min, successful concentration targets could be reached with intermittent dosing of 1000 mg/8 h. Conclusions: In patients with septic shock and possible augmented renal clearance, doses should be increased and...

  13. Septic arthritis: what is the role for the rheumatologist?

    Directory of Open Access Journals (Sweden)

    V. Carraro

    2011-09-01

    Full Text Available Septic arthritis (SA is a clinical emergency with considerable morbidity and mortality that can lead to rapid joint destruction and irreversible loss of function. The reported incidence varies from 2-5 cases per 100.000 individuals per year in the general populations to 70 cases per 100.000 individuals annually among patients with rheumatoid arthritis (RA. Predisposing factors are immunosuppressive and corticosteroids therapy and RA “itself”. The expected decrease in incidence of SA was not seen over the last 20 years period but we can, on the contrary, expect an increase in the frequency of its appearance because of the population ageing, the increasingly prosthetic joint replacement, the ability of the bacteria to evade clearance by the host immune response and the rapidly growing number of patients with RA, ankylosing spondylitis and psoriatic arthritis treated with tumour necrosis factor α (TNFα antagonists. Up to now there have been conflicting reports regarding joint infections in patients under anti-TNF therapy but according to data from Deutsch as well as the British register there might be an increase in the incidence of joint infections in anti TNF treated patients. Microscopic analysis and culture of synovial fluid are fundamental diagnostic tools in the evaluation of possible joint sepsis. Sonographic guidance of arthrocentesis led to successful aspiration of difficultto- access joints as shoulder and hip. There is controversy over which mode of drainage of septic synovial fluid should be employed but needle aspiration appear to be preferable to surgical treatment as an initial mode of treatment of SA. Rheumatologists should have a central role in the diagnosis and management of SA.

  14. Septic complication following porous hydroxyapatite cranioplasty: prosthesis retention management.

    Science.gov (United States)

    Iaccarino, Corrado; Mattogno, Pier P; Zanotti, Bruno; Bellocchi, Silvio; Verlicchi, Angela; Viaroli, Edoardo; Pastorello, Giulia; SGULò, Francesco; Ghadirpour, Reza; Servadei, Franco

    2016-05-13

    After failing of autologous cranioplasty or when the bone flap is unavailable, the alloplastic (heterologous) materials are the choice for cranial reconstruction. No agreement has been reported about the material with a significant lower risk of septic complications. This is due to extremely heterogeneous prognostic factors related not only to the material used but also to the surgical procedures and/or to the timing of the procedure. More attention should be focused on the material whose characteristic could enable a delay in bacterial colonization, where an antibiotic therapy could be effective, without need of prosthesis removal. Four cases of severe septic complication following cranioplasty with porous hydroxyapatite (HA) prosthesis are presented. Patients were conservatively treated, without heterologous bone flap removal. All of our patients presented reasons for delaying HA cranioplasty removal: Patients 1, 3 and 4 had an associated shunted hydrocephalus and the need for non- removing the prosthesis was related to the predictable recurrence of overshunting and/or sinking skin flap syndrome. In case 4 the revision surgery would have also damaged the microvascular flap with latissimus dorsi muscle used by plastic surgeon for skin reconstruction. In case 2 the patient refused revision surgery. In all cases systemic and/or radiological signs of infection were observed. In Case 2 the infective process surrounded completely the HA prosthesis, while it was located in the epidural region in Case 1 and 4. In Case 3 a surgical curettage of the infected wound was performed over the HA prosthesis. Following prosthesis retention management with antibiotic therapy, all patients revealed systemic and/or radiological signs of sepsis resolution at follow-up. The possibility to avoid a prosthesis removal with effective antibiotic treatment is mainly due to the combination of three factors: targeted antibiotic therapy, good anatomical area revascularization (resulting of an

  15. [SEPTIC SHOCK IN PATIENT WITH SEVERE HEAD TRAUMA].

    Science.gov (United States)

    Sichev, A A; Tabasaransky, T Φ; Savin, I A; Gorachev, A S; Tenedieva, V D; Abramov, T A; Oshorov, A V; Polupan, A A; Mazkovsky, I V; Gavrilov, A G; Potapov, A A

    2015-01-01

    The clinical observation illustrates the role of screening of inflammatory markers and advanced hemodynamic monitoring in optimization of the treatment of the patient with severe traumatic brain injury (sTBI). The level of consciousness by the Glasgow Coma Scale at admission was 5 points. From the first day of stay the patient suffered hyperthermia to 39,0° C° The diagnosis of the aspiration pneumonia was determined by radiological signs, bronchoscopy and inflammatory blood markers, C-reactive protein, leukocytosis. From the second day the constant infusion of norepinephrine was necessary to maintain mean ABP above 80 mmHg. On the 10th day the patient's condition deteriorated sharply. Developed hyperthermia to 40, 2° and cardiovascular collapse (in spite of the high level of norepinephrine support a sharp decline in ABP up to 49/20 mmHg). Invasive advanced hemodynamic PiCCO monitoring (transpulmonary thermodilution) was started Septic shock was suspected. Standard laboratory tests did not meet the criteria for septic shock. Witnessed a slight increase in CRP and procalcitonin (PCT) was within normal limits. Diagnostic search was supplemented by a study of interleukins (IL-6 and IL-2R) in the blood plasma. The significant increase in their values, was regarded as the initial manifestations of the systemic inflammatory response. Sepsis was confirmed. The extended antibiotic therapy started Continuous Veno-Venous hemofiltration was used as part of treatment of the inflammatory-toxic condition. In two days of the therapy the patient's condition has stabilized, the patient recovered consciousness in the form of opening the eyes, simple instructions. At discharge, the patient's condition according to the Glasgow outcome scale was estimated at 4 points.

  16. Arthroscopic Treatment of Septic Arthritis in Very Young Children.

    Science.gov (United States)

    Thompson, Rachel M; Gourineni, Prasad

    2017-01-01

    Arthroscopic lavage is a well-established, minimally invasive treatment for septic arthritis (SA) in adults, but the use of arthroscopy in the pediatric population is typically restricted to sports injuries and deformity. Previous research on arthroscopic lavage of septic joints in the pediatric population has been limited to case reports and small case series of older children. As such, we aimed to evaluate the safety and efficacy of arthroscopic treatment of SA in various joints in very young children. Between 2011 and 2015, 24 children (aged 3 wk to 6 y) were treated for SA with arthroscopic lavage. A single portal was adequate for both inflow and outflow in most cases. A second portal was used in all knees and in other joints for synovectomy, when indicated. Drains were placed through the portal site and remained in place for 2 to 3 days. Antibiotics were managed by the infectious disease service. Nine hips, 9 knees, 4 ankles, and 2 shoulders were included. Portal placement, visualization, and adequate lavage were straight forward in all joints. There was 1 transient femoral nerve palsy and no other arthroscopy-associated complications (iatrogenic damage, difficult drain placement, or conversion to open). Two patients required repeat arthroscopic lavage for disease eradication, one of which required a second admission. A third patient underwent open irrigation following arthroscopic lavage with a resultant 1.125 average procedures per subject. At final follow-up (2 to 49 mo, average 16 mo), no recurrence of infection or decreased range of motion was noted. Arthroscopic lavage appears to be a safe, quick, and effective alternative to open arthrotomy for the treatment of SA in very young children. It is feasible in any large joint even in the infantile population, allowing for improved visualization and irrigation with little soft-tissue dissection and morbidity. Our relatively simple technique and positive results should encourage regular use of arthroscopic

  17. External tank space debris considerations

    Science.gov (United States)

    Elfer, N.; Baillif, F.; Robinson, J.

    1992-01-01

    Orbital debris issues associated with maintaining a Space Shuttle External Tank (ET) on orbit are presented. The first issue is to ensure that the ET does not become a danger to other spacecraft by generating space debris, and the second is to protect the pressurized ET from penetration by space debris or meteoroids. Tests on shield designs for penetration resistance showed that when utilized with an adequate bumper, thermal protection system foam on the ET is effective in preventing penetration.

  18. Flexible polyimide fuel tank sealants

    Energy Technology Data Exchange (ETDEWEB)

    Jones, R.J.; Cassey, H.N.

    1978-01-01

    Requirements for elastomers or compliant polymers used as integral fuel tank sealant materials and as seals in high-performance military aircraft are examined, and a polyimide system with the appropriate properties is described. The system contains methylene dianiline, 4,4'-diaminostilbene, polyethyleneoxide diamine, and bis(4-(3,4-dicarboxyphenoxyl)phenyl) sulfone dianhydride. Development, preparation, and applications of the polyimide sealant are discussed.

  19. Models of liquid storage tanks

    Energy Technology Data Exchange (ETDEWEB)

    Ismail, K.A.R. [Departamento de Engenharia Termica e Fluidos, FEM, UNICAMP, Campinas (Brazil); Leal, J.F.B. [Departamento Basico, FAENQUIL, Lorena (Brazil); Zanardi, M.A. [Departamento de Energia, FEG, UNESP, Guaratingueta (Brazil)

    1997-08-01

    We present the results of a comparative study on thermally stratified tanks for hot storage. A two-dimensional model is employed. A numerical solution was obtained using the control-volume technique due to Patankar. The two-dimensional model was simplified for the pure conduction case. Results from the two models were compared with each other and with available numerical and experimental results. (Author)

  20. Thermal stratification in a hot water tank established by heat loss from the tank

    DEFF Research Database (Denmark)

    Results of experimental and numerical investigations of thermal stratification and natural convection in a vertical cylindrical hot water tank during standby periods are presented. The transient fluid flow and heat transfer in the tank during cooling caused by heat loss are investigated...... on the natural buoyancy resulting in downward flow along the tank side walls due to heat loss of the tank and the influence on thermal stratification of the tank by the downward flow and the corresponding upward flow in the central parts of the tank. Water temperatures at different levels of the tank...... by computational fluid dynamics (CFD) calculations and by thermal measurements. A tank with uniform temperatures and thermal stratification is studied. The distribution of the heat loss coefficient for the different parts of the tank is measured by tests and used as input to the CFD model. The investigations focus...

  1. Thermal stratification in a hot water tank established by heat loss from the tank

    DEFF Research Database (Denmark)

    Fan, Jianhua; Furbo, Simon

    2009-01-01

    Results of experimental and numerical investigations of thermal stratification and natural convection in a vertical cylindrical hot water tank during standby periods are presented. The transient fluid flow and heat transfer in the tank during cooling caused by heat loss are investigated...... on the natural buoyancy resulting in downward flow along the tank side walls due to heat loss of the tank and the influence on thermal stratification of the tank by the downward flow and the corresponding upward flow in the central parts of the tank. Water temperatures at different levels of the tank...... by computational fluid dynamics (CFD) calculations and by thermal measurements. A tank with uniform temperatures and thermal stratification is studied. The distribution of the heat loss coefficient for the different parts of the tank is measured by tests and used as input to the CFD model. The investigations focus...

  2. CRITICAL ASSUMPTIONS IN THE F-TANK FARM CLOSURE OPERATIONAL DOCUMENTATION REGARDING WASTE TANK INTERNAL CONFIGURATIONS

    Energy Technology Data Exchange (ETDEWEB)

    Hommel, S.; Fountain, D.

    2012-03-28

    The intent of this document is to provide clarification of critical assumptions regarding the internal configurations of liquid waste tanks at operational closure, with respect to F-Tank Farm (FTF) closure documentation. For the purposes of this document, FTF closure documentation includes: (1) Performance Assessment for the F-Tank Farm at the Savannah River Site (hereafter referred to as the FTF PA) (SRS-REG-2007-00002), (2) Basis for Section 3116 Determination for Closure of F-Tank Farm at the Savannah River Site (DOE/SRS-WD-2012-001), (3) Tier 1 Closure Plan for the F-Area Waste Tank Systems at the Savannah River Site (SRR-CWDA-2010-00147), (4) F-Tank Farm Tanks 18 and 19 DOE Manual 435.1-1 Tier 2 Closure Plan Savannah River Site (SRR-CWDA-2011-00015), (5) Industrial Wastewater Closure Module for the Liquid Waste Tanks 18 and 19 (SRRCWDA-2010-00003), and (6) Tank 18/Tank 19 Special Analysis for the Performance Assessment for the F-Tank Farm at the Savannah River Site (hereafter referred to as the Tank 18/Tank 19 Special Analysis) (SRR-CWDA-2010-00124). Note that the first three FTF closure documents listed apply to the entire FTF, whereas the last three FTF closure documents listed are specific to Tanks 18 and 19. These two waste tanks are expected to be the first two tanks to be grouted and operationally closed under the current suite of FTF closure documents and many of the assumptions and approaches that apply to these two tanks are also applicable to the other FTF waste tanks and operational closure processes.

  3. Analysis of PD-1 expression in the monocyte subsets from non-septic and septic preterm neonates.

    Directory of Open Access Journals (Sweden)

    Magdalena Zasada

    Full Text Available Programmed death-1 (PD-1 receptor system represents a part of recently reported immunoregulatory pathway. PD-1 is an immune checkpoint molecule, which plays an important role in downregulating the immune system proinflammatory activity. Until recently, PD-1 expression was not established on immune cells of the preterm infants. The study objectives were to confirm expression of the PD-1 receptors on the monocytes isolated from very low birth weight newborns (VLBW, and to analyze their expression during the first week of life and late-onset sepsis. Peripheral blood mononuclear cells were isolated from 76 VLBW patients without early-onset sepsis on their 5th day of life (DOL. PD-1 expression was determined on the monocyte subsets (classical, intermediate, non-classical by flow cytometry. In case of late-onset sepsis (LOS, the same analysis was performed. Our results demonstrated that on the 5th DOL, PD-1 receptors were present in all the monocyte subsets. Children, whose mothers had received antenatal steroids, presented higher absolute numbers of non-classical monocytes with PD-1 expression. Infants born extremely preterm who later developed LOS, initially showed a lower percentage of PD-1 receptor-positive intermediate monocytes in comparison to neonates born very preterm. During LOS, we observed a rise in the percentage of classical monocytes with PD-1 expression. In case of septic shock or fatal outcome, there was a higher percentage and absolute count of intermediate monocytes with PD-1 expression in comparison to children without these complications. In conclusion, monocytes from VLBW children express PD-1 receptors. Antenatal steroid administration seems to induce PD-1 receptor expression in the non-classical monocytes. PD-1 might play a role in immunosuppressive phase of sepsis in the prematurely born children with septic shock and fatal outcome.

  4. 241-SY Tank Farm Construction Extent of Condition Review for Tank Integrity

    Energy Technology Data Exchange (ETDEWEB)

    Barnes, Travis J.; Boomer, Kayle D.; Gunter, Jason R.; Venetz, Theodore J.

    2013-07-25

    This report provides the results of an extent of condition construction history review for tanks 241-SY-101, 241-SY-102, and 241-SY-103. The construction history of the 241-SY tank farm has been reviewed to identify issues similar to those experienced during tank 241-AY-102 construction. Those issues and others impacting integrity are discussed based on information found in available construction records, using tank 241-AY-102 as the comparison benchmark. In the 241-SY tank farm, the third DST farm constructed, refractory quality and stress relief were improved, while similar tank and liner fabrication issues remained.

  5. 241-AZ Tank Farm Construction Extent of Condition Review for Tank Integrity

    Energy Technology Data Exchange (ETDEWEB)

    Barnes, Travis J.; Boomer, Kayle D.; Gunter, Jason R.; Venetz, Theodore J.

    2013-07-30

    This report provides the results of an extent of condition construction history review for tanks 241-AZ-101 and 241-AZ-102. The construction history of the 241-AZ tank farm has been reviewed to identify issues similar to those experienced during tank AY-102 construction. Those issues and others impacting integrity are discussed based on information found in available construction records, using tank AY-102 as the comparison benchmark. In the 241-AZ tank farm, the second DST farm constructed, both refractory quality and tank and liner fabrication were improved.

  6. ANNUAL RADIOACTIVE WASTE TANK INSPECTION PROGRAM - 2011

    Energy Technology Data Exchange (ETDEWEB)

    West, B.; Waltz, R.

    2012-06-21

    Aqueous radioactive wastes from Savannah River Site (SRS) separations and vitrification processes are contained in large underground carbon steel tanks. Inspections made during 2011 to evaluate these vessels and other waste handling facilities along with evaluations based on data from previous inspections are the subject of this report. The 2011 inspection program revealed that the structural integrity and waste confinement capability of the Savannah River Site waste tanks were maintained. All inspections scheduled per SRR-LWE-2011-00026, HLW Tank Farm Inspection Plan for 2011, were completed. Ultrasonic measurements (UT) performed in 2011 met the requirements of C-ESR-G-00006, In-Service Inspection Program for High Level Waste Tanks, Rev. 3, and WSRC-TR-2002-00061, Rev.6. UT inspections were performed on Tanks 25, 26 and 34 and the findings are documented in SRNL-STI-2011-00495, Tank Inspection NDE Results for Fiscal Year 2011, Waste Tanks 25, 26, 34 and 41. A total of 5813 photographs were made and 835 visual and video inspections were performed during 2011. A potential leaksite was discovered at Tank 4 during routine annual inspections performed in 2011. The new crack, which is above the allowable fill level, resulted in no release to the environment or tank annulus. The location of the crack is documented in C-ESR-G-00003, SRS High Level Waste Tank Leaksite Information, Rev.6.

  7. In situ vitrification of radioactive underground tanks

    Energy Technology Data Exchange (ETDEWEB)

    Koegler, S.S.; Gibby, R.D.; Thompson, L.E.

    1991-10-01

    In situ vitrification (ISV) is a treatment process with great potential for remediating underground tanks previously used for storing radioactive and hazardous chemical wastes at US Department of Energy (DOE) sites. Tests at several scales have demonstrated the utility of ISV for these tanks. An engineering-scale test vitrified a 30-cm-diameter buried steel and concrete tank that contained simulated tank sludge. Hazardous components of the tank sludge were immobilized, or removed and captured in the off-gas treatment system, and the tank walls were melted or incorporated into the ISV block. A pilot-scale ISV test vitrified a 1-m simulated underground tank than contained a simulated refractory sludge. The ISV process completely vitrified the tank, its contents, and the soil below the tank to a depth of 2.4 m, producing a uniform glass and crystalline monolith with an estimated mass of 30 tons. A large-scale underground tank test is scheduled for early 1991. 5 refs., 4 figs.

  8. RETRIEVAL & TREATMENT OF HANFORD TANK WASTE

    Energy Technology Data Exchange (ETDEWEB)

    EACKER, J.A.; SPEARS, J.A.; STURGES, M.H.; MAUSS, B.M.

    2006-01-20

    The Hanford Tank Farms contain 53 million gal of radioactive waste accumulated during over 50 years of operations. The waste is stored in 177 single-shell and double-shell tanks in the Hanford 200 Areas. The single-shell tanks were put into operation from the early 1940s through the 1960s with wastes received from several generations of processing facilities for the recovery of plutonium and uranium, and from laboratories and other ancillary facilities. The overall hanford Tank Farm system represents one of the largest nuclear legacies in the world driving towards completion of retrieval and treatment in 2028 and the associated closure activity completion by 2035. Remote operations, significant radiation/contamination levels, limited access, and old facilities are just some of the challenges faced by retrieval and treatment systems. These systems also need to be able to successfully remove 99% or more of the waste, and support waste treatment, and tank closure. The Tank Farm retrieval program has ramped up dramatically in the past three years with design, fabrication, installation, testing, and operations ongoing on over 20 of the 149 single-shell tanks. A variety of technologies are currently being pursued to retrieve different waste types, applications, and to help establish a baseline for recovery/operational efficiencies. The paper/presentation describes the current status of retrieval system design, fabrication, installation, testing, readiness, and operations, including: (1) Saltcake removal progress in Tanks S-102, S-109, and S-112 using saltcake dissolution, modified sluicing, and high pressure water lancing techniques; (2) Sludge vacuum retrieval experience from Tanks C-201, C-202, C-203, and C-204; (3) Modified sluicing experience in Tank C-103; (4) Progress on design and installation of the mobile retrieval system for sludge in potentially leaking single-shell tanks, particularly Tank C-101; and (5) Ongoing installation of various systems in the next

  9. Septic shock: recognizing and managing this life-threatening condition in pediatric patients.

    Science.gov (United States)

    Silverman, Adam M

    2015-04-01

    Septic shock is a relatively rare but life-threatening condition in pediatric patients that can often be difficult to recognize in the emergency department. Once recognized, the emphasis of therapy is to reverse deficits in cellular respiration by increasing oxygen and other substrate delivery to tissue beds. Providing oxygen, improving tissue perfusion through augmentation of cardiac output, and administering antibiotics in a timely manner have all been shown to significantly improve outcomes in children with septic shock. Goal-directed therapy is relatively straightforward, emphasizes the need for effective surveillance and timely recognition of this disease process, and has the potential to significantly reduce morbidity and mortality. This review discusses how to identify specific populations at the greatest risk for septic shock, lays out the essential components of goal-directed therapy, examines potential pitfalls in management, and distinguishes additional ways that emergency clinicians can avoid the devastating consequences of septic shock in pediatric patients.

  10. The use of recombinant factor VIIa in a pediatric septic shock patient with disseminated intravascular coagulation

    Directory of Open Access Journals (Sweden)

    Ronaldo Arkader

    2008-03-01

    Full Text Available This is a report on a pediatric patient with septic shock and disseminated intravascular coagulation, who developed life-threatening bleeding which was successfully treated with recombinant factor VIIa.

  11. Acute septic arthritis of the acromioclavicular joint caused by Haemophilus parainfluenzae: a rare causative origin.

    Science.gov (United States)

    Hong, Myong-Joo; Kim, Yeon-Dong; Ham, Hyang-Do

    2015-04-01

    Septic arthritis of the acromioclavicular (AC) joint is a rare entity with symptoms that include erythema, swelling, and tenderness over the AC joint, fever, and limitation of shoulder motion with pain. In previous reports, Staphylococcus and Streptococcus species have been mentioned as common causative organisms. Haemophilus parainfluenzae is a normal inhabitant of the oral cavity, respiratory tract, gastrointestinal tract, and urogenital tract. However, it sometimes causes opportunistic infections leading to septic arthritis and osteomyelitis. AC joint infection associated with H.parainfluenzae is very rare, and only one case has been reported in the literature. Moreover, septic arthritis in immunocompetent patients is also very rare. Here, we report the case of a healthy patient with H. parainfluenzae-related septic arthritis of the AC joint.

  12. Oxidative stress and 'monocyte reprogramming' in septic patients with acute kidney injury requiring CRRT.

    Science.gov (United States)

    Silva, Sandra; de Cal, Massimo; Cruz, Dinna; Lentini, Paolo; Corradi, Valentina; Gallo, Giampiero; Salvatori, Gabriella; Verbine, Anton; Pogoshyan, Lusine; Nalesso, Federico; Brendolan, Alessandra; Piccinni, Pasquale; Ronco, Claudio

    2008-01-01

    Oxidative stress (OS) and monocyte HLA-DR expression are known to be predictive of mortality in sepsis; nevertheless, limited information exists regarding sepsis with acute kidney injury (AKI). The aim of the study was to correlate these markers with outcome in septic patients with AKI requiring continuous renal replacement therapy (CRRT). Advanced oxidation protein products (AOPP) were measured in 32 patients on days 1, 3, 7, 14, 21, and 28. In 14 we assessed the percentage of monocytes expressing HLA-DR (%DR+) and the HLA-DR mean fluorescence intensity (MFI). 20 healthy volunteers, 17 septic patients without AKI and 20 septic AKI patients not treated by CRRT were used for comparison. The mortality rate was 59%. Septic CRRT patients had higher AOPP and lower %DR+ (p CRRT. However, this study was not able to confirm the usefulness of these markers in predicting survival in this subset of patients. Copyright 2008 S. Karger AG, Basel.

  13. Association between sympathoadrenal activation, fibrinolysis, and endothelial damage in septic patients

    DEFF Research Database (Denmark)

    Johansson, Pär I; Haase, Nicolai; Perner, Anders

    2014-01-01

    for Severe Sepsis/Septic Shock trial who were expected not to receive catecholamines at screening preintervention (baseline) and had baseline blood sampled. Clinical, outcome data, and measurements of plasma concentration (p-) biomarkers reflecting sympathoadrenal activation, endothelial activation......PURPOSE: The purpose of this study is to investigate potential associations between sympathoadrenal activation and/or vasopressor/inotropic therapy and endothelial activation, damage, and coagulopathy in septic patients. MATERIALS AND METHODS: Septic patients included in the Scandinavian Starch......). CONCLUSIONS: In septic patients, endogenous noradrenaline was independently associated with biomarkers of endothelial activation, damage, fibrinolysis and mortality, comparable with findings in trauma and myocardial infarction patients. The catecholamine surge in critical illness may contribute to balance...

  14. Induced hypothermia in patients with septic shock and respiratory failure (CASS)

    DEFF Research Database (Denmark)

    Itenov, Theis Skovsgaard; Johansen, Maria Egede; Bestle, Morten

    2018-01-01

    -dependent patients with septic shock. METHODS: In this randomised, controlled, open-label trial, we recruited patients from ten intensive care units (ICUs) in three countries in Europe and North America. Inclusion criteria for patients with severe sepsis or septic shock were a mean arterial pressure of less than 70...... died within 30 days versus 77 (35·8%) of 215 in the routine thermal management group (difference 8·4% [95% CI -0·8 to 17·6]; relative risk 1·2 [1·0-1·6]; p=0·07]). INTERPRETATION: Among patients with septic shock and ventilator-dependent respiratory failure, induced hypothermia does not reduce...... mortality. Induced hypothermia should not be used in patients with septic shock. FUNDING: Trygfonden, Lundbeckfonden, and the Danish National Research Foundation....

  15. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016

    NARCIS (Netherlands)

    Rhodes, Andrew; Evans, Laura E.; Alhazzani, Waleed; Levy, Mitchell M.; Antonelli, Massimo; Ferrer, Ricard; Kumar, Anand; Sevransky, Jonathan E.; Sprung, Charles L.; Nunnally, Mark E.; Rochwerg, Bram; Rubenfeld, Gordon D.; Angus, Derek C.; Annane, Djillali; Beale, Richard J.; Bellinghan, Geoffrey J.; Bernard, Gordon R.; Chiche, Jean-Daniel; Coopersmith, Craig; de Backer, Daniel P.; French, Craig J.; Fujishima, Seitaro; Gerlach, Herwig; Hidalgo, Jorge Luis; Hollenberg, Steven M.; Jones, Alan E.; Karnad, Dilip R.; Kleinpell, Ruth M.; Koh, Younsuck; Lisboa, Thiago Costa; Machado, Flavia R.; Marini, John J.; Marshall, John C.; Mazuski, John E.; McIntyre, Lauralyn A.; McLean, Anthony S.; Mehta, Sangeeta; Moreno, Rui P.; Myburgh, John; Navalesi, Paolo; Nishida, Osamu; Osborn, Tiffany M.; Perner, Anders; Plunkett, Colleen M.; Ranieri, Marco; Schorr, Christa A.; Seckel, Maureen A.; Seymour, Christopher W.; Shieh, Lisa; Shukri, Khalid A.; Simpson, Steven Q.; Singer, Mervyn; Thompson, B. Taylor; Townsend, Sean R.; van der Poll, Thomas; Vincent, Jean-Louis; Wiersinga, W. Joost; Zimmerman, Janice L.; Dellinger, R. Phillip

    2017-01-01

    Objective: To provide an update to "Surviving Sepsis Campaign Guidelines for Management of Sepsis and Septic Shock: 2012!' Design: A consensus committee of 55 international experts representing 25 international organizations was convened. Nominal groups were assembled at key international meetings

  16. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)

    NARCIS (Netherlands)

    Singer, Mervyn; Deutschman, Clifford S.; Seymour, Christopher Warren; Shankar-Hari, Manu; Annane, Djillali; Bauer, Michael; Bellomo, Rinaldo; Bernard, Gordon R.; Chiche, Jean-Daniel; Coopersmith, Craig M.; Hotchkiss, Richard S.; Levy, Mitchell M.; Marshall, John C.; Martin, Greg S.; Opal, Steven M.; Rubenfeld, Gordon D.; van der Poll, Tom; Vincent, Jean-Louis; Angus, Derek C.

    2016-01-01

    IMPORTANCE Definitions of sepsis and septic shock were last revised in 2001. Considerable advances have since been made into the pathobiology (changes in organ function, morphology, cell biology, biochemistry, immunology, and circulation), management, and epidemiology of sepsis, suggesting the need

  17. Group A Streptococcus Septic Shock after Surgical Abortion: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Stephanie C. Tardieu

    2017-01-01

    Full Text Available Group A Streptococcus (GAS causing puerperal sepsis is a leading cause of maternal mortality worldwide. Although rare, GAS infection is a relatively significant public health concern because of its propensity to evolve rapidly into septic shock, streptococcal toxic shock syndrome, and death. We report the case of a 27-year-old patient who presented with GAS septic shock after undergoing a surgical termination of pregnancy and was treated successfully and recovered without sequelae. GAS septic shock should always be included in the differential diagnosis of any patient who develops sepsis after a surgical abortion. Patients with GAS septic shock have a rapid clinical decline and need aggressive fluid management, early initiation of broad-spectrum antibiotics, and rapid surgical intervention.

  18. High-performance detection and early prediction of septic shock for alcohol-use disorder patients

    Directory of Open Access Journals (Sweden)

    Jacob Calvert

    2016-06-01

    Conclusions: Analysis of the higher order correlations and trends between relevant clinical measurements using the InSight algorithm leads to more accurate detection and prediction of septic shock, even in cases where diagnosis may be confounded by AUD.

  19. Pylephlebitis and Crohn’s disease: A rare case of septic shock

    Directory of Open Access Journals (Sweden)

    Stefano Scaringi

    2017-01-01

    Conclusion: This case highlights the importance of promptly considerate and treat mesenteric pylephlebitis in presence of a septic shock in a Crohn’s disease patient who is not showing clinical signs of peritonitis.

  20. STRUCTURAL CHANGES OF THE HEART DURING SEVERE SEPSIS OR SEPTIC SHOCK

    NARCIS (Netherlands)

    Smeding, Lonneke; Plotz, Frans B.; Groeneveld, A. B. Johan; Kneyber, Martin C. J.

    Cardiovascular dysfunction is common in severe sepsis or septic shock. Although functional alterations are often described, the elevated serum levels of cardiac proteins and autopsy findings of myocardial immune cell infiltration, edema, and damaged mitochondria suggest that structural changes to

  1. Septic olecranon and prepatellar bursitis in hockey players: a report of three cases.

    Science.gov (United States)

    Tuff, Taylor; Chrobak, Karen

    2016-12-01

    Septic bursitis (SB) is an important differential diagnosis in athletes presenting with an acute subcutaneous swelling of the elbow or knee. Prompt recognition is essential to minimize recovery time and prevent the spread of infection. Due to the significant overlap in clinical features, it is often difficult to differentiate SB from non-septic bursitis (NSB) without bursal aspirate analysis. SB is commonly not considered unless the bursitis is accompanied by a local skin lesion or fever. This study describes two cases of septic olecranon bursitis and one case of septic prepatellar bursitis in adult hockey players presenting to a sports medicine clinic. None of the cases presented with an observable skin lesion and only one case developed a fever. It is therefore essential that clinicians maintain a high index of suspicion and monitor for signs of progression when presented with an acute bursitis even in the absence of these features.

  2. Beta-lactam dosing in critically ill patients with septic shock and continuous renal replacement therapy

    National Research Council Canada - National Science Library

    Ulldemolins, Marta; Vaquer, Sergi; Llauradó-Serra, Mireia; Pontes, Caridad; Calvo, Gonzalo; Soy, Dolors; Martín-Loeches, Ignacio

    2014-01-01

    .... This article aims to describe the current clinical scenario for beta-lactam dosing in critically ill patients with septic shock and CRRT, to highlight the sources of variability among the different...

  3. Hospital Mortality of Septic Acute Kidney Injury Requiring Renal Replacement Therapy in the Postoperative Elderly

    Directory of Open Access Journals (Sweden)

    Wei-Lun Liu

    2012-06-01

    Conclusions: The hospital mortality of postoperative elderly patients with septic AKI was more than 60% and was not affected by age. Mechanical ventilator use was the major risk factor and prognostic factor for elderly patients in this clinical setting.

  4. Evolution of peripheral vs metabolic perfusion parameters during septic shock resuscitation. A clinical-physiologic study

    NARCIS (Netherlands)

    Hernandez, Glenn; Pedreros, Cesar; Veas, Enrique; Bruhn, Alejandro; Romero, Carlos; Rovegno, Maximiliano; Neira, Rodolfo; Bravo, Sebastian; Castro, Ricardo; Kattan, Eduardo; Ince, Can

    2012-01-01

    Purpose: Perfusion assessment during septic shock resuscitation is difficult and usually complex determinations. Capillary refill time (CRT) and central-to-toe temperature difference (Tc-toe) have been proposed as objective reproducible parameters to evaluate peripheral perfusion. The comparative

  5. Development of a hot water tank simulation program with improved prediction of thermal stratification in the tank

    DEFF Research Database (Denmark)

    Fan, Jianhua; Furbo, Simon; Yue, Hongqiang

    2015-01-01

    A simulation program SpiralSol was developed in previous investigations to calculate thermal performance of a solar domestic hot water (SDHW) system with a hot water tank with a built-in heat exchanger spiral [1]. The simulation program is improved in the paper in term of prediction of thermal......, taking into account the influences of tank volume, height to diameter ratio, tank insulation, thickness and material property of the tank and initial thermal conditions of the tank. The equation is validated for a tank volume between 150 l and 500 l, a tank height to tank diameter ratio of 1-5, a tank...... property of the tank wall on thermal stratification in the tank. It is elucidated how thermal stratification in the tank is influenced by the natural convection and how the heat loss from the tank sides will be distributed at different levels of the tank at different thermal conditions. The existing...

  6. Multimodal monitoring for hemodynamic categorization and management of pediatric septic shock: a pilot observational study*.

    Science.gov (United States)

    Ranjit, Suchitra; Aram, Gnanam; Kissoon, Niranjan; Ali, Mhd Kashif; Natraj, Rajeshwari; Shresti, Sharad; Jayakumar, Indira; Gandhi, Deepika

    2014-01-01

    To evaluate the cardiovascular aberrations using multimodal monitoring in fluid refractory pediatric septic shock and describe the clinical characteristics of septic myocardial dysfunction. Prospective observational study of patients with unresolved septic shock after infusion of 40 mL/kg fluid in the first hour. Two tertiary care referral Indian PICUs. Patients aged 1 month to 16 years who had fluid refractory septic shock. Changes in therapy were based on findings of clinical assessment, bedside echocardiography, and invasive blood pressure monitoring within 6 hours of recognition of septic shock. Over a 4-year period, 48 patients remained in septic shock despite at least 40 mL/kg fluid infusion. On clinical examination, 21 patients had cold shock and 27 had warm shock. Forty-one patients (85.5%) had vasodilatory shock on invasive blood pressure; these included 14 patients who initially presented with cold shock. The commonest echocardiography findings were impaired left ± right ventricular function in 19 patients (39.6%) and hypovolemia in 16 patients (33%). Three patients who had normal myocardial function on day 1 developed secondary septic myocardial dysfunction on day 3. Echocardio graphy, along with invasive arterial pressure monitoring, allowed fluid, inotropy, and pressors to be titrated more precisely in 87.5% of patients. Shock resolved in 46 of 48 patients (96%) and 44 patients (91.6%) survived to discharge. Bedside echocardiography provided crucial information leading to the recognition of septic myocardial dysfunction and uncorrected hypovolemia that was not apparent on clinical assessment. With invasive blood pressure monitoring, echocardiography affords a simple noninvasive tool to determine the cause of low cardiac output and the physiological basis for adjustment of therapy in patients who remain in shock despite 40 mL/kg fluid.

  7. Hemodynamic Analysis of Pediatric Septic Shock and Cardiogenic Shock Using Transpulmonary Thermodilution

    OpenAIRE

    En-Pei Lee; Shao-Hsuan Hsia; Jainn-Jim Lin; Oi-Wa Chan; Jung Lee; Chia-Ying Lin; Han-Ping Wu

    2017-01-01

    Septic shock and cardiogenic shock are the two most common types of shock in children admitted to pediatric intensive care units (PICUs). The aim of the study was to investigate which hemodynamic variables were associated with mortality in children with shock. We retrospectively analyzed 50 children with shock (37 septic shock cases and 13 cardiogenic shock cases) in the PICU and monitored their hemodynamics using transpulmonary thermodilution from 2003 to 2016. Clinical factors were analyzed...

  8. Differential expression of the Nrf2-linked genes in pediatric septic shock.

    Science.gov (United States)

    Grunwell, Jocelyn R; Weiss, Scott L; Cvijanovich, Natalie Z; Allen, Geoffrey L; Thomas, Neal J; Freishtat, Robert J; Anas, Nick; Meyer, Keith; Checchia, Paul A; Shanley, Thomas P; Bigham, Michael T; Fitzgerald, Julie; Howard, Kelli; Frank, Erin; Harmon, Kelli; Wong, Hector R

    2015-09-17

    Experimental data from animal models of sepsis support a role for a transcription factor, nuclear erythroid-related factor 2 p45-related factor 2 (Nrf2), as a master regulator of antioxidant and detoxifying genes and intermediary metabolism during stress. Prior analysis of a pediatric septic shock transcriptomic database showed that the Nrf2 response is a top 5 upregulated signaling pathway in early pediatric septic shock. We conducted a focused analysis of 267 Nrf2-linked genes using a multicenter, genome-wide expression database of 180 children with septic shock 10 years of age or younger and 53 healthy controls. The analysis involved RNA isolated from whole blood within 24 h of pediatric intensive care unit admission for septic shock and a false discovery rate of 5 %. We compared differentially expressed genes from (1) patients with septic shock and healthy controls and (2) across validated gene expression-based subclasses of pediatric septic shock (endotypes A and B) using several bioinformatic methods. We found upregulation of 123 Nrf2-linked genes in children with septic shock. The top gene network represented by these genes contained primarily enzymes with oxidoreductase activity involved in cellular lipid metabolism that were highly connected to the peroxisome proliferator activated receptor and the retinoic acid receptor families. Endotype A, which had higher organ failure burden and mortality, exhibited a greater downregulation of Nrf2-linked genes than endotype B, with 92 genes differentially regulated between endotypes. Our findings indicate that Nrf2-linked genes may contribute to alterations in oxidative signaling and intermediary metabolism in pediatric septic shock.

  9. A case of Candida orthopsilosis associated septic arthritis in a patient with Systemic Lupus Erythematosus (SLE

    Directory of Open Access Journals (Sweden)

    Orville D. Heslop

    2015-03-01

    Full Text Available We report a case of persistent Candida orthopsilosis associated septic arthritis. Repeated isolation of C. orthopsilosis from tissue and joint fluid was confirmed by identification of the ITS region of the rRNA gene using a Candida-Specific Luminex based assay and gene sequencing of the D1/D2 regions. This was the first case of C. orthopsilosis associated septic arthritis reported in Jamaica and in the literature.

  10. Candida septic arthritis with rice body formation: A case report and review of literature

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Yu Mi; Cho, Hyun Yee; Lee, Sheen Woo; Hwang, Yun Mi; Kim, Young Kyu [Gachon University, Gil Hospital, Incheon (Korea, Republic of)

    2013-06-15

    Rice body formation in a joint or bursa is a rare condition, and is usually associated with rheumatoid arthritis or tuberculous arthritis. Here we describe a case of multiple rice body formation in a shoulder joint and in adjacent bursae, which was confirmed to be due to septic arthritis by Candida species. To the best of our knowledge, rice body formation in Candida septic arthritis in an immune-competent patient has not been previously reported.

  11. Severe Osteomyelitis and Septic Arthritis due to Serratia marcescens in an Immunocompetent Patient

    OpenAIRE

    Hiba Hadid; Muhammad Usman; Sudeep Thapa

    2015-01-01

    Septic arthritis and osteomyelitis due to Serratia marcescens in immunocompetent patients without risk factors are extremely rare. Here, we report a case of septic arthritis and severe adjacent osteomyelitis of the tibia due to Serratia marcescens in a diabetic community-dweller patient. The patient had no contact with healthcare workers or facilities and had no chronic disease except for poorly controlled diabetes. Without predisposing risk factors, this type of infection is extremely rare, ...

  12. Severe Osteomyelitis and Septic Arthritis due to Serratia marcescens in an Immunocompetent Patient.

    Science.gov (United States)

    Hadid, Hiba; Usman, Muhammad; Thapa, Sudeep

    2015-01-01

    Septic arthritis and osteomyelitis due to Serratia marcescens in immunocompetent patients without risk factors are extremely rare. Here, we report a case of septic arthritis and severe adjacent osteomyelitis of the tibia due to Serratia marcescens in a diabetic community-dweller patient. The patient had no contact with healthcare workers or facilities and had no chronic disease except for poorly controlled diabetes. Without predisposing risk factors, this type of infection is extremely rare, even in diabetics.

  13. Severe Osteomyelitis and Septic Arthritis due to Serratia marcescens in an Immunocompetent Patient

    Directory of Open Access Journals (Sweden)

    Hiba Hadid

    2015-01-01

    Full Text Available Septic arthritis and osteomyelitis due to Serratia marcescens in immunocompetent patients without risk factors are extremely rare. Here, we report a case of septic arthritis and severe adjacent osteomyelitis of the tibia due to Serratia marcescens in a diabetic community-dweller patient. The patient had no contact with healthcare workers or facilities and had no chronic disease except for poorly controlled diabetes. Without predisposing risk factors, this type of infection is extremely rare, even in diabetics.

  14. Septic arthritis and acute rheumatic fever in children: the diagnostic value of serological inflammatory markers.

    Science.gov (United States)

    Mistry, Raakhi M; Lennon, Diana; Boyle, Matthew J; Chivers, Karel; Frampton, Chris; Nicholson, Ross; Crawford, Haemish

    2015-01-01

    Joint pain and raised inflammatory markers are features of both acute rheumatic fever (ARF) and septic arthritis, often posing a diagnostic challenge to clinicians. Important differences in the presenting serological inflammatory marker profile may assist patient diagnosis, however, as clinical experience suggests that ARF is associated with a higher erythrocyte sedimentation rate (ESR), whereas other serological markers may be similarly elevated in these 2 conditions. The goal of this study was to determine the diagnostic value of serological inflammatory markers and white cell count (WCC) in children presenting with acute joint pain secondary to ARF or septic arthritis. Data were obtained from the Auckland regional rheumatic fever database and hospital computer records between 2005 and 2012. Records of all patients under the age of 16 years who were admitted with a new diagnosis of ARF or septic arthritis were analyzed. The diagnosis of ARF was defined on the basis of the New Zealand modification of the Jones Criteria, and the diagnosis of septic arthritis was defined on the basis of joint fluid cytology and culture. Baseline characteristics, serological inflammatory markers, and serum WCC were compared between the ARF and septic arthritis patient groups. Children with ARF displayed significantly higher ESR, higher serum C-reactive protein, and lower serum WCC than children with septic arthritis on presentation to hospital. In children presenting with monoarthritis, an ESR>64.5, serum WCCmedication before hospital presentation, and 74% of these children (25/34) had abnormal echocardiograms on admission. ARF and septic arthritis are important diagnoses to consider in children presenting with acute joint pain in New Zealand. A significant proportion of patients with ARF initially present with acute monoarthritis. Serological inflammatory markers and WCC on presentation differ significantly between children with ARF and septic arthritis.

  15. FDG-PET/CT for differentiating between aseptic and septic delayed union in the lower extremity.

    Science.gov (United States)

    van Vliet, Kirsten E; de Jong, Vincent M; Termaat, M Frank; Schepers, Tim; van Eck-Smit, Berthe L F; Goslings, J Carel; Schep, Niels W L

    2017-09-27

    (18)F-fluorodeoxyglucose ((18)F-FDG) positron emission tomography (PET)/computed tomography (CT) has proven to have a high diagnostic accuracy for the detection of bone infections. In patients with delayed union it may be clinically important to differentiate between aseptic and septic delayed union. The aim of this study was to evaluate the efficacy and to assess the optimal diagnostic accuracy of FDG-PET/CT in differentiating between aseptic and septic delayed union in the lower extremity. This is a retrospective study of consecutive patients who underwent FDG-PET/CT scanning for suspicion of septic delayed union of the lower extremity. Diagnosis of aseptic delayed union or septic delayed union was made based on surgical deep cultures following PET/CT scanning and information on clinical follow-up. FDG-uptake values were measured at the fractured site by use of the maximum standardized uptake value (SUVmax). Sensitivity, specificity and diagnostic accuracy of FDG-PET/CT were calculated at various SUVmax cut-off points. A total of 30 patients were included; 13 patients with aseptic delayed unions and 17 patients with septic delayed unions. Mean SUVmax in aseptic delayed union patients was 3.23 (SD ± 1.21). Mean SUVmax in septic delayed union patients was 4.77 (SD ± 1.87). A cut-off SUVmax set at 4.0 showed sensitivity, specificity and diagnostic accuracy of FDG-PET/CT were 65, 77 and 70% to differentiate between aseptic and septic delayed union, respectively. Using a semi-quantitative measure (SUVmax) for interpretation of FDG-PET/CT imaging seems to be a promising tool for the discrimination between aseptic and septic delayed union.

  16. Mettre au point un vaccin contre la septicémie hémorragique chez ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    12 janv. 2018 ... Photo: Markus Kostner / Banque mondiale. Le fardeau de la septicémie hémorragique pour les petits exploitants. La septicémie hémorragique est une maladie bactérienne aiguë et souvent mortelle touchant principalement les bovins et les buffles en Asie et en Afrique. La bactérie responsable est ...

  17. Severe Sepsis and Septic Shock Associated with Chikungunya Fever in an Adolescent.

    Science.gov (United States)

    Sharma, Pradeep Kumar; Kumar, Maneesh; Bhandari, Neha; Kushwaha, Anand

    2018-01-06

    Chikungunya is usually a benign disease, and little is known on the occurrence of severe clinical complications. We describe a 12-year-old boy with rapid onset septic shock and multi-organ failure associated with chikungunya fever. Severe sepsis and septic shock can be associated with chikungunya. © The Author(s) [2018]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  18. Application of fluorescent and vibration spectroscopy for septic serum human albumin structure deformation during pathology

    Science.gov (United States)

    Zyubin, A.; Konstantinova, E.; Slezhkin, V.; Matveeva, K.; Samusev, I.; Bryukhanov, V.

    2017-12-01

    In this paper we perform results of conformational analysis of septic human serum albumin (HSA) carried out by Raman spectroscopy (RS), infrared (IR) spectroscopy and fluorescent spectroscopy. The main vibrational groups were identified and analyzed for septic HSA and its health control. Comparison between Raman and IR results were done. Fluorescent spectral changes of Trp-214 group were analyzed. Application of Raman, IR spectroscopy, fluorescent spectroscopy for conformational changes study of HSA during pathology were shown.

  19. Simple characterisation of solar DHW tanks

    DEFF Research Database (Denmark)

    Andersen, Elsa; Furbo, Simon

    1998-01-01

    The aim of the project is to compare different methods used for testing small solar domestic hot water tanks. A small hot water tank is tested at three different European laboratories by means of the test methods normally used at the laboratories. The tank is marketed in Denmark.The test carried...... out at the Department for Buildings and Energy compromises determination of the heat loss coefficient for the tank and the heat transfer coefficient for the auxiliary helix. A dynamic test is performed and a simulation model of the tank is made and validated against measured energy quantities...... and temperatures. The annual thermal performance for a solar domestic hot water system based on the tested tank is calculated. Further, proposal for a future test on mixing during draw-off as well as proposal for a maximum acceptable mixing during draw-off is given....

  20. Combining Prognostic and Predictive Enrichment Strategies to Identify Children With Septic Shock Responsive to Corticosteroids.

    Science.gov (United States)

    Wong, Hector R; Atkinson, Sarah J; Cvijanovich, Natalie Z; Anas, Nick; Allen, Geoffrey L; Thomas, Neal J; Bigham, Michael T; Weiss, Scott L; Fitzgerald, Julie C; Checchia, Paul A; Meyer, Keith; Quasney, Michael; Hall, Mark; Gedeit, Rainer; Freishtat, Robert J; Nowak, Jeffrey; Raj, Shekhar S; Gertz, Shira; Lindsell, Christopher J

    2016-10-01

    Prognostic and predictive enrichment strategies are fundamental tools of precision medicine. Identifying children with septic shock who may benefit from corticosteroids remains a challenge. We combined prognostic and predictive strategies to identify a pediatric septic shock subgroup responsive to corticosteroids. We conducted a secondary analysis of 288 previously published pediatric subjects with septic shock. For prognostic enrichment, each study subject was assigned a baseline mortality probability using the pediatric sepsis biomarker risk model. For predictive enrichment, each study subject was allocated to one of two septic shock endotypes, based on a 100-gene signature reflecting adaptive immunity and glucocorticoid receptor signaling. The primary study endpoint was complicated course, defined as the persistence of two or more organ failures at day 7 of septic shock or 28-day mortality. We used logistic regression to test for an association between corticosteroids and complicated course within endotype. Among endotype B subjects at intermediate to high pediatric sepsis biomarker risk model-based risk of mortality, corticosteroids were independently associated with more than a 10-fold reduction in the risk of a complicated course (relative risk, 0.09; 95% CI, 0.01-0.54; p = 0.007). A combination of prognostic and predictive strategies based on serum protein and messenger RNA biomarkers can identify a subgroup of children with septic shock who may be more likely to benefit from corticosteroids. Prospective validation of these strategies and the existence of this subgroup are warranted.

  1. Prognostic factors in the survival of patients with blood disorders recovering from septic shock.

    Science.gov (United States)

    Waszczuk-Gajda, Anna; Wiktor Jedrzejczak, Wieslaw

    2017-06-01

    Septic shock is one of the major direct causes of death in patients in hematology departments. The knowledge about clinical outcomes and factors associated with negative outcome in these patients can be important and useful for physicians to identify the patients who are most likely to benefit from ICU therapy. We retrospectively analyzed records of 214 episodes of septic shock in patients with different blood diseases hospitalized between 1998 and 2011 in the Department of Hematology, Oncology and Internal Medicine, the Medical University of Warsaw, Poland. Direct survival with resolution of septic shock was 46%. Among these survivors, 75% continued to live at 30 days, 49% at 6 months, and 12% at 5 years after shock resolution. It was found that the most important prognostic factors for direct (short-term) mortality were multiorgan failure, lack of concordance of empiric antibiotic treatment with results of in vitro sensitivity testing, the Karnofsky score below 60%, presence of more than two comorbidities. Long-term prognosis (3-year follow-up) was affected by multiple factors with the most significant being Karnofsky score, higher organ failure score, hematologic disease relapse or resistance to treatment. Septic shock in patients with blood disorders treated in the hematology ward was associated with very high risk of mortality in all periods after its completion. However, although the results of treatment of septic shock in patients with blood diseases are poor, they were comparable to the results of treatment of septic shock in mixed populations treated in intensive care units.

  2. Site-specific changes in cytokine response to septic dose of lipopolysaccharide in ovariectomized female rats.

    Science.gov (United States)

    Iwasa, T; Matsuzaki, T; Gereltsetseg, G; Munkhzaya, M; Tungalagsurv, A; Murakami, M; Yamasaki, M; Yamamoto, Y; Kuwahara, A; Kato, T; Yasui, T; Irahara, M

    2014-08-01

    The immune response is altered according to hormonal and metabolic status. Obesity increases the inflammatory and fever response, whereas loss of gonadal steroid decreases behavioral response to immune stress. However, the immune systems of ovariectomized animals exhibiting obesity and gonadal steroid deficiency, particularly under septic conditions, have not been fully examined. In the present study, we evaluated the ovariectomy-induced changes of central and peripheral immune responses to life-threatening septic stimulus. Ovariectomized rats showed heavier body weight and lighter uterine weight when compared with gonadally intact rats. Fever response to septic dose of lipopolysaccharide (LPS) in ovariectomized rats was less evident when compared with that in gonadally intact rats. In addition, under LPS-injected septic conditions, hypothalamic gene levels of Interleukin-1β (IL-1β), Interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) and serum protein levels of IL-1β and TNF-α in ovariectomized rats were lower than those in gonadally intact rats. On the other hand, IL-6 levels in visceral fat under septic conditions were higher in ovariectomized rats than in gonadally intact rats. These findings indicate that ovariectomy-induced site-specific changes in cytokine response under septic conditions. As hypothalamic, but not peripheral, pro-inflammatory cytokines are directly involved in the fever response, the attenuation of fever response observed in ovariectomized rats may be caused by a reduction in central cytokine responses.

  3. Epidemiology of septic arthritis of the knee at Hospital das Clinicas, Universidade de Sao Paulo

    Directory of Open Access Journals (Sweden)

    Camilo Partezani Helito

    Full Text Available Background: Septic arthritis is an infrequent disease although very important due to the possibility of disastrous outcomes if treatment is not adequately established. Adequate information concerning the epidemiology of septic arthritis is still lacking due to the uncommon nature of the disease as well as the struggle to establish a correct case-definition. Objective: To epidemiologically characterize the population seen at Hospital das Clínicas, University of São Paulo with a diagnosis of septic arthritis between 2006 and 2011. Methods: Sixty-one patients diagnosed with septic arthritis of the knee between 2006 and 2011 were retrospectively evaluated. The patients' clinical and epidemiological characteristics, the microorganisms that caused the infection and the patients' treatment and evolution were analyzed. Results: Septic arthritis of the knee was more common among men, with distribution across a variety of age ranges. Most diagnoses were made through positive synovial fluid cultures. The most prevalent clinical comorbidities were systemic arterial hypertension and diabetes mellitus, and the most commonly reported joint disease was osteoarthritis. Staphylococcus aureus was the prevailing pathogen. Fever was present in 36% of the cases. All patients presented elevation in inflammatory tests. Gram staining was positive in only 50.8% of the synovial fluid samples analyzed. Six patients presented complications and unfavorable evolution of their condition. Conclusion: S. aureus is still the most common pathogen in acute knee infections in our environment. Gram staining, absence of fever and normal leukocyte count cannot be used to rule out septic arthritis.

  4. Asymmetric dimethylarginine and L-arginine levels in neonatal sepsis and septic shock.

    Science.gov (United States)

    Aydemir, Ozge; Ozcan, Beyza; Yucel, Husniye; Bas, Ahmet Yagmur; Demirel, Nihal

    2015-05-01

    Nitric oxide (NO) formed by the enzyme NO synthase (NOS) from L-arginine, is an important mediator for pathogen elimination. Being a potent vasodilator NO is implicated in hypotension and decreased organ perfusion in sepsis. Asymmetric dimethylarginine (ADMA) is an endogenous NOS inhibitor. We investigated ADMA and L-arginine levels in neonatal sepsis and their relation to disease severity. A prospective controlled study was conducted including 31 neonates with sepsis and 20 controls. Serum ADMA and L-arginine levels were measured within 24 h of sepsis diagnosis. Clinical and laboratory data including clinical risk index for babies (CRIB) score, presence of septic shock, organ dysfunction and death were recorded. L-arginine and ADMA levels were higher in neonates with sepsis compared to controls (p = 0.029 and p = 0.001, respectively). Neonates with septic shock had higher ADMA levels compared to septic neonates without shock (p = 0.026) and controls (p neonates with septic shock compared to septic neonates without shock (p = 0.012) and controls (p neonatal sepsis and even higher levels are observed in septic shock.

  5. Septic shoulder presenting as a shoulder dislocation in the pediatric patient: a case report.

    Science.gov (United States)

    Maguire, Kathleen J; Otsuka, Norman Y

    2017-05-01

    Shoulder dislocation is relatively uncommon in the younger pediatric population. Because of the relative strength of the surrounding soft tissue structures of the shoulder compared with the proximal humeral physis, subluxation or dislocation resulting from a traumatic event or application of force is rare and instead a proximal humeral physeal injury occurs. Case presentation - We present a 5-year-old male who presented to the office with post-traumatic left shoulder pain for about 1 week. Radiographs of the left shoulder indicated inferior subluxation of the humeral head. He was ultimately diagnosed and treated for a septic shoulder. Septic arthritis of the glenohumeral joint accounts for about 3% of all septic arthritis cases. About half of the pediatric patients with a septic arthritis will present with a concomitant osteomyelitis about the joint involved. Widening of the glenohumeral joint and subluxation clinically as well as radiographically have been described in cases of large joint effusions because of an increase in intra-articular fluid in adults. This inferior subluxation is often noted without a frank dislocation. The case described in this report is unique in that this is the first to describe a pediatric septic shoulder presenting as a shoulder subluxation. Given the rarity of pediatric shoulder dislocations and subluxations, the pediatric orthopaedist and pediatrician should maintain a suspicion for a septic joint. Level V.

  6. Lower mitochondrial dysfunction in survivor septic patients with mitochondrial DNA haplogroup JT.

    Science.gov (United States)

    Lorente, Leonardo; Martín, María M; López-Gallardo, Ester; Ferreres, José; Solé-Violán, Jordi; Labarta, Lorenzo; Díaz, César; Jiménez, Alejandro; Montoya, Julio; Ruiz-Pesini, Eduardo

    2017-10-17

    The comparison on mitochondrial function between severe septic patients and healthy control subjects according to mitochondrial deoxyribonucleic acid (mtDNA) haplogroup has not been previously reported; and this was the objective of the current study. Prospective, multicenter, observational study. We obtained blood samples from 198 severe septic patients at days 1, 4 and 8 of severe sepsis diagnosis and from 96 sex- and age-matched healthy controls to determine mtDNA haplogroup and platelet respiratory complex IV (CIV) specific activity. The endpoint of the study was 30-day mortality. We included 198 severe septic patients (38 with mtDNA haplogroup JT and 160 with mtDNA haplogroup non-JT) and 96 healthy control subjects (16 with mtDNA haplogroup JT and 80 with mtDNA haplogroup non-JT). We have no found statistically significant differences in platelet CIV specific activity between healthy controls and survivor severe septic patients with mtDNA haplogroup JT at days 1, 4 and 8 of severe sepsis diagnosis; and the remaining severe septic patients showed lower platelet CIV specific activity than healthy controls with the same mtDNA haplogroup. The new finding of our study was that survivor severe septic patients and healthy controls with mtDNA haplogroup JT showed no different platelet Civ specific activity. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  7. Divergent results induced by different types of septic shock in transglutaminase 2 knockout mice.

    Science.gov (United States)

    Yoo, Hyun; Ahn, Eu-Ree; Kim, Se-Jin; Lee, Seon-Hyeong; Oh, Seung Hyun; Kim, Soo-Youl

    2013-01-01

    Acute sepsis can be induced by cytokines such as TNF-α and biological products such as LPS. All of these agents cause systemic inflammation, which is characterized by hemodynamic shock and liver toxicity. However, the outcomes of different septic shock models were totally opposite in transglutaminase 2 knockout (TGase 2(-/-)) mice. The aim of our study was to clarify the role of TGase 2 in liver injury. Therefore, we explored the role of TGase 2 in liver damage using two different stress models: LPS-induced endotoxic shock and TNF-α/actinomycin D (ActD)-induced sepsis. TNF-α-dependent septic shock resulted in increased liver damage in TGase 2(-/-) mice compared with wild-type (WT) mice, and was accompanied by increased levels of caspase 3 and cathepsin D (CTSD) in the damaged liver. Conversely, LPS-induced septic shock resulted in ablation of inflammatory endotoxic shock in TGase 2(-/-) mice and decreased liver injury. We found that TGase 2 protected liver tissue from TNF-α-dependent septic shock by reducing the expression of caspase 3 and CTSD. However, TGase 2 differently participated in increased the hemodynamic shock in LPS-induced septic shock through macrophage activation rather than protecting direct liver damage. Therefore, these findings demonstrate that septic shock caused by different agents may induce different results in TGase 2(-/-) mice depending on the primary target organs affected.

  8. Retrospective evaluation of recurrent secondary septic peritonitis in dogs (2000-2011): 41 cases.

    Science.gov (United States)

    Barfield, Dominic M; Tivers, Michael S; Holahan, Matthew; Welch, Kristin; House, Arthur; Adamantos, Sophie E

    2016-01-01

    To describe the clinical characteristics of recurrent septic peritonitis in dogs. Multicenter retrospective observational study. Client-owned dogs with recurrent septic peritonitis. Three university emergency and referral hospitals. None. Medical records from 3 veterinary university teaching hospitals were reviewed and data were collected using a standardized data collection sheet for all cases of septic peritonitis during the study period (2000-2011). Forty one dogs met the inclusion criteria for recurrent peritonitis. All dogs underwent relaparotomy. The original cause of septic peritonitis in these cases included previous surgery for gastrointestinal foreign body removal (n = 26), gastrointestinal neoplasia (n = 3), gastric or duodenal ulceration (n = 3), biliary tract leakage (n = 2), and single instance for each of the following: penetrating foreign body, hernia strangulation, intussusception, mesenteric volvulus, infection of the laparotomy incision, prostatic abscess, and trauma. Eighteen animals survived to discharge. There was no difference detected between survivors and nonsurvivors with recurrent peritonitis in terms of inciting cause, serum albumin concentration, surgical management, or provision of appropriate initial antimicrobials. The survival rate for dogs having recurrent peritonitis was 43.9% (18/41 dogs). This retrospective study did not identify any significant prognostic indicators for dogs with recurrent peritonitis and that the mortality rate for dogs having more than one surgery for septic peritonitis is similar to that reported for a single surgery for septic peritonitis. ©Veterinary Emergency and Critical Care Society 2015.

  9. ICPP tank farm closure study. Volume 1

    Energy Technology Data Exchange (ETDEWEB)

    Spaulding, B.C.; Gavalya, R.A.; Dahlmeir, M.M. [and others

    1998-02-01

    The disposition of INEEL radioactive wastes is now under a Settlement Agreement between the DOE and the State of Idaho. The Settlement Agreement requires that existing liquid sodium bearing waste (SBW), and other liquid waste inventories be treated by December 31, 2012. This agreement also requires that all HLW, including calcined waste, be disposed or made road ready to ship from the INEEL by 2035. Sodium bearing waste (SBW) is produced from decontamination operations and HLW from reprocessing of SNF. SBW and HLW are radioactive and hazardous mixed waste; the radioactive constituents are regulated by DOE and the hazardous constituents are regulated by the Resource Conservation and Recovery Act (RCRA). Calcined waste, a dry granular material, is produced in the New Waste Calcining Facility (NWCF). Two primary waste tank storage locations exist at the ICPP: Tank Farm Facility (TFF) and the Calcined Solids Storage Facility (CSSF). The TFF has the following underground storage tanks: four 18,400-gallon tanks (WM 100-102, WL 101); four 30,000-gallon tanks (WM 103-106); and eleven 300,000+ gallon tanks. This includes nine 300,000-gallon tanks (WM 182-190) and two 318,000 gallon tanks (WM 180-181). This study analyzes the closure and subsequent use of the eleven 300,000+ gallon tanks. The 18,400 and 30,000-gallon tanks were not included in the work scope and will be closed as a separate activity. This study was conducted to support the HLW Environmental Impact Statement (EIS) waste separations options and addresses closure of the 300,000-gallon liquid waste storage tanks and subsequent tank void uses. A figure provides a diagram estimating how the TFF could be used as part of the separations options. Other possible TFF uses are also discussed in this study.

  10. ANNUAL RADIOACTIVE WASTE TANK INSPECTION PROGRAM 2010

    Energy Technology Data Exchange (ETDEWEB)

    West, B.; Waltz, R.

    2011-06-23

    Aqueous radioactive wastes from Savannah River Site (SRS) separations and vitrification processes are contained in large underground carbon steel tanks. Inspections made during 2010 to evaluate these vessels and other waste handling facilities along with evaluations based on data from previous inspections are the subject of this report. The 2010 inspection program revealed that the structural integrity and waste confinement capability of the Savannah River Site waste tanks were maintained. All inspections scheduled per SRR-LWE-2009-00138, HLW Tank Farm Inspection Plan for 2010, were completed. Ultrasonic measurements (UT) performed in 2010 met the requirements of C-ESG-00006, In-Service Inspection Program for High Level Waste Tanks, Rev. 3, and WSRC-TR-2002-00061, Rev.6. UT inspections were performed on Tanks 30, 31 and 32 and the findings are documented in SRNL-STI-2010-00533, Tank Inspection NDE Results for Fiscal Year 2010, Waste Tanks 30, 31 and 32. A total of 5824 photographs were made and 1087 visual and video inspections were performed during 2010. Ten new leaksites at Tank 5 were identified in 2010. The locations of these leaksites are documented in C-ESR-G-00003, SRS High Level Waste Tank Leaksite Information, Rev.5. Ten leaksites at Tank 5 were documented during tank wall/annulus cleaning activities. None of these new leaksites resulted in a release to the environment. The leaksites were documented during wall cleaning activities and the waste nodules associated with the leaksites were washed away. Previously documented leaksites were reactivated at Tank 12 during waste removal activities.

  11. Tank 241-A-105 leak assessment

    Energy Technology Data Exchange (ETDEWEB)

    1991-06-01

    Tank 241-A-105 is one of 149 single shell tanks constructed at Hanford to contain and store highly radioactive wastes originating from the processing of spent nuclear reactor fuel. Radiation detection and temperature monitoring devices installed beneath the tank indicate that several episodes of leakage of waste from the tank have occurred. The aim of this study was to evaluate the previous estimates and reanalyze the data to provide a more accurate estimate of leakage from the tank. The principal conclusions of this study are as follows: Earlier investigators estimated leakage prior to August 1968 at 5,000 to 15,000 gallons. Their estimate appears reasonable. Leakage while the tank was being sluiced (8/68--11/70) probably exceeded 5,000 gallons, but probably did not exceed 30,000 gallons. Insufficient data are available to be more precise. Cooling water added to the tank during the sprinkling phase (11/70 -- 12/78) was approximately 610,000 gallons. Sufficient heat was generated in the tank to evaporate most, and perhaps nearly all, of this water. Radionuclides escaping into the soil under the tank cannot be estimated directly because of many uncertainties. Based on a range of leakage from 10,000 to 45,000 gallons, assumed compositions, and decayed to 1/1/91, radioactivity under the tank is expected to be in the range of 85,000--760,000 curies. Measured radiation peaks were nearly all located directly below the perimeter of the tank and, except in rare cases, they showed no tendency to spread horizontally. Moreover, the maximum radiation readings detected are a very small fraction of the radiation reading in the tank. This is the basis for the conclusion that the rate of leakage and, most likely, the quantity leaked, was small. 51 refs., 5 figs., 3 tabs.

  12. Surge Tank Atlas for Hydropower Plants

    OpenAIRE

    Sandvåg, Simon Utseth

    2016-01-01

    The objective of this master's thesis is to describe the existing surge tank solutions and additional improvements, and to simulate the hydraulic behavior of the surge tanks and how it affects the hydropower plant. The high head hydropower plant Torpa and the low head hydropower plant Åna-Sira are used for the case study, thus the surge tanks can be simulated under different hydraulic conditions. Turbine pressures and mass oscillations after a complete turbine shutdown, and turbine regulation...

  13. Criteria: waste tank isolation and stabilization

    Energy Technology Data Exchange (ETDEWEB)

    Metz, W.P.; Ogren, W.E.

    1976-09-01

    The crystallized Hanford high-level wastes stored in single-shell underground tanks consist of sludges and salt cakes covered with supernatural liquor. Purpose of stabilization and isolation is to reduce the releases and losses as a result of a loss of tank integrity. The tanks will be modified so that no inadvertent liquid additions can be made. Criteria for the isolation and stabilization are given and discussed briefly. (DLC)

  14. Thermal stratification in a hot water tank established by heat loss from the tank

    DEFF Research Database (Denmark)

    Fan, Jianhua; Furbo, Simon

    2012-01-01

    This paper presents numerical investigations of thermal stratification in a vertical cylindrical hot water tank established by standby heat loss from the tank. The transient fluid flow and heat transfer in the tank during cooling caused by standby heat loss are calculated by means of validated...... computational fluid dynamics (CFD) models. The measured heat loss coefficient for the different parts of the tank is used as input to the CFD model. Parametric studies are carried out using the validated models to investigate the influence on thermal stratification of the tank by the downward flow...... the heat loss from the tank sides will be distributed at different levels of the tank at different thermal conditions. The results show that 20–55% of the side heat loss drops to layers below in the part of the tank without the presence of thermal stratification. A heat loss removal factor is introduced...

  15. Utilities:Water:Water Tanks at Pipe Spring National Monument, Arizona (Utilities.gdb:Water:tanks)

    Data.gov (United States)

    National Park Service, Department of the Interior — This feature class represents tanks at Pipe Spring National Monument, Arizona. It consists of 2 polygons representing the Tunnel Spring Division Tank and the 1/2...

  16. Tank waste remediation system (TWRS) mission analysis

    Energy Technology Data Exchange (ETDEWEB)

    Rieck, R.H.

    1996-10-03

    The Tank Waste Remediation System Mission Analysis provides program level requirements and identifies system boundaries and interfaces. Measures of success appropriate to program level accomplishments are also identified.

  17. Hybrid Composite Cryogenic Tank Structure

    Science.gov (United States)

    DeLay, Thomas

    2011-01-01

    A hybrid lightweight composite tank has been created using specially designed materials and manufacturing processes. The tank is produced by using a hybrid structure consisting of at least two reinforced composite material systems. The inner composite layer comprises a distinct fiber and resin matrix suitable for cryogenic use that is a braided-sleeve (and/or a filamentwound layer) aramid fiber preform that is placed on a removable mandrel (outfitted with metallic end fittings) and is infused (vacuum-assisted resin transfer molded) with a polyurethane resin matrix with a high ductility at low temperatures. This inner layer is allowed to cure and is encapsulated with a filamentwound outer composite layer of a distinct fiber resin system. Both inner and outer layer are in intimate contact, and can also be cured at the same time. The outer layer is a material that performs well for low temperature pressure vessels, and it can rely on the inner layer to act as a liner to contain the fluids. The outer layer can be a variety of materials, but the best embodiment may be the use of a continuous tow of carbon fiber (T-1000 carbon, or others), or other high-strength fibers combined with a high ductility epoxy resin matrix, or a polyurethane matrix, which performs well at low temperatures. After curing, the mandrel can be removed from the outer layer. While the hybrid structure is not limited to two particular materials, a preferred version of the tank has been demonstrated on an actual test tank article cycled at high pressures with liquid nitrogen and liquid hydrogen, and the best version is an inner layer of PBO (poly-pphenylenebenzobisoxazole) fibers with a polyurethane matrix and an outer layer of T-1000 carbon with a high elongation epoxy matrix suitable for cryogenic temperatures. A polyurethane matrix has also been used for the outer layer. The construction method is ideal because the fiber and resin of the inner layer has a high strain to failure at cryogenic

  18. Tank Waste Remediation System Guide

    Energy Technology Data Exchange (ETDEWEB)

    Robershotte, M.A.; Dirks, L.L.; Seaver, D.A.; Bothers, A.J.; Madden, M.S.

    1995-06-01

    The scope, number and complexity of Tank Waste Remediation System (TWRS) decisions require an integrated, consistent, and logical approach to decision making. TWRS has adopted a seven-step decision process applicable to all decisions. Not all decisions, however, require the same degree of rigor/detail. The decision impact will dictate the appropriate required detail. In the entire process, values, both from the public as well as from the decision makers, play a key role. This document concludes with a general discussion of the implementation process that includes the roles of concerned parties.

  19. Tank characterization report for single-shell tank 241-U-110. Revision 1

    Energy Technology Data Exchange (ETDEWEB)

    Brown, T.M.; Jensen, L.

    1993-09-01

    Tank 241-U-110 (U-110) is a Hanford Site waste tank that was ;most recently sampled in November and December 1989. Analysis of the samples obtained from tank U-110 was conducted to support the characterization of the contents of this tank and to support Hanford Federal Facility Agreement and Consent Order milestone M-10-00 (Ecology, et al. 1992). Because of incomplete recovery of the waste during sampling, there may be bias in the results of this characterization report.

  20. Tank 241-C-109 vapor sampling and analysis tank characterization report

    Energy Technology Data Exchange (ETDEWEB)

    Huckaby, J.L.

    1995-05-10

    This report presents the details of the Hanford waste tank characterization study for tank 241-C-109. The drivers and objectives of the headspace vapor sampling and analysis were in accordance with procedures that were presented in other reports. The vapor and headspace gas samples were collected and analyzed to determine the potential risks to tank farm workers due to fugitive emissions from the tank.

  1. Tank 241-TY-104 vapor sampling and analysis tank characterization report

    Energy Technology Data Exchange (ETDEWEB)

    Huckaby, J.L.

    1995-05-31

    This report presents the details of the Hanford waste tank characterization study for tank 241-TY-104. The drivers and objectives of the headspace vapor sampling and analysis were in accordance with procedures that were presented in other reports. The vapor and headspace gas samples were collected and analyzed to determine the potential risks to tank farm workers due to fugitive emissions from the tank.

  2. Dynamic response of ground supported rectangular water tanks to ...

    African Journals Online (AJOL)

    ... reinforced concrete rectangular water tank under earthquake excitation. A linear three-dimensional finite element analysis and SAP2000 software have been used to predict tank response. The variable analysis parameters considered are the aspect ratio (tank height to length ratio) and tank water level, while the tank wall ...

  3. 49 CFR 230.115 - Feed water tanks.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Feed water tanks. 230.115 Section 230.115... Tenders Steam Locomotive Tanks § 230.115 Feed water tanks. (a) General provisions. Tanks shall be... water. Feed water tanks shall be equipped with a device that permits the measurement of the quantity of...

  4. 46 CFR 154.412 - Cargo tank corrosion allowance.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 5 2010-10-01 2010-10-01 false Cargo tank corrosion allowance. 154.412 Section 154.412... Containment Systems § 154.412 Cargo tank corrosion allowance. A cargo tank must be designed with a corrosion...) carries a cargo that corrodes the tank material. Note: Corrosion allowance for independent tank type C is...

  5. Thermodynamic optimization of heat exchanger tanks by exergy ...

    African Journals Online (AJOL)

    The paper introduces heat exchanger tanks, detailing their dominant thermodynamic relations to obtain the exergy analysis relations of heat exchanger tanks. Heat exchanger tank is examined under various laboratory conditions, including the power of heat element inside the tank, mass flow rate of cooling water of tank ...

  6. 33 CFR 183.552 - Plastic encased fuel tanks: Installation.

    Science.gov (United States)

    2010-07-01

    ... tank by capillary action. (c) If the plastic is bonded to the surface of a metallic fuel tank, the... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Plastic encased fuel tanks... § 183.552 Plastic encased fuel tanks: Installation. (a) Each fuel tank encased in cellular plastic foam...

  7. 27 CFR 24.230 - Examination of tank car or tank truck.

    Science.gov (United States)

    2010-04-01

    ... tank truck. 24.230 Section 24.230 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND... truck. Upon arrival of a tank car or tank truck at the bonded wine premises, the proprietor shall carefully examine the car or truck to see whether the seals are intact and whether there is any evidence of...

  8. Supporting document for the historical tank content estimate for A Tank Farm

    Energy Technology Data Exchange (ETDEWEB)

    Brevick, C.H.; Gaddis, L.A.; Walsh, A.C.

    1994-06-01

    This document provides historical evaluations of the radioactive mixed wastes stored in the Hanford Site 200-East Area underground single-shell tanks (SSTs). A Historical Tank Content Estimate has been developed by reviewing the process histories, waste transfer data, and available physical and chemical characterization data from various Department of Energy (DOE) and Department of Defense (DOD) contractors. The historical data will supplement information gathered from in-tank core sampling activities that are currently underway. A tank history review that is accompanied by current characterization data creates a complete and reliable inventory estimate. Additionally, historical review of the tanks may reveal anomalies or unusual contents that are critical to characterization and post characterization activities. Complete and accurate tank waste characterizations are critical first steps for DOE and Westinghouse Hanford Company safety programs, waste pretreatment, and waste retrieval activities. The scope of this document is limited to the SSTs in the A Tank Farm of the northeast quadrant of the 200 East Area. Nine appendices compile data on: tank level histories; temperature graphs; surface level graphs; drywell graphs; riser configuration and tank cross section; sampling data; tank photographs; unknown tank transfers; and tank layering comparison. 113 refs.

  9. Supporting document for the SW Quadrant Historical Tank Content Estimate for U-Tank Farm

    Energy Technology Data Exchange (ETDEWEB)

    Brevick, C.H.; Gaddis, L.A.; Johnson, E.D.

    1994-06-01

    This Supporting Document provides historical characterization information gathered on U-Tank Farm, such as historical waste transfer and level data, tank physical information, temperature data, sampling data, and drywell and liquid observation well data for Historical Tank Content Estimate of the SW Quadrant at the Hanford 200 West Area.

  10. Supporting document for the historical tank content estimate for S tank farm

    Energy Technology Data Exchange (ETDEWEB)

    Brevick, C.H.; Gaddis, L.A.; Walsh, A.C.

    1994-06-01

    This document provides historical evaluations of the radioactive mixed wastes stored in the Hanford Site 200 West Area underground single-shell tanks (SSTs). A Historical Tank Content Estimate has been developed by reviewing the process histories, waste transfer data, and available physical and chemical characterization data from various Department of Energy (DOE) and Department of Defense (DOD) contractors. The historical data will supplement information gathered from in-tank core sampling activities that are currently underway. A tank history review that is accompanied by current characterization data creates a complete and reliable inventory estimate. Additionally, historical review of the tanks may reveal anomalies or unusual contents that are critical to characterization and post characterization activities. Complete and accurate tank waste characterizations are critical first steps for DOE and Westinghouse Hanford Company safety programs, waste pretreatment, and waste retrieval activities. The scope of this document is limited to all the SSTs in the S Tank Farm of the southwest quadrant of the 200 West Area. Nine appendices compile data on: tank level histories; temperature graphs; surface level graphs; drywell graphs; riser configuration and tank cross section; sampling data; tank photographs; unknown tank transfers; and tank layering comparison. 113 refs.

  11. Supporting document for the historical tank content estimate for AY-tank farm

    Energy Technology Data Exchange (ETDEWEB)

    Brevick, C H; Stroup, J L; Funk, J. W.

    1997-03-12

    This Supporting Document provides historical in-depth characterization information on AY-Tank Farm, such as historical waste transfer and level data, tank physical information, temperature plots, liquid observation well plots, chemical analyte and radionuclide inventories for the Historical Tank Content Estimate Report for the Southeast Quadrant of the Hanford 200 Areas.

  12. Supporting document for the historical tank content estimate for the SX-tank farm

    Energy Technology Data Exchange (ETDEWEB)

    Brevick, C.H., Fluor Daniel Hanford

    1997-02-25

    This Supporting Document provides historical in-depth characterization information on SX-Tank Farm, such as historical waste transfer and level data, tank physical information, temperature plots, liquid observation well plots, chemical analyte and radionuclide inventories for the Historical Tank Content Estimate Report for the Southwest Quadrant of the Hanford 200 West Area.

  13. Supporting document for the historical tank content estimate for AP-tank farm

    Energy Technology Data Exchange (ETDEWEB)

    Brevick, C.H.; Stroup, J.L.; Funk, J.W., Fluor Daniel Hanford

    1997-03-06

    This Supporting Document provides historical in-depth characterization information on AP-Tank Farm, such as historical waste transfer and level data, tank physical information, temperature plots, liquid observation well plots, chemical analyte and radionuclide inventories for the Historical Tank Content Estimate Report for the Southeast Quadrant of the Hanford 200 Areas.

  14. Supporting document for the historical tank content estimate for C-tank farm

    Energy Technology Data Exchange (ETDEWEB)

    Brevick, C.H.

    1996-06-28

    This Supporting Document provides historical in-depth characterization information on C-Tank Farm, such as historical waste transfer and level data, tank physical information,temperature plots, liquid observation well plots, chemical analyte and radionuclide inventories for the Historical Tank Content Estimate Report for the northeast quadrant of the Hanford 200 East Area.

  15. Supporting document for the historical tank content estimate for AX-tank farm

    Energy Technology Data Exchange (ETDEWEB)

    Brevick, C.H., Westinghouse Hanford

    1996-06-28

    This Supporting Document provides historical in-depth characterization information on AX-Tank Farm, such as historical waste transfer and level data, tank physical information,temperature plots, liquid observation well plots, chemical analyte and radionuclide inventories for the Historical Tank Content Estimate Report for the northeast quadrant of the Hanford 200 East Area.

  16. Supporting document for the historical tank content estimate for B-Tank farm

    Energy Technology Data Exchange (ETDEWEB)

    Brevick, C.H.

    1996-06-28

    This Supporting Document provides historical in-depth characterization information on B-Tank Farm, such as historical waste transfer and level data, tank physical information,temperature plots, liquid observation well plots, chemical analyte and radionuclide inventories for the Historical Tank Content Estimate Report for the northeast quadrant of the Hanford 200 East Area.

  17. Supporting document for the historical tank content estimate for BX-tank farm

    Energy Technology Data Exchange (ETDEWEB)

    Brevick, C.H.

    1996-06-28

    This Supporting Document provides historical in-depth characterization information on BX-Tank Farm, such as historical waste transfer and level data, tank physical information,temperature plots, liquid observation well plots, chemical analyte and radionuclide inventories for the Historical Tank Content Estimate Report for the northeast quadrant of the Hanford 200 East Area.

  18. Supporting document for the historical tank content estimate for A-Tank farm

    Energy Technology Data Exchange (ETDEWEB)

    Brevick, C.H.

    1996-06-28

    This Supporting Document provides historical in-depth characterization information on A-Tank Farm, such as historical waste transfer and level data, tank physical information,temperature plots, liquid observation well plots, chemical analyte and radionuclide inventories for the Historical Tank Content Estimate Report for the northeast quadrant of the Hanford 200 East Area.

  19. Supporting document for the historical tank content estimate for BY-Tank farm

    Energy Technology Data Exchange (ETDEWEB)

    Brevick, C.H.

    1996-06-28

    This Supporting Document provides historical in-depth characterization information on BY-Tank Farm, such as historical waste transfer and level data, tank physical information,temperature plots, liquid observation well plots, chemical analyte and radionuclide inventories for the Historical Tank Content Estimate Report for the northeast quadrant of the Hanford 200 East Area.

  20. Supporting document for the historical tank content estimate for the S-tank farm

    Energy Technology Data Exchange (ETDEWEB)

    Brevick, C.H., Fluor Daniel Hanford

    1997-02-25

    This Supporting Document provides historical in-depth characterization information on S-Tank Farm, such as historical waste transfer and level data, tank physical information, temperature plots, liquid observation well plots, chemical analyte and radionuclide inventories for the Historical Tank Content Estimate Report for the Southwest Quadrant of the Hanford 200 West Area.